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Life In Illegality - When Depression, Anxiety And Alcoholism Become Norms

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Life in illegality - When depression, anxiety and alcoholism become norms

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By Rajiv Kunwar

Indepdendent Researcher based in Germany

(The following write-up is based on my original Master’s thesis titled “Undocumented migrants’ access to health care in Germany: Limitations and strategies”. This article is the first in a series. The rest will be in the Immigration section.)

Ninety percent of undocumented Punjabis living in isolation in Germany due to their illegal status are suffering from severe mental and psychological problems. This was one of the several findings of my fieldwork research for the South Asia Institute, Ruprecht-Karls-Universität Heidelberg. A qualitative analysis of the semi-structured interviews of 30 undocumented Punjabi migrants’ in 2009 clearly showed that this single largest South Asian ethnic community is suffering from immense emotional distress characterised by strong feeling of guilt and self-stigmatisation. This dismal mental condition stems from their isolated life and prolonged confinement to hideouts due to fear of being unmasked and deported to their home country.

Almost every medical and social care giver interviewed for this study has accepted that a life of self-stigmatisation combined with a traumatic past, marked by a loss of self-esteem and deepening inferiority complexes is severely damaging the mental condition of these migrants forcing them to resort to unhealthy tendencies and behaviours. “Sharam” ( “ shame), “badnaami”( “stigmatisation”), “bay-izzati”( “ insult”) and “ pachchtava” ( “ regret”) were the terms used by these undocumented Punjabi migrants during several one-to-one interviews to express their feelings about a tarnished life alienating them from their family and children.

Interestingly, contrary to the general impression that these migrants from the Indian state of Punjab may have come to Germany due to security reasons, almost every migrant admitted to have entered Germany illegally primarily for job, money or for the purpose of establishing a relationship with someone in order to obtain a legal status. Also, these migrants accepted that they entered Germany after spending a fair amount of time with a life of illegality in some other countries of the EU or former Soviet Union states. Henceforth, it is quite ironical that these migrants crib and complain about their dismal mental condition when they themselves have chosen a path of illegality for their materialistic needs.

While most of the migrants agreed that fear was a dominant feature of their lives, they expressed varying views regarding the origin of their poor mental condition. In the opinion of Dalbir and Sikka, the fear of being identified, unmasked and persecuted haunts them all the time, forcing them to remain invisible. Iqbal Singh, another undocumented migrant, contends that the problem of anxiety has also to do with a high level of jealousy among the housemates. He explains that every time someone from their group informs others about the possibility of finding an escape route from illegality leave alone actually finding one, others go into their shells. Almost all interviewed migrants admitted to some sort of rivalry among housemates as to who will be first to obtain a legal status. After all, this is what every undocumented migrant is aiming for.

Even the very common health problem of body pain particularly headache is mostly a result of these migrants’ vulnerable physical and psychological condition. Being away from their family and relatives and living such an incalculable life of consigned oblivion affects their body and psyche. And when the point is reached when their health needs some attention in a country like Germany where the legal system does not seem to have any prominent loopholes, lack of proper access to medical care further compounds their health woes.

Lack of trust in people particularly belonging to the host population is something which creates several impediments for such migrants especially when they need medical care, something which is hardly accessible to these people due to state’s restrictive health care policy. An example in this regard is that these Punjabis are overcautious when it comes to choosing a physician during the time of their illness. They want to be absolutely sure that the doctor they are going to see is either known to them through a reliable friend or is someone with a similar cultural background. They think that seeing a German doctor is an enormous risk due to fear of being identified and caught by Police. The general impression among these undocumented migrants is that the German doctors are too law-abiding and therefore they are under some kind of obligation to inform the police or the Foreigners’ Registration Office about the arrival of any illegal migrant to their clinic or hospital. This is what makes these migrants too suspicious about other people in general and medical fraternity in particular.

As regards trusting a specific community of the medical fraternity, physicians, pharmacists and traditional healers of the South Asian origin are considered more approachable by these migrants because of a certain cultural and linguistic affinity. They are usually preferred over other doctors so that the patient’s health problems can be addressed without any cultural barriers. However, interestingly there are also some Punjabi migrants who feel uncomfortable talking to physicians of their own nationality and ethnicity about venereal diseases and alcohol abuse. This study has also found some migrants admitting that they are not used to sharing such problems with South Asian practitioners openly due to cultural conservatism. One reason to avoid seeing doctors of one’s own nationality or cultural background is shame and embarrassment in facing such doctors due to the stigma associated with these migrants’ illegal status. The preference of Russian doctors in this case, however, is noteworthy. Physicians of Russian origin are also very popular among South Asian undocumented migrants particularly Punjabis. This could be attributed to the fact that the majority of these South Asians enter the European Union after spending a fair amount of time in Russia. Familiarity with Russian doctors and their language helps them enjoy a certain comfort level. So, this tug of war between trust and suspicion takes a heavy toll of these migrants for most part of their life of illegality and they are sometimes left with their instincts alone to help them in such complex situations.

Yet another example which can be cited here with regard to these migrants encountering a constant conflict between suspicion and trust is that they do not even trust people they are sharing a room with, and prefer to remain tight-lipped about their plans and personal matters. 25-year-old Sukhi reveals that there have been a few instances when people from within the same group secretly informed the police about a specific hideout or an individual working illegally at a certain place which caused a serious trouble for many of them. According to him, such things happen due to continuous frustration and despondency.

Even the problems of alcoholism and sleep disorders among this population are also a result of vulnerable psychological condition this population is faced with. It is worth mentioning here that approximately 85 to 90 percent of these Punjabi migrants belong to Sikhism, wherein drinking is clearly considered against the spirit and tenet of Sikhism. However, most of the migrants especially the young ones are addicted to drinking hoping that it helps them fight depression and sleep disorders. Unfortunately, this perception goes the other way round and, as confirmed by some doctors during this study, this misconception leads these Punjabi migrants to deeper depression. In fact, a young Punjabi undocumented migrant Sikka reveals that alcohol abuse has been a major trigger of abdominal pain among lot of his housemates as a result of which some of them even suffer from recurring abdominal pain. He discloses that one of his friends, who often complained of body pain especially in the abdominal area, was recently diagnosed with a liver infection. Although Sikka´s friend managed to get some treatment for his liver infection, his life eventually could not be saved as his condition needed regular and prolonged medical attention, which was not possible because of lack of resources and access owing to his illegal status.

A life full of depression, anxiety and social alienation for several months and even years is also fast giving rise to a new but unusual practice of ‘laundebaazi’ (a term these Punjabis use for gayness) among this population. Though claiming to have refrained from homosexuality, Dara , an undocumented migrant of the Pathan community in Pakistan, gives away details of the practice of gayness among his housemates that includes Indian Punjabis as well. Gayness, he tries to explain, is seen as an ideal foil to man-woman sex especially when the latter is more risk-prone due to the migrants’ restricted mobility. However, he clarifies, gayness works for those who find it a feasible option by choice and not by force. With homosexuality having ceased to be a social taboo in European society, some of his South Asian housemates are also fast coming to terms with this practice. Although this new tendency vis-à-vis sexual behaviours is not a disease, it definitely can be attributed to frustration and depression in their life due to lack of their contact with female members of the population. Needless to say that their forced and prolonged sexual abstinence is encouraging them to resort to this new sexual behaviour.

In case of the undocumented migrants who manage to have some contact with female members of the population due to proximity of their hideout, their mental condition does not augur too well either. A lot of young migrants between the age category of 20 to 25 years are fast getting used to the excessive use of certain cheap quality libido-enhancing Viagra pills. Initially sold as anti-depression pills under code names like Sardard ki Goli (Headache pills), Murga Chhaap Pathaka (a popular brand name for fireworks and crackers in India) and Pink City (the city of Jaipur from where originally the supplier of such pills hailed from), these local versions of Viagra arriving from India are playing havoc on the minds and bodies of these young migrants. Most of these young migrants fail to resist the temptation of using these pills in order to achieve what they describe as “total mazaa” ( “complete fun”) vis-à-vis ecstatic sexual pleasures. However, some of these migrants have already undergone a life-threatening phase of their illness due to overdose of these pills which could not have been avoided due to their lack of access to health care options and facilities.

Now the question arises as to why this population of undocumented migrants should be allowed an easy access to health care? The fact that the government uses these migrants as a cheap and effective workforce has ceased to be a secret any more. In fact, this labour force reasonably contributes towards overall economy of Germany while still be devoid of proper rights to seeking medical care. The time has come when the government should accept that these migrants do fill a gap in the socio-economic system and therefore rightly deserve some kind of leeway in availing of medical care facilities in this country.

P.S. Names of all the migrants in the above article have been changed due to interviewees’ request.

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