Humanitarian Assistance to Irregular Migrants following Andaman sea

Humanitarian Assistance to Irregular Migrants following Andaman sea crisis 2015: Mercy Malaysia’s Experience Dr Mohammad Iqbal Omar Mercy Malaysia © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Irregular Maritime Migration Southeast Asia region Slide 2 • Primary mode of migration for refugees are by boat in search of economic prosperity, safety and opportunities. • Irregular maritime movement in the region is monopolized by Human traffickers and Smugglers. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Irregular Maritime Migration Southeast Asia region Refugees comes indirectly through Thailand by boat. Their journey begins from Sittwe and Maungdaw; from here, they may stay briefly in Bangladesh or transfer directly to larger vessels that carry them across the seas © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 3

Andaman sea migrant crisis • Malaysia is the preferred final destination for most refugees as Islam is the official state religion and there is already a significant refugees community in Malaysia. • Refugees from Rakhine state begun to trickle into Peninsular Malaysia since mid 1970 s. • This lead to formation of sizable refugees communities in some urban areas in Malaysia which was estimated to be around 150, 000. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 4

Andaman sea migrant crisis Slide 5 • In 2012, widespread intercommunal violence in Rakhine state left 140 000 people, displaced. • 133, 000 IDPs - are estimated now living in IDP camps with limited access to health care, education and livelihood opportunities. • 7 000 people est. – including women and children – have travelled on precarious boat journeys to neighboring countries every month. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Andaman sea migrant crisis • The United Nations High Commissioner for Refugees (UNHCR) estimates that a total of over 150, 000 migrants have left Myanmar on boats since 2012 including 31, 000 departures in the first half of 2015 represents a 34 percent increase compared to the first half of 2014. • Over 1, 100 people are now estimated to have died at sea along this route since 2014, including an estimated 370 deaths in 2015 http: //www. unhcr. org/5396 de 0 f 9. html and http: //www. unhcr. org/555 aee 739. html © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 6

Andaman sea migrant crisis © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 7

Andaman sea migrant crisis Slide 8 • These irregular maritime movements received worldwide media attention during May 2015 when several boats carrying a total of over 5, 000 migrants were abandoned by smugglers in the open sea due to fears related to the increase in crackdowns on human trafficking in the region • Indonesia, Malaysia and Thailand are three primary host countries in the ASEAN region for those migrants. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Andaman sea migrant crisis 10 May 2015 Discovery of mass migrant graves in Thai southern jungle “Crack down” by Thai authorities on smuggling networks Smuggles abandon boats/race to shore Slide 9 20 May 2015 Malaysia, Thailand Indonesia hold talks = statement to “continue uphold responsibilities & obligations under international law” 24 May 2015 Discovery 30 mass migrant graves in Malaysia along Thai border 29 May 2015 17 nations gather to talk about the “crisis” in Bangkok +3, 000 migrants have landed on boats in Malaysia & Indonesia “push back” panic by Thailand, Indonesia & Malaysia June 2015 19 May 2015 Indonesian fishermen rescue 400 migrants on stranded boat in Ache waters 21 May 2015 Malaysian PM announces S&R missions for migrant boats (attached with resettlement conditions) © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Crackdown by all nations, including Myanmar on migrant boats

Andaman sea migrant crisis 2015 Slide 10 5, 543 migrants departed Myanmar and Bangladesh between 10 th May – 30 th July 2015 1, 107 migrnats disembarked in Langkawi and placed in Belantik Detention Centre 2, 796 migrants placed in shelters and immigration detention centres in Indonesia 1, 000 migrants believed to have perished at sea during crisis © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Andaman sea migrant crisis © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 11

Andaman sea migrant crisis Slide 12 • Increase in the number of female passengers on boats, from 10% in first three quarters of 2014 to 14% in last quarter of 2014 and first quarter of 2015. • Boat that landed in North Aceh - 10 May, 584 people. 86 women (5 pregnant) and 59 - children. • Boat landed in Malaysia - 11 May has 1107 people. (111 women and 90 -children • Many migrants women are going to join husbands, or are involved in arranged marriages with those irregular migrants already in Malaysia. • Reports of widespread sexual abuse and impunity at every step of the journey. (Ref: Humanitarian Policy Group/Yayasan Geutanyoe) © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Malaysian shore Slide 13 • 11 May 2015 -Two smugglers’ boats arrive in Langkawi, Malaysia, from which 1, 107 passengers disembark, over 700 of whom are Bangladeshi nationals. • Malaysian government approved this disembarkation on the condition of resettlement or voluntary assisted repatriation within twelve months. • Over the next few days, they were all relocated to Belantik Immigration Detention Centre (IDC) in Kedah state of Malaysia. • All refugees arriving via boat are subject to mandatory detention until UNHCR can assess their refugee claim. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Andaman sea migrant crisis Special Meeting on Irregular Migration in the Indian Ocean’ held on 29 May 2015 in Bangkok • Attended by 17 nations • Malaysia and Indonesia have agreed to provide temporary shelter for the refugees in their respective countries for up to a year, after which the international community should assist to repatriate and resettle the refugee to a third country © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 14

UNHCR & Andaman sea migrants Slide 15 • Despite a history of decades of work in Malaysia, UNHCR lacks any formal agreement with the government of Malaysia on mechanisms for processing asylum seekers and refugees in the country. (REF: EQUAL RIGHTS TRUST IN PARTNERSHIP WITH THE INSTITUTE OF HUMAN RIGHTS AND PEACE STUDIES, MAHIDOL UNIVERSITY) • As such, UNHCR bears sole responsibility for the processing of all asylum seekers and refugees in Malaysia. • UNHCR have recently been granted access to Belantik IDC. The process of registering irregular migrants as Po. C has just started. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Po. Cs registered with UNHCR as of June 2015 © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 16

Slide 17 Mercy Malaysia and Andaman sea migrants • Mercy Malaysia was permitted by Malaysian Government – To enter Belantik IDC ONLY – To join SAR operation of Malaysian Navy to deliver humanitarian assistance if other boat people arrive. • Mercy Malaysia responded by providing short term emergency healthcare assistance. – Primary health care and nutritional support to detainees for about 3 weeks in June 2015 © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 18 MERCY Malaysia & Refugees MERCY Malaysia has been working with “Persons of Concern” in Malaysia since 2004 in collaboration with UNHCR Outreach Clinics Primary Healthcare Number of Patients 1564 1444 Reproductive Healthcare 877 930 700 TB Awareness 600 Vaccinations 202 2004 2007 2008 © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia 2009 2010 2011 2012 150 2013 120 2014

2012 to 2014 1. Mobile medical teams ( 7 medical doctors, 5 health assistants, and 12 community health workers) 2. Delivered health care services to almost 60, 000 patients in 6 IDP Camps 2015 1. MM increased its mobile clinic access to 20, 000 men and boys, 35, 000 women and girls and 28, 000 children under 5. 2. Constructed the Rural Health Centre in one of the camp – catering for a population of more than 5, 700 people – was recently completed. 3. Set up 3 additional static clinics which operate 5 days a week in 3 camps and serve an average of 135 patients a day. WHO HEALTH CLUSTER BULLETIN ISSUE 2 /March 2016

Capacity of 950 is now holding over 2241 detainees in Belantik IDC June 2015 Ø 1107 asylum seekers (717 Bangladeshi and 392 Persons of Concerned) • 203 adult male • 107 adult female • 82 children Slide 20 April 2016 Ø 374 Po. Cs ( 16% of 2241) • 223 males, • 70 females, • 51 boys, & 30 girls. • All Bangladeshi boat people has been repatriated. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 21 MERCY Malaysia Emergency Response Objective: Increase access to healthcare services to the asylum seekers and irregular migrants in Belantik Detention Centre Output 1: Provision of primary healthcare services to detainees Output 2: Provision of deworming services to detainees Output 3: Distribution of “basic hygiene kit” to detainees Date No. of Patients 20/5 28 25/5 77 25/5 450 25/5 5 Timeline: 1 Month Budget: MYR 50, 000 Output 4: Immunization of centre staff Output 5: Psychosocial assessment of children Date No. of Patients 26/5 48 26/5 77 © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 22 Health care for Detainees at Belantik IDC • Primary heath care services was continued by Medical team from MOH. • 2 Assistant Medical officers and 1 assistant pharmacist to provide routine primary care services. Surveillance /3 times a week which was later reduced to twice a week • MOH team is not mandated to provide vaccination program and nutritional program for children. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 23 Health care for Detainees at Belantik IDC • Since July 2015 Belantik IDC appoint one permanent assistant medical officer to run in-house clinic • Our assessment team found that said clinic is ill equipped even to provide primary care ( No Blood pressure set, no glucometer, no dressing sets , no beds for observation etc. ) • Hence patients attendance was less than 10 per day for the whole camp • Cases needing urgent care referred to nearby station hospital or to state referral hospital both are less than 30 km from the IDC © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Common Health issues at Belantik IDC Slide 24 Majority having skin infection especially Scabies Upper respiratory infection No case of severe malnutrition and Beriberi 3 positively identified Tuberculosis 3 cases of positively identify leprosy 1 case of suspected leprosy awaiting confirmation • Screening process for tuberculosis is ongoing • Screening of Leprosy has completed • • • © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Tuberculosis screening in Belantik Ø Risk of transmission very high due to , poor ventilation, hygiene overcrowded and conditions Ø Water shortage in the IDC due to current draught in northern region Ø Very poor ventilation in some of the cells Ø Inadequate screening protocols § Only skin test is done § X-ray only for suspected case of TB and can be done only in health clinic outside the IDC © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 25

Beriberi among migrants Slide 26 In the first half of 2014, 144 Po. C to UNHCR in Malaysia presented with symptoms of beri, compared to a dozen during the period from August 2012 to November 2013. Reached a peak of 37 new cases in February 2014. Ref: Irregular Maritime Movements – UNHCR Regional Office for South-East Asia © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Mercy Malaysia’s longer term plan for boat people in Belantik IDC Slide 27 • Mercy Malaysia’s concluded detailed health need assessment in Belantik IDC ( 13 to 15 April 2016 ) to implement health program for all irregular migrants detained there. Report is being prepared. • This program will be funded by IOM ( RM 1. 3 millions) as a longer-term strategy and operational plan. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 28 Future Program at Detention Centre Goal: Improve the health status of migrants held in detention centres in Malaysia Objective 2: Improve the health status of children in Belantik Detention Centre Objective 2: Increase & improve the provision of medical services to detainees and staff Output 1. 1: Health Screening for detainees & Staff Output 1. 2: Health & Hygiene Education + Basic Hygiene Kit + Dignity & diaper packages Output 1. 3: Immunizati on for detainees & staff Output 1. 4: Provision medical equipment © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Output 2. 1: Provision nutritional food packages to children in Belantik Centre

Challenges Slide 29 • Malaysia not being signatory of 1951 Geneva convention and 1967 New York Protocol • Malaysia lacks comprehensive national legislative frameworks regarding refugee • Malaysia domestic policies and public concerns • Funding • Health, security and education • Issue of root cause ( Push factor) © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Malaysia’s domestic concerns • The growing presence of refugees could worsen the social, economic , political health and security problems associated with illegal immigrants in Malaysia. Ref: RSS Commentary No. 128 – 28 May 2015 /www. rsis. edu. sg © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 30

Tuberculosis on the rise due to irregular migrants in Malaysia © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 31

Recommendations (1) Slide 32 1. To initiate effective search and rescue operations • Indonesia, Malaysia and Thailand to extend their legally mandated search and rescue operations for all maritime movements within their territorial waters • to go beyond ad hoc interception at sea, and set in place regular search and rescue operations. © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Recommendations (2) Slide 33 2. To Allow safe disembarkation • Indonesia, Malaysia, Myanmar and Thailand - all states parties to the 1982 UN Convention on the Law of the Sea - to adhere to their obligations which is to follow customary international law, which requires allowing refugees rescued at sea to disembark safely and safe transfer of all rescued people to temporary official government holding shelters. • Ensuring that alternatives to detention are made available to Po. Cs, such as conditional release © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Recommendations (3&4) Slide 34 3. Right to work • By issuing work permits to all refugees and protecting their workplace rights as set forth in the 16 International Labor Organization conventions already ratified by Malaysia 4. Right to education • Irregular migrant children have no access to government-funded public schools education in Malaysia • Currently UNHCR and a few local CSOs are running private schools for limited number of children of Po. Cs © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Recommendations (5) Slide 35 5. The right to access healthcare Ø Government health care facilities to help unregistered asylum seekers and NOT report to the police or immigration authorities. Ø Government health care facilities to work together with NGOs and UNHCR in a systematic way of helping unregistered asylum seekers get access to healthcare. ( Registered migrants are eligible for 50% discount) © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Slide 36 THANK YOU © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia

Bibliography 1. 2. 3. 4. 5. 6. 7. 8. The Asia Pacific Refugee Rights Network : Submission to the ASEAN Intergovernmental Commission on Human Rights (AICHR) on: Maritime movements of the Rohingya and recommendations to improve human rights protection for Rohingya refugees, April 2016 ASEAN Parliamentarians for Human Rights report The Rohingya Crisis and the Risk of Atrocities in Myanmar: An ASEAN Challenge and Call to Action ; April 2015 Fahisham Taib (2011)INVISIBLE, VULNERABLE AND MARGINALIZED CHILDREN IN MALAYSIA Malaysian Journal of Paediatrics and Child Health Online Early MJPCH 01 -18 -2 -2012 RSS Commentary No. 128 – 28 May 2015 /www. rsis. edu. sg Sarnata Reynolds and Ann Hollingsworth (2015) Field report : MALAYSIA: ROHINGYA REFUGEES HOPE FOR LITTLE AND RECEIVE LESS The European Commission: Humanitarian Aid and Civil Protection department (ECHO), ECHO Factsheet – The Rohingya crisis – April 2015 The Institute of Human Rights and Peace Studies (IHRP) : Equal Only in Name-The Human Rights of Stateless Rohingya in Malaysia; October 2014 United Nations High Commissioner for Refugees (UNHCR) – www. unhcr. org © All rights reserved. Confidential and property of MERCY Malaysia. No part of this material shall be reproduced, copied or published in any form by any means, nor should the materials be disclosed to third parties without the consent of MERCY Malaysia Slide 37