As we enjoy this Thanksgiving holiday, reflecting on what we are thankful for, let us remember that our nation’s first settlers were refugees. The Pilgrims arrived in North America fleeing oppression and persecution. They were escaping the same type of life-threatening situations that drive many refugees to American shores today.
Unfortunately, due to increasing conflict areas, economic disparity and the effects of climate change, forced displacement is growing. Ukraine alone has accounted for over 7 million refugees in Europe, the largest such exodus since the Second World War. In the United States this past March, Biden pledged to welcome 100,000 Ukrainians to safe haven. Since that time, that number has been surpassed, with over 150,000 Ukrainians arriving in the U.S.
As part of this initiative, the U.S. Department of Homeland Security set up Uniting for Ukraine, a process in which citizens can apply to host a Ukrainian family to assist in resettlement. The program has been wildly successful with over 120,000 applications submitted as of September. Through the program, refugees are offered social security numbers, employment and health benefits. Other countries have followed suit with a generous outpouring of support and benefits. Many nations have offered protection and unconditional asylum for Ukrainian refugees shortening an otherwise tedious process for many.
We write this as physicians — one from the United States and one from the Democratic Republic of the Congo (DRC). One is a lifelong U.S. citizen who cares for refugees in Washington, D.C. and one has experienced life as a refugee. We have seen firsthand the massive turmoil that refugees face as they are forcibly uprooted from their homeland. We know that the kind of support that the United States and other nations are offering Ukraine is critical and much needed.
Yet, we are dismayed to see there has been a selective solidarity approach. Countries welcome Ukrainian refugees but do not extend this same commitment to refugees from elsewhere, especially those from the Global South.
Forced displacement is growing at an all-time high with 10 countries accounting for most of the world’s asylum seekers. Nine of these countries are in the Global South.
Take, for example, the DRC. From 2019-2021, the country had the highest number of refugees arriving in the United States with a large proportion of them being children. The DRC continues to suffer from violence causing forced migration and the displacement of 5.4 million people. It has been described as one of the world’s most neglected refugee crises, marked by the lack of funding, media attention and political inactivity. Yet, there was no similar outpouring of support or extension of public benefits similar to what we are seeing with Ukraine. In fact, the United States has a ceiling on refugees arriving from all African countries that restricts its refugee arrivals to 40,000 total.
We do not write this to criticize the world’s actions toward Ukraine. In fact, we applaud these actions wholeheartedly. We hope that we can actually learn from the example set by how Ukrainian refugees are treated to better care for all refugees.
Refugees have a number of health and social needs. The resettlement process is taxing and the process of seeking asylum can take over 5 years, Refugees often face the threat of inadequate access to food and water preceding their journey increasing their risk of communicable disease.
When refugees arrive in the country for which they seek asylum, they face a number of barriers to care. They rely on a voluntary network of providers since most do not have the means to pay for care. They do not have housing and instead must live in camps or other facilities that offer only basic and bare necessities. They also face the mental scars left by the trauma of conflict.
Differences in how refugees are accepted and integrated into society further contribute to worsening physical and mental health. Programs such as United for Ukraine are pathways that promote integration and lessen the negative effects of displacement.
This is why the U.S.’s actions of opening its doors to Ukrainian refugees and offering the potential for host resettlement are so very important and admirable. And it is why we need to replicate these actions for all, not just selecting one group of refugees. By standing in solidarity with all refugees, we can reduce overall healthcare costs instead of addressing health conditions that worsen without preventive healthcare and mental health services. We would also be able to improve the economic prosperity of not only those integrating into our society but also society at large.
Let us remember that America is a society that believes in kindness and giving to others. The nation’s earliest and most memorable holiday celebrated gratitude for the plentiful. Let us show our solidarity and share what we have with those who need it most. Let’s use Ukraine as an example of how to do things right.
Dr. James Huang is a family medicine physician in Washington, D.C. Dr. Marx Itabelo Lwabanya is a hospital medical director in the Democratic Republic of the Congo. They are both Senior Fellows with Atlantic Fellows for Health Equity. The opinions expressed here are their own.