26th of June 2023
House of Commons
Dear Suella Braverman,
I am writing as a medical and anthropology student to advocate for policy change impacting refugee and migrant health and suffering, in light of your Illegal Migration Bill (Braverman and The Lord Murray of Blidworth 2023). As I am sure you do, I feel passionate about minimising human suffering and injustice, and I hope that this letter presents new perspectives and literature.
Refugees and asylum seekers fleeing persecution, (defined under The Refugee Convention of 1951 (United Nations High Commissioner for Refugees 2021)) see increased prevalence of infectious disease, sexually transmitted infections, cardiac disease, diabetes and cancer, associated with elevated poverty, psychologically and physically traumatic experiences, and violence, including sexual and gender-based violence compared to non-displaced populations. This coincides with curtailed healthcare access often before displacement, in detention, in temporary accommodation, and after resettlement or repatriation due to societal marginalisation. Refugees also experience increased risk of mental illness compared to non-refugees. Multiple traumas, detention, loss of social support and delayed asylum proceedings are all partially causative of this. Therefore, refugee healthcare is not only a question of access: The asylum system and displacement process present key opportunities for morbidity and mortality prevention. This is only possible with sufficient political will and public empathy spurring legislative intervention (Carruth 2018).
Bridget Anderson’s work explores the narratives and metaphors of migration. The foremost example is that of the ‘refugee’ and ‘migrant’ terms. These terms (ostensibly denoting legal categories) carry differing moral judgements: ‘Refugee’ invokes the vulnerability of a war-victim, where ‘migrant’ suggests potential for violence or terrorism, plus the greed of the undeserving, angling for a better life they have not earned (Anderson 2017, 11). ‘Migrant’ also correlates with descriptions of poverty and low skill, compared to ‘expat’ professionals, Northern Europeans and Americans (Anderson 2017, 12). Fassin (2013) shows how the perceived worthiness of migrants or refugees is always spun by the political climate of the day, with this instability facilitating the imposed politicisation of migrants.
Another facet of migration language is metaphor. Since the First World War, refugees have been “the scum of the earth” according to Hannah Arendt (2004, 2), and Anderson highlights a specificity of this: Allusions to animality; “the migrant as invasive insect” (2017, 8) are common. (‘Cockroaches’, for example (Hopkins 2015)). The depiction as ‘low’ animals lacking productivity, charisma or sentience is deindividualizing and dehumanising, further invoking the habitat of insects and vermin – often urban and associated with human waste and detritus. Anderson points to their association with chaos, as vermin thrive with poverty, conflict and natural disaster, “ambassadors of entropy” (2017, 16) symbolising overwhelming nature and the fear of those at its mercy. These help to legitimise what would and should be socially unacceptable; the unqualified denigration and maligning of a vulnerable class of people. This can in turn stifle empathy felt for these people and facilitates artificially inflated divisions and competition between the interests of refugees and similar groups, like the impoverished citizens of the UK.
It is important to consider the historical context of this mobility and its relationship to Europe. Rather than neutrality, European past has often seen involvement in the root causes of migration, more proximally in conflicts in the Middle East for example, but earlier too through colonialism, slavery, massacres, and resource seizure. It can be argued that colonial histories of violence, oppression and theft cycling down the years have exposed downstream human manifestations of this past. In the UK we are relatively insulated to these (negative) consequences of global inequality, so the response has been to maintain this comforting illusion rather than face the ugliness of fleeing violence and abject economic scarcity.
Rowley, Morant, and Katona’s qualitative study of refugees who experienced extreme cruelty and subsequently were granted leave to remain in the UK shows significant and persistent increased rates of mental illness (2020). Contributory to worsening mental health are sequential trauma, detention, the threat of deportation and anxieties about asylum rulings. Loss of social networks and roles, language barriers, precarious housing and homelessness, adaption to a new culture, and unemployment have all been shown as potentially detrimental to refugee mental health. One participant, Hafsa (participants recorded under pseudonyms) stated after leaving the asylum process: “Now I feel that no one is helping me, like I’m facing everything by myself.” (Rowley, Morant, and Katona 2020, 14). Hafsa and a male participant, Riaz, found tension between self-advocacy in accessing reasonable services from reluctant or discriminatory providers and pressure not to entertain stereotypes: “I have a phobia of meeting new people […] I can’t go ‘Hi, I am an immigrant, I’m on benefits, you know that’s just going to entertain the stereotypical way of thinking: ‘immigrants come here to abuse our benefits.’” (Riaz, in (Rowley, Morant, and Katona 2020, 16)). A sense of abandonment and degradation contributed to worsening mood and self-esteem among some participants. Lami, another participant, shared: “I feel bad. Very, very, very bad. But sometimes I, I end up crying. You know sometimes I think this world is not… I think about the world in general. Is it really worth living, you know?” (Lami, in (Rowley, Morant, and Katona 2020, 20)). Barriers to employment were also counterproductive in the lives of refugees, unnecessarily impeding financial productivity and independence. These findings are conveyed as a short vignette showing obvious humanity in a gruelling situation, and because the factors above are salient targets for intervention by host countries to improve refugee health, in turn boosting wellbeing, social functioning and employment.
Holmes and Castañeda assert that representation is highly salient in where blame is directed for the situations of refugees, whether their own agency is platformed, or political, historical and economic context are interrogated for causation. This then informs the same narrative of ‘deserving’ and ‘undeserving’, which are crucial in understanding the legitimising power associated with being in control of setting these distinctions that ascribe rights. As above, the power imbalance favours the influential of Euro-America, to whose advantage it is to locate responsibility away from their countries’ policies, onto the cultures and behaviours of the displaced. However, this is contested ground that sees opposition from third parties, for example Welsh local community pro-refugee action, using Welsh cakes to symbolise their hospitality (Nagesh 2023).
Holmes and Castañeda’s assertion is clear; the character of the ‘economic’ migrant is reductionist to the point of ignoring structural violence and colonial legacies of economic inequality as vastly important push factors, up to the point of survival. It also overvalues migrants’ choice to migrate, centring individualism and unworthiness of any more political, social or economic provision on moral grounds (Holmes 2013; Holmes and Castañeda 2016). They refer to a conversation with a refugee who had been a dentist in Syria and fled the war with his family due to the inherent danger of violence, electricity and utilities removal in his home and threat of conscription. It bears considering how many UK professionals (and their families) would accept living without utilities, and with the threat of conscription and armed conflict, to complicate the reductionism of ‘deserving refugees’ and ‘greedy economic migrants’. It is crucial to note that displaced people are not monolithic, as Holmes and Castañeda’s work with Syrian refugees ranging “from illiterate working-class people to English-speaking professionals” (2016, 17) shows. This deservingness stratification in policy would be alien were it appraising people born in the UK. This recalls Achille Mbembe’s theory of ‘necropolitics’, in which governments, imbued with the power to decide who lives and dies, makes these decisions by assigning varying value to certain bodies and lives. Typically restricted to the most dire situations, this is roundly criticised, see Douglas’ work for example (Mbembe 2019; Douglas 2020). Holmes and Castañeda mobilise philosopher Michel Foucault’s theory of ‘biopower’ to help explain the lethal consequences of migration policy: Biopower also considers governments with power over life, and to the end of ensuring survival of the life of the population, permits the idea that some lives may be excluded from the population, and thus their deaths facilitate protection of life for the population (Foucault 1998). The key lies in who decides whose lives are ‘in the population’, and whose are Othered out of the population.
According to the UNHCR, the Illegal Migration Bill puts an effective end to the UK asylum system (United Nations High Commissioner for Refugees 2023b; 2023a). This bill must be joined by legislation to improve accommodation provision that is less detrimental to health so that the UK does not fail to meet its ethical and legal obligations and put any more vulnerable people at risk. it is vital that real safe and legal routes to the UK be provided, to negate the need to set foot in the UK to claim asylum. I hope the information presented shows the difficulty of refugee life and inhumane treatment these people have been subjected to, both in the UK and abroad, with directions to redress this injustice.
Anderson, Bridget. 2017. ‘The Politics of Pests: Immigration and the Invasive Other’. Social Research 84 (1): 7–28.
Arendt, Hannah. 2004. ‘The Decline of the Nation-State and the End of the Rights of Man’. In The Origins of Totalitarianism / Hannah Arendt ; Introduction by Samantha Power., 341–84. New York: Schocken Books.
Braverman, Suella and The Lord Murray of Blidworth. 2023. Illegal Migration Bill. https://bills.parliament.uk/bills/3429.
Carruth, Lauren. 2018. ‘Refugee Health’. In The International Encyclopedia of Anthropology, 1–8. John Wiley & Sons, Ltd. https://doi.org/10.1002/9781118924396.wbiea2077.
Douglas, Cristina. 2020. ‘Lives and Deaths with Dementia During Covid-19: Our Shameful (But Hopefully Transformative) Post-Pandemic Legacy’. Medical Anthropology at UCL. 12 June 2020. https://medanthucl.com/2020/06/12/lives-and-deaths-with-dementia-during-covid-19-our-shameful-but-hopefully-transformative-post-pandemic-legacy/.
Fassin, Didier. 2013. ‘The Precarious Truth of Asylum’. Public Culture 25 (1 (69)): 39–63. https://doi.org/10.1215/08992363-1890459.
Foucault, Michel. 1998. The Will to Knowledge / Michel Foucault ; Translated from the French by Robert Hurley. The History of Sexuality ; Vol. 1. London: Penguin.
Holmes, Seth M. 2013. Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States. University of California Press. https://hdl.handle.net/2027/heb33915.0001.001.
Holmes, Seth M., and Heide Castañeda. 2016. ‘Representing the “European Refugee Crisis” in Germany and beyond: Deservingness and Difference, Life and Death’. American Ethnologist 43 (1): 12–24. https://doi.org/10.1111/amet.12259.
Hopkins, Katie. 2015. ‘Rescue Boats? I’d Use Gunships to Stop Migrants.’ The Sun, 17 April 2015.
Mbembe, Achille. 2019. Necropolitics. Theory in Forms. Durham, NC: Duke University Press.
Nagesh, Ashitha. 2023. ‘Patriotic Alternative: The Town Fighting the Far-Right with Welsh Cakes’. BBC News, 25 March 2023, sec. UK. https://www.bbc.com/news/uk-65057093.
Rowley, L., N. Morant, and C. Katona. 2020. ‘Refugees Who Have Experienced Extreme Cruelty: A Qualitative Study of Mental Health and Wellbeing after Being Granted Leave to Remain in the UK’. Journal of Immigrant & Refugee Studies 18 (4): 357–74.
United Nations High Commissioner for Refugees. 2021. ‘What Is a Refugee?’ UNHCR. 2021. https://www.unhcr.org/what-is-a-refugee.html.
———. 2023a. ‘UK Asylum and Policy and the Illegal Migration Bill’. UNHCR UK. 2023. https://www.unhcr.org/uk/what-we-do/uk-asylum-and-policy/uk-asylum-and-policy-and-illegal-migration-bill.
———. 2023b. ‘UNHCR LEGAL OBSERVATIONS ON THE ILLEGAL MIGRATION BILL 02 MAY 2023’. UNHCR UK. 2023. https://www.unhcr.org/uk/media/unhcr-legal-observations-illegal-migration-bill-02-may-2023.