An emergency within an emergency

Noah Leavitt: Coming up on Harvard Chan: This Week in Health…An emergency within an emergency

Vasileia Digidiki: They come to Greece. They leave war. They try to reach safety. They’re stuck in a country that cannot satisfy and secure their basic rights.

Noah Leavitt: A new report details an epidemic of abuse and sexual exploitation among refugees in Greece. Plus—Roma rights. The new push to address centuries of racism and discrimination.

Hello and welcome to Harvard Chan: This Week in Health; it’s Thursday, April 27, 2017. I’m Noah Leavitt

Amie Montemurro: And I’m Amie Montemurro. This week we’ll be bringing you two human rights stories that have rarely been covered in the United States.

Noah Leavitt: First, we’ll be examining a disturbing epidemic of child abuse and sexual exploitation among refugees in Greece.

Amie Montemurro: And then later in the episode—a new push to address centuries of discrimination targeting millions of Roma—a multi-national ethnic group who have lived nomadically across Europe.

Noah Leavitt: But we begin in Greece—where tens of thousands of refugees from the Middle East and Africa remain in migratory limbo in refugee camps, but also scattered in cities and even rural communities.
They’ve escaped conflicts in Syria, Pakistan, Afganistan, Eritrea, and Somalia—but now they’re now are unable to enter other countries in Europe.

Amie Montemurro: A third of those refugees are children. And a new report from the FXB Center for Health & Human Rights at the Harvard Chan School finds those youth are the victims of widespread sexual exploitation and abuse. Some of the victims have been as young as 11.

Noah Leavitt: The report was authored by Jackie Bhabha, director of research at the FXB Center and Vasileia Digidiki, a research fellow. They spent time in Greece, uncovering human rights abuses.

Amie Montemurro: And according to Digidiki, the roots of this situation dates back to 2015 when an influx of approximately a million refugees and migrants headed north from the Middle East and Africa.

Noah Leavitt: Tens of thousands arrived in Greece, but are now unable to leave because the borders to neighboring countries have been blocked.

Vasileia Digidiki: A series of regional political developments in Europe stranded people for more than a year in Greece and now they’re not able to leave Greece to go further to the countries of Central and Northern Europe. So for a year now they are forced to stay under very perilous living conditions without having adequate housing, without having privacy or separation from the adult population within the camps. They face a series of problems, the main of which is the exposure to violence. And we talk about of cases of physical violence, such as violent outbreaks inside the camps. We talk about cases of sexual abuse, of psychological abuse. We notice cases of child marriage. And we also noticed cases of commercial sexual exploitation of migrant children, which is an epidemic right now in Greece.

Noah Leavitt: The result says Digidiki and Bhabha is one of the worst humanitarian crises since the second world war.

Amie Montemurro: The situation for children—many of whom are unaccompanied—is particularly perilous. Because borders are closed, these children and their families often turn to smugglers—who charge exorbitant prices to ferry them to other countries.

Noah Leavitt: In turn many children turn to sex work to pay for smugglers. To put their plight in perspective—a smuggler will often charge thousands of euros—but the report found that the average price of a sexual transaction with a child is about 15 euros. Digidiki calls what’s happening an emergency within an emergency.

Vasileia Digidiki: They come to Greece. They leave war. They try to reach safety. They’re stuck in a country that cannot satisfy and secure their basic rights. And now they have to face very basic violations of human rights. And suddenly they need to find ways to continuing lack of legal migration options. So because of that reason, they try to find resources to continue the journey. And one of the ways to gain financial resources is to engage in illegal dangerous, very dangerous ways, such as the survival sex or the commercial sexual exploitation.

Noah Leavitt: The researchers say the situation in Greece highlights the challenges that many countries face with integrating refugees—especially children—into their countries.

Amie Montemurro: One of the key questions Digidiki and Bhabha want to look at going forward is whether similar cases of exploitation and abuse are being seen in other countries where large numbers of refugees are stuck in limbo. Adding to the difficulty is that it is incredibly hard to quantify how severe the problem is.

Noah Leavitt: Victims of sexual abuse or exploitation often don’t want to report crimes for fear of reprisal—because many times they are living near—or even with—their abusers. Often times these victims feel there is no support system in place to help them.

Amie Montemurro: And unfortunately there are no easy solutions to prevent this cycle of abuse and exploitation until it becomes easier for refugees and migrants to permanently settle in Europe.

Noah Leavitt: What can be done, says, Digidiki is ensure that there is a strong support system in place—especially when it comes to shelters for children.

Vasileia Digidiki: We call them third-line facilities, which are community-based shelters where people can stay within the community and start interacting with the local population to have a normal life. Secondly, we have to separate the efforts to the efforts before the sexual violence, and then respond to the sexual violence. So right now we have a huge gap in sexual abuse services, and huge gaps in cooperation and coordination between different actors to help these children heal. So I think that we need to focus on that also. Find appropriate place and shelters for these children so that they can leave from the camps and they can stay among other children, and second of all, to have trained people to help them heal from the trauma of the war, from the trauma of migration, and from the trauma of exposure to violence.

Noah Leavitt: What’s happening in Greece is a consequence of protacted stays in refugee camps, says Bhabha.

Amie Montemurro: The average refugee will be stuck in limbo for a decade. But as we mentioned earlier—many are not even in camps—they may be in cities, in temporary shelters or even homeless.

Noah Leavitt: And Bhabha says the world must re-think how it responds to those in need by addressing critical issues such as schooling and health care.

Jacqueline Bhabha: So you’re talking about…this is not like three months as a displaced person after World War II. This is a complete different situation. Secondly, our whole model of thinking about humanitarian and refugee migration has been kind of built around a notion of camps. You know, refugees are in camps, or they move very quickly. But actually, these refugees are– I think 60%, 70% are not in camps. The vast majority– I mean, even maybe more that, we could check the figure– are not in camps. They’re in cities. So they’re living without proper provision. And so how does this affect the infrastructure? How does it affect the local population? How does it affect schools? How does it affect housing? So I think that’s another thing. And thirdly, more and more and more of this responsibility– or burden– of course, is being shouldered by countries that are really poor, that are really overcrowded, and that are really struggling with inadequate humanitarian aid. So you have a kind of growing inequality in provision. For the cost of processing one case in a Western country, that budget will cover like 1,000 people in a camp inadequately. So we really have to think about, as Vasileia said, we have to think about relocation, which is within Europe. We have to think about resettlement, which is in the world. But we also have to think about making it possible for refugees to be self-sufficient and self-reliant and integrated, given that the prospects of returning home anytime soon are remote. So I think these are all in a way very different frameworks from when the Refugee Convention was first drafted. And even if you think about the early period of refugee protection– people fleeing the Cold War in Russia, or people fleeing from Cuba– very different situations.

Noah Leavitt: If you’d like to read the full report on the situation in Greece, you can visit our website, hsph.me/thisweekinhealth

Amie Montemurro: And Noah, now we’ll be turning to another human rights issue—one that has been lingering in Europe for centuries.

Noah Leavitt: Jackie Bhabha…who you just heard from…recently co-authored a book called realizing Roma Rights. Along with co-authors Margareta Matache and Andrzej Mirga, Bhabha investigates anti-Roma racism and documents a growing Roma-led political movement engaged in building a more inclusive Rurope. I spoke to Bhabha about the book—and I began our conversation by asking her to explain who the Roma people are.

Jacqueline Bhabha: The Roma people are multinational populations numbering between 10 and 12 million who have originally moved in the seventh century, it is said, from Northern India towards Middle East, and then towards Europe, but who are now mainly resident within Europe. And they are a community that for centuries has suffered from very extreme forms of stigma and discrimination, initially because they were outsiders, initially darker skinned. But now it’s a kind of vicious circle of endemic racism that they’ve experienced.

And so I would say they are a community previously often referred to as gypsies. A community that is of the kind of European communities, the most stigmatized. And one of the things that is remarkable is that even though we have in Europe a very robust human rights regime, which prohibits discrimination as a matter of law, but also as a matter of kind of culture. It’s not acceptable really to make racist comments, generally, with some exceptions.

The Roma are somehow outside that. And it’s often considered fine for people to typecast the whole community as being criminals or as being beggars or thieves. So there is an enormously negative stereotype about Roma. And this stereotype really permeates Roma life.

So the reason why the FXB Center for Health and Human Rights at Harvard, an American research center, focuses on the Roma is because we think of the Roma as an egregious outstanding example of discrimination and racism within one of the richest parts of the world.

Noah Leavitt: What has driven this discrimination? And kind of what forms has that discrimination taken, historically?

Just like with many other communities, not every Roma looks like your stereotypical image or idea of a Roma. But the Roma are a community that have traditions and that have their own sense of belonging. Many Roma speak Romanes, which is their language. And so there’s suspicion, there’s hostility.

And the vicious circle, of course, is that because of a sense of exclusion and real hatred from host communities, Roma have historically been denied opportunities to work. Children have been discriminated in school. They’ve not been allowed to live where other communities live.

And so they are– many– not all, but many Roma are very severely impoverished. And so this is then a kind of self-perpetuating situation where they’re exposed to violence, to hatred, to discrimination from jobs. And so the only work that they can get then is kind of self-employed, very low-level work, which means the community is very, very poorly resourced.

I guess the most egregious forms of discrimination against Roma are two. Firstly, slavery. So slavery of Roma in some parts of Eastern Europe was only eliminated in the middle or late 19th century. So it’s still much more recent than in other parts of the world.

And then I guess one of the most egregious human rights violations the world’s ever seen, which was the Holocaust, Roma were targeted just like other groups were. And hundreds of thousands of Roma lost their lives, something which has not been really adequately recorded or memorialized.

And then to this day, Roma continue to experience discriminations. So for example, we have been working with colleagues in France on problems that the Roma community faces. These are the evictions, which are a recurrent problem in suburbs outside Paris. So police come and want to clear the areas where they’re living, and force people to move on. And so there’s this recurrent cycle of homelessness and encampments and exclusion from a real place of safety or residence.

Noah Leavitt: It’s interesting hearing you talk, because it seems like if we think like in the US, there are a lot of parallels between African-American slavery, institutional structural racism throughout the 19th and 20th century, and even continuing today. Are there any lessons to be learned regarding the Roma by what’s happening in the US, although we haven’t solved everything. But are there any lessons to be learned from that?

Jacqueline Bhabha: That’s a great question. And in fact, that was the question that motivated the book that we were just bringing out, which is called Realizing Roma Rights. One of the big questions was what can the Roma rights movement learn in a way from the civil rights movement in the US? As you say, by no means all the problems have been solved. But at least there have been some big strides in terms of desegregation and integration and real proscription of– proscription as in prohibition– of institutionalized racism.

So what can we learn? And in fact, Roma leadership some time ago approached the legal and other leadership of the NAACP with precisely that question. And I think the answer is twofold. Firstly, the situations are different.

In America, until Brown v. Board of Education, it was actually lawful to segregate. There was nothing illegal about having black schools and white schools. There was nothing illegal about preventing black kids from going to one school or from living in a neighborhood. It was perfectly consistent with the interpretation of the US Constitution.

Whereas in Europe, this is not– so it took Brown v. Board to reverse that and to make this unconstitutional. But in Europe, it is already unconstitutional. So a legal victory is not actually going to change the normative framework, because that normative framework is already in place. That’s one difference.

The second difference, I think, though, is more, if you like, to do with the community, which is that the African-American community– the civil rights movement– really did manage to galvanize over time a very powerful civil society movement, obviously extremely powerful and charismatic and brilliant leadership. And so there was– and then all the marches and all the kind of civil unrest and civil disobedience that led, in a way, to a successful challenge of the racial divisions in the US.

So that has not really occurred in the Roma movement. And I think there are many reasons for that. One, of course, is that the community is very scattered. I mean, so it’s not in one country. It doesn’t always have one language. It doesn’t even share a religion.

So even though people who are Roma have a very strong sense of being Roma, and they share a culture, and many of them do have a sense of a Roma language, it’s a more complex political proposition to build a unified movement. And I think one of the main points that our book makes is that really that is at the end of the day, the only way that redistributive justice is going to take place. It s to take more effective Roma organizing to make sure that community votes, that the community participates, that the community is elected to power. These are still goals which are somewhat remote.

Noah Leavitt: That was my conversation with Jackie Bhabha on Roma rights.

Amie Montemurro: She says that one of the main goals of the Roma rights movement is to mainstream how we think about stigma and discrimination—especially amid a rising tide of xenophobia and anti-immigrant sentiment in Europe and the U.S.

Noah Leavitt: Because of this, there’s a growing push among the Roma to integrate with other minorities or marginalized groups in order to mobilize politically.

Amie Montemurro: But speaking out and becoming politically active is difficult—especially when the Roma are worried about being evicted or harassed.

Noah Leavitt: Bhabha says that one strategy being used by the Roma is to create institutions that highlight their unique culture—such as art—in order to make their history more visible. There is also a growing push to memorialize the injustices faced by the Roma—and there has even been discussion of reparations for human rights violations.

Amie Montemurro: If you want to learn more about the FXB Center’s work on Roma rights, you can visit our website, hsph.me/thisweekinhealth

Noah Leavitt: Coming up next week—we’ll be examining structural racism in the united states—what is it—and how does it affect health? That will be the focus of our conversation with a Harvard Chan alum who’s now working for the New York City Department of Mental Health and Hygiene.

Amie Montemurro: In the meantime, you can always  subscribe to this podcast on iTunes or Stitcher…or listen any time at soundcloud.com/harvardpublichealth