Letter for the Minister for Immigration and Citizenship, Australia on the Refugee Swap Deal

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The Honourable Chris Bowen
Minister for Immigration and Citizenship, Australia
PO Box 6022
House of Representatives
Parliament House
Canberra, ACT 2600                                                                                                                                          24 August 2011

Dear Minister,

The refugee swap agreement between Australia and Malaysia is of deep concern to us because it undermines existing legitimate mechanisms for international protection of people fleeing persecution, and, exacerbates the problem of shrinking protection space for refugees and asylum seekers worldwide, and in the Asia Pacific in particular.


We deeply regret that Australia has decided to proceed with the transfer of the newly arrived asylum seekers who are currently being detained on Christmas Island, even considering the use of force, in spite of the traumatic experiences endured by these people in their country of origin and during the perilous boat journey.


We strongly urge Australia to refrain from sending all children, including unaccompanied minors and children traveling with their families to Malaysia.

Refugee children have generally not been exempt from arrest and detention in Malaysian immigration detention centers, and are often detained with adults. A 17 year old girl who was held in detention for 15 days with her 13 year old sister, and was traumatized by the experience and brought to the mental health services of Health Equity Initiatives (HEI) in 2009, presented with prominent symptoms of Post Traumatic Stress Disorder (PTSD) and Depression including reliving the detention experience, poor appetite, intermittent insomnia, low mood, frequent headaches, fatigue, negative thoughts about herself, and a fear of uniformed personnel.

The “private education arrangements in the community” (Annex-A: Operational Guidelines to Support Transfers and Resettlement; 3.3(a)), that transferees will have access to includes ill equipped and understaffed schools run by underpaid volunteers most of the time.  Given that these schools are not officially registered, refugee children are unable to graduate with certification.

Asylum Seekers with Mental Health Problems

We also ask that vulnerability assessments including mental health assessments be done in Australia, and those with mental health problems not be sent to Malaysia, to prevent an exacerbation of their condition, given the various stressors they will need to endure.

The following items related to the arrangement between the governments of Australia and Malaysia on transfer and resettlement do not provide for reliable guarantees of basic human rights of the transferees.

  • “Operations under this Arrangement will be carried out in accordance with the domestic laws, rules, regulations and national policies from time to time in force in each country…”  (Arrangement Between the Government of Australia and the Government Of Malaysia on Transfer and Resettlement; Clause 12)
  • “Transferees will enjoy an adequate standard of treatment, including having access to the same support as other asylum seekers and refugees in the community” (Annex-A: Operational Guidelines to Support Transfers and Resettlement; 3.0)

It is a known fact that Malaysia lacks an administrative and legal framework for refugee protection.  The lack of legal recognition of refugees and asylum seekers in the country constantly exposes them to the risk of arrest and impedes their access to education, legal employment, health care, and other social freedoms.

Further, there is no information to date on the modalities of how “(a) Transferees will have ongoing access to self reliance opportunities particularly through employment, and, (b) Transferees will be encouraged to become self sufficient as soon as possible. “ (Annex-A: Operational Guidelines to Support Transfers and Resettlement; 3.2)

Afghan Refugees

We also urge the Australian government to promptly and without delay determine the refugee status of those Afghan refugees on Christmas Island and to immediately release from detention all those who are found to be refugees.

A study by HEI in 2009 with 73 Afghan refugees and asylum seekers indicates that the majority of Afghan refugees in Malaysia belong to ethnic minorities (mainly Hazara, but also others like the Tajiks, Qizilbash) and religious minorities (Shiite) fleeing persecution by the Taliban.  Their religious status poses potential risks for them in Malaysia and impedes their integration locally.  Moreover, linguistic and cultural barriers make it extremely difficult for them to find employment and rent houses in Malaysia. Their lack of community support networks which are imperative for those surviving in subterranean spaces without a legal identity exacerbates the multi-dimensional poverty experienced by this group.

As a community that had endured decades of conflict and inter-generational refugeehood we believe that unless the humanitarian and security situation in Afghanistan improves, unless the strident efforts to compel Afghan refugees in Iran to return home to situations of insecurity are capped, and unless there is an increase in resettlement opportunities, they will continue to undertake precarious journeys further afield in search of more effective refugee protection and more sustainable life solutions.

We plead for a thoughtful and compassionate consideration of these above mentioned population groups requiring international protection.


There is a compelling body of evidence on the association between forced migration related policies and poor mental health outcomes. As such, we are constrained to draw attention to the potential negative health outcomes of policies such as the current arrangement and strongly urge Australia to:

  1. Refrain from sending all children, including unaccompanied minors and children traveling with their families to Malaysia.
  2. Give special consideration to the international protection needs of Afghan refugees, including promptly and without delay determining the refugee status of those Afghan refugees on Christmas Island and to immediately release from detention all those who are found to be refugees.
  3. Cease from sending those suffering from mental health problems to Malaysia.
  4. Recognize and integrate the special protection needs of refugees and asylum seekers within enforcement of border control, anti-trafficking and anti-smuggling strategies.
  5. Uphold its obligations under international law, especially in relation to the 1951 Refugee Convention

Please find attached to this letter the report of the study on Afghan refugees and asylum seekers in the Klang Valley.

Please feel free to contact us if you require any additional information.

Yours Faithfully,

  1. Health Equity Initiatives (HEI)
  2. Women’s Aid Organisation
  3. Lawyers for Liberty
  4. Tenaganita
  5. Suara Rakyat Malaysia (SUARAM)
  6. Malaysian Social Research Institute (MSRI)
  7. Pusat Kebajikan Good Shepherd
  8. Good Shepherd Sisters Malaysia


  1. Mr. Andrew Metcalfe, Secretary of the Department of Immigration and Citizenship (DIAC)
  2. Prime Minister’s Office
  3. Ms. Emily Johnson, Adviser, Office of Senator Sarah Hanson-Young
  4. Mr. Paul Power, Chief Executive Officer, Refugee Council of Australia
  5. Dr. Graham Thom, Amnesty International Australia
  6. Mr. Paris Aristotle, Director, Victorian Foundation for Survivors of Torture
  7. Ms. Michelle Dimasi, Director, Asylum Seekers Christmas Island

Desperate wait for refugees in Malaysia

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Muhammad Rafique can’t deny his hopes have been boosted by the Malaysia deal, but
tears well up in his eyes as he explains that 15 years as a refugee have taught him not
to be so foolish as to trust such feelings.

On the walls inside the squalid shack where he lives with his wife and young child are a
map of Burma and a poster of the Universal Declaration of Human Rights.

The 34-year-old, an ethnic Rohingya who arrived in Malaysia from Burma when he was
19, is desperate to know whether he and his family might be among the 4000 refugees
that will be resettled in Australia.

Under the deal signed in Kuala Lumpur on Monday, Australia will resettle 1000 bona-
fide refugees a year over four years, in exchange for Malaysia taking the next 800
asylum seekers that arrive in Australia by boat.

But Rafique and his family are just three among more than 90,000 refugees in Malaysia.
“I want to go to Australia with my family. I hope to have a chance to go to Australia,” he

It’s obvious when he speaks that he sees their chances as bleak.

His English is poor and, having been a refugee for his entire adult life, Rafique has no

He believes his chances are even poorer because the United Nations High
Commissioner for Refugees (UNHCR), which will have input into who makes it into the
4000, “doesn’t like to send Muslim people to Australia”.

“I am worried the UNHCR don’t want to pick me and my family. I fear the UNHCR will
not want to listen to me.”

Unlike the 800 asylum seekers that will be transferred from Australia, Rafique has no
rights to work or access to education.

He has little access to health care, and like many of the refugees waiting in a long
queue in Malaysia, Rafique suffers from anxiety and depression brought on by the
parlous life he and his family live, and their uncertain future.

A study by the non-government organisation, Health Equity and Initiatives (HEI), in
March this year found that 70 per cent of asylum seekers and refugees in Malaysia
suffered symptoms of anxiety, depression and stress as a result of human trafficking,
forced labour and unemployment.

Xavier Pereira, the director of HEI, said the figure was three times higher than in any
normal population.

“Both men and women are equally affected, especially those who are unemployed,
involved in human trafficking and forced labour,” he said.

The level of anxiety was much higher among those who were yet to be granted refugee
status, according to the study of 1074 asylum seekers and refugees, aged between 18
to 70 years.

Rafique has been ripped off by agents that have promised to help with resettlement in
another country, and he admits to having paid a people smuggler in a failed attempt to
make it to Australia on a boat.

He cannot return to Burma, according to Amnesty International, because as he is from
the Rohingya minority, the Burmese authorities would refuse to grant him citizenship,
rendering him stateless.

In Burma, he would suffer from systematic persecution, including forced labour, forced
eviction, land confiscation, and severe restrictions on freedom of movement.
He says he will now do the right thing and wait, and hope for a chance of resettlement in

But he says others will still pay people smugglers and get on the boats in a perilous
crossing to Australia, despite the deal with Malaysia meaning that within 72 hours, they
will be sent back.

“They will still go, whatever chance they have, they must try to go, even if it means they
go to the back of the queue,” Rafique said.

Karlis Salna, AAP South-East Asia Correspondent

This article was published in The Sydney Morning Herald on 28 July 2011.



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該項論壇是由Health Equity Initiatives(HEI)、律師公會及大馬職工總會聯辦。




This article was published in the Sin Chew Daily on 26 July 2011.


Study: Refugees and asylum seekers prone to mental illness

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KUALA LUMPUR (July 26, 2011): Refugees and asylum seekers who have experienced forced labour are prone to suffer from depression, anxiety and stress, a study by NGO Health Equity Initiatives (HEI) revealed today.

The research was conducted on 1,074 Burmese refugees and asylum seekers living in the Klang Valley and showed that a third of respondents had experienced forced labour.

Also, 70% of 1,037 respondents had symptoms of depression and anxiety while 41% of the respondents displayed symptoms of stress.

In revealing the research findings today, HEI director Sharuna Verghis said today: “Although forced labour occurs in all work sectors, the construction and agriculture or plantation sectors had a higher proportion of forced labour.”

“The risk of unemployment was associated with higher levels of depression, anxiety and stress,” she added.

According to the International Labour Organisation’s Convention Concerning Forced or Compulsory Labour 1930, forced or compulsory labour includes “all work or service which a person did not volunteer for and under the menace of any penalty”.

According to the findings, out of 1,037 respondents, 21.4% of respondents showed symptoms of mild depression, 33.5% displayed symptoms of moderate depression, 8.7% were severely depressed and 5% exhibited extremely severe depression.

On anxiety, 11.1% of 1,037 respondents showed a mild level, 29.4% were moderate, 14.1% werensevere and 14% were extremely severe.

On stress, 18.8% showed a mild level, 15% displayed a moderate level, 5.8% had severe stress while 1.5% had extremely severe stress levels.

The findings of the research were deduced from Depression Anxiety Stress Scales (DASS) questionnaires.

At a press conference later, Sharuna said it is imperative that the Government recognise the United Nations’ 1951 Refugee Convention and 1967 Protocol relating to the status of refugees to ensure easier access to medical facilities.

HEI director Dr Xavier Pereira said the findings indicate a “serious problem” as prolonged stress, depression and anxiety can cause permanent structural and chemical changes in the brain.

“If we don’t look at preventive measures or interventions to reduce forced labour, then there are serious health implications,” he said.

“Refugees and asylum seekers have the least access to healthcare in the country,” he added.

Bar Council sub-committee on migrants, refugees and immigration affairs chairman Datuk M. Ramachelvam said the “irregular status and uncertain status of undocumented persons and more so refugees contributes to negative medical and psychological conditions.”
He said the Government should abolish the outsourcing for labour.

“It has no place in the labour market,” he said, adding there are 100,000 refugees that can be
employed in the country but present laws prohibit such employment.

Meena L. Ramadas

This article was published in the Sun Daily on 26 July 2011.


70 Pct Of Asylum Seekers, Refugees Suffer Symptoms Of Mental Illness – NGO

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Seventy per cent of men and women asylum seekers and refugees in Malaysia suffer symptoms
of anxiety, depression and stress due to human trafficking, forced labour and unemployment,
according to a non-governmental organisation.

The figure was three times higher than in any normal population, said the Dr Xavier Pereira, the
director of Health Equity and Initiatives (HEI).

He said the finding was based on a study done in March on 1,074 asylum seekers and refugees,
aged between 18 to 70 years.

“Both men and women are equally affected, especially those who are unemployed, involved in
human trafficking and forced labour,” he told reporters after the National Consultation of the
Health Dimensions of Human Trafficking and Forced Labour, here today.
He said that the study also showed that extreme symptoms of anxiety was more evident than both
depression and stress.

He added that the level of anxiety among asylum seekers were higher than the refugees.

This article was published in Bernama on 26 July 2011.

This article was published in the New Straits Times on 26 July 2011.

This article was published in the Star Online on 26 July 2011.




Baby Dumping: Allow for Termination of Pregnancy

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Dear Editor,

Health Equity Initiatives is very concerned about the current debates on baby dumping and infanticide that once again seems to adopt a moralistic approach, which has proved ineffectual in dealing with this long standing problem.

As such, we laud the call by Federal police CID director Commissioner Datuk Seri Mohd Bakri Zinin “to find a more effective mechanism to resolve this and all parties must play their part” (The Sun, February 9).

We support Reproductive Rights Advocacy Alliance Malaysia’s (RRAAM) call for women to have more control over their reproductive health and have access to the termination of pregnancy (TOP) services (The NST, February 13).

We do not view the termination of pregnancy as a means of nor as an alternative to contraception.  However, we do believe that the termination of pregnancy should be examined within the broader context of women’s lives, unequal power relations between men and women, the lack of access, especially for women, to accurate and appropriate sexual and reproductive health information and services, the development of technologies related to TOP, and importantly, evidence related to TOP.

Unsafe abortions come at a high cost to human life and material resources.   Unsafe abortions are one of the leading causes of maternal mortality and morbidity globally and treating complications that result from unsafe abortions brings unnecessary and avoidable costs to the health care system.  Studies indicate that the availability of legally induced abortion has reduced mortality due to abortion.  Further, high quality studies indicate no increased risk of mental health problems in women having a TOP.

The decision to terminate a pregnancy is never easy for any woman and alternative options to carry the pregnancy to term, childbirth, raising the child and/or giving the baby up for adoption comes with its own psychological, financial and social hardship.

As an organization working with marginalized communities, we notice that particularly in the case of non-citizen refugee women, TOP services while much needed are extremely difficult to access.  Undertaking risky journeys as they flee persecution, refugee women experience the risk of unwanted pregnancies as they are exposed to rape and sexual violence and lack access to emergency contraception.  Given their insecure legal status and lacking the formal right to work in Malaysia, they are barely even able to meet their own basic needs, including of security.  Carrying the pregnancy to term, accessing maternal health services via a public health system which charges extremely high foreigners’ rates, and, raising the baby after birth sans child care and social support within such an environment is extremely challenging.

In 2009 the United Nations recognized maternal mortality as a violation of human rights and reproductive health rights are enshrined in several international declarations and laws.  The exercise of judgment related to the woman’s body and personal morals should be the right of the woman – not of the family, the State, or even of the medical practitioner.  In the context of reproductive health services, General Recommendation 24 of the Convention on the Elimination of All Forms of Discrimination against Women (1979) which Malaysia has ratified states that “if health service providers refuse to perform such services based on conscientious objection, measures should be introduced to ensure that women are referred to alternative health providers”.

The failure of overly moralistic and legalistic approaches to the problems of baby dumping and infanticide in our country and the consequent loss of lives must strengthen our efforts towards greater dialogue and creating more spaces where these issues can be discussed openly, rationally and compassionately.

Health Equity Initiatives

This letter was published in the News Straits Times on 5 April 2011. http://www.rraam.org/art/hei2.html

This letter was published in the Sun Daily on 4 March 2011.