Refugee Health and Wellbeing Conference

I'd like to acknowledge Sir Paul Reeves, Professor Abbott, Dean of Health and Environmental Sciences, Mr Towle, Regional Representative for the United Nations High Commissioner for Refugees, Dr Rasalingam, President of the Refugee Council of New Zealand, honoured guests.

As a signatory to the 1951 Convention on the Status of Refugees, New Zealand is one of only 17 countries worldwide that offer a permanent home to refugees in need of resettlement.

We have been accepting refugees for resettlement since the end of the Second World War and, in 1987, we committed to a formal annual quota of refugees for resettlement.  Since the mid-70s, New Zealand has welcomed around 30,000 refugees from nearly 50 different nationalities. Most have settled and built new lives in our country.  This is creditable record and we have much to look back on with pride.

New Zealand's commitment

Over time, New Zealand's refugee quota policy has evolved, in response to changing global circumstances and needs.  In recent years, our focus on refugees in need of protection - as identified by the UNHCR - has resulted in the resettlement of a diverse range of nationalities, from East Africa, the Middle East and Southeast Asia.

We also contribute financially towards the work of the United Nations High Commissioner for Refugees. And New Zealand is a key partner in the Refugee Resettlement Working Group that meets in Geneva annually.

Sustaining our commitment to protect and resettle refugees is not without its costs.  As a result of the global recession, the Government faces serious budgetary pressures.  Nevertheless, New Zealand continues to accept 750 refugees per year as part of the quota mandated by the United Nations.  A further 118 asylum seekers were recognised as refugees under the Refugee Convention in 2007-08, and 111 in 2008-09. Our commitment to protecting and resettling refugees is longstanding, and we fully intend to maintain a strong international role. 

The size and composition of the quota is set annually. It is agreed jointly by me, as Minister of Immigration, and my colleague the Minister of Foreign Affairs and Trade. This is done after consultation with the United Nations High Commissioner for Refugees. Volunteer organisations involved in the support of refugees and our local refugee communities also contribute to this process.

Protecting vulnerable refugees

As part of its annual quota, New Zealand accepts a minimum of 75 refugees classified as women at risk. This accounts for at least ten percent of the annual quota. It covers refugee women who are without the support of their traditional family protectors or community and are at risk in their country of refuge.  These women would usually be outside the normal criteria for acceptance by resettlement countries and are in need of protection from gender-related persecution such as abduction, sexual abuse and exploitation.

We also accept up to 75 medical or disability cases per year. As with the women at risk category, this accounts for around ten percent of the annual quota. New Zealand is one of the few countries that will accept mandated refugees without a full and comprehensive medical check. Although we screen for HIV and TB in order to ensure safe travel and to prepare required medical services, HIV/AIDS and TB are not used as a basis for exclusion from the quota.

The medical or disabled subcategory provides for the resettlement of refugees with medical, physical or social disabilities which place them outside the normal criteria for acceptance by resettlement countries.

Generally, applicants under this category must have a medical condition that cannot be treated in their current circumstances. Further, it must be shown that resettlement to New Zealand would be potentially life-saving or would significantly improve the applicant's health and well-being. This subcategory generally includes the nuclear and dependent family members of the principal applicant. 

In all cases where there is an apparent physical or psychological condition, full medical reports must be provided by the United Nations High Commissioner for Refugees for assessment by health authorities in New Zealand. The full disclosure of the condition and its effects is essential for planning purposes.

Health needs of refugees

The Ministry of Health reports that the number of quota refugees requiring urgent or serious medical treatment on arrival in New Zealand is much higher than the 75 allocated cases.

This is due to a range of factors. Refugees are often located in places where medical assessments are either limited or simply not available. Or treatment may not be accessible because of the cost. Also refugees are often not aware that they have a serious medical condition. Sometimes this is only diagnosed after arrival in New Zealand.

Health and social services are important components of the six-week orientation programme at Mangere Refugee Reception Centre, where the Auckland Regional Public Health Service of the Ministry of Health provides comprehensive medical and dental check-ups. Access to specialised medical services outside the clinic is also provided where necessary.

Many refugees are victims of violence and even torture. They need both physical and psychological support.  Refugees also have little or no choice where they eventually settle and often know nothing of New Zealand. Many are separated from their families.  Both their past experiences and an unknown future can cause a high degree of stress. This makes settlement difficult.

The Refugees as Survivors Service, based at the Mangere Refugee Reception Centre, has a multidisciplinary team that provides a trauma counselling service and therapeutic activities for both adults and children.

Early intervention is important and the Mangere Reception Centre works with a number of agencies to ensure that refugees who have been identified as "at risk" or "high need" get the support they need as soon as possible. This includes both refugees who have been severely traumatised and those who suffer from physical disabilities.

This collaborative approach ensures that staff can make informed decisions about the support individual refugees need. This support is provided both during their stay at the Mangere Centre and later when they are settled into the community.

Settlement support

As New Zealand permanent residents, refugees are entitled to live in New Zealand permanently and enjoy the same rights as all New Zealand residents in terms of access to education, health care, employment and social welfare.

This is where continuing settlement support is so important. Beyond the Mangere Centre, the Department of Labour funds a range of settlement support services that benefit refugees.

Refugee Services Aotearoa New Zealand is funded by the Department of Labour. It is a key component of the package of services provided to Quota refugees during their first 12 months residence here. Its national network of volunteers helps with access to housing and social services, English language tuition, education and work opportunities.

The large number of volunteers in this agency make a huge contribution to the success of a refugee's resettlement - most importantly, linking them in to everyday New Zealand life in local communities.

Refugee Services is an inspiring example of how voluntary agencies can work within a broad government framework, to deliver better and more customised services.

Of course, Government also has a role to play in establishing the framework within which such initiatives can take place. The New Zealand Settlement Strategy and National Settlement Action Plan provide a framework for government and volunteer agencies to work together.

 A number of exciting initiatives are underway.

The Department of Labour and Refugee Services are jointly leading a new inter-agency project - the Comprehensive Resettlement Plan. This will provide a detailed measure of how effective our work is. It will confirm what works and what doesn't. It will provide a sound basis for further improving both the standard of cooperation between agencies and the quality of refugee resettlement services they provide.

In recognition of the continuing health needs of refugees, specialist services are provided after they leave the Mangere Reception Centre by agencies such as Refugees as Survivors in Auckland and Wellington, and Christchurch Resettlement Services in Christchurch. These agencies provide invaluable support for refugees as they settle into the local community.

When I opened the National Refugee Resettlement Forum held in Wellington this May it was apparent that Health-related issues had also been  a prominent topic at the Regional Refugee Resettlement Forums that had  led up to the national conference. The Forum provides an invaluable opportunity for Government to consult directly with refugee communities on the development of settlement services and policies. And I am optimistic that it will generate especially helpful ideas on how we can best provide for the health needs of our refugee communities

Family Reunification

Family is fundamental to us all.  So it comes as no surprise that family reunification forms an important part of New Zealand's refugee support activities. However, it also needs to be acknowledged that there is a consistently high level of demand for family reunification from refugees in New Zealand that cannot be met through the Refugee Quota Programme alone.

Where the family members of refugees in New Zealand are themselves recognised as refugees and the case is considered to meet the resettlement guidelines of the United Nations High Commissioner for Refugees, it will usually be referred to the Refugee Quota branch for consideration.

In recognition of the fact that it is often difficult for family members of refugees to meet the eligibility requirements of normal immigration policy, Immigration New Zealand operates a Refugee Family Support Category policy. This provides resident refugees with an opportunity to sponsor family members who do not qualify for residence under any other category of Government residence policy.    This immigration category is currently limited to 300 places per year.

Collaborative approaches between government agencies, non-government organisations and communities are critical to the development of successful settlement programmes. This approach underpins New Zealand's resettlement activities. The Settlement National Action Plan takes a whole-of-government approach to resettlement. This is supported by regional action plans that mirror this at a local level.  

This local input is essential because community development holds the key to successful settlement.  This is particularly the case for refugees where social and language barriers can easily lead to isolation and disengagement.

Conclusion

New Zealand's resettlement policy is founded on a collaborative approach, and I am proud to state that it is one that is held in high regard internationally. 

Refugee resettlement is challenging for all players - for the resettling countries and for the refugees who are resettled far from their homeland in a new country and culture.

These challenges we face in improving refugee health and wellbeing will only be met by moving forward together, as we are encouraged to do by the theme of this conference and by the commitment of the organisers and participants.

Thank you