• projectneighbours

Need for a better sense of history

project neighbours gracia fellemeth

I’ve always struggled with the British sense of history. There is still a lot of pride in the old colonies and there is reverence of people like Nelson. There is also a kind of attachment to the country; people often say “we” when referring to Britain, “we” invaded this or that country. It’s as if Britain has yet to consider its role in the world.

In Germany, in the 1960s, there was a big student movement about questioning the role of Germany in the Second World War. It was a period of critical self-reflection and examination of how the war happened and how to prevent it happening again. In a place like Germany, where history is very much “in your face”, it was a process that couldn’t be avoided. It seems the UK is yet to go through something similar.

I never really lived in Germany though we always spoke German at home. We moved to Thailand when I was three and it is probably the place that shaped me most. Thai was the second language I learnt. I remember playing with a girl next door who would point at things and tell me their Thai name. When I was twelve, after a short spell in Canada, we moved to Geneva. At the time, whenever people asked where I was from, I said, Thailand. Surprised, people would look at me and say, you don’t look Thai. True, yet I couldn’t bring myself to say I was German.

Having lived in different places has taught me to respect a different point of view instead of seeing one culture as the “right” culture. I try to teach my kids that every country is special; there are different ways of speaking, living, being, but they’re all equally “correct”. I feel passionately about doing good in the world and making a difference in people’s lives. I think being able to see cultures as distinct but equally important helps move things ahead.

During medical school, I ended up on Thai-Burma border in a health clinic that served migrant and refugee populations. There were all these people who arrived with nothing but the clothes on their back after carrying their kids through the forests.

I remember this one boy who was nine or ten. He was found in the forest and brought to the clinic and no one knew where his parents were. He was mute and in so much need of love and care. It made me wonder, how can any country refuse help and close their borders?

It’s so arbitrary, where we’re born and where we end up. I know we can’t allow everybody everywhere, but we should not feel threatened by people arriving in our countries.

These discussions are very difficult and I don’t have any answers, but I feel passionately about helping people. I’ve been called naïve in the past, but I believe that, in the West, we often don’t appreciate how lucky we are; not everyone is this lucky.

Having said that, hostility isn’t a Western thing. In the refugee camp where I worked, there were many ethnic groups and even there, there was a lot of violence against the Muslim community; so much so, they had to live separately. It surprised me; even though all these people were fleeing their country for similar reasons, they still distinguished between each other.

I believe there is more that we share than what divides us. I see it in the context of my work, which focuses on depression in pregnant refugees and migrants along the Thai-Burma border. In my research, we saw that it’s the universal factors that have the biggest influence on whether or not women in that group experience depression: interpersonal violence, past history of depression, low levels of social support, all the things that come up again and again as risk factors. None of the migrant-specific factors were significant on their own, though the fact that through their circumstances these women were exposed to multiple risk factors made them particularly vulnerable.

At the same time, depression is not something that these women talk about. There is a lot of stigma around mental health and addressing it is difficult and when there’s no incentive, it’s never a priority. In many countries, it’s not seen as urgent because it’s not immediately life threatening, unlike severe injuries or infectious disease.

Internationally, at a top level, there is a lot of talk about mental health and how it accounts for the burden of disease. On a national or local level, there is little resource and a lot of fear. People are rarely prepared to work with mental illness and often fear they’re difficult or impossible to treat. This isn’t the case, but professionals who don’t have the skills or the confidence to deal with these issues choose to ignore them. Mental health should never be ignored.

Gracia Fellmeth is was born in Germany to German parents, but moved to Thailand at the age of three. Her childhood and adolescence were spent in Thailand, Canada and Switzerland, followed by a move to the UK for university. She studied medicine in London and worked as a junior doctor for two years in Dorset, but soon realised that her interest lay in the ‘bigger picture’, rather than in clinical medicine. Following an MSc in Public Health, she completed the NHS Specialty Training Scheme in Public Health in Oxford. She has always had an interest in migrant health, perhaps because of having moved around a lot herself and feeling at home in many cultures. You can read her work on perinatal deperssion in migrants at the Thai-Myanmar border and a case report on suicide in young refugee couple.