Guest author Ariel Zarate, MA, LSW, is a mental health and psychosocial support technical advisor who is serving as intern in the CVT Washington, DC office.

Migration, although a human right, has significant impacts on the physical and mental health of those in flight, even beyond the physical risks of the journey. Resettlement for displaced communities like the Rohingya and 80 million others globally, is an opportunity to realize their rights and to find stability and healing from migration trauma, exclusion and surviving violent atrocities. President Joe Biden must follow through on his promise to repair the U.S. migration system and again welcome refugees to the United States.  He has started off strongly, taking executive actions during his first day in office, that will begin to dismantle the barriers established for immigrants, asylum seekers and refugees in the U.S.

I joined the humanitarian response in Cox Bazar, Bangladesh as a mental health and psychosocial support (MHPSS) technical advisor in 2020, the third year since the Rohingya fled the most recent violent campaign waged against them by the Myanmar army. The Rohingya are a majority Muslim ethnic minority from Myanmar whose citizenship and other rights have been stripped by successive governments, both military and civilian. Myanmar authorities assert that Rohingya are ethnically Bengali and therefore foreigners, although the community can trace their roots in Myanmar back centuries. Facing restrictions on employment, education, marriage and religious freedoms, the Rohingya have endured institutionalized discrimination for decades and fled waves of violence targeting them since the 1990s. Since 2012, the Rohingya in Myanmar have been forcibly relocated to fenced-in villages, likened to open air prisons, where today they continue to face persecution amidst the looming threat of violence. Most recently in 2017, violent attacks were unleashed upon the Rohingya where at least 6,700 people died. Over 700,000 people fled over the border to Bangladesh carrying the trauma of discrimination, mass killings, widespread rape and the destruction of 200 entire villages.

Their flight into Bangladesh ballooned existing Rohingya populations there, creating the world’s largest refugee camp. The sight of shelters, service centers, shops and thousands of people sprawling over about 26 square kilometers of hilly terrain was arresting every time I visited. Although the magnitude of sadness, fear and daily challenges, like making money, were bleak, the camp was vibrant regardless of monsoon rains or hot and humid temperatures. People were in constant motion, pushing through their fear and anxiety to recreate a semblance of normalcy as they wait for opportunity and more sustainable solutions. Many refugees I spoke to shared the sentiment one person expressed:

“We want to be resettled in a safe country [to have] a future. Still we don’t find a future in Bangladesh and not in Myanmar yet.”

Although resettlement has been sparse for the Rohingya, elections bring glimmers of hope for the community resettled in the United States as they voted for the first time, identified as Rohingya, in the U.S. elections. The opportunity, a right they were denied in Myanmar, finally made them feel like they had a future. Activists like Yasmin Ullah and Wai Wai Nu, and refugees I worked alongside in the camps, continue to call for expanding this opportunity for hope to more people. They call on the international community to not only hold Myanmar accountable for atrocities they perpetrated but to establish more paths to resettlement.

Unfortunately, hope for resettlement has recently narrowed as President Trump set the Presidential Refugee Determination at 15,000 for 2021 slicing resettlement for the 4^th consecutive year. As a global leader, the U.S. has a responsibility to uphold the right to seek safety for refugees like the Rohingya. Instead, under the Trump administration the U.S. sharply reduced refugee admissions, following a global trend of migrant deterrence.

The daily stress, insecurity and uncertainty of displacement have a profound impact on physical and mental health. During the year I spent working with the Rohingya, the deterioration of mental wellbeing was increasingly apparent. It could be seen on the faces of those who came for support at our service centers and in conversations with community members at water points and tea stalls. Even as mental health services expand, they remain limited in comparison to the scale of the need. With friends and relatives facing ongoing persecution in Myanmar and opportunities such as resettlement in a safe third country like the U.S. narrowing, this mental deterioration is unsurprising. When discussing the mental state of the community, two refuges shared with me that:

“The entire community becomes hopeless. . . ” – Min Thet*,  female Rohingya refugee

“For these issues [violence & COVID19] we cannot sleep well at night . . .” – male Rohingya refugee

Compounding this near-daily turmoil are the dwindling rights of the Rohingya people in Bangladesh. Prohibition from attending schools, the controversial relocation plan and increased security threats from gangs and alleged extremist groups within the camps exacerbates the community’s distress. As the Government of Bangladesh has nearly finished fencing in the entire perimeter of the mega-camp, soon 860,000 Rohingya will live in open air, prison-like conditions, similar to their relatives in Myanmar. While the fences progressed, anxiety was palpable when I walked through the camp. A news release from Fortify Rights highlights that the community remembers what followed the erection of fences in Myanmar:

“We are afraid of the fence going up here in the camps [in Bangladesh] because the Myanmar government built wire fences on all four sides before the violence took place. After building the fence in Myanmar, many of our mothers and sisters were killed and young children were cut and thrown into fires.”

With little recourse to oppose their confinement, such fear and anxiety is widespread and is a constant complaint of those seeking mental health services. One female refugee shared with me that “[most people] are feeling [heart] palpitations, depression, insomnia [and are] insecure.” Many refugees regularly re-live the violence they witnessed and carry immense guilt for surviving atrocities that many of their loved ones – children and elders included – could not. The daily stress of life in the camps and the Rohingya’s ever-waning rights complicate the mental health of the community even further, recent studies have shown.

As senior mental health officer for UNHCR, Dr. Pieter Ventevogel recently said, “. . . psychotherapy is not the answer to everything, because that would mean the problem is simply in people’s heads. Refugees need lasting solutions. That is key.” While mental health services exist, with little to no options for stability and the creation of home, distress and sadness often remain chronic. Solutions for physical and psychological healing are hindered as the Rohingya remain suspended between Myanmar, a state that wishes to expel them, and Bangladesh, a state that wishes to contain or relocate them. A lasting solution is the resettlement of the Rohingya to countries where they can heal and begin to thrive.

With the presidential refugee determination set at an all-time low by a country that has been the leader in providing refuge, Rohingya refugees experience profound despair and hopelessness.  Addressing these wounds and demonstrating our commitment to the mental and physical health of people in displacement globally through an increased refugee determination is the first step to once again fulfilling this responsibility. As we usher in a new administration, we welcome President Joe Biden’s promise to admit 125,000 refugees and open the country to resettlement again.

*Name changed for privacy.