Syrian Refugees

Only tangentially related to medicine, but it's been in the news almost constantly and is a really good case study in the intricacies of actually helping others - and how intuition can undermine those efforts.

First and foremost, there's been an attitude floating around that Syrian refugees should be going to countries more similar to their ethnic, cultural, or socioeconomic backgrounds, particularly countries nearby. The thing is, they have. In massive numbers. The number of internally displaced Syrians is enormous, hundreds of thousands have moved within the country to avoid the conflict. Millions have relocated to nearby Turkey, Lebanon, and Jordan. A mere fraction of the approximately 4 million Syrian refugees have gone further than the Middle East, most to Europe. If Canada took even the 25,000 proposed refugees, it would represent a drop in the bucket compared to the number of total refugees. The proposals on the table don't represent Canada being enormously generous - we're mostly bickering about us barely doing our part to help refugees.

Perhaps more importantly, some of the need to relocate refugees to countries like Canada is a direct result of an unwillingness to be charitable beforehand. While hardly the only factor, a major contributor to Syrian refugees attempting to settle further away than Syria's neighbours is the horrible conditions in these refugee camps. Turkey, Lebanon and Jordan are not horribly poor countries, but they're not excessively rich either, and they have taken on a massive number of refugees. Lebanon, for example, has taken on at least 1.1 million Syrian refugees, in addition to another 500 thousand or so refugees from other countries (mostly Palestine), yet the number of actual Lebanese citizens is only about 4.1 million - over a quarter of the people in Lebanon are refugees! They needed (and still need) financial support to care for all these refugees properly and despite a mountain of promises from Western nations, that didn't come. If more Syrian refugees could have stayed in a reasonable state in the Middle East, we'd have less needing relocation. Western nations, insufficiently sensitive to the needs of these refugees, now find themselves in a penny-wise, pound-foolish state. Rather than cough of some money to support refugees close to their homes, they are faced with the prospect of higher costs to absorb refugees directly. Perhaps most ironically, the most vocal opponents of foreign aid are often the most vocal opponents of accepting new refugees, even though proper funding of foreign aid may have minimized the current refugee crisis, and potentially side-stepped the issue of accepting refugees in the first place. The Syrian refugee crisis is an odd case of self-defeating xenophobia.

Now, the past is the past - we can't now change the fact that there are thousands of Syrians who need a new home. Bringing some to Canada will undoubtedly help them, but could it hurt us? The Paris attacks have exposed lingering fears about the possibility of a terrorist attack in Canada, and that fear is being directed towards Syrian refugees. Unfortunately this is guilt by association. Heck, not even guilt by association, it's guilt by proxy. There's not much evidence that these refugees - or refugees in general - are at higher risk of committing violent acts, including terrorism. The Paris attackers were all EU nationals as far as we know, not refugees. Even if one or two come up as refugees, the majority will still be EU citizens. It's worth remembering that these people are running away from the very extremists Western citizens fear. While we're worried about being potential victims of extremism, these are actual victims of extremism. They deserve help.

Concerns about adequate screening have also come up frequently in the conversations I've heard/read. It's absolutely fair to want to take appropriate precautions against a Trojan Horse of some sort within the refugee population. However, no screening process will be 100% effective. Not only can good screens miss pertinent information or be fooled, but those who commit future attacks may have no plans to do so now. I have the dubious distinction of having amicably spent time with a terrorist, who eventually went on to be a suicide bomber. Of course we were in public school at the time, he wouldn't become radicalized for years after I knew him. But I never would have guessed he'd end up a terrorist and if any adults did at the time, there certainly wasn't any indication. Point is that background checks are only so effective and you can't just pick out a terrorist, even with extended close contact.

And that brings me to my last point. We often think of terrorists as fundamentally bad people. Certainly, anyone who commits atrocities like what happened in Paris has perpetrated a horrible crime and deserves punishment in accordance with the laws of a just society. Yet, terrorists aren't born evil, nor are they influenced solely by other evil people. They're affected by their circumstances, just as all of us are, and even good intentions can push people towards a bad path. My friend from public school - and at the time, I did consider him a friend - wasn't particularly malicious or cruel at the time. He could be a bit mean at times, but no more than any preteen. He did carry a lot of frustration though. Looking back, I can remember his fear, his anxiety, his anger. By the sounds of it, someone found an outlet for those emotions, and unfortunately it wasn't a positive one, which led him down the path towards terrorism. He had a lot of positive influences in his life too though. For my part, I hope I was one of those positive influences. But it wasn't enough, he got lost in the shuffle of life, and wound dead, far away from home, with his most notable impact on the world being cold-blooded murder.

Terrorists, as much as we hate to admit it, are just people, like you and me. Sometimes lost, sometimes confused, sometimes angry, misled, deceived, scared, or disturbed people, but still people.

And it is in this light we need to view Syrian refugees. They could become terrorists. Or they could become contributing member of society, including physicians - the number of immigrants to Canada who practice medicine is remarkably high. How we treat them will impact their future. Right now Western countries are sending a message that are not wanted, not deserving of help. To me, that can only build the fear, the frustration, the anger that I saw in my friend. By treating refugees with suspicion and distrust, we could easily create a self-fulfilling prophecy.

Yet we can also create the opposite self-fulfilling prophecy. If we accept these refugees with open arms, with compassion, we might find they're just as eager to help us as I hope we are to help them. We can keep trying to catch terrorists, foil terrorists, kill terrorists. Or we can try to stop terrorists from existing in the first place.