Ismail, N.

Kaur, K.

English

UEL Research Repository at University of East London

 23  I am from Somalia, Mogadishu. I fled my coun-try of origin because of the war and the perse-cutions I was seeing every day. I knew nothing of Malaysia, when I arrived and had no idea how to start living.  I saw that refugee rights, especially access to healthcare, was very limited in Malaysia. Being an educated person with a bachelors honours degree in Public Health, I knew I could support my community. I decided to use my language skills in English and knowledge from my de-gree as a translator in different health clinics, NGOs and hospitals. Here I saw that the Somali mothers seeking treatment were mostly illit-erate, and I wondered if there was a communi-ty role for me in assisting these women and girls. I started conducting health education sessions for community members particularly women and girls by volunteering at the Somali Community Centre. I also worked part-time with Health Equity Initiatives (HEI), a local Ma-laysian NGO, as a community health worker to help refugees with mental health problems. After a while I have met my mentor Kiran Kaur, a PhD in Law from Tilburg University. She equipped me with a lot of knowledge on hu-man rights, ethics, and showed in me the po-tential in myself so that I am able to serve my community even more than I thought I could. I have learnt from her a lot of the laws in Malay-sia and the refugee context. All of this allowed me to see how Somali women in Kuala Lum-pur, having escaped violence from the war in Somalia, were still denied access to basic health. Their voices were being hidden and I wanted to do something more about it. During those years, I faced a lot of hardships and felt that the Somali women needed to be more nurtured and empowered. As such I founded a women’s centre named Somali Women’s Association Malaysia (SWAM) in Au-gust 2018, whose vision was to create an ac-tively supportive refugee women circle. We hope  this will empower women and their fami-lies to thrive economically, provide a safe and secure environment. We offer community building services such as counselling and ac-cess to personal development and enrichment.  The goal is to improve the quality of their liv-ing, so that in a longer term they enable to be a self-sufficient, integrate into the local eco-system and effectively overcome the barriers they face. I wanted women to connect with op-portunities and network with one another. SWAM galvanizes access, resources, tools and opportunities that will value-add in creating sustainable changes.  The centre is a private and a safe space for the Somali women and girls thus, I had to continue to work part time in order to pay for the monthly rental from my own pocket. I contin-ued doing so for one year, single-handedly. eventually, these women needed more sup-port, as there are over 200 members regis-tered under SWAM, so giving up my job was necessary and this is how my experience will help.  “The centre is like a second home for us and our children, we come to learn, to heal, socialize, educate ourselves and share our per-sonal problems, It’s a safe place for us to be and it is the heart and soul of our women com-munity” they say. Health Inequities with Somali Women  in Kuala Lumpur  Author Naima Ismail, (Founder of SWAM) Edited with Kirandeep Kaur   24  Health Challenges The Somali women who are asylum seekers and refugees (ASR) face difficulty accessing health care in the host country Malaysia that they often face circumstances in which their health and wellbeing can be compromised. The constant fear of arrest, detention and even deportation pushes these women and other undocumented members underground. Most are reluctant to venture outside and delay seeking healthcare, even in emergencies, in case hospital staff report them to immigration services.  The Somali refugee women have different types of issues that hinder them from maintain-ing a proper treatment. Whether in the public and private clinics / hospitals, there is  always a language barrier, as large number of these women are illiterate. This means they are de-pendent on someone else’s assistance. They are barely able to communicate with the doc-tors. Nor is it acceptable to accompany with a male interpreter from the community as it is al-ways sensitive and shameful for the women to share or talk about their private parts or pain with the male allies in the society.  Another barrier is a cultural stereotype among the Somali community which escalates a gen-der sensitivity as being a women, a fear of cul-tural behavior, a shame based on nowhere among the society belief which women make them deteriorate at their homes instead of sharing their pain and seeking treatment in time. Moreover, residing in a country where it is a non-signatory of 1951 refugee convention and all its protocol is another reason that refu-gee education, work, and health treatment are very limited as refugees recognize as illegal im-migrants making all their rights limited and in-accessible.  Cost of treatment is another main challenge for these women as refugees are not legally al-lowed to work in Malaysia, this opens up doors of refugees’ inability to finance their own treat-ment and determinants of health. The good thing is, there is a 50% discount entitled for the refugee card and under consideration (UC) let-ter holders, which even means that the remain-ing cost of the 50% refugees are yet unable to cover. But, the bad is that there are a large per-centage of asylum seekers holding an appoint-Photo Credit: Naima Ismail and Waheeb.je. Somali women of SWAM   25  ment letter and being registered under UN-HCR who are thoroughly left behind having ze-ro entitlement from the 50% discount, thus they remain the most vulnerable among the community. When these women with an ap-pointment letters submit a health complaints, my capacity is very limited however I do refer third parties NGOs or UNHCR to assist their cases.  Unemployment is another significant concern. Generally refugees in Malaysia work odd jobs called 3D, meaning dangerous, dirty and diffi-cult. Somali refugee women mostly work as cleaners, maid servants, cookers / bakers, and nannies as they are mostly uneducated. How-ever, this covid-19 pandemic making the life worse for refugees. Under the Conditional Movement Control Order (CMCO) movements for refugees especially is severely restricted. Some pregnant women, for example, who re-quire a delivery operation (caesarian) are una-ble to attend the hospital. Others are in on their last stages of cancer and being on chem-otherapy whereas a few others are diabetics and taking insulin twice or thrice daily are find-ing it hard to have their treatment. It is impossi-ble that refugee women cover their medical treatment costs, as most are single mothers struggling to access and maintain the basic meals for the day to feed themselves and chil-dren. Fear of arrest and detention is a primary con-cern for Somali women. The police have always every authority to arrest refugees at any time as refugees in general are recognized as illegal immigrants in Malaysia. However, Somali refu-gee women live as being gender based vio-lence victims whether  from their own spouses or strange perpetrators, in the result of bleed-ing, being beaten with physical injuries or sex-ually assaulted, yet they hide it, for they fear of seeking medical treatment and eventually end-ing up to worsen their injuries suffering more and more that might even possible losing their lives.  Adolescent girls and women of reproductive age reports that the travel experiences during Photo credit: Naima Ismail, SWAM. Crafts for Sale, made by local Somali Women. SWAM sup-ports women to make their own crafts for sale. To encourage entrepreneurship and support them to gain further financial independence.   26  migration, unaffordability of the living costs and cultural practices of the refugee communi-ty affect the reproductive health of female refu-gees. Reproductive health issues are a main leading factor of maternal morbidity and mor-tality, for Somali women. This includes men-strual health issues, reproductive tract infection and sexually transmitted diseases, gender-based violence, poor access to family planning and limited knowledge on reproductive health issues and services. The Somali female refugees are vulnerable to various types of SGBV before, during and after displacement and resettlement resulting in so-cietal, emotional and financial implications. It is crucial to address the family planning needs of women in refugee settings. Unexpected preg-nancies will rise without appropriate accessibil-ity of family planning (FP) and result in an in-crease in unsafe abortion practices; a cause of maternal deaths. A few of the women members under SWAM got pregnant unwillingly and unplanned as these women’s spouses stop them to partici-pate in the family planning, reproductive health workshops and the awareness raisings of those topics. However they come and suffer after pregnancy, as the less knowledge and the per-ception of the Somali mothers led them be less interested and involved in using contraceptive tools and methods of family planning as such they prefer ending up unexpected children with unexpected times while no initial budget planned ahead. Some of the Somali mothers developed differ-ent mental health problems due to a long wait-ing of their processes under UNHCR Neverthe-less, few had passed away with cancer, Tuber-culosis, and other chronic surgery related mat-ters that triggered the long hopeless living as being a refugee in Malaysia for many years.  In the midst of Covid-19 pandemic, some women visit at the centre suffering from do-mestic violence as this pandemic accelerated and opened doors for the perpetrators and women abusers at home, quite a number of mothers are domestic violence survivors cur-rently in our community, however I can assist only those few women and girls who can have a voice and have the courage to come, share, show their pain and suffering. There are times when I have no choice but to take them to my home until further response from NGOs with shelters, making sure these women are safe. Health is a fundamental human right and wom-en rights are human rights. I hope Malaysia will consider health as a first line priority for the all refugees and asylum seekers in the country and funders and NGOs provide platforms and training projects to support those women suf-fering on mental health and reproductive health issues, or try to support the livelihood projects at the centre that required to be fund-ed so these refugee women might at least earn some income. Due to the Malaysian government hosting refu-gees, both refugees and asylum seekers are subjected to discrimination, exploitation and lack protection. As a leader of this organization, I have faced worst as few organizations/NGOs approach me for partnership, never respecting the core value of our community, culture and religion.  Rather they ask for implementation on their projects even when It is not a need of the community. Stating that since we are refugees, we can’t choose. They take photos, videos with-out the consent of the refugee members. In these circumstances I never felt an appreciation or recognition from those NGOs of what I do for my community. The struggle to create change is bigger than I ever thought. I humbly request the sponsors/donors or other NGOs out there to help cooperate and work with me on this hard journey for a good cause.  

Health Inequities with Somali Women in Kuala Lumpur

https://repository.uel.ac.uk/download/7790d6146385b0b837bae0331c02a479a98a5ef859ed11fbf35c10fd11a9106b/615758/Health-Inequities-with-Somali-Women-in-Kuala-Lumpur-by-Naima-Ismail.pdf

Health Inequities with Somali Women in Kuala Lumpur

Abstract

Similar works

Full text

Available Versions

UEL Research Repository at University of East London