UNHCR- 52% of refugees are children
global gateways
Home country experiences (pre-migration)[edit]
The pre-migration stage refers to home country experiences leading up to and including the decision to flee. Pre-migration experiences include the challenges and threats children face that drive them to seek refuge in another country.[21] Refugee children migrate, either with their families or unaccompanied, due to fear of persecution on the premise of membership of a particular social group, or due to the threat of forced marriage, forced labor, or conscription into armed forces.[5] Others may leave to escape famine or in order to ensure the safety and security of themselves and their families from the destruction of war or internal conflict.[22] A 2016 report by UNICEF found that, by the end of 2015, five years of open conflict in the Syrian Arab Republic had forced 4.9 million Syrians out of the country, half of which were children. The same report found that, by the end of 2015, more than ten years of armed conflict in Afghanistan had forced 2.7 million Afghans beyond the country's borders; half of the refugees from Afghanistan were children.[1] During times of war, in addition to being exposed to violence, many children are abducted and forced to become soldiers.[23]:p.1 According to an estimate, 12,000 refugee children have been recruited into armed groups within South Sudan.[24] War itself often becomes a part of the child's identity, making reintegration difficult once he or she is removed from the unstable environment.[23]:p.3
Examples of children's pre-migration experiences:
- Some Sudanese refugee children reported that they had either experienced personally or witnessed potentially traumatic events prior to departure from their home country, during attacks by the Sudanese military in Darfur. These events include instances of sexual violence, as well as of individuals being beaten, shot, bound, stabbed, strangled, drowned, and kidnapped.[25]
- Some Burmese refugee children in Australia were found to have undergone severe pre-migration traumas, including the lack of food, water, and shelter, forced separation from family members, murder of family or friends, kidnappings, sexual abuse, and torture.[4]
- In 2014 the President of Honduras testified in front of the United States Congress that more than three-quarters of unaccompanied child migrants from Honduras came from the country's most violent cities.[26] In fact, 58 percent of 404 unaccompanied and separated children interviewed by the UN Refugee Agency, UNHCR, about their journey to the United States indicated that they had been forcibly displaced from their homes because they had either been harmed or were under threat of harm.[27]
In general, children may also cross borders for economic reasons, such as to escape poverty and social deprivation, or some children may do so to join other family members already settled in another State. But it is the involuntary nature of refugees' departure that distinguishes them from other migrant groups who have not undergone forced displacement.[28] Refugees, and even more so their children, are neither psychologically nor pragmatically prepared for the rapid movement and transition resulting from events outside their control.[28] Any direct or witnessed forms of violence and sexual abuse may characterize refugee children's pre-migration experiences.[29]
Refugee camps[edit]
Some refugee camps operate at levels below acceptable standards of environmental health; overcrowding and a lack of wastewater networks and sanitation systems are common.[40][41][42]
Hardships of a refugee camp may also contribute to symptoms following a refugee child's discharge from a camp. A small number of Cuban refugee children and adolescents, who were detained in a refugee camp, were assessed months after their release, and it was found that 57 percent of the youth exhibited moderate to severe posttraumatic stress disorder (PTSD) symptoms.[43] Unaccompanied girls at refugee camps may also face harassment or assault from camp guards and fellow male refugees.[44] In addition to having poor infrastructure and limited support services, there are a few refugee camps that can present danger to refugee children and families by housing members of armed forces. Also, at a few refugee camps, militia forces may try to recruit and abduct children.[1]
Host country experiences (post-migration)[edit]
The third stage, host country experiences, is the integration of refugees into the social, political, economic, and cultural framework of the host country society. The post-migration period involves adaptation to a new culture and re-defining one's identity and place in the new society.[20] This stress can be exacerbated when the children arrive in the host country and are expected to adapt quickly to a new setting.[45]
It is only a minority of refugees who travel into new host countries and who are allowed to start a new life there. Most refugees are living in refugee camps or urban centres waiting to be able to return home. For those who are starting a new life in a new country there are two options:
Seeking asylum[edit]
Asylum seekers are people who have formally applied for asylum in another country and who are still waiting for a decision on their status.[46] Once they have received a positive response from the host government, they will legally be considered as refugees. Refugees, like citizens of the host country, have the rights to education, health, and social services, whereas asylum seekers do not.[47]
For instance, the majority of refugees and migrants who arrived in Europe in 2015 through mid-2016 were accommodated in overcrowded transit centers and informal settlements, where privacy and access to education and health services were often limited.[1] In some accommodation centers in Germany and Sweden, where asylum seekers stayed until their claims were processed, separate living spaces for women, as well as sex-separated latrines and shower facilities, were unavailable.[44]
Unaccompanied children face particular difficulties throughout the asylum process. They are minors who are separated from their families once they reach the host country, or minors who decide to travel from their home countries to a foreign country without a parent or guardian.[17] More children are traveling alone, with nearly 100,000 unaccompanied children in 2015 filing claims for asylum in 78 countries.[1] Bhabha (2004) argues that it is more challenging for unaccompanied children than adults to gain asylum, as unaccompanied children are usually unable to find appropriate legal representation and stand up for themselves during the application process.[48] In Australia, for instance, unaccompanied children, who usually do not have any kind of legal assistance, must prove beyond any reasonable doubt that they are in need of the country's protection.[8] Many children do not have the necessary documents for legal entry into a host country, often avoiding officials due to fear of being caught and deported to their home countries.[49] Without documented status, unaccompanied children often face challenges in acquiring education and healthcare in many countries. These factors make them particularly vulnerable to hunger, homelessness, and sexual and labor exploitation.[6] Displaced youth, both male and female, are vulnerable to recruitment into armed groups.[50] Unaccompanied children may also resort to dangerous jobs to meet their own survival needs.[51] Some may also engage in criminal activity or drug and alcohol abuse.[52][53][54] Girls, to a larger extent than boys, are vulnerable to sexual exploitation and abuse, both of which can have far-reaching effects on their physical and mental health.[55]
Refugee resettlement[edit]
Third country resettlement refers to the transfer of refugees from the country they have fled to another country that is more suitable to their needs and that has agreed to grant them permanent settlement.[56] Currently the number of places available for resettlement is less than the number needed for children for whom resettlement would be most appropriate.[24] Some nations have prioritized children at risk as a category for resettlement:
The United States established its Unaccompanied Refugee Minor Program in 1980 to support unaccompanied children for resettlement. The Office of Refugee Resettlement (ORR) by the Department of Homeland Security currently works with state and local service providers to provide unaccompanied refugee children with resettlement and foster care services. This service is guaranteed to unaccompanied refugee minors until they reach the age of majority or until they are reunited with their families.[57]
Some European nations have established programs to support the resettlement and integration of refugee children.[24] The European countries admitting the most refugee children in 2016 via resettlement were the United Kingdom (2,525 refugee children), Norway (1,930), Sweden (915), and Germany (595). Together, these accounted for 66% of the child resettlement admissions to all of Europe.[58] The United Kingdom also established a new initiative in 2016 to support the resettlement of vulnerable refugee children from the Middle East and North Africa, regardless of family separation status.[24] It was reported in February 2017 that this program has been partially suspended by the government; the program would no longer accept refugee youth with "complex needs," such as those with disabilities, until further notice.[59] Refugee children without caretakers have a greater risk of exhibiting psychiatric symptoms of mental illnesses following traumatic stress.[60]:p.9Unaccompanied refugee children display more behavioral problems and emotional distress than refugee children with caretakers.[60]:p.9 Parental well-being plays a crucial role in enabling resettled refugees to transition into a new society. If a child is separated from his/her caretakers during the process of resettlement, the likelihood that he/she will develop a mental illness increases.[60]:p.17
Health[edit]
This section covers health throughout the different stages of the refugee experience.
Health status[edit]
Nutrition[edit]
Refugee children arriving in the United States often come from countries with a high prevalence of undernutrition.[61] Nearly half of a sample of refugee children who arrived to the American state of Washington, the majority of which were from Iraq, Somalia, and Burma, were found to have at least one form of malnutrition. In the under five age range refugee children had significantly higher rates of wasting syndrome and stunted growth, as well as a lower prevalence of obesity, in comparison to low-income non-refugee children.[62]
However, some time after they arrived in the United States and Australia, many refugee children demonstrated an increasing rate of overnutrition. An Australian study, assessing the nutritional status of 337 sub-Saharan African children aged between three and 12 years, found that the prevalence rate for overweight amongt refugee children was 18.4%.[63] The prevalence rate of overweight and obesity among refugee children in Rhode Island, increased from 17.3% at initial measurement at first arrival to 35.4% at measurement three years after.[64]
But the nutritional profiles of refugee children also often vary by their country of origin. A study involving Syrian refugee children in Jordanian refugee camps found them to be on average more likely overweight than acutely malnourished. The low prevalence of acute malnutrition among them was attributed, at least partly, to UNICEF's infant and child feeding interventions, as well as to the distribution of food vouchers by the World Food Programme (WFP).[65]
Among newly arrived refugees in Washington state, significantly higher rates of obesity were observed among Iraqi children, whereas higher rates of stunting were found among Burmese and Somali children. The latter also had higher rates of wasting.[62] Such variation in the nutrition profiles of refugee children may be explained by the variance in refugees' location and time in transition.[66]
Mental health and illness[edit]
Traditionally, the mental health of children experiencing conflict is understood in terms of either post-traumatic stress disorder (PTSD) or toxic stress.[76] Prolonged and constant exposure to stress and uncertainty, characteristic of a war environment may result in toxic stress that children express with a change in behavior that may include anxiety, self-harm, aggressiveness or suicide.[77] A 2017 study conducted in Syria by Save the Children determined that 84% of all adults and most children considered ongoing bombing and shelling to be the main psychological stressor, while 89% said that children were more fearful as the war progressed, and 80% said that children had become more aggressive. These stressors are leading causes of the symptoms described above, which lead to diagnosis of PTSD and toxic stress, among other mental conditions. These issues may then be further exacerbated by a forced migration to a foreign country, and the beginning of the process of refugee status determination.[77]
Refugee children are extremely vulnerable during migration and resettlement, and may experience long-term pathological effects, due to "disrupted development time." Psychoanalysts of refugee health have proposed that refugee children experience mourning for their culture and countries, despite the fact that the war-torn state of their homes is unsafe. This sudden loss of familiarity places children at a greater risk for mental dysfunction. In addition, studies have shown that refugee children show a higher vulnerability to stress when separated from their families.[78] Studies from treatment facilities and small community samples have confirmed that refugee youth are at higher risk for psychopathologic disorders, including post-traumatic stress disorder, depression, conduct disorder, and problems resulting from substance abuse. However, it is important to note that other large-scale community surveys have found that the rate of psychiatric disorder among immigrant youth is not higher than that of native-born children.[79][80] Nonetheless, experiments have shown that these adverse outcomes can be prevented through adequate protective factors, such as social support and intimacy.[78] Additionally, effective adaptation strategies, such as absorption in work and creation of pseudofamilies, have led to successful coping in refugees. Many refugee populations, particularly Southeast Asian, undergo a secondary migration to larger communities of kinfolk from their countries of origin, which serve as social support networks for refugees. Research has shown that family reunification, formation of new social groups, community groups, and social services and professional support have contributed to successful resettlement of refugees.[78]
Refugees can be stigmatized if they encounter mental health deficiencies prior to and during their resettlement into a new society.[60]:p.14 Differences between parental and host country values can create a rift between the refugee child and his/her new society.[81]:p. 5 Less exposure to stigmatization lowers the risk of refugee children developing PTSD.[60]:p.14
Access to healthcare[edit]
Cognitive and structural barriers make it difficult to determine the medical service utilization rates and patterns of refugee children. A better understanding of these barriers will help improve mental healthcare access for refugee children and their families.[82]
Cognitive and emotional barriers[edit]
Many refugees develop a mistrust of authority figures due to repressive governments in their country of origin. Fear of authority and a lack of awareness regarding mental health issues prevent refugee children and their families from seeking medical help.[83]:p.76 Certain cultures use informal support systems and self-care strategies to cope with their mental illnesses, rather than rely upon biomedicine.[84]:p.279 Language and cultural differences also complicate a refugee's understanding of mental illness and available healthcare.[84]:p.280
Other factors that delay refugees from seeking medical help are:[84]:p.284
- Fear of discrimination and stigmatization
- Denial of mental illness as defined in the Western context
- Fear of the unknown consequences following diagnosis such as deportation, separation from family, and losing children
- Mistrust of Western biomedicine
Culturally competent care[edit]
Culturally competent care exists when healthcare providers have received specialized training that helps them to identify the actual and potential cultural factors informing their interactions with refugee patients.[85]:p.524 Culturally competent care tends to prioritize the social and cultural determinants contributing to health, but the traditional Western biomedical model of care often fails to acknowledge these determinants.[85]:p.527
To provide culturally competent care to refugees, mental healthcare providers should demonstrate some understanding of the patient's background, and a sensitive commitment to relevant cultural manners (for example: privacy, gender dynamics, religious customs, and lack of language skills).[85]:p.527 The willingness of refugees to access mental healthcare services rests on the degree of cultural sensitivity within the structure of their service provider.[85]:p.528
The protective influence exercised by adult refugees on their child and adolescent dependents makes it unlikely that young adult-accompanied refugees will access mental healthcare services. Only 10-30 percent of youth in the general population, with a need for mental healthcare services, are currently accessing care.[87]:p.342 Adolescent ethnic minorities are less likely to access mental healthcare services than youth in the dominant cultural group.
Parents, caretakers and teachers are more likely to report an adolescent's need for help, and seek help resources, than the adolescent.[87]:p.348 Unaccompanied refugee minors are less likely to access mental healthcare services than their accompanied counterparts. Internalizing complaints (such as depression and anxiety) are prevalent forms of psychological distress among refugee children and adolescents.[87]:p.347
Health education[edit]
The World Association of Girl Guides and Girl Scouts (WAGGGS) and Family Health International (FHI) have designed and piloted a peer-centered education program for adolescent refugee girls in Uganda, Zambia, and Egypt. The goal of the program was to reach young women who were interested in being informed about reproductive health issues. The program was split into three age-specific groups: girls aged seven to 10 learned about bodily changes and anatomy; girls aged 11 to 14 learned about sexually transmitted diseases; girls aged 15 and older focused on tips to ensure a healthy pregnancy and to properly care for a baby. According to qualitative surveys, increased self-esteem and greater use of health services among the program's participants were the largest benefits of the program.[96]
Education[edit]
This section covers education throughout the different stages of the refugee experience. The report, "Left Behind: Refugee Education in Crisis," compares UNHCR sources and statistics on refugee education with data on school enrollment around the world provided by UNESCO, the United Nations Educational, Scientific, and Cultural Organization. The report notes that, globally, 91 percent of children attend primary school. For all refugees, that figure is at 61 percent. Specifically in low-income countries, less than 50 percent of refugees are able to attend primary school. As refugee children get older, school enrollment rates drop: only 23 percent of refugee adolescents are enrolled in secondary school, versus the global figure of 84 percent. In low-income countries, nine percent of refugees are able to go to secondary school. Across the world, enrollment in tertiary education stands at 36 percent. For refugees, the percentage remains at one percent.[97]
Adapting to a new school environment is a major undertaking for refugee children who arrive in a new country or refugee camp.[98] Education is crucial for the sufficient psychosocial adjustment and cognitive growth of refugee children.[99] Due to these circumstances, it is important that educators consider the needs, obstacles, and successful educational pathways for children refugees.[100]
Graham, Minhas, and Paxton (2016) note in their study that parents' misunderstandings about educational styles, teachers' low expectations and stereotyping tendencies, bullying and racial discrimination, pre-migration and post-migration trauma, and forced detention can all be risk factors for learning problems in refugee children. They also note that high academic and life ambition, parents' involvement in education, a supportive home and school environment, teachers' understanding of linguistic and cultural heritage, and healthy peer relationships can all contribute to a refugee child's success in school.[101] While the initial purpose of refugee education was to prepare students to return to their home countries, now the focus of American refugee education is on integration.[102]
Access to education[edit]
Structure of the education system[edit]
Schools in North America lack the necessary resources for supporting refugee children, particularly in negotiating their academic experience and in addressing the diverse learning needs of refugee children.[103] Complex schooling policies that vary by classroom, building and district, and procedures that require written communication or parent involvement intimidate the parents of refugee children.[103] Educators in North America typically guess the grade in which refugee children should be placed because there is not a standard test or formal interview process required of refugee children.[104]:p.189
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The ability to enroll in school and continue one's studies in developing countries is limited and uneven across regions and settings of displacement, particularly for young girls and at the secondary levels.[105] The availability of sufficient classrooms and teachers is low and many discriminatory policies and practices prohibit refugee children from attending school.[105] Educational policies promoting age-caps can also be harmful to refugee children.[104]:p.176
Many refugee children face legal restrictions to schooling, even in countries of first asylum. This is the case especially for countries that have not signed the 1951 Refugee Convention or its 1967 Protocol.[106] In countries where they lack official refugee status, refugee children are unable to enroll in national schools.[107] In Kuala Lumpur, Malaysia, unregistered refugee children described being hesitant to go to school, due to risk of encountering legal authorities at school or while on the way to and from school.[107]
Language barriers and ethnicity[edit]
Acculturation stress occurs in North America when families expect refugee youth to remain loyal to ethnic values while mastering the host culture in school and social activities. In response to this demand, children may over-identify with their host culture, their culture of origin, or become marginalized from both.[110] Insufficient communication due to language and cultural barriers may evoke a sense of alienation or "being the other" in a new society. The clash between cultural values of the family and popular culture in mainstream Western society leads to the alienation of refugee children from their home culture.[103]
Many Western schools do not address diversity among ethnic groups from the same nation or provide resources for specific needs of different cultures (such as including halal food in the school menu). Without successfully negotiating cultural differences in the classroom, refugee children experience social exclusion in their new host culture.[103] The presence of racial and ethnic discrimination can have an adverse effect on the well-being of certain groups of children and lead to a reduction in their overall school performance.[104]:p.189 For instance, cultural differences place Vietnamese refugee youth at a higher risk of pursuing disruptive behaviour.[111]:p.7 Contemporary Vietnamese American adolescents are prone to greater uncertainties, self-doubts and emotional difficulties than other American adolescents. Vietnamese children are less likely to say they have much to be proud of, that they like themselves as they are, that they have many good qualities, and that they feel socially accepted.[111]:p.11
Classes for refugees, more often than not, are taught in the host-country language.[107] Refugees in the same classroom may also speak several different languages, requiring multiple interpretations; this can slow the pace of overall instruction.[106]Refugees from the Democratic Republic of Congo living in Uganda, for example, had to transition from French to English. Some of these children were placed in lower-level classes due to their lack of English proficiency. Many older children therefore had to repeat lower-level classes, even if they had already mastered the content.[107] Using the language of one ethnic group as the instructional language may threaten the identity of a minority group.[112]
The content of the curriculum can also act as a form of discrimination against refugee children involved in the education systems of first asylum countries.[7] Curricula often seem foreign and difficult to understand to refugees who are attending national schools alongside host-country nationals. For instance, in Kakuma refugee camp in Kenya, children described having a hard time understanding concepts that lacked relevance to their lived experiences, especially concepts related to Kenyan history and geography.[107] Similarly, in Uganda, refugee children from the Democratic Republic of Congo studying together with Ugandan children in government schools did not have opportunities in the curriculum to learn the history of their home country.[107] The teaching of one-sided narratives, such as during history lessons, can also threaten the identity of students belonging to minority groups.[113]
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Other obstacles[edit]
Although high-quality education helps refugee children feel safe in the present and enable them to be productive in the future, some do not find success in school.[114]:p.67 Other obstacles may include:[83]
- Disrupted schooling - refugee children may experience disruptive schooling in their country of origin, or they may receive no form of education at all. It is extremely difficult for a student with no previous education to enter a school full of educated children.[114]:p.71
- Trauma - can impede the ability to learn and cause fear of people in positions of authority (such as teachers and principals)[83]:p.340
- School drop outs - due to self-perceptions of academic ability, antisocial behaviour, rejection from peers and/or a lack of educational preparation prior to entering the host-country school. School drop outs may also be caused by unsafe school conditions, poverty, etc.[83]:p.341
- Parents - when parental involvement and support are lacking, a child's academic success decreases substantially. Refugee parents are often unable to help their children with homework due to language barriers. Parents often do not understand the concept of parent-teacher meetings and/or never expect to be a part of their child's education due to pre-existing cultural beliefs.
- Assimilation - a refugee child's attempt to quickly assimilate into the culture of their school can cause alienation from their parents and country of origin and create barriers and tension between the parent and child.[83]:p.340–344
- Social and individual rejection - hostile discrimination can cause additional trauma when refugee children and treated cruelly by their peers[83]:p.350
- Identity confusion[83]:p.352
- Behavioral issues - caused by the adjustment issues and survival behaviours learned in refugee camps[83]:p.355
Role of teachers[edit]
North American schools are agents of acculturation, helping refugee children integrate into Western society.[99]:p.291Successful educators help children process trauma they may have experienced in their country of origin while supporting their academic adjustment.[115] Refugee children benefit from established and encouraged communication between student and teacher, and also between different students in the classroom.[115] Familiarity with sign language and basic ESL strategies improves communication between teachers and refugee children.[98] Also, non-refugee peers need access to literature that helps educate them on their refugee classmates experiences.[115] Course materials should be appropriate for the specific learning needs of refugee children and provide for a wide range of skills in order to give refugee children strong academic support.[98]
Educators should spend time with refugee families discussing previous experiences of the child in order to place the refugee child in the correct grade level and to provide any necessary accommodations[104]:p.189 School policies, expectations, and parent's rights should be translated into the parent's native language since many parents do not speak English proficiently. Educators need to understand the multiple demands placed on parents (such as work and family care) and be prepared to offer flexibility in meeting times with these families.[98][103]
Academic adjustment of refugee children[edit]
Teachers can make the transition to a new school easier for refugee children by providing interpreters.[115] Schools meet the psychosocial needs of children affected by war or displacement through programs that provide children with avenues for emotional expression, personal support, and opportunities to enhance their understanding of their past experience.[116]:p.536 Refugee children benefit from a case-by-case approach to learning, because every child has had a different experience during their resettlement. Communities where the refugee populations are bigger should work with the schools to initiate after school, summer school, or weekend clubs that give the children more opportunities to adjust to their new educational setting.[115]
Bicultural integration is the most effective mode of acculturation for refugee adolescents in North America. The staff of the school must understand students in a community context and respect cultural differences.[83]:p.331 Parental support, refugee peer support, and welcoming refugee youth centers are successful in keeping refugee children in school for longer periods of time.[83]:p.334 Education about the refugee experience in North America also helps teachers relate better with refugee children and understand the traumas and issues a refugee child may have experienced.[83]:p.333
Refugee children thrive in classroom environments where all students are valued. A sense of belonging, as well as ability to flourish and become part of the new host society, are factors predicting the well-being of refugee children in academics.[110]Increased school involvement and social interaction with other students help refugee children combat depression and/or other underlying mental health concerns that emerge during the post-migration period.[117]
Peace education[edit]
Implemented by UNICEF from 2012 to 2016 and funded by the Government of the Netherlands, Peacebuilding, Education, and Advocacy (PBEA) was a program that tested innovative education solutions to achieve peacebuilding results.[118] The PBEA program in Kenya's Dadaab refugee camp aimed to strengthen resilience and social cohesion in the camp, as well as between refugees and the host community.[106] The initiative was composed of two parts: the Peace Education Programme (PEP), an in-school program taught in Dadaab's primary schools, and the Sports for Development and Peace (SDP) program for refugee adolescents and youth. There was anecdotal evidence of increased levels of social cohesion from participation in PEP and potential resilience from participation in SDP.[106]
Peace education for refugee children may also have limitations and its share of opponents. Although peace education from past programs involving non-refugee populations reported to have had positive effects,[119][120] studies have found that the attitudes of parents and teachers can also have a strong influence on students' internalization of peace values.[121] Teachers from Cyprus also resisted a peace education program initiated by the government.[122] Another study found that, while teachers supported the prospect of reconciliation, ideological and practical concerns made them uncertain about the effective implementation of a peace education program.[123]
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