Iran set global precedent by opening refugees’ access to healthcare

Iran has set a global precedent by opening the access of all refugees into its Salamat Universal Public Health Insurance (UPHI) which provides health insurance services similar to that of Iranian nationals,” Sivanka Dhanapala notes.

The UNHCR diplomat also says the launch of UPHI coverage can ensure refugees’ “social protection” and “resilience”.

The following is the complete text of the interview.

Q: What strategy has UNHCR taken to shelter Afghan refugees in the world in general?

A: UNHCR has certain responsibilities upon the arrival of refugees in a host country; this includes meeting their basic needs and providing them with shelter. There is a lot of material assistance they need which is provided directly through the government or with the assistance of our partners.

It differs depending on the situation. In times of crisis or displacement, a core part of our protection mission is to guarantee access to adequate shelter which is a vital survival mechanism and the key to restoring personal security, self-sufficiency, and dignity.

Delivering protection and humanitarian assistance for refugees settled/sheltered in camps is common in some operations. While camps can be practical, particularly during emergencies, encampment can result in a range of problems, including aid dependency and isolation.

In Iran, we are proud that only less than 3 % live in settlements, however, UNHCR supports and complements the efforts of the government of the Islamic Republic of Iran in some targeted settlements, and by providing some support to renovate communal infrastructures. Examples of such interventions include electricity, water or gas connection. UNHCR is also supporting the local authorities to renovate some limited number of shelters in settlements where and when the needs are greatest and most urgent. Renovating shelters ensures the physical safety and dignity of refugees and prevents possible accidents due to any deterioration of building structures.

Q: It is not just Afghan refugees, but also Iraqis who have found shelter in Iran from their war-stricken countries. What has UNHCR done to help Iran provide better facilities such as health benefits and education for refugees and their children?

A: As for Afghans and Iraqis, Iran hosts some 950,000 registered Afghan and 29,000 Iraqi refugees. These are individuals who are recognized as refugees by the government of Iran and UNHCR and hold Amayesh cards.

UNHCR in Iran is very grateful for the protection and assistance that the Islamic Republic of Iran has provided to refugees for now over 35 years.
The Bureau for Aliens and Foreign Immigrants Affairs (BAFIA) of the Ministry of Interior is UNHCR’s main governmental counterpart in Iran with regard to refugee affairs in Iran with whom we have built very good working relations.

Our main interventions are in the areas of health, education, and livelihoods in an effort to improve access to services for refugees. We work under the umbrella of a regional multi-year strategy known as the Solutions Strategy for Afghan Refugees (SSAR) in an effort to find more viable solutions for the very large population of refugees hosted in Iran.

I mention some major interventions and policies as examples of services provided to refugees in Iran.

In regard to health, the Islamic Republic of Iran is rendering free of charge primary healthcare services to all refugees. In addition, Iran has set a global precedent by opening the access of all refugees into its Salamat Universal Public Health Insurance (UPHI) which provides health insurance services similar to that of Iranian nationals.

The implementation of the UPHI creates large protection dividends and plays an essential role in enhancing refugees’ social protection and their resilience.

In the area of education, refugee children have access to education and over 360,000 refugee children study side by side with Iranian children. As one of its major contributions, UNHCR supports the government through the construction of co-funded schools, benefiting both refugees and host communities in areas with high refugee populations. In May 2016 the revision of the regulations on the registration of foreign national students in Iran resulted in the removal of any refugee-specific tuition fees (USD $70-90 per child) for primary and secondary education, which further facilitated the access of the refugee children to education, including  for the most vulnerable and economically challenged families. Additionally, UNHCR supports the Literacy Movement Organization (LMO) in their efforts to provide literacy-related services to refugee adults and over-aged children.

In May 2015, Iran’s Supreme Leader issued a decree allowing all Afghan children of school age, regardless of their documentation status, to attend primary and secondary school education, resulting in an additional 50,000 Afghan and Iraqi children enrollments.

In the area of livelihoods, the government of Iran together with UNHCR strive towards ensuring that refugees gain access to vocational education and demand-driven skills so that they can earn a sustainable living and positively contribute to society during their stay in Iran and that they are equipped with the necessary skills to help rebuild their lives and their society when they voluntarily return to their homeland.

Q: Iran has banned the presence and restricted travels of Afghan refugees in certain cities and provinces. To what extent do you believe Iran’s refugee regulation on Afghan mobility across the country is in conformity with international law on refugees?

A: In 2001, the government adopted a No-Go Areas (NGAs) policy, whereby entire or specific parts of provinces were declared as ‘no-go’ for foreigners, including refugees. However the policy was not implemented until 2007, and then refugees in NGAs were given the choice of relocating to designated areas or returning to their country of origin. Of the 31 provinces in Iran, currently 17 are entirely NGAs and 11 are partially NGAs. They are largely near border areas which remain sensitive for security reasons. The government informed UNHCR that there is no plan to declare new NGAs.

While the 1951 Convention Relating to the Status of Refugees sets the threshold on the enjoyment of rights and obligations of refugees in their host countries, refugees are expected to conform to the laws and regulations, as well as measures taken for the maintenance of public order in host societies. It is important to mark that the enjoyment of rights is fundamentally guided by the principle of non-discrimination based on race, religion or country of origin. In the same context, specific regulations introduced by the host countries, such as the establishment of the no-go areas that are applicable to all non-nationals and based on the protection of specific government interests that are not specifically targeting refugee populations would not amount to contradicting the principle of freedom of movement of refugees as set in the context of the Art. 26 of the Geneva Convention.

Art. 26. “Each Contracting State shall accord to refugees lawfully in its territory the right to choose their place of residence and to move freely within its territory subject to any regulations applicable to aliens generally in the same circumstances”.

Q: Has UNHCR taken any initiatives for safe and voluntary refugee repatriation from Iran?

A: UNHCR continues to facilitate the voluntary repatriation of Afghans and Iraqis to their respective countries of origin, although voluntary return has reduced over the years due to the increasing insecurity in Afghanistan and Iraq. The figure of 16,000 individuals that repatriated in 2012, has decreased to only 2,426 individuals in 2016.

Documented Afghan refugees who volunteer for return approach a BAFIA office to submit their Amayesh refugee ID card, receive their Laissez-Passer (LP), approach UNHCR offices (Voluntary Repatriation Centres), reconfirm their voluntary repatriation, receive a transportation grant and a number of relief items for their journey home and finally receive their voluntary repatriation fund at entry level inside their home country, assisting them to settle down upon arrival.

Q: Will UNHCR provide volunteer positions for Iranian citizens to gain experience at UNHCR?

A: UNHCR Iran operation systematically posts several internship positions for its Programme, Protection, External Relations, and Field units open to all Iranian citizen applicants. These internship positions, which are usually for a six month period, offer a unique opportunity to gain first-hand knowledge regarding the operation and its various projects and joint activities with the government.

Q: Do you personally know of any immigrant or their family whose story touched your heart?

A: Recently the story of a 1 year old infant baby girl named Masoumeh who was born with a birth deficiency in which the backbone and spinal canal do not close before birth, a life-threatening condition with a high risk of permanent paralysis, touched the hearts of many in our office. Masoumeh needed urgent surgery yet treatment cost would place a huge financial burden with many ramifications for her entire family like putting them at risk of eviction from their house, her siblings not being able to attend school due to financial barriers, debt, and so on. However enrolling in the UPHI scheme and obtaining the Salamat insurance booklet, enabled her to receive her life saving surgery this July (costing 150,000,000 IRR) in Children’s Hospital in Tehran.  The insurance paid 90% of the expenses (hospital bill and other medical costs) and gave her the chance for a new healthy life. She is continuing to use the insurance for her follow up treatments and her family will definitely continue to enroll in the scheme in the coming cycle knowing the benefits. Her family is overcome with joy and are ecstatic to see their baby girl’s healthy and happy.

Q: How much has your organization highlighted Iran’s services to Afghan refugees, especially free education for their children? Iran itself is suffering from a high unemployment rate and the refugees have robbed many job opportunities, yet Iranians think the international community is not thankful enough of them.

A: UNHCR believes that the Islamic Republic of Iran has been an exemplary host to refugees yet not enough is known to the international world. Hence, for more information sharing and awareness raising, UNHCR takes every opportunity  – at international and national fora, conferences and meetings – to highlight the generosity and exemplary services rendered by Iran to refugees residing here; going from the United Nations Secretary General, the United Nations High Commissioner for Refugees and myself as the UNHCR Representative in Iran.  We also use any advocacy tool, whether through Press Releases, interviews and organizing events among others so-on many more to reflect these laudable services and the kindness of the people of Iran for hosting such a large population of refugees now for more than three decades whilst highlighting that UNHCR contributions are very minimal in comparison to that of the government of Iran.
When the High Commissioner, Filippo Grandi, was in Iran in June 2016, he noted that he was taken by surprise by the steadily growing volume of services rendered to refugees in Iran, and expressed hope international bodies would further assist refugees in Iran. He further stated that “the international community should be very grateful for Iran’s very high-quality services to refugees.”

Q: What action has UNHCR taken to relieve the sufferings of hundreds of thousands of the minority Rohingya community who have been trying to escape atrocities and execution brought upon them by the Myanmar military since August?

A: It is a terrible tragedy going on. We’ve seen tensions there in the past. I was actually the deputy representative of UNHCR in Myanmar from 2004 to 2007, some time ago, and so I am intimately familiar with Rakhine State where the Rohingya have fled from. The root problem is the fact that the government of Myanmar for some time now has not given legal status to these people. So it is not simply another ethnic group, it is a group that has not been recognized by the government. That is the primary, let’s say, problem.

Myanmar is a very diverse country. You have the Bamar population as a majority. But then you also have something like 135 national races as they call them. The Rohingya do not feature among those 135 national races. So, I think to describe it as a situation where you have discrimination against a Muslim community by itself maybe is a mischaracterization of it; because it is not simply that; it is beyond that. It is the fact that these people haven’t been recognized, and so the government of Myanmar has been saying that they belong to Bangladesh; the government of Bangladesh saying No, No, these people have always been in your territory. And it has been very difficult.

So what UNHCR and a number of other bodies have been advocating for is that they are given residency and national legal status inside Myanmar. They have faced tremendous difficulties in that country, being sequestered in a particular area and their freedom of movement is extremely restricted.
And the issue of establishing a camp came up in 2012 because of some violence in 2012. We can go back. There have been a number of sad milestones of violence over the decades. The last very large movement from Myanmar to Bangladesh of Rohingya was in the early 1990s; let’s say 1992 or so. Soon after that, there was an agreement between the two countries and UNHCR that we head. And we had quite a large voluntary repatriation movement from Bangladesh back to Rakhine State, and because of that agreement, UNHCR was given a role in monitoring that repatriation movement. So actually we had a very early presence in that part of Myanmar in Rakhine State.

Now, after the 2012 violence, there was a lot of internal displacement and you have these camps that are being established since then. But you also now, after 2012, have a much larger international humanitarian community working in the area as well. In addition to UNHCR, a number of UN agencies and a number of NGOs and others are working there.

What are we doing for the Rohingya are on the Myanmar side. Obviously, there is a lot of advocacy with regard to how we can advance this argument for legal status. That has now become a political issue and I think Kofi Annan was given the mission at the request of Aung San Suu Kyi and he has come up with a set of recommendations. So I think what everybody is calling for is that the set of recommendations be reviewed by the government and be implemented.

But from a humanitarian point of view, of course, there is a lot of work going on inside Myanmar in that area in terms of assisting those people who are internally displaced but also those people who are in their villages and are finding it still quite difficult.

On the Bangladesh border, of course, the high commissioner for refugees was actually in Bangladesh in the camps on September 23. But we are stepping up our activities in the area. The location where they are is completely overwhelmed.  One month ago Nobody could have envisaged 400,000 people crossing the border in such a short time. Because we had two camps in that area of registered refugees because there were also a number of unregistered persons who were also outside of the camp. But those camps had collectively about 28,000 people. So you can imagine how they are completely overwhelmed. There are some new camps that I believe are being established and thank God for the generosity of the government of Bangladesh for opening their borders and welcoming these people because it is a very, very desperate situation.