Can we solve the migration crisis?

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{***Noah***}

Coming up on Harvard Chan: This Week in Health…

Can we solve the world’s refugee and migration crisis?

{***Jacqueline Bhabha Soundbite***}
(As long as people are living in places where their life or their family’s lives are in danger, they’re going to move. And nobody is going to be able to stop them. You might end up forcing them to take routes which are so dangerous that they lose their life in a different way. But they’re certainly not going to stay incarcerated in a hellhole where they have no future.)

More than 65 million worldwide are currently displaced. In this week’s episode: A conversation about how we got to this point, and the changes necessary to resolve this global crisis.

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{***Noah***}

Hello and welcome to Harvard Chan: This Week in Health, I’m Noah Leavitt.

Every minute 24 people around the world are forced to leave their homes—and it’s estimated that more than 65 million people are currently displaced.

Some of these people are refugees fleeing armed conflicts—such as Syria—while in other cases economic circumstances forced people to migrate.

And many times, those forced from their homes are stuck in limbo—in squalid refugee camps. In other cases, new arrivals face harassment and threats.

In this week’s episode we’re speaking with Jacqueline Bhabha, Professor of the Practice of Health and Human Rights at the Harvard Chan School and Director of Research at the FXB Center for Health and Human rights.

I spoke to Bhabha about the myriad factors driving the current refugee and migration crisis, how rising nationalism and xenophobia worldwide is affecting migration, and the policy changes needed to build a better global migration system.

Bhabha writes extensively about this in her new book, “Can We Solve the Migration Crisis?”—and we’ll have a link to that on our website, hsph.me/thisweekinhealth.

It’s important to note that this interview was recorded before the full scope of President Trump’s “zero tolerance” policy of separating migrant children from their parents was realized.

While Bhabha didn’t discuss the since-reversed policy, we do have a Q&A with her up on our website.

She also told us that she’s interested in exploring how she and other researchers can assess how these border separations may affect the development of young children.

But now let’s jump into our interview. And I began by asking Bhabha to provide some historical context for the current refugee and migration crisis.

{***Jacqueline Bhabha Interview***}

NOAH LEAVITT: So I wanted to start– I thought one of the things that I found really useful from this book was kind of early on you set the stage where you put what we’re seeing with the current migration crisis in context with past historic migrations. So for people who may be wondering, how does what we’re seeing now globally stack up with what we’ve seen elsewhere in the 20th century, and even earlier than that? How does this crisis fit into that historical context?

JACQUELINE BHABHA: One of the main arguments I make in that section of the book– the first part of the book where I talk about the historical continuities– is to really make the point that migration has always been a feature of human society, right from the very outset. And that point really has two elements.

One is that therefore we’re all mixtures. There is no pure origin person link anywhere, because people have been moving and evolving and intermarrying or interrelating ever since the start of human history. And so I think that’s a very important point. And I point out in the book how will we know this from the early migrations from Africa– which is where the kind of start of human migration happened– right across the globe in different ways.

Another point I think– which also comes out of this historical survey– is that there have always been different types of migration. And of course, these are not categorically separated silos. But people have moved to flee persecution, or war, or danger. People have moved for opportunity where perhaps that land or their space was not adequate to service their needs. People have moved for conquest, because they wanted to dominate, or proselytize, or both. And then people often move for trading, or for maybe more what they consider to be more short term goals, which will then may or may not end up being long-term goals.

So you have this layering of different migration drivers, which I think is also historically omnipresent, and very interesting. For me, the historical kind of longue durée— the historians say this long picture– is important, because those of us who work in the migration field tend to be very present-ist. We really think maybe in the last 20 years max. And more like of the last year only. And so the flows of people that we see are always set in this very narrow context.

So one of the things I point out in the book is how there’ve actually been enormous movements of people in short spaces of time at certain periods, and over different boundaries. I also point out that we have– we in the academy, or in the migration advocacy community– have tended to focus very much on certain types of migration, and very much neglect others. And so there’s a lot of work now showing that migrations in Asia, for example– from China, up north, through Central Asia and Russia– have been every bit as significant as massive as what we think of as the classic kind of European to America and transatlantic migration, or the migrations from Africa. So in other words, there are these multiple flows at different stages, which we really need to take into consideration.

NOAH LEAVITT: And so we talk about the different drivers of migration, whether it’s the stress, like fleeing a war, economic, et cetera. How does understanding the different types of migration play into formulating responses?

JACQUELINE BHABHA: Our current regime tends to dichotomize migration into two big categories. On the one hand, we think of people who are refugees, who are fleeing conflict or persecution, who have an international right to some form of humanitarian protection. So the notion here is that even if you’re not a citizen of a country, you have some sort of right of protection by virtue of your humanity. And that’s something that dates back a long time, but in our modern period it really stems from World War II. So that’s the kind of forced migration refugee camp, if you like.

And the way the argument goes is on the other side of the spectrum is what people often refer to as economic migration. Migration which is not forced, which is not distressed, migration which is chosen in order to improve your opportunities, or to have a better life, however you define that. And so the sense is here you have no right to demand entry somewhere. As a refugee, you have certain rights. In particular, the right not to be sent back to somewhere where you would be persecuted.

But as a migrant, you don’t have any absolute right to say, I need to enter your country to get a better job. And so countries have the power to give you a visa, or give you permission to enter, or refuse that. So that’s the way in which we have thought about this sort of big distinction.

So the drivers which stem from threats to your life, or your basic safety, determine one set of outcomes. Drivers which stem from personal aspiration or choice determine another set of outcomes. And that’s the way we thought about it.

One of the points I make in the book repeatedly is this dichotomy is very flawed. And it’s not just my point. Many people have acknowledged– many agencies have acknowledged now for decades– that really a very large share of migration is what’s called mixed migration. In other words, you have elements of distress and compulsion, and elements of choice and personal election, if you like.

And so we need to really try to think of ways in which people who are moving for multiple reasons– like all of us do, because life often is determined by multiple motivations– that these people also have access to some of the protections, and the safeties, and the guarantees, and the rights that people who are only moving because they’re fleeing persecution have.

NOAH LEAVITT: And you talk a lot about the rise of nationalism, the rise of xenophobia, How big of a barrier is that to getting to that point where migration is viewed– I guess as you said– not categorizing into one category or other, but just kind of viewing human migration on a whole, and making policies that support that? So how is the rise of nationalism that we’re seeing providing a barrier to that eventual goal?

JACQUELINE BHABHA: The rise of nationalism and of xenophobia and of real hatred for the other is, of course, having an enormous impact on policy. And we see this in many ways, and in many places. So it’s not confined to one country, or even one continent, or one region.

We see a growing sense of nativism maybe best encapsulated by somebody like the Prime Minister of Hungary– Viktor Orban– who talks about the fact that Hungarians are a Christian nation, and that they have nothing in common with Muslims, with outsiders. They don’t want them, they don’t need them, and there is no space for them. That sort of view is now, of course, widely diffused in parts of Europe, and also elsewhere, as I said. In Australia there are people who have these views. And of course in North America we’re hearing a lot in this same vein.

So those sort of political views, of course, lead to and determine policies, which have a very negative effect on migrants of all types. Not just migrants who are choosing to move, but also on refugees. And so we’re just now seeing stories of refugees not being allowed to land, being forced to move from place to place. Even when it’s quite clear that they’re fleeing very serious harm and very serious danger.

I think one thing that we haven’t addressed adequately is really understanding what the causes of this new rise in xenophobia are, and why we’re witnessing so much of it now, at this particular time, when there is relative prosperity, when we don’t have the total economic desperation that we’ve seen in past times when there’s been a massive rise in xenophobia. And I think one major factor here is the failure on the part of governments and policy makers to really address the uneven responsibility that comes with accommodating new arrivals. In other words, when large numbers of people arrive– say as refugees– in a particular place, there tends to be a concentration in particular areas. And very often those areas– like many other spaces– are hospitable initially, and generous, and welcoming, and have human compassion for the other.

But then if the responsibility– some call it the burden– of supporting migrants who are refugees– continues to be limited to a particular area, without adequate outside support, then of course resentment starts building up. And there’s a sense of intolerance, and a sense of exhaustion, and a sense of resentment and hostility, as I say.

So I asked really what’s happened in very large measure, both in some localities– within districts, within countries– but also in some countries vis-a-vis other countries. So if you take Europe, the burden or the responsibility of hosting refugees from Syria, refugees from other places, has been massively maldistributed distributed. Resettlement across the continent– which is after all, a massive continent with lots of space– resettlement has been extremely limited.

And so you see a gross disproportion in the impact that migration’s had on different communities. And I think the same can be said elsewhere– including probably in this country– that the burden or the costs of certain types of changes are borne disproportionately. And so a failure to address that is inevitably going to make people receptive to nationalist and xenophobic views.

And so these views then– just to conclude– of course, do underpin policies which make it very difficult for people to access protection. They make it difficult for people to cross borders legally. They lead to a situation in which the only way you can really move is by doing so surreptitiously, or by hiring commercial, often criminal agents to help you cross the border.

NOAH LEAVITT: So it sounds like what you’re saying in a sense is that one of the best ways to combat this is to improve the system of migration at its core. So that when migrants are coming into a country, they are not– as you say– only congregating in one small area of the nation. So I guess that’s interesting, where the best way to combat it is to make it easier for migration to occur. But I imagine that’s probably a pretty tough needle to thread for governments and policymakers.

JACQUELINE BHABHA: So there’s a whole process going on now– which I allude to at the end of the book– within the UN and broadly within many state’s parties– where they’re discussing a new model for considering how to deal with migration. And it takes shape within the context of something called a Global Compact. So these two global compacts– one on migration and one on refugees– that the UN is producing and are meant to be delivered to the General Assembly in September of this coming for September 2018.

And the idea here is that the refugee crisis– the large unregulated flows of people– have shown up several dramatic weaknesses which need to be addressed, and need to be addressed through better procedures, as you say. And one idea is– and one now goal of the international community– is to make migration safe, legal, and regular for a much larger cohort of people. So in other words, not to have the division that we have now where a small– not so small– but a group of people can travel very easily across borders with passports, and with money, and with arrangements made for where they’re going to go, and welcome on the one hand. And on the other hand, other people who may have equally good cause for crossing a border have enormous difficulty and suffer considerable hardship.

So the idea is to increase the access to safe, legal, and regular migration. It’s one of the Sustainable Development Goals, the new Sustainable Development Goal Agenda. And so I think there’s a lot of useful work going on thinking about how that can happen. As you say, it’s difficult to imagine a situation in which states are going to just say, oh, come on in. Let’s make it as easy as possible. But it’s not so difficult to imagine a situation in which states say, we have demographic needs. We need workers in these areas of the economy. We need to be training young people for these sort of competences. We have an educational system where, given declining birth rates, we have spare capacity. So why can’t we do a better job of regulating how people come in, what status they have, what supports they get?

And this is a system which could be a very rational system. We saw it in on a relatively small scale in Europe. When Europe established freedom of movement within the continent, at the outset there were all these cries about how dramatically dangerous this would be, and how every kind of poor Spaniard, or Portuguese person, or whatever would migrate up to Scandinavia. And of course, that hasn’t happened. The opposite has happened. And actually, many northerners have tended to come from the south.

But the point is that people move for rational reasons, and people will move where there are jobs, or opportunities, or safety. And this could be mutually beneficial. But as long as we insist and ensure that large portions of people can only move irregularly to fill jobs where jobs are needed, we are perpetuating a system of gross inequality.

NOAH LEAVITT: And I know you write– you give in the book this example when people say like, the system is broken. Well the visa system, there are all these examples of international travel that do work well. So I mean there are lessons to be taken from the implementation of things like that that can be applied to migration?

JACQUELINE BHABHA: Absolutely. I think that we could do it much better. And I think there are many models that we could adopt for having, for example, much more efficient and upscaled blue collar or unskilled worker visas. We know many, many jobs which are open for people with no skills, or few skills. I mean in terms of educational training. And those people have the hardest time actually getting visas, which is completely paradoxical. And so what it means is that many of those people are working undocumented, illegally, exploitable. Which of course is convenient, but should not be a model for just states.

Secondly there are ways of creating regional polities or exchange programs– again– where you have a virtuous cycle. And I give in the books some examples of the European context, where there have been very successful educational exchange, something called the Erasmus program, where millions of young Europeans have had the opportunity of studying in universities, away from their own countries, and benefiting enormously. And in the process, also developing a kind of more cosmopolitan European identity and consciousness. Those are win-win situations. And there’s really no reason– I argue– why that shouldn’t happen on a much broader scale.

NOAH LEAVITT: And so I know a lot of this is about addressing the current and future movements. But I know you also write about addressing the drivers of migration itself. Whether it’s conflict, whether it’s climate change, and viewing it from that lens. So how important is that to also, while looking at ways to improve the system, also think about ways to alleviate those conditions that force people into migration? And for example, climate change is something we’re probably going to see more in the decades ahead.

JACQUELINE BHABHA: I think it’s essential that we realize that migration is part of a much broader set of social and political economic phenomena. People who think that you can regulate, control, manage migration by just focusing on migration I think are completely misguided. So I do make the point that migration is one element of a response to big phenomena that we need to address better. And I do point out several of these phenomena, and briefly address what might be done. So conflict– I argue– is one of the biggest drivers.

And we’ve seen it again and again. As long as people are living in places where their life or their family’s lives are in danger, they’re going to move. And nobody is going to be able to stop them. You might end up forcing them to take routes which are so dangerous that they lose their life in a different way. But they’re certainly not going to stay incarcerated in a hellhole where they have no future. So addressing conflicts more productively, thinking much more carefully about diplomatic solutions to potential heart war I think is absolutely essential.

And I quote in the book the depressing statistics that actually– despite perhaps appearances to the contrary– the numbers of conflicts are increasing. And we have lots of situations where there is explicit and pernicious use of weapons and danger. And I think with the delicate stage of world leadership at the moment, we may see more of this. So that’s the first point. That I think is much more successful in serious engagement with the drivers of national and regional conflict is absolutely essential.

Secondly I do talk quite a lot about environmental harms, and disasters, and humanitarian emergencies. Because I think these two– which are in some cases related to conflict, and in other cases not– are also preventable in many cases, and our drivers of massive distress, migration flows. So where you have dessertification of large areas where previously arable fields no longer are arable, or where you have massive changes in land tenure which lead to flooding, or lead to other types of changes which make places uninhabitable again, you’re going to find huge dislocations of populations.

And this is an enormous problem that people have been thinking about for some decades. And there are some policy measures in place already to address some of the most key and vulnerable areas. But the political will to sign on to taking responsibility for people who are from a particular country is still tenuous. And so I think a lot more work needs to be done, both ideally in reducing the drivers of climate change, but also in addressing environmental refugees, of whom were going to see millions more.

NOAH LEAVITT: So what would success look like? Not just for the tens of millions of refugees and migrants currently, but in the decades ahead. As you said, this is a long-term problem. So what would success– like how would we measure it? And how would we measure success?

JACQUELINE BHABHA: For me, success would have various elements. One element would be a much greater general investment in just systems. In systems which treat people with dignity, which don’t discriminate on the basis of race, or nationality, or sexuality, or whatever, or economic status. Systems where people who are crossing borders could expect a reasonable interface with the border officials that they encounter.

Secondly I would think that success would include systems for promoting virtuous exchange. So as I mentioned, access to work in areas where labor force is needed, and where the domestic labor force is inadequate. But legal access and rights space access, I think that would be very important.

I think success would look like a system in which people’s needs and people’s aspirations could find an outlet which was safe and acceptable to the political powers that be, and which wasn’t going to be a driver for hostilities. So I think governments and states need to think much more thoroughly about what inclusion looks like. It’s not just the border crossing, it’s not just facilitating the visa for the unskilled worker, or the university student, or the apprentice. It is also thinking about what communities need to do to integrate newcomers, and how inclusion needs to be a two way process of really reconfiguring who we are. And that’s always a process of change. So for me, success would be a much more inclusive conception of belonging, which really accepted the reality that our societies are increasingly diverse and increasingly drawn from different origins– geographic, social, religious– and that that’s a strength.

I think that one of the positive things about the current difficult climate we’re in is that there is– at least in some quarters– acknowledgment that migration is a positive asset. The whole Global Compact procedure is based and premised on that assumption. And I think even in the Sustainable Development Goals, there’s a strong statement about the value of migration. The fact that migration is a positive force. It’s not a threat, or a security hazard, or a negative detraction from national pride. And I think that’s very important to build on that, because of course there are many forces pulling in the opposite direction. But I think this notion that migration is a virtuous opportunity for exchange and for collective growth is something we need to build on much more.

NOAH LEAVITT: And I wanted to actually end with that, because as you said at the beginning, we all come from somewhere. The history of migration is so long. So how do we– in public health, governments, policymakers, media– how do we better communicate that value of migration? Whether it’s economic, social, et cetera, how do we better communicate that?

JACQUELINE BHABHA: I think we do that in various ways. One is I think to insist that the responsibility for migration must be equally shared. I think many of us who lead relatively privileged lives have very little idea of what it’s like to have your whole neighborhood changed overnight, with no support. So I think that’s a responsibility that we all have, to actually share the initial costs of new arrivals. I think there is a transitional period of maybe 5, 10, maybe up to 15 years in which people adjust to a new place. And then life goes on as normal, and people become part of the polity. So I think that’s a very important contribution.

I think in public health where we do think about preventing harm, and we think about social determinants of ill health, and failure to thrive, or social determinants of health and well-being, I think it’s very important to think about the social determinants and the preventative possibilities when it comes to racism and xenophobia. How can you avert a predictable decrease in people’s quality of life through racist attacks, or through hatred? So how can we build a sense of inclusion?

And I think we can do that, of course, through education. We can do that through exposure, through projects which build the resilience of communities, and which provide support to vulnerable communities who would otherwise be forced into maybe more risky and potentially negative behavior choices. So where people have good choices and have the social support they need, then you’re onto a much more virtuous cycle.

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{***Noah***}

That was my conversation with Jacqueline Bhabha about the global refugee and migration crisis.

If you’re interested in purchasing her book—or reading that Q&A on border separations—you can visit our website hsph.me/thisweekinhealth.

And a reminder that you can always find our podcast on iTunes, Soundcloud, Stitcher, and Spotify.