Q J Med 2003; 96: 781-782
© 2003 Association of Physicians
Coda |
The refugee’s tale
Valentina and Aferdita are both refugees from the former Yugoslavia who see me at the surgery. Their stories, on the face of it at least, are very different. (I have changed names and some other details here to preserve their anonymity.)Valentina is of Serbian Christian origin and comes from Sarajevo. She married her Bosnian Muslim husband before such liaisons mattered very much to anyone there. Then, during the war, ethnic rage and murderous insanity possessed many of their former friends and neighbours. As a mixed couple, they were regarded as traitors by both ‘sides’, and so they left. Now, Valentina tells me that she would rather die than go back. She and her husband lack permission to work in Britain, so they sit at home for most of the time, fighting off apprehension and despair while they wait for their asylum applications to be processed. Understandably, they shun contact with their fellow refugees here. What keeps them going (just) is their infant daughter, born since they arrived in London. Valentina is also devoted to her studies, and now speaks fluent and expressive English.
Aferdita and her husband, by contrast, are both Muslims. Aferdita spends every minute of her life wishing that she was back home in her village. In four years in Britain, she has scarcely learned a word of English. A friend comes with her to the surgery every time to translate, and explains to me that Aferdita feels ‘emptiness in her soul’. The friend knocks on her own chest to illustrate this. Aferdita also ‘loses her mind’ several times a day; the metaphor in this case does not seem trite, but evokes her loss of any bearings in her life. Aferdita grieves that her two elder sons have not seen their grandparents since they left their village, and that her younger son has never seen them at all. What keeps Aferdita in Britain, apparently, is her husband’s passionate determination to win asylum status. If he can convince the authorities to let him stay, on the grounds that his life would be at risk if he returned, he will be able to earn a better living for his family than he could at home. Paradoxically, this would then allow the family, illicitly, to come and go between the two countries as they please.
It is tempting to see Valentina’s story and Aferdita’s in black and white terms, with Valentina’s family cast as ‘deserving’ asylum seekers and Aferdita’s as ‘economic migrants’ who could and perhaps should return home. However, I do not find such distinctions helpful. I wonder, for example, how far the stories that Valentina and Aferdita bring me have an aspect of performance to them—not in the sense that they are dishonest or manipulative, but because all narratives are told, to some degree, in the hope of affecting the hearer. Perhaps Valentina sees me as an ally in her fight with officialdom, and heightens certain elements of her story when we meet. By contrast, Aferdita’s most pressing need is for compassion, so she too may be selective in what she says, hoping to draw me into an alliance that will further her own wish to return.
I wonder too how my reading of the two stories might change if I spoke with the two husbands—neither of whom I ever see. In the accounts I hear from their wives, both men seem to lack any ambivalence. Yet perhaps Valentina’s husband is struggling with secret homesickness, or Aferdita’s is too traumatized by the war to be willing to return—while neither man dares disclose such things to his wife. And if I could talk to some of their neighbours and acquaintances back home, who knows what frightening secrets I might learn, or new perspectives I might acquire?
Inevitably, I find myself thinking about the task faced by those who have to interview people like Valentina and Aferdita and their husbands, in order to make decisions about asylum. In this hall of mirrors, how on earth can they interpret what they are told? Through repetition and self-interest, even narratives that once bore a connection with some atrocious truth must degenerate into the quality of melodramatic fiction. Perhaps some immigration officers who have an unswerving commitment and adequate resources for investigation might sometimes be able to retrace the path all the way back from these stories to some historical facts. But common sense suggests that often this may not be the case—either because the path has become too murky, or because the commitment and resources are not there in the first place. The decisions that follow must be fairly arbitrary.
In suggesting this, I am making no claim for the moral high ground. These days, we sometimes spend up to a third of all our consultations in our surgery seeing refugees like Valentina and Aferdita. Such a proportion is common for many GP surgeries in London, and no doubt for some hospital departments too. We are bowed down by the workload, and without determined political action of one kind or another, it will become unsustainable. However the real dilemma for us, and for society, is that increased pressure on public services does not equate automatically with guilt in those who cause it—nor with total innocence either.
If we can contribute anything from our experience as doctors to the wider debate about refugees, it may be through avoiding the polarized banalities of politics and tabloid journalism, and by pointing out that the narratives told by refugees like Valentina and Aferdita are more complex, and harder to judge, than many people on either the political left or right might wish. When you are dealing with stories rather than visible scars, you cannot hope to eradicate abuses of the system, or injustices, let alone both.
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