Repatriation and Reintegration: can Hmong refugees begin to look homeward?
WOMEN'S COMMISSION FOR REFUGEE WOMEN AND CHILDREN DELEGATION TO LAOS AND THAILAND
“I find that the Lao people have not changed. They still have their dignity and their pride; they still want to give, even though they have little.” - Tou Meksavanh, Women's Commission Member
“If women are behind, the country can be developed for only half the population.” - Khemphet Pholsena, Lao Women's Union
“At one point in time, we were very focused on Laos. Where are we now, 20 years later?” - Ann Crittenden, Women's Commission Member.
The Women's Commission for Refugee Women and Children operates under the auspices of the International Rescue Committee, the largest nonsectarian refugee relief and resettlement agency in the United States. In addition to this mission to Laos, in the past two years Women's Commission delegations to Southeast Asia have visited refugee camps in Thailand and displaced persons in Cambodia. The purpose of this mission was to review issues related to the repatriation and reintegration of Laotian refugees.
This delegation began its mission in Bangkok, Thailand where it met with representatives of the United States Embassy and Joint Voluntary Agency. Two members visited Chiang Kham Refugee Camp in Northern Thailand and spent one day meeting with representatives from the UNHCR, JVA, voluntary agencies providing services within the camp, and Hmong refugee leaders.
The Commission traveled to Vientiane, Laos, and met with the United States Charge d'Affaires and his staff, officials of the Lao Minstries of Foreign Affairs, Health and Education, the Lao Women's Union, UNHCR, UNICEF, voluntary agencies, and with personal contacts within the Laotian community. A list of people with whom the Commission met is attached as Appendix A.
HISTORICAL SUMMARY
Since 1975 and the victory of the Pathet Lao, more than 350,000 Laotians have fled Laos. For the Lowland Lao, many of whom were educated and living in urban areas, their flight was from the communist regime of the Lao Peoples' Democratic Republic (LPDR). For the highlanders - and the Hmong in particular - their flight was in direct response to the persecution they suffered for having assisted
Normalization in Southeast Asia is slowly occurring, but against a backdrop of perceived compassion fatigue in donor and resettlement nations, as well as increasing tensions in countries of first asylum. By the end of 1989, refugee camp populations in Southeast Asia were at their highest level since 1979. Even though Thailand's border with Laos has been technically closed for a decade, refugees continue to arrive. In June, 1989, the International Conference on Indo-Chinese Refugees, in response to this crisis, enacted measures to discourage further departures while at the same time preserving the principle of first asylum for genuine refugees. This included the expansion of Orderly Departure Programs, screening programs in countries of first asylum to distinguish refugees from migrants, and acceptance of the principle of repatriation, either voluntary or involuntary, to Laos or Vietnam for those who do not qualify as refugees.
The days of automatic resettlement ended earliest for the Khmer and more recently for the Vietnamese and Hmong. Many newly arriving Hmong are being screened out, not qualifying as refugees, and therefore are not eligible for resettlement. In part because of this increase in the number of screened out arrivals, the number of involuntary repatriations to Laos is increasing. In January, of 1991, the forced return of 122 persons included 40 screened out Hmong sent a shock wave through the Hmong community internationally.
In addition, the announcement of Thai government plans to close Ban Vinai Camp in December, 1992, and to pursue a 3-5 year plan to complete the repatriation process from Thai refugee camps has lent a sense of urgency to the decision making process which lies ahead for Hmong and Lao refugees. Clearly, it is time to bring a well-reasoned end to the existence of refugee camps in Thailand. Clearly, as the number of screened out new arrivals rises, resettlement options dwindle, and repatriation plans are finalized, refugees in Thai camps will be faced with making crucial choices about their future. Equally as clear is the need to preserve humanitarian principles while the planning for and the process of voluntary repatriation occurs.
Because we firmly believe that people need to be reintegrated fully to avoid permanent labels as refugees, and to avoid a dependency mentality, and because repatriation cannot occur well without being planned in the context of Laos as one of the world's poorest countries, we spent a significant amount of time looking at
CHIANG KHAM REFUGEE CAMP AND DETENTION CENTER
This camp, which opened in 1976, serves more than 22,000 hill tribe refugees from the highlands of Laos. It is also a detention center for those who continue to arrive from Laos, but whose claims to refugee status have not been determined or have been rejected. Those who have been rejected -or “screened out” - are under constant threat of involuntary repatriation to Laos. During the past two Years refugees from Ban Nam Yao Camp and Ban Vinai Camp have been moved into Chiang Kham as part of the Thai government's plan to close camps and repatriate those not resettled abroad. It is anticipated that Ban Vinai Camp will close by late 1992 and the 26,000 living there now will be moved into Chiang Kham. These movements cause extraordinary overcrowding in housing and have adversely affected education and health services.
In order to learn how women and children access services within Chiang Kham Camp, a survey was prepared by members of the Women's Commission Program Committee. Some of the information derived from this survey tells us the following about life in the camp:
According to UNHCR statistics as of the end of February, 1991, 6,549 women and 7,882 children aged 9 and under, are residing in Chiang Kham Refugee Camp. Together they account for more than two thirds of the total camp population of 21,024.
In reviewing the physical protection of woman and children, it was learned that if assaults and rapes result in hospitalization, they are reported to the UNHCR, which then takes up the issue with the Thai Ministry of the Interior Security Officer. Perpetrators of rape are required to pay a fine to the victim. Assaults that do not result in hospitalization usually remain unreported and are handled within the community - abiding by traditional rather than written law.
Neither the Ministry of Interior nor the UNHCR has a trained counselor/social worker on staff at present to work with victims, although the UNHCR is attempting to fill this position. A Traditional Medicine Center operates within Chiang Kham and offers services to persons in need of counselling as well as traditional forms of treatments. There are no female protection officers in Chiang Kham. In the last year, 3 of the 5 Thai policemen were transferred from Chiang Kham due to their involvement with protection problems affecting refugees.
― 4 ―Unaccompanied minors, very young children, and orphans are most often taken in by extended family members as is the custom among hill tribe families. Older unaccompanied children often live on their own in the camp. Children less than 11 years old are not allowed to be in jail.
Skills training programs offered in Chiang Kham by the International Rescue Committee (IRC) are geared primarily to men. This is not deliberate but reflects the cultural barriers in place within Hmong society. The female director of this program expressed her disappointment with efforts to recruit women to these programs. Unfortunately, once Hmong girls marry (often around the age of 15 or 16) they immediately drop out of the skills programs. We were told, “when women are married, they belong to the man, and the man's family - they have a lot of work to do”. The major skills training programs offered are sewing, electricity, motor repair, carpentry, radio repair, black smithing, and silk screening. of 30 teachers in IRC skills training programs, only three are female. Approximately 400 camp residents are enrolled at any given time, but women comprise only 80 of the students. All programs are open to women, but sewing is the major one in which they participate.
Interestingly those women whose families have applied for voluntary repatriation - and who had never previously taken advantage of skills training - are applying in large numbers now. The staff in the skills training program attribute this change in motivation to the fact that a decision had finally been made regarding their future. With this in mind, the staff requested more information about conditions in Laos in order to adapt and improve skills programs for the returnees. The staff also suggested that if repatriates have a longer period of time from notification to departure, they can take greater advantage of skills training programs.
In looking at access to education within the camp, it is interesting to note that in grade 1,895 boys are enrolled and 773 girls. By grade 6, the difference is much greater - 68 boys and 10 girls. The demands on young girls to assist with child care at home is the main reason given for this decline.
The IRC Health Education and Community Health Outreach Program was visited. The staff of these programs include two expatriates (director and volunteer), and 43 refugee workers. Health education programs are directed only towards children, as health education workers are not comfortable teaching adults. Despite the efforts of the female program director, the refugee staff is comprised primarily of men. In discussing this, one of the Hmong health educators made it clear that Hmong culture prohibited women from working outside of the home. However, when it was
― 5 ―pointed out that many Hmong women in the United States work outside of the home, he agreed that this cultural prohibition is often dropped when the benefits outweigh the negative feelings the Hmong have toward this practice. The most important element appeared to be the receipt of a much needed salary. In the U.S. this is given as the reason for permitting women to work; in the refugee camps agencies are not permitted to pay cash salaries to refugees. Thus, there is little incentive to break with tradition.There are no formal traditional birth attendant (TBA) training courses available in the camp, nor are there are any counselling services for commercial sex workers (CSW). Since TBA and CSW exist in this setting, training remains an unmet need. The director of the Health Education/Community Health Outreach Program is most interested in having such programs.
In a visit to the IRC Opium Detoxification Program, we again heard that the option to repatriate had created an increase in the number of people attempting to detoxify. Ninety-five percent who enter the program complete it, an increase over previous years. Twenty percent to those who enroll are women. Infants and babies who are being nursed may accompany mothers. As of February, 1991, all highlanders aged 14 and over who are being processed for the United States Refugee Program undergo urine testing for opiates. Testing positive in Chiang Kham may delay resettlement until the refugee detoxifies, and testing positive on two occasions in Phanat Nikhom results in ineligibility for United States resettlement.
There is no formal women's organization within the camp. Although it is not a format with which the hill tribes would be familiar, a women's organization does exist in Ban Vinai Camp. Such an organization could do much to promote greater participation by women in programs, in the hiring process, in program planning, and in the area of protection. The input of women into planning for repatriation is critical.
Time did not permit a visit to the MSF-run hospital and medical service programs. However, a copy of the survey will be sent with the request to complete and return it to the Women's Commission, and the information will be included in any future report.
SCREENING AND FORCED REPATRIATION
A formal screening program for arrivals from Laos has been in place since July, 1985. In the past, significant problems have occurred with lack of access to screening programs as well as with reports of bribery to gain access to camps. There have been complaints
According to the UNHCR, those who are screened out have the right to appeal before the UNHCR. This process has been hindered for several reasons: refugees have not been notified of their screened out status, and many do not know they have the right to appeal. One UNHCR official told us “the right to appeal has been discussed at length with the Thais, and it will probably occur.” In the past five years, 2,000-3,000 Lowland Lao have disappeared when informed of their screened out status, and the Thai government would like to avoid such escapes in the future. UNHCR stated that a new policy is now in place to provide two days notice prior to involuntary repatriation.
In January, 1991, forced repatriation from Chiang Kham and Ban Napho took place in the middle of the night, giving families no time to prepare, and causing tremendous fear within the community. “Recently, it was nasty,” noted one official in reference to the January incident. Such movements conducted by the Thai authorities may occur without the knowledge of UNHCR officials in Laos. We were dismayed to learn that neither UNHCR Thailand nor UNHCR Laos had registered a protest with the Thai government over the handling of this involuntary repatriation.
MOI Thailand has said that all those screened out will be moved back to Laos and Laos has, in accordance with the CPA and a Thai-Lao government understanding, agreed to accept back screened out individuals who are involuntarily repatriated. The Lao government does not differentiate between voluntary repatriation cases and screened out cases. Reintegration assistance from UNHCR Laos is given to both groups of returnees. Since there are people in the camps who have volunteered for repatriation to Laos, it makes sense to focus on moving them first. It also seems more humane to return quickly to Laos those screened out, rather than keep them in refugee camps for extended periods of time.
In considering the screening process, the Women's Commission supports the recommendations made by Refugees International which state:
“A review and appeal procedure must be instituted and codified in writing. A UNHCR officer should interview the family to make sure that no elements of political persecution have been overlooked, that family composition is complete, and that the refugees are in good health. Also very importantly, for all
VOLUNTARY REPATRIATION
Although the overall number of refugees opting for voluntary repatriation remains quite small, the last two years have seen a significant increase in the numbers returning to Laos. Approximately 7,000 Laotians have been voluntarily repatriated over the past ten years - most have been Lowland Lao. Recently, more Mien have opted for repatriation. Very few Hmong (just over 400 at this writing) have taken this route. More than 54,000 Hmong remain in camps in Thailand. Seventy-five percent of the Hmong at Ban Vinai Camp have been there over ten years, and 42% of the children in camp are less than ten years old. For the ethnic Lao in Thai camps, 17% are long stayers. If there is ever going to be a solution to this problem, a broad initiative must take place to determine the critical needs which must be met for successful repatriation, and to set in place actions and programs addressing these needs. There are a number of stumbling blocks which will have to be overcome.
The government of Laos has announced an official policy of welcoming back those who fled after 1975. We were told by officials of the Ministry of Foreign Affairs, “The Lao government wants to welcome back all Laotians who come back voluntarily and sincerely, and not to do sabotage.” In December, 1990, MOI Thailand accepted a plan, drafted by UNHCR, for a three year program to repatriate refugees from camps in Thailand to Laos. This plan is currently being revised to extend to 3-5 years, and will include details regarding sites, infrastructure needs, health and education needs, and other issues. In May, 1991, UNHCR representatives from Geneva and Thailand conducted technical meetings with Lao government representatives, NGO's, and international organizations working with development in Laos regarding the repatriation plan. Voluntary repatriation is clearly moving ahead, and remains the most viable durable solution for refugees from Laos.
For the Lowland Lao, there have been few significant problems occurring during ten years of repatriation programs. Many return to their original towns and villages, and 95% have family in Laos. The Lao government recently announced legislation detailing eligibility and mechanisms for reclaiming land and homes in Laos.
For the Hmong, reintegration is fraught with worry - on both sides. For the refugees, an over-riding concern remains the fear of reprisals. While some of these fears may be exaggerated, rumors of reprisals or planned reprisals by the Lao government against the Hmong remain very prevalent, even among Hmong leaders. One Hmong in Chiang
Regardless of their validity, these beliefs - particularly among Hmong leaders - remain a major barrier to return of the Hmong to Laos. Seventy-nine percent of Hmong at Ban Vinai Camp in a May-June, 1990 survey indicated an unwillingness to return to Laos unless significant political change occurs. Because of these concerns, the Hmong are seeking UNHCR presence in, and the right to select repatriation sites in Laos. The government has indicated it sees no need to increase UNHCR presence in repatriation sites. Until recently, the government was unwilling to permit Hmong leaders from refugee camps to visit potential repatriation sites, but indications are now that such visits may be possible.
Another Lao official stated in meetings in 1990: “Personal safety is guaranteed for all returning refugees, even for old soldiers, except for those who join the resistance…. No repatriates will have any problems returning if they have good intentions.”
A CCSDPT official in Thailand has said, “The effectiveness of voluntary repatriation can only be measured by the mental attitude and readiness of the refugees themselves.” Surveys show that many Hmong continue to follow the decisions made by their leaders regarding repatriation. Over the years, UNHCR attempts to educate refugees about repatriation sites, through the use of letters, photographs, audio, and now video cassettes, have been unsuccessful. This mutual distrust, coupled with the desire to hold on to the familiarity of refugee camp life rather than resettle, has created a decade-long impasse, particularly for the Hmong.
One NGO director in Thailand commented “50,000 people repatriating with a country population of 4 million is eminently workable. The problem is not that they are a real threat - the problem is Hmong attitudes, emotionally and psychologically. The irony is they say they can't go back because they are fiercely independent, yet they have subjected themselves to total control and dependence. This has affected the Young Hmong in ways we cannot know.”
Perhaps a more immediate problem is concern on the part of returning refugees regarding basic needs: arable land, adequate water, sanitation, shelter, health and education facilities. Lao government officials have acknowledged that all the needs of returness cannot be met given the tremendous problems with finances, infrastructure, and provision of basic services that affect the country as a whole. Hmong refugees need to be realistic about what services can be provided upon
Of particular interest to the Women's Commission were surveys of women refugees in Ban Vinai conducted by Mr. Tom Conroy, as part of a Ford Foundation Study. Two thirds of all the male and female refugees surveyed felt genuinely positive about living in Ban Vinai, particularly because the camp provided enough food, services, and safety, as well as the company of other Hmong. The women refugees, without exception, said they liked living in Ban Vinai, and the main reasons given were peace and free rations. “Hmong women value the stability and safety of family most of all, both of which can be obtained in Ban Vinai” the report stated. Also of note, was that “Women, with only two exceptions, were not in favor of moving to third countries, and generally preferred the security of Ban Vinai or the familiarity of Laos under conditions as they had known it prior to 1975.”
These concerns of women regarding being placed in economically marginal areas are valid. One official told us, “A woman in camp has a lot of responsibility and work, but at least there is food security. Once they are back to Laos there will be no food security.” Some provincial leaders in Laos have expressed concerns regarding the sharing of land, water, and hospitals with repatriates. “They will go back to pockets of poverty where they will have to work,” one official told us. For women who have had the luxury of time in refugee camps - particularly time to do handicrafts - this will change. “Women in Laos have no time to do needlework. Even if she has time, there is no market”, we were told. For those who may have lived as internally displaced persons for a decade in Laos during the war, then in a refugee economy for another decade, these will be times of very difficult adjustment. “People in camps are not farmers any more - they are more businessmen than before,” one official commented.
Concerns regarding the repatriation process exist on the LPDR side as well. There is the obvious fear that the Hmong resistance will gather strength from the returnees. “The government is very concerned about security,” we were told by one UN official, even though the resistance is though by most Laos watchers to have no hope of achieving its political goals. The road to Luang Prabang has been unsafe, for example, due to the resistance attacking convoys along the road. The Lao government is also worried that Hmong returnees will want to resettle on old lands where they once grew opium, or will slash and burn mountain sides, increasing the environmental damage in an already fragile area.
COMMENTARY
If repatriation is to be successful, the reintegration of the Hmong and Lao must be durable and sustainable. It must be accomplished in safety, and it must have sufficient resources attached to it to ensure that it will work. UNHCR is committed to building the basic village level infrastructure, as well as attempting to promote real integration and long-term economic self-sufficiency. However, the Women's Commission shares the concerns expressed by others that there is a lack of coordination and funding for an effective reintegration plan, that necessary supplies are not being distributed to returnees, and that critical resources (water systems for example), are not in place for those repatriating to under-developed sites.
The Commission urges that the concerns of refugee women and children be addressed. Since women ordinarily collect water, how far from the source will villages be established? If health and education services are not available, will members of their community receive training while in the camps? Skilled teachers are on hand in the camps to give them the necessary training now. What services will be offered to returning refugee women in terms of birth spacing, an issue of primary concern to rural women in Laos? When asked what assistance would be most useful, one woman from Vieng Kham village replied to a Women's Commission member, “The life of the Lao women is so hard because she has so many children to take care of. The births just happen naturally and we can do nothing about this problem. We need help to not have so many children to raise.” What specific programs will be developed to reduce the work load and assist with income generation for women?
Linkages between UNHCR and NGO's or international organizations working in Laos can and should be a primary method of providing needed services to returning refugees. For example, UNHCR and UNICEF are currently working on a collaborative project for returning refugee women. UNICEF has increased its budget to provide services for three villages with returnees selected by UNHCR, and is concentrating on activities designed to train women, generate income, and reduce the workload of woman. UNHCR will monitor these villages with returnees.
To date, many of the groups which have returned were moved in small clusters of 70 to 140. Recent increasing requests for group repatriation are an exciting development, and may indicate a change in Hmong attitudes about the concept of voluntary repatriation. On March 1, 1991, the UNHCR in Geneva received a letter from the Hmong leadership at Ban Vinai Camp stating that the Hmong want to return home and asking that ten conditions be observed, including a renewed declaration of amnesty, as well as guarantees regarding arable land, water, etc. Of major significance was an agreement not to be involved in the resistance if their other conditions could be met. A large group of 1,000 Hmong in Chiang Kham Camp has asked to be resettled near Vientiane in two villages of 500 each. This pilot project could
The Hmong are not going to be able to select every repatriation site. But when they see a large group resettled in an area with arable land, and access to other services and markets, some of their fears will be allayed. The UNHCR cannot be placed in every village for an extended period of time, but staff must be increased to a level where frequent and substantive monitoring can take place for two years following repatriation. With current UNHCR staffing, we were told, “We cannot guarantnee that we will see them once a month”. Currently, UNHCR staff in Vientiane consists of two persons, with no sub-offices outside of Vientiane. We were also told, “Although there is no real discrimination at the national level against the Hmong, there may be at the district level.” Another NGO official commented “Human rights abuses on the provincial level may occur due to old grudges.” In a country where 85% of the 4.6 million population are rural subsistence farmers, and where infrastructure and communications are a major problem, the ability to monitor adequately for human rights abuses is obviously very problematic. However, it costs less to monitor returnees living in self-sufficient villages than it does to maintain refugee camps abroad. From 1980-1989, UNHCR Laos has supervised 30 repatriation projects in twelve districts, at a cost of US 4 million dollars. There are many people with the relevant experience, language, and cultural skills available to employ in this task. One expert suggested that a Lao anthropologist assist with site selection. It is not an assignment for the inexperienced or uninitiated.
One barrier to building confidence on both sides will be overcome when the Hmong separate themselves from the resistance movement - in America, in Thailand, and in Laos. The resistance does not offer any durable solution to their homelessness, and through dissemination of misinformation it prolongs an already painful situation. At the same time, more accurate information is needed now in the refugee camps to reply to the charges of attacks on Hmong villages in Laos by government forces.
While it is clear that the LPDR has been involved with attacks on Hmong villages, one observer commented that the ultimate result is that “innocent people are caught in the middle” as a result of the LPDR and the resistance forces, “exchanging atrocities”. One longtime Laos observer has commented, “Both the Lao People's Army and the resistance are guilty of unspeakable acts against peasants who only want to be left alone. But for the attacks initiated by resistance groups, I would suggest that the Lao government and the Lao People's Army would leave well enough alone”. As an example, the Ministry of Interior and Ministry of Social Welfare in Laos knew of three pre-1975 members of the resistance who were part of a group of Hmong repatriated to Laos last year. Lao government officials told UNHCR officials in Laos, “there is no problem if they don't get involved
DEVELOPMENT ISSUES
Through this thicket of fear and apprehension a middle ground must be reached. And perhaps one road that will lead to it is the economic development of Laos. The country is welcoming business and trade ventures with the West after 15 years of isolation and dependence on the Soviet Union and Eastern Europe. Economic reforms or the “new economic mechanism” began after the fourth Party Congress in 1986, and presaged changes in Eastern Europe which resulted in significant decreases in Eastern bloc aid to Laos. This shift from a nationalized economy to a more market-oriented economy was driven in large part by pragmatic leaders recognizing the failure of collectivization, and the resultant necessity of economic changes.
Those changes are most dramatic in Vientiane, where more cars are on the roads, brightly - lit restaurants are busy, and the morning market stays open day and night, brimming with Thai household goods, Cambodian jewelry, and Japanese televisions. Thai tourist groups to Luang Prabang fill the hotel lobbies, and an occasional Western tourist frequents the popular nighttime discos. The Asian Development Bank, World Bank, and International Monetary Fund are advising the government on privatization, and changes in the foreign investment code have resulted in increased foreign investment in Laos.
Thailand has become the leading investor and trader in Laos and, particularly since Thailand's 1989 ban on logging native forests, has been looking elsewhere in Southeast Asia for much needed timber for its increasingly prosperous population. There are plans to construct a bridge across the Mekong River between Thailand and Laos and, once completed, it will be impossible to halt the growth in exchanges between the two countries. “Laos will change forever when the Australian bridge at Nong Khai is finished,” one observer commented. However, there are conerns that with only two significant exports - timber and hydroelectric power - Laos' prosperity may be superficial. An Asian diplomat stated in 1990, “Laos has no industry or firm basis to sustain its economy.” One United States diplomat in Vientiane told us he felt timber and wildlife in Laos were “lost causes.” Evidence of the plunder of rare species was present on the walls in hotels and restaurants throughout Vientiane. In this type of setting, development needs to proceed thoughtfully and cautiously. Linkage
Economic concerns are particularly significant for rural Laotians, the majority of whom are members of the 60 minority groups of midland and upland hill tribes. Much of the foreign aid and government spending has been concentrated in the lowland areas along the Mekong River. Economic changes in the larger cities have not been felt in the countryside, where the per capita income is $156 per year and where basic needs in medical care, public health, education, and infrastructure development are not met. “The changes to decentralize after 1987 opened a Pandora's box,” one individual commented, “Increased provincial autonomy and decreased central government financial support allows creative provincial leaders with resources to increase the benefit to their area. But it increases the gap between the poor and rich provinces, as the poor are cut off from central government support.” One international organization staff member commented, “The focus is on economics - on making money. It is harder to focus on social services, which are an investment over time. The villagers can't afford the tax on wood, so they can't even build a village health post.” A UNICEF official in Vientiane told us, “Our programs are national by definition, but in reality we barely reach the hill tribes.”
In 1989, Laos' GNP was 300 million dollars and the country received 200 million dollars in foreign aid, clearly emphasizing the importance of foreign aid to the country's economy. However, opinions vary regarding the need for development money for Laos, largely because of concerns regarding the country's capacity to absorb such funds. The flight of 10% of the population since 1975 has created a tremendous brain drain which leaves the country bereft of trained educators, physicians, legal experts, technicians, and managers. “At every level, people will tell you the biggest problem is the ability to analyze and solve problems,” one NGO official told us. Many NGO's in Laos have recognized the need to focus on training rather than infrastructure development in order to have a long-term positive impact which is sustainable. “We must train the Lao,” one Laotian agriculturist commented. “I blame both the government and the NGO's - they tend to rush for the outside expert. Even with the best of intentions, a development project without training is not sustainable.” Accountability is also a significant issue with the provision of development aid. One NGO official commented, “Unless villagers help themselves, nothing will be sustainable…it's very much a handout mentality still.” “This robs the people of a sense of pride and dignity,” Women's Commission member Tou Meksavanh commented. Local villagers need to be involved with identifying problems and solutions appropriate to the village level, and conditions must be placed on programs offered.
Despite the positive economic changes occurring in Laos, this shift in focus has not been felt in the political arena. One aid official commented, “Laos is an interesting mix of economic liberalism and political hard line.” The message from the party has been that Laos will not follow in the footsteps of Eastern Europe. Although there has been some abatement in the previously dogmatic political rhetoric, and a reduction in the number of Vietnamese military stationed in Laos, the current government, after 16 years in power, still has no constitution. Freedom to travel within the country or publicly to criticize the government does not exist. In 1990, Amnesty International reported that three Lao officials were arrested for speaking in favor of a multi-party system.
However, positive changes are clearly occurring in the political arena. In 1975, 30,000-40,000 political prisoners were in reeducation camps. In 1985, that number had dropped to 1,000. In the past several weeks, unconfirmed reports indicate the last 34 political prisoners were released from re-education camps. The LPDR is drafting a constitution which will include first amendment rights of free speech, press, and assembly, as well as elections by secret ballots and universal suffrage. The five female members of the People's Assembly are addressing women's issues in the drafting of the new constitution, including child support, abolishing polygamy, equal inheritance, and equal division of property during divorce. A system of published laws on contracts, inheritance, and ownership of private property is being drafted. The open practice of Buddhism is being tolerated, and fresh coats of paint have been applied to pagodas in Vientiane. Private criticism of official policies are heard more frequently. A comment was made that, “the pace in Laos is different,” and the people of Laos, particularly rural people are often “politically passive.”
The coming economic changes may very well be the tail that wags the political dog. With private ownership of business growing and prosperity increasing, political change may not be too distant. In order to evolve successfully, Laos clearly needs outside support - multi-lateral international aid programs, UNDP, UNICEF, and NGOs. obtaining this support will depend greatly upon the political direction the LPDR chooses to take in the near future.
With an improved political relationship based on measurable gains, the United States should consider supporting important programs and funding sources to assist Laos. Of particular interest to the Women's Commission would be funds supporting programs for refugee women and children, integrated with programs for the women and children of all of Laos. One important signal that previous antagonism is lessening, and that improved relationships are occurring is the fact that the Peace Corp will send its first contingent of 15 volunteers to Laos in July, 1991.
In exchange for increased economic assistance, the Lao government should develop a more flexible approach to the repatriation process. This could include a more relaxed attitude towards the request for increased UNHCR/NGO presence in repatriation areas. NGO's are interested in providing community development projects, sanitation and irrigation projects, health worker training, reduction in rural women's work through improvement to water systems, maternal and child health programs including birth spacing and immunization programs for infants and children, and sustainable farming techniques. All of these programs could bring great benefits to the entire country.
The natural historical link between the Thai and the Lao could be used very effectively in this regard. Thai experts and NGO's with experience in development could provide technical expertise in the repatriation process. Refugees who are well trained while spending years in camps could return to work as village health officers. One important source of technical assistance could come from educated and well trained Lao refugee professionals living abroad. “We need more linkage with the Lao in the United States,” one Lao agriculturist told us. “Lao experts should sponsor development projects in villages, not just businesses in Vientiane.”
When considering community development programs, there exists a strong network established by the Lao Women's Union that reaches out to all provinces, districts, and villages. Although it would be necessary to separate its political aim from these humanitarian efforts, the Lao Women's Union is one network through which services for women can be expanded throughout the country.
Innovative agricultural programs (such as the rice based intensive farming system, RIFS) are being developed in Laos as well as in Thailand. A program like RIFS could teach returning highlanders sustainable agricultural practices promoting food production without causing deforestation. “With appropriate technology, agriculture can be stabilized up in the hills,” we were told. Although land is unavailable in the camp, elements of this program could be taught in refugee camps prior to repatriation. Women in refugee camps need to be particularly targeted for such training. One Laotian agricultural expert told us “85% of the country are farmers, and most of the farming is done by women. The tedious, time-consuming work is done by women.”
Roads to markets are needed. The United States government's crop substitution program has the ability to combine the goal of eradicating opium production with the need to establish roads and markets for substitute crops. In turn, these roads will increase prosperity and bring services into areas previously never served. This 8.7 million dollar program began in 1989 and extends for a six year period. It focuses on the concept that reducing opium production requires an integrated approach with rural development including dam building, irrigation projects, improving schools and
HEALTH ISSUES
A major issue of concern to returning refugees, and to the population at large, is the abysmal state of health care in Laos. The few health statistics which are available outline the extent of the problem: life expectancy for men is 42 years; for women, 45 years. (In the United states, life expectancy for men is 72 years, for women, 79 years.) The crude birthrate is 40.8/1,000, and the infant mortality rate is 122/1,000: 12 out of every 100 babies born die before the age of one. One 50 year old mother of 15 children, nine of whom are living, told us, “we have many children, and many of them die.” Immunization coverage for children is less than 20%. According to the Ministry of Health, maternal mortality is 3/1,000. “Women's health care is very inadequate,” we were told by one physician in the Ministry of Health. Laos has, according to one report, 38 hospitals, 156 physicians (including six pediatricians for the entire country), 15 dentists, 16 pharmacists, and 1,028 nurses for a population of over 4 million.
Malaria is reported to be the number one killer of children in Laos, but diarrhea with dehydration, polio, tuberculosis, typhoid, measles, diphtheria, and tetanus are “rampant” according to UNICEF. “Forty percent of children in villages are malnourished,” commented a Ministry of Health physician. Health statistics show that infant mortality may be as high as 200/1,000 in rural areas; a child born in Vientiane has a much better change of survival than a child born in upland provinces. One UNHCR official told us, “I've been in Udom Sai Province in Xieng Khouang, and there is absolutely nothing - a big empty house for a hospital, with one wooden table, a few scissors, and 10-20 beds with no medicines.” Health statistics, if kept, are written with chalk on the wall of village health stations, which are often a small wooden room with a single bed. In 1987, UNICEF was able to gather nutrition statistics in five provinces; in 1990 that number had increased to 11 provinces. “We have looked very long and hard for good health statistics, and I can tell you that they are not available,” commented a UNICEF health officer. “In fast, if someone gives you firm statistics, you should question them.”
Logistics and access to rural areas are a major problem; finances are an even greater issue. Health care in Laos is free, and generates no profit for the government. As a result, one observer commented, “the government has done absolutely nothing about health care - they have designated different NGO's to provide health care in different
A major focus of NGO work has been trying to make an impact at the district and village health level by training officials to train community health workers. Although the district is the lowest official level, and each of the approximately 160 districts is designed to have a hospital, only perhaps two thirds do. Many village health posts established between 1985 and 1988 have been abandoned due to lack of backup from district hospitals. “The orientation is still towards the hospital instead of primary health care. District health officers only occasionally go out to villages,” we were told.
This focus on the national and provincial level is evident in requests for sophisticated medical equipment which is unused due to lack of knowledgeable personnel, spare parts, or electricity to run equipment. “We must stress preventive more than curative health, and doctors don't want this,” a UNICEF official commented. “They want more hospitals and equipment.” “Medical doctors just operate and give pills - that is the attitude…a place like Laos must have generalists,” another observer commented. Finances and political will, both from the Lao government and the international community, need to be focused on clean water, sanitation, maternal and child health, and primary health care, including immunizations. This focus will save many more lives in Laos than providing sophisticated medical equipment.
Health care suffers from a lack of political will as well, with the government being more focused on other issues related to development than health care. “Health is the weakest service industry,” we were told by one NGO official. Lack of medical equipment and pharmaceuticals, lack of staff, poor training and motivation of staff, lack of coordination between health care programs, and lack of community participation in health care are all major problems identified by UNICEF in a 1987 study.
Health care education programs are similarly in great need of assistance. One former US diplomat working with the Pediatrics staff at the University of Health Sciences in Vientiane, commented, “we found the curriculum a disaster, and the faculty demoralized.” On touring the University of Health Sciences, Women's Commission members saw buildings 50-70 years old built by the French with 1950's chemistry equipment in the student laboratories. The School of Public Health, now two years old, has no curriculum and no graduates. “It's a question as to whether they have trained anyone,” one observer commented. The School of Dentistry trains only dental assistants. “However, there are still bright, eager people devoted to Laos there,” one former diplomat commented in reference to the University faculty. This despite the fact that the average
One bright note on education was shared with Women's Commission members by the Vice Dean of the University of Health Sciences, “Prior to the revolution, you had to pay for University, so families didn't send girls. Since the revolution, all education, including the University, is free, so families are proud if girls are good students. Parents are proud if their daughters are doctors.”
That focus on curriculum reform, and primary health care, along with an ongoing educational exchange program between US health care providers in Laos is now occurring through a program begun by the Center for International Health at Case Western University in Ohio. Such programs need to be encouraged through private and government funding sources. It is critical that Lao health care professionals, particularly physicians, nurses, and public health personnel, are involved at every level of the process, both as resources, and also to help identify needs and to develop and implement programs.
While the Women's Commission does not feel qualified to make overall recommendations regarding health care in Laos based on a short visit, it is obvious that the needs are simply overwhelming, and are not getting the attention they deserve. United States Embassy data from Vientiane show that the United States has donated $135,353 for medical supplies to Laos since 1975. Laos clearly needs international financial support to provide clean water and sanitation to its people, to reduce the maternal and infant mortality rates, to ease malnutrition, and to provide even the most basic health and primary care to its population. Programs need to focus on such basics, and the hard task of reaching rural populations as well. They need to be designed by experts in third world health care, who recognize the importance of transferring knowledge and skills to community health workers. Such issues are not insurmountable; finding the international and national political will and finances for such programs are more problematic.
EDUCATION IN LAOS, AND ITS RELATIONSHIP TO REFUGEES
“The very poorest, most remote K-12 school in the United States has more than this post-graduate program.” - Tou Meksavanh, after touring the University of Health Sciences.
Population studies in 1990 placed the literacy rate for Laos at 45%. This is not surprising. Forty percent of teachers have had no formal training. Most did not choose to become teachers. When young adults fail to be selected for the profession of their choice, they are assigned by the government to teach.
Since 1975 Laos has relied heavily on assistance from socialist countries such as Bulgaria, Czechoslovakia, East Germany, Hungary, Poland, and the USSR for scholarships at universities and technical schools. Currently, 7,000 to 9,000 Lao students are studying abroad. The focus has been on sending students abroad for higher education. “This country has not tried to develop its post-graduate curriculum at all,” commented a Lao community development worker. “In the long run, this undercuts the development capacity of Laos.”
Many with whom we met questioned the quality of the training professionals have received and indicated that retraining will be necessary. They may have learned how to study or use textbooks, but often their training was inappropriate. The suggestion was made that the US should be encouraged to fund education programs for Laotians in the countries of the surrounding region: Thailand, India, and the Philippines. “That's going to be a crucial issue - training the Lao,” commented Bruce Shoemaker, AFSC Laos.
The individuals involved with curriculum development for Laos are rarely experienced teachers. The National Institute for Education Research, which is responsible for textbooks and curriculum, has taken the past five years to rewrite the first grade writing and arithmetic texts, as well as the second grade readers. This effort has been very slow because the educational content must be screened for political acceptability as well as pedagogical content.
For Hmong and other highlanders, the ability to speak Lao will be critical for acceptation into programs for higher education. At Chiang Kham Refugee Camp, Lao literacy was 50% greater among men than women. However, the Hmong literacy rate is 50% greater among women than men. What appears to be lacking is the opportunity for women to learn Lao. This affects their access to public health, maternal and child health, and other programs when they return to Laos. Dr. Vannareth in the Lao Ministry of Public Health commented that “It is extremely difficult to teach public health principles to the Hmong, when they do not know their ABC's.” It is crucial that returning refugees have some literacy, preferably in both Lao and Hmong.
Beginning in 1987-88 the New Economic Reform “Chintanakarn Mai” allowed the 17 provinces of Laos to have greater autonomy for planning and allocation of financial resources. A major concern is that funding and programs, for both the Lao nationals and returning refugees, are focused on the provinces along the Mekong which have had an historical advantage economically. This will create a wider gap between rich and poor provinces, straining the resources of the remote provinces even further.
One UNICEF staff member in Vientiane pointed out that “There are many experts here, and they are all foreign experts. They are not going to stay committed to the country. You can have the best of intentions, and not transfer skills.” When planning future education and vocational training programs, the Women's Commission urges that consideration be given to the many Laotian refugees who have received significant training and experience in the refugee camps. This training should be put to good use in development programs and could be the first step in transferring much needed skills to all of Laos.
CONCLUSIONS
Many Hmong and Lao refugees would like to return to Laos if they can do so safely, with their basic needs met. The United States, UNHCR, and NGO's involved with Laotian refugees agree that voluntary repatriation meeting these conditions may be the most viable solution in this setting. Thailand is increasingly anxious to end the long term problem of refugees within her borders. And the Lao government, eager for Western aid and improved economic relations with Thailand, is willing to accept larger numbers of returnees. Clearly, the existence of such mutually complimentary goals should favor a repatriation process for Laotians which is largely successful.
United States government goals in Laos since 1975 have focused on MIA's, of which 530 are listed for Laos, and on Laos' production of the world's third largest opium crop. United States assistance to Laos has funded the 8.7 million dollar integrated rural development/crop substitution program previously mentioned, as well as a 1990-91 Prosthetics Assistance Project for $850,000 to buy artificial limbs and rehabilitative devices. Of 29 NGO's now in Laos, only four are American. In the past 15 years, United States aid to Laos has amounted to 11.4 million dollars, which is equivalent to the amount spent in five days of the nine years of the bombing of Laos by the United States during the war.
The question must be asked as to whether we have a particular responsibility to the Hmong, who were the CIA's secret army in Laos, and who lost 30,000 Hmong soldiers as a result. It is clear that our particular past with the Hmong is in large part responsible for the creation of Hmong refugee camps in Thailand. To the Hmong people in Thailand and the United States, America's promises to care for the
The United States has acknowledged its responsibility to the Hmong with a generous resettlement program for 15 years. The attitude in the United States that reminders of past relationships are passe may have less to do with America's short memory than with a painful need for catharsis from the era of US involvement in Asia in the 1960's and the 1970's. If we are truly to move on from such memories and “beat the Vietnam syndrome,” the United States needs to take a leading role in normalization with Laos, Vietnam, and Cambodia. Our particular responsibility toward Laos and the Hmong can perhaps best be addressed not by focusing on the past but, in remembering it, by acknowledging the appropriateness of the United States playing a leading role, particularly financially, in guaranteeing a humane end to the tragedy of lives spent enduring the inching by of days, years, and decades in refugee camps in Thailand.
Courtesy of Special Collections and Archives. The UC Irvine Libraries, Main Library 5th Floor, PO Box 19557, Irvine, CA 92623-9557; https://special.lib.uci.edu
http://content.cdlib.org/view?docId=hb0b69n6nq&brand=oac4
Title: Repatriation and reintegration : can Hmong refugees begin to look homeward
By: Women's Commission for Refugee Women and Children. Delegation to Laos and Thailand, Author
Date: 1991
Contributing Institution: Special Collections and Archives. The UC Irvine Libraries, Main Library 5th Floor, PO Box 19557, Irvine, CA 92623-9557; https://special.lib.uci.edu
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Women's Commission for Refugee Women and Children
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