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Children

No Childhood At All
Film: 1997
Director: Sam Kalayanee
Producer: Sam Kalayanee
Distributor: Images Asia, Witness
Runtime: 30 minutes
  Abstracted by: Ellen Jorgensen [2010]
Abstract:
12-year-old twins stare into the camera, with a devil-may-care attitude and an AK-47. They are co-commanders of a battalion in a Burmese rebel army, known as God's Army. They have been soldiers for three years, in one of the many heavily armed ethnic groups fighting against the Burmese dictatorship, for the last twenty years.
  In Burma, and surrounding countries like Thailand, children have been severely affected by the war. In the Burmese military alone, approximately 70,000 children serve as soldiers. The state is entrenched in permanent conflict and abject poverty. The director, Sam Kalayanee, presents the story of Burma in the 1980s and 1990s, through interviews, graphic photos, and video images of internally displaced persons and refugees, specifically children. It is a matter of great urgency, as the region has one of the world's highest numbers of child soldiers both in government forces and ethnic guerilla groups. Refugee children are forced to work as slaves in hard labor, serve as child soldiers, or human shields in mine sweeps, or are raped and tortured. Girls often end up as slaves in sweatshops or brothels in neighboring countries, while young boys are handed guns, uniforms, and marching orders.
  For an IDP, life in a uniform is often seen as safer than living as an unarmed villager, and provides a secure avenue for food. Refugees often join the army, mostly to avenge abuses. Although a child is seen as the most precious human possession in Burmese folklore, this documentary shows that many children have known nothing but killing. Violence is an accepted, normal way of life. As the filmmakers show, these children have no childhood at all.

Health

Beyond the burqa: addressing the causes of maternal mortality in Afghanistan
Forced Migration Review, 2004, no.19, pp. 81-89(9)
del Valle, H.
Abstracted by: Teresa Braun
Abstract:
In this article, Herman del Valle, a humanitarian affairs officer for M"dicins Sans Fronti"res (Doctors Without Borders), examines the status of Afghanistan's reproductive health system in the post-Taliban era and the programs that have been implemented thus far by the United Nations (UN) and non-governmental organizations (NGOs). He addresses the restrictions in access to health care for women that existed under the Taliban regime, resulting in one of the highest maternal mortality rates in the world, and the focus that subsequent programs have given to gender inequalities as mechanisms for trying to reduce these rates. However, such programs have not had the anticipated improvement on maternal mortality rates, leading to the need for a less one-dimensional approach to the issue. Del Valle lays out three reasons for the failure, thus far, of a women's rights-based approach to alleviating high maternal mortality in Afghanistan. First, he points to the change in access to reproductive health care being regulated by restrictive government policies and legislation to being more greatly influenced by culture and traditions, which are much more difficult for outsiders to advocate against. Second is the context from which Western workers approach women's rights as a tool for improving health care, which he argues must be questioned as an effective tool given its tendency to be at odds with tradition. Third, even more important than culture and tradition preventing women from accessing health care, is the lack of infrastructure and health facilities in Afghanistan, as those facilities that do exist are under-staffed, under-equipped, and extremely difficult to reach via roads and existing transportation networks. Compounding these infrastructure issues are the large numbers of returning Afghans living in temporary services outside of Kabul, along with officially-recognized internally displaced persons (IDPs). These two factors have combined to result in a programmatic approach of quick impact projects, often being implemented in the limited space of IDP camps, that deal with safe environments and health education initiatives that do not prove to be sustainable or have a long-term impact on maternal mortality rates. Del Valle stresses the need to combine initiatives focused both within camps and the rest of the country, especially in rural areas, that allow for comprehensive restructuring and support of the Afghan administration in developing a nationwide infrastructure and policy. He stresses the need to meet four conditions in order to address the needs of IDPs and the general public. Reproductive health should be incorporated within a larger public health plan that is sustainable and accountable to the public, not just dependent upon NGOs. Linked to this is the need for support of the Afghan administration in delivering care and supplies, developing an infrastructure and building capacity in both rural and urban communities. Strategies to reduce maternal mortality, which incorporate the necessary equipment and staff, must target all three levels: pre-natal care, assistance during deliveries, and post-natal care. Finally, basic needs in rural and urban areas, including safe water, nutrition, and security, must become a priority. The failure to reduce maternal mortality rates cannot simply be attributed to, and excused by, entrenched social cultural traditions that diminish the importance of women's health. The national and international communities must work together to rehabilitate the Afghan health system, including reproductive health services.

Understanding Mental Health Needs of Southeast Asian Refugees: Historical, Cultural, and Contextual Challenges
Clinical Psychology Review , 1 May 2004 , vol. 24, no. 2, pp. 193-213(21)
Hsu E., Davies C.D., and Hansen D.J.
  Abstracted by: Cindy Bosley
Abstract:
Providing mental health services for refugees is challenging for many reasons, most notably language and cultural barriers. Many clinicians tend to make generalizations about refugees as one group, and still others group large geographic regions of refugees together (i.e. Asians). This article explores the historical, cultural, and contextual challenges of providing mental health support to Southeast Asian Refugees (SEARs). After exploring these challenges, the authors then give an overview of common mental health problems among SEARs, followed by an outline of clinical implications. This information is obtained from a variety of prior research over the past 25 years, including numerous clinical research studies. The authors' primary conclusion is that the complex background and experiences of each individual SEAR must be thoroughly examined if any treatment of mental health problems is to be effective. Examining historical factors is important because the type of loss or trauma that a refugee has faced can influence their mental health problems (and associated symptoms) as well as their reactions to treatment. Thus, historical factors should be taken into account during diagnosis and treatment. Cultural factors will also affect the types of mental health problems and their reactions to treatment, but these factors will also influence refugees' attitudes towards treatment and clinicians in general. For example, children and adolescent SEARs often learn English very quickly and thus acquire large responsibilities within their family. Because this runs counter to the value of respecting and obeying elders, SEARs often develop mental health problems because of their conflicting roles within the family. These, and other issues such as gender roles, sexuality, and religious beliefs, must be taken into account when diagnosing and treating SEARs. Contextual factors in the resettlement process can include financial strains, language difficulties, the employment situation, discrimination, safety, and others. These challenges must also be explored to develop a holistic picture of SEARs and their mental health situation. The most common mental health problems among SEARs are depression, anxiety, posttraumatic stress disorder (PTSD), adjustment disorder, and somatization of mental problems. The authors provide numerous statistics of various mental health problems among particular groups with Southeast Asia , as well as statistics among Southeast Asian youth. Resilience against mental health problems among SEARs can be attributed to factors such as language proficiency, presence of close family members, social support networks within the ethnic community, and others. Based on these examinations of the common mental health problems and associated challenges, the authors conclude with an assessment of clinical implications. These implications include recommendations for assessing mental health problems and for treating mental health problems (long and short-term). The primary recommendation of the authors is to approach each patient (or potential patient) as an individual, and explore the often complex situation of each SEAR. Classifying all SEARs into one, monolithic group will only lead to false generalizations, errant diagnoses, and ineffective treatment.

Human Rights

The Perils of Being a Borderland People: On the Lhotshampas of Bhutan
Contemporary South Asia, 2010, vol. 18, no.1, pp 25-42.
Evans, Rosalind
  Abstracted by: Trishna Shah [2010]
Abstract:
In this article, Evans expounds on Baud and van Schendel's approach of considering the perspectives and active roles played by people living in borderlands, in protecting their distinct cultural and social identities in the nation-state. It presents an overview of such a struggle by the Lhotshampas or ethnic Nepalese of Bhutan through their own perspectives and narratives.
  Evans outlines the history of the migration of the Lhotshampas from Nepal and Darjeeling, to the southern border area of Bhutan from 1865-1930. As the Lhotshampas differed significantly from the native Bhutanese population or the Drukpas, they were isolated, treated as non-citizens, and overtaxed. During the 1940s and 1950s, the Lhotshampas appealed for their political and civil rights and the government made efforts to address their needs.
  However in 1989, the Royal Bhutanese Government (RBG) adopted the policy of "one nation, one people" based on Driglam Namzha or the traditional Buddhist code of dress and etiquette, to homogenize the Bhutanese population and build a uniform national identity. In the article, the Lhotshampas" narratives illustrate their struggle to resist the policy and preserve their own cultural customs and traditions. In turn, their resistance was perceived by the RBG as their ineptitude to identify with the native Bhutanese population, which posed a significant threat to the national integrity. This mistrust was further magnified when violent separatist movements gained momentum in India and Sikkim, and revolutionary organizations were also established in Bhutan. Refugee accounts reveal how the revolutionary organizations used brute force and intimidation to coerce the Lhotshampas into joining the revolution against the government. Thus, the Lhotshampas became embroiled in the conflict between the government and the revolutionary organizations.
  Following several violent movements and unrest, an estimated 80,000 Lhotshampas were forcibly expelled or fled the country to settle in refugee camps in southeastern Nepal. Evans further highlights the social, economic, and psychological problems faced by these refugees as they lived in the camps for a protracted period of time, before they were granted third-country resettlements.

Refugees

Afghan refugees and their general practitioners in The Netherlands: To Trust or Not to Trust
Sociology of Health and Illness, 2007, vol. 29, no.4, pp. 515-535(21)
Feldmann, T., Bensing, J., de Ruijter, A. and Boeije, H.
Abstracted by: Katherine Courtnage
Abstract:
Health can positively or negatively affect the overall experience that refugees have post flight in their country of settlement. Feldmann et al research the effect that general practitioners have on resettlement and health in the population of Afghan refugees in the Netherlands. In a study encompassing 32 people, using semi-structured interviews, Feldmann et al gauged whether refugees had a positive or negative experience with their general practitioners and how this affected their individual health and integration into society. The authors look at two types of resources that aid refugees in resettling successfully: personal resources and social resources. Personal resources include a sense of control, ethnic pride, time perspective, and level of acculturation" (p.516). Social resources encompass the relationships that people have either within their ethnic group or in the community as a whole. General practitioners fall into the category of social resources.
The main component that affects a refugee's experience of health care is their level of trust in their general practitioner. The study found that refugees that had a positive experience with their general practitioner gained trust in the health system while those that had a negative experience had a negative opinion of the health system, lacked trust, and often had more health problems. Examples of positive experiences included a general practitioner that was perceived as friendly, listened, and quickly gave referrals that addressed the illness. Incidents that caused a negative reaction included perceived rudeness, slow diagnoses, a feeling of not being taken seriously, and unjustified psychological explanations. Narratives of Afghan refugees showed a trend regarding experiences, in which a relationship with the general practitioner could end in one of four ways: the experience could be only positive, only negative, positive in the past but now negative, or negative in the past but now positive.
Beyond trust, the social resources of a refugee also influences whether they have a positive or negative experience. In the study, Afghans that had connections to Dutch society were more likely to receive appropriate care. Likewise, if the general practitioner acted as a positive social resource then the refugee often felt more acculturated into society. The perception of health care in general also has an affect on the experience of the refugee. When Afghans heard stories from their friends and family it biased their view of the health system. If the stories were positive it could promote trust and positive views, but when the stories were negative it reiterated already pessimistic views.
Feldman et al. stress that health plays a crucial role in the resettlement process of refugees. Therefore when negative experiences occur it is cause for great apprehension and concern. Refugees must trust the health system enough to believe that if medical care were needed they could get it. When that trust is not there or prejudice occurs it causes problems in resettlement and can undermine the health system as a whole. It is necessary for health care workers to treat their patients in a humane and friendly manner where shared decision-making is part of treatment.

Exploring Identity, Culture and Suffering with a Kashmiri Sikh Refugee
Social Science & Medicine, 2007, vol. 65, no. 8, pp. 1654-1665(12)
Aggarwal, Neil K.
Abstracted by: Ellie Azoff
Abstract:
Refugees and internally displaced peoples face the issue of how their identity is altered and shaped through their experiences. In his article, Neil Krishan Aggarwal attempts to explore this identity shift within the context of those who have suffered persecution in the past and are now living in a contained structure such as a refugee camp. Aggarwal also aims to explore how researchers and service providers, such as anthropologists and psychologists, can ensure the accuracy of the interviews they undertake by abstaining from tainting those interviews with their own personal biases. Aggarwal draws his conclusions based upon one interview with a displaced Kashmiri Sikh living in a migrant camp outside of the city of Jammu.
Aggarwal begins by explaining the political structure and social problems that have existed in the states of Jammu and Kashmir. He then goes on to reference the abhorrent conditions of many of the migrant camps located outside of Jammu. The author creates through his descriptions what he calls "local worlds." He describes these "local worlds" as camps that maintain certain cultures of their own because they are so isolated from the mainstream culture. In this case the "local world" is a refugee camp just fifteen kilometers outside the city of Jammu.
It is within one of these camps that Aggarwal interviews a man he nicknames Singh Sahib. During this interview Aggarwal makes an interesting discovery; Singh Sahib identifies himself both as a Sikh and a Hindu. The author notices that the man obviously identifies as a Sikh first, Hindu second. This is strange, the author explains, because most Sikhs would reject the idea that they are part of a Hindu sect. Singh Sahib continues to speak of his duel religions and invokes a religious story that involves Hindu, Sikh and Muslim identities to explain his current situation. Aggarwal finds this alarming, as the tensions that caused Singh Sahib's displacement are products of religious and cultural differences.
In an effort to understand the statements of Singh Sahib Aggarwal assumes that part of Sahib's identification with both Hindus and Sikhs stems from living in his unique "local world." Sahib can identify with the persecution of both the Hindus and the Sikhs as they live communally within the camp. Therefore, in his "local world" Sahib is exposed to diverse religious practices and is thus able to identify with both Sikhism and Hinduism.
To contend with the issue of biases that may exist in the work of anthropologists and psychologists Aggarwal uses his own personal identity as an example. He is an Indian-American Hindu with Sikh heritage in his background. He explains that his own inability to contend with these issues may have stopped him from asking more in-depth questions or exploring the issue further. The author describes these types of biases as "transference" and "intersubjectivity." Within these themes he also explores how his own background may have made Sahib more reluctant to answer truthfully and extensively, thus altering Aggarwal's own perception of Sahib's religious beliefs.
Finally Aggarwal comes to the conclusion that culture and religion are tools for coping and that people use their religion as a comfort zone when times are bad or they have experienced suffering. Aggarwal uses Singh Sahibs religious story to demonstrate that religions provide Sahib with a sense of order, which is why he invoked all three major religions of the area within his story. Sahib has formed his own culture within his own unique world and Aggarwal postulates that this may be a phenomenon within refugee camps worldwide. Refugees and IDPs are removed from their homelands and surrounded by new cultures and religions. As a way of coping with these new experiences people may begin to bend and mesh these cultures to provide themselves with a sense of order and identity. Aggarwal maintains that service providers must acknowledge this identity phenomenon without entering into relationships with clients with preconceived notions of religion and culture. We must understand that each refugee camp experience may be different in key ways.

The Geopolitics of Afghan Refugees in Pakistan
Refugee Manipulation – War, Politics, and the Abuse of Human Suffering, Stedman S., Tanner F. (eds.), 2003, pp. 57-94
Grare F.
  Abstracted by: Marie E. Ott
Abstract:
Manipulation of refugee populations by the host country’s government and/or other groups is not uncommon during conflicts. President Zia-ul-Haq of Pakistan took advantage of the large Afghan refugee presence in his country in order to improve the economic and political security in Pakistan. The refugees’ participation in resistance against the Soviet occupation in Afghanistan was a vital part of this plan to serve Pakistan’s geopolitical objectives. This article explores how the Afghan refugees became a vital part of the resistance against the Soviet occupation in Afghanistan while strengthening the geopolitical position of Pakistan. Unlike other cases of refugee manipulation and refugee camp militarization such as Rwanda and Cambodia, the Afghan refugees had a greater freedom to choose to participate in the resistance. Additionally, the refugees’ resistance was seen as legitimate by the international community. The article presents the causes of Afghan refugee flight into Pakistan as well as the environmental, economic, domestic security and geopolitical threats that Pakistan faced by hosting the refugees. Pakistan’s policy toward refugees was a key factor in the political manipulation of the Afghan refugees by President Zia-ul-Haq. The Pakistani government did not want the primarily Islamic Afghan resistance in exile to unite and become too powerful. The government recognized seven separate Islamic Afghan resistance political parties within Pakistan and required all Afghan refugees to join one of the parties. International public opinion considered the presence of these parties as a legitimate form of Afghan resistance against the Soviet occupation, especially since it seemed that the parties had the support of the Afghan population. The international community sent financial assistance to Pakistan in support of its Afghanistan policy and its humanitarian treatment of refugees. The Pakistani government, however, was not able to pursue much longer the manipulation of the Afghan refugees without some consequences. When the resistance parties began to attack each other, Pakistan supported the Taliban and aided the group’s recruitment of refugees to fight for them in Afghanistan. As it became more clear that the Taliban identified with Islamic fundamentalism and had a poor women’s rights record, international public opinion, led by the United States, became critical of Pakistan’s link to the Taliban. In conclusion the article states that it would be ideal to create new refugee regimes that eliminate political manipulation of refugees by states and conflicting parties. However, this would not get to the root of the political problem. As is shown by the case of Afghan refugees in Pakistan, Pakistan’s objective was not only politically self-serving, it was also accepted by the international community.

Seoul Train: A Documentary Film
Film: 2005
Runtime: 54 Minutes
Directed by: Jim Butterworth, Aaron Lubarsky and Lisa Sleeth
Produced by: Lisa Sleeth and Jim Butterworth
Distribution: Films Transit International
  Abstracted by: Brian Diffley [2010]
Abstract:
This film aims to expose the realities faced by North Korean refugees during their journey along the "underground railroad," which takes them out of North Korea, through China, and eventually into a country where they can obtain refugee status. The goal, for many escapees, is to travel through China in order to reach countries such as Mongolia or Thailand. The Chinese government does not recognize North Koreans as refugees, and will thus arrest and forcibly repatriate any North Koreans who manage to make it to China. According to Article 47 of North Korea's Criminal Code, defecting is punishable by death. Unsuccessful defectors and their families, at minimum are subject to imprisonment in labor camps. Despite these risks, it is estimated there are between 250,000 and 300,000 North Korean refugees presently residing in China. The film highlights the work done by "underground railroad" activists such as Chun Ki-won, Kim Sang-hun, and Moon Kook-han, who each have different roles in helping North Koreans escape their country. These individuals help refugees during their journey by providing food, safe houses, and escape plans and routes. North Korean refugees interviewed for the film describe the desperate lives they endure in North Korea, trying to survive without enough food, gainful employment, or any chance for a decent life. Defecting is a difficult endeavor for the refugees. They have little chance of successfully escaping North Korea for good due to the restrictive policies of the Chinese government. The film also describes the failure of the UNHCR to formally recognize that this problem exists, and its failure to pressure the Chinese government to change their policy towards North Koreans in China. In the eyes of the filmmakers, little to nothing is being done by either the UNHCR or China to help North Korean citizens who seek to escape. A crisis is at hand, and more attention needs to be paid to the plight of these people.

Acts of Betrayal: The Challenge of Protecting North Koreans in China
Refugees International, Washington D.C., 2005
Charny, Joel R.
  Abstracted by: Brian Diffley [2010]
Abstract:
This report provides an overview of the situation that exists for North Korean refugees in China. Interviews conducted by the organization Refugees International of North Koreans in Yanbian, China are featured and depict the difficult and dangerous lives that these refugees face both in North Korea and in China. North Koreans leave their country and enter China in order to survive. Those interviewed in the report cited food deprivation, loss of employment, and death of family members in the famine as the main reasons for choosing to escape their county. The exact number of North Korean migrants and asylum seekers in China is unknown, but current estimates run anywhere from 250,000 to 300,000. China considers all North Koreans who enter the country to be economic migrants, and not refugees. When Chinese authorities discover North Koreans, most are sent back to North Korea where they face imprisonment or even death, depending on the nature of their actions while in China. Those who are known to have met with foreigners while in China, or who have converted to Christianity, are subject to execution. The report lays out the various policy options that the four major parties have in changing this situation. China, South Korea, the United States, and the UNHCR must all take action to help save the lives of North Koreans who make their way into China. From the author's perspective, China is the most influential party and must therefore take the lead role in policy change. Refugees International believes that China must both "honor its obligation under the 1951 Refugee Convention," and "allow UNHCR unimpeded access to North Koreans in China," which it currently prohibits. UNHCR staff in Beijing are not permitted to travel to Yanbian to assess the situation of North Koreans in the area. For its part, China's security concerns include criminal acts committed by North Koreans in China, as well as the possibility of a mass movement of North Koreans across the border. Despite these concerns, China must abide by the Convention to which it is signatory and make it easier and safer for North Koreans to remain in China as refugees.

Out of Sight, Out of Mind: Thai Policy Towards Burmese Refugees
New York: Human Rights Watch, 2004
Human Rights Watch
  Abstracted by: Sarah Jessup [2010]
Abstract:
Over 140,000 documented Burmese refugees and asylum seekers live along the Thai-Burma border, due to the brutal political, social, and economic pressures they face by the Myanmar military regime, the State Peace and Development Council (SPDC). In 2004, Human Rights Watch (HRW) produced a report reviewing the conditions that these refugees live under. Reports of militia-controlled camps and gender-based violence were rampant, yet a shift in Thai policy towards these refugees occurred since the forging of closer relationships between the two governments. The report illustrates how these policies could impact the hundreds of thousands of refugees, migrant workers, and asylum seekers currently living in Thailand and those who are seeking to flee the brutal military regime that the SPDC has established. One policy includes the forced migration of recognized refugees living in Bangkok to camps along the border. While this may have been beneficial to those urban refugees who continually lived in fear, many felt that this was a tool to silence rather than help those refugees. Another major shift in policy was the suspension of a core function of the UNHCR Thai-Refugee Status Determination process. This suspension meant that there was no longer an objective and effective way to screen and admit new refugees and asylum seekers. In addition to examining past and present policies, the report looks at how Burmese nationals became refugees under either expulsion from Burma, under growing socio-political or economic-political pressures from the SPDC. The expulsion of political dissidents was and is common practice in Burma as the SPDC seeks to continue its policy of isolation and non-dissent. Furthermore, HRW highlighted the important role of the activist-refugees, who have been repeatedly brutalized and persecuted in Thailand since the forging of new policies within the country. While Thailand has an obligation to uphold the right to free speech, it failed to protect this right, even going so far as to push activist-refugees out of camps and silencing them under fear of arrest or detention.

Asylum Seekers and "Non-Political Native Refugees" in Papua and New Guinea
Australian Historical Studies 120 (2002): 359 " 372
Neumna, Klaus
  Abstracted by: Sarah Jessup [2010]
Abstract:
Between 1963 and 1969, several thousand West Papuans from the Indonesian-occupied province of Irian Jaya fled to the Australian territory of Papua and New Guinea. Much of this was related to the "Act of Free Choice," which officially made the linguistically, ethnically, and religiously distinct western half of New Guinea a province of Indonesia. Most of these asylum seekers were sent back to Irian Jaya, while a few who Australia considered "legitimate" refugees were given temporary visas and housed in detention centers. In this paper, Klaus Neuman seeks to explore the associative links between the past policies and the present, particularly with today's new group of refugees from Iraq, Afghanistan, and Iran. Historical and colonial roots of the Dutch in West New Guinea, as well as colonial links with Australia in what is today the independent nation of Papua New Guinea, are examined, including the pressure on the Dutch to relinquish control to Indonesia by the United States and Australia, given the significant geopolitical location it held during the Cold War. The treatment of the so called "boat people" from West Papua and that of today's refugees is looked at in the context of driving forces, detention centers, and Australia's obligations as a signatory to the 1951 Refugees Convention. From the framework of detention centers, Neuman exhibits a belief that the West Papuan refugees detained in Manus Island share no common links with the Iraqi, Iranian, and Afghan refugees of today, and thus, the new wave of refugees should not be handled in the same way as those from West Papua. Neuman believes that this detailed historical discussion is missing, and that while the missing historical element in today's discourse would not necessarily explain the current situation, it would shed a seemingly analogous light.

Distinguishing Means and Ends: The Counterintuitive Effects of UNHCR's Community Development Approach in Nepal
Journal of Refugee Studies, 2005, vol. 19, no. 2, pp. 151-164.
Muggah, Robert
  Abstracted by: Trishna Shah [2010]
Abstract
In this article, Muggah presents a critique of the UNHCR's Community Development approach (CDA) being utilized in the Bhutanese refugee camps in Nepal. CDA is a development-centered approach that seeks to encourage self-reliance and ownership" among the refugees while also being a cost-effective strategy for the UNHCR to provide better and equitable services to the refugees. Muggah acknowledges that such approaches might be necessary in protracted refugee situations like in Nepal but is also wary that such a Western "liberal and rights-laden" developmental approach may prove detrimental for the refugees in the long run. He purports that a major flaw of the CDA is that it lacks "clear standards, indicators, and benchmarks" to measure its efficacy in helping the refugees when they leave the refugee camps, as a result of intended durable settlement in the host country, repatriation, or third-country resettlement.
  In the article, Muggah examines how the approach is seen as an end in itself rather than as a means, in a temporary situation, to provide durable solutions to the Bhutanese refugee problems. Although the utilization of the approach shows increases in well-being and self-reliance among the refugees in the camps, it does not indicate its applicability after the refugees leave the camps. Some critics believe that the approach has led the Bhutanese Government to be less responsible and encouraged reliance on international aid. Muggah also mentions how the approach has created socio-economic problems and resentment among the host population due to the disproportionate levels of development among the refugees as compared to their own. He also emphasizes that the approach has led to widespread disillusionment among the refugees, and there have been mounting reports of mental illness, suicide, alcoholism, trafficking of women, and prostitution in the camps.
  In conclusion, Muggah notes that although the Bhutanese refugee camps in Nepal are hailed as "model" refugee camps, it is necessary to consider the pitfalls and long-term adverse consequences of utilizing development-centered approaches such as CDA without setting clear standards.

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