How India and the UNHCR failed to provide healthcare and vaccination for Chin refugees

On 16 April, after visiting three different hospitals in Delhi, a 30-year-old Chin refugee died of COVID-19. According to his mother, who wished to remain anonymous, the 30-year-old told her about the last hospital, “Since my features are different, they don’t pay attention to me. I am very hurt. I want to jump from the top floor but I cannot.” His mother, amid sobs, told me that his last days had been torturous. “He told me they used to shout at him. They asked for 50,000 rupees, the next day they asked for 70,000. And on the third day, they asked for 80,000. He used to call us and he said that he had not even seen a doctor. ‘I am very hungry; I am always hungry’ he said. When we went, they didn’t allow us to see him.” Along with the 30-year-old, four others of Delhi’s small Chin refugee community have died of COVID-19 during the second wave, often without any medical care in government hospitals because they lacked the documentation or money required for private hospitalisation.

The COVID-19 pandemic has ravaged India’s various refugee communities, particularly Delhi’s Chin community, a predominantly Christian group of people from the Chin state of Myanmar that borders Mizoram and Manipur. The only perceivable end to the disease for the community is when they are fully vaccinated. However, India’s vaccine-distribution system, the government-developed CoWIN app, requires an identity card such as an Aadhar card, passport, PAN card or voter ID, all of which Chin refugees are ineligible for. The only identifying document many refugees possess is the United Nations High Commissioner for Refugees card—commonly referred to as the UN card—and the UNHCR and the government have seemed to have done little to ensure that refugees are vaccinated.

The only government document that addresses vaccination for undocumented communities is a Statement of Purpose published by the ministry of health and family welfare on 6 May. The SoP aimed to create a procedure through which marginalised groups who do not have access to government recognised identification cards could access vaccines. Representatives of the UNHCR told me that this SoP addressed the problem of vaccine registration for refugees despite it not mentioning refugees a single time.

The Chin state has seen a prolonged armed struggle for self-government and a federated government of Myanmar since the late 1980s. The Chin Human Rights Organization—a human rights NGO working in consultation with the UN—has reported that the Burmese army have committed ethnic cleansing against the Chin community. Many Chin refugees fled to India during the following decades.

More recently, following the military coup in Myanmar, on 1 February, and the arrest of 171 pro-democracy Chin activists, many more Chin refugees have fled to the neighbouring state of Mizoram. On 20 March, Zoramthanga, the chief minister of Mizoram, wrote a letter to Prime Minister Narendra Modi criticising the union government’s orders to prevent migration from Myanmar, stating that it was unacceptable and that all refugees should be provided asylum on humanitarian grounds. Despite this, on 22 March, the ministry of home affairs deployed the paramilitary Assam Rifles on the Myanmar border to prevent Chin refugees from entering the country. On 26 March, the Manipur government’s home department issued a circular to five deputy commissioners asking them to “not open any [refugee] camps to provide food and shelter” and “politely turn away” asylum seekers. The circular was later withdrawn.

There is no clear estimate of the number of Chin refugees in India. There are no estimates of how many Chin refugees arrived in the late 1980s. In 2017, 1,800 Chin refugees reportedly reached India after fleeing fighting between the Burmese army and separatist groups. A 2009 report by Human Rights Watch estimated that Mizoram alone had upwards of 1,00,000 Chin refugees. James R Fanai, the president of the Chin Refugee Committee in India, told me that he did not have an estimate of the number of Chin refugees in the country, though he said it doubtless would have increased since 2009. “Sometimes people came in large scale like a thousand in one year around 2002, 2003,” he said. “Since then people have been coming from time to time, as people come from different places with different cases and problems.” The UNHCR office in Delhi told me on 2 June that they, too, did not have an estimate of the number of Chin refugees in India.

Fanai told me the current system set up by the government did not allow refugees to get vaccines. “No one is able to take vaccines because we need to do online registration and for online registration, the portal gives options for driving license, Aadhar card, passport, PAN card or voter ID,” Fanai told me. “We have to enter the ID numbers. But there is no option for a UN Card.” Meanwhile, the Indian government has mandated the need to register for a vaccine with one of 11 documents, which does not include the UNHCR card. As of January 2020, there are 2,10,201 asylum seekers and refugees registered under UNHCR in India.

Fanai told me that the CRC had tried contacting every relevant official to ensure that the Chin refugee-community have access to vaccines. “We have gone to the UNHCR many times even before the vaccines started being distributed,” Fanai told me. “We have sent a letter to the Delhi chief minister once and we have not received any response. The Delhi CM has not made one statement regarding refugees.” Fanai told me it was unclear to them what they should do next.

On 14 May, Chite, a Chin refugee-community leader, told me that the UNHCR had told them that they were awaiting a response from the Indian government regarding allowing refugees with the UN card to get access to vaccinations. “The only response we receive from the UN is that they are taking measures,” Chite told me. “The UNHCR said they have written to the health minister and home-affairs minister so we are waiting for that result. They said they have written to higher authorities but there is no response.”

On 28 May, Kiri Atri, the UNHCR’s assistant external-relations officer, wrote to me, “In view of the COVID-19 pandemic, UNHCR had to drastically scaled up its support for most vulnerable refugees and asylum seekers with food, non-food items and lifesaving medical support.” The email continued, “But as needs grow, our ability to respond to growing needs is severely threatened by limited funding. UNHCR welcomes the SOP issued by the Ministry of Health and Family Welfare for COVID-19 vaccination of persons without prescribed identity cards. This will provide an opportunity for vulnerable groups including refugees and asylum seekers to access vaccines.”

The health ministry had published the SoP on 6 May. Contrary to UNHCR optimism about it, the SoP does not directly discuss refugees at all. The SoP mentions that for vaccination, the individual needs one of seven documents, which does not include the UN card. The SoP noted, “Ministry is cognizant of the need for facilitating COVID-19 vaccination for all people, and especially the vulnerable groups who may not possess any of the seven prescribed Identity Cards.” To address this, the SoP states that a District Task Force or Key Facilitator can identify vulnerable groups that do not have access to government identification and register them for the vaccination process. The document does not mention who a District Task Force should include and mentions only “Prison officials for prison inmates, Executive Officer/Superintendent of and Old Age Home,” under examples of Key Facilitators. When I asked Fanai if any member of a District Task Force had contacted CRC for details about vaccination, he told me, “No one has taken any information from us for vaccination. “

The omission of refugees from the SoP’s list of vulnerable groups is conspicuous by its absence. The document lists “nomads (including sadhu/saints from various religions), prison inmates, inmates in Mental Health Institutions, citizens in Old Age Homes, road side beggars, people residing in rehabilitation centres/camps,” but does not mention refugees. Atri did not respond to emails asking if the UNHCR had any other agreement with the Indian government regarding vaccination, besides the non-committal SoP. Ashwin Kumar Choubey, the minister of state for health and family welfare and Rajesh Bhushan the health secretary did not respond to questions about the vaccination of refugees either.

Fanai told me that the UNHCR had given them no clarity on vaccination. “The UNHCR informed us that their partner Bosco will take up the initiative for the vaccine,” he said. “However, the government’s order for vaccination without prescribed ID is still for Indian nationals to a certain point, so it is not known what will happen. There are many Indians who do not have ID card like how some people are scared to have Aadhar card for religious reasons in Mizoram. Those who had considered it unnecessary.  If the monitoring is not good, we cannot just go there and also, there is no separate registration portal.” 

According to a UNHCR report from March this year, Nepal is the first country in the Asia Pacific region to provide COVID-19 vaccination to refugees through its national vaccination rollout. It did so after India donated one million doses of Covishield to the country. Another UNHCR report from April states that around twenty countries including Serbia and Rwanda have included refugees in their inoculation drive.

The UNHCR card has often proved to cause complications for the refugees when seeking medical care during the pandemic. In July 2020, Vijay Rajkumar, a Delhi-based development consultant, and the Chin Refugee Committee jointly published a study titled, “Rapid situation assessment  of  the impact  of  the COVID-19  epidemic  related lockdown  on  the  Burmese  refugee community  in  Delhi.” It noted, “Harassment and  delay in getting  testing and treatment for COVID-19 in the health care facilities has led to  untold sufferings to families that tested positive in the refugee population.”

Fanai told me that most hospitals did not accept the UN card. “Some hospitals do not understand the concept of a UN card, we have to speak to many people and go through different authorities to explain it,” he told me. Fanai said that the virus was spreading rapidly among the refugee population. “Five people have died so far,” he told me. “It is hard to tell exactly how many have been infected with the virus as some people do not tell it out. As of now, 170 people is the number that we have out of which three are currently in a critical condition.”

Fanai told me that there are over 3,000 Chin refugees living in Delhi. I spoke to a few of them, including senior citizens. While a few struggled to put words together, all of them ultimately told me the same thing—that they were afraid. “We are very scared as so many people have died in Delhi,” a 45-year-old Chin refugee, who wished to remain anonymous, told me. “Some of our refugees have also died. A 32-year-old from the Hakha community died due to COVID-19. Our lives have come to an abrupt stop.” The 45-year-old came to Delhi six years ago and lives with his four children and a grandchild. He told me he has a sewing machine with which he stitches bedsheets to make a living. “My children work in restaurants and other places, waitressing or working at weddings,” he said. “That is our main livelihood. They do not go to school. The oldest is 24 years old and the youngest is 18 years old.”

Sawivela, a Chin refugee who has lived in Delhi for over ten years, told me he feared that he would not have anywhere to go if his already poor health deteriorated further. “I am 64 years old and I am worried,” he said. “I wonder if there will be a way for us in the future. I am scared to get the virus as I am old now. It is very dangerous but we don’t know what to do. I have high blood pressure.” He told me that he had gotten violently sick a few days ago. “I had a bad cold and I went for a check-up,” he said. “They said it was because of high blood pressure. I was vomiting all the way in the auto rickshaw. For senior citizens like us who are not healthy, it is very dangerous and I do not have mental peace these days.”

Other Chin refugees also told me that they had no surety when it came to their health. “I live alone,” Esther Chemi, a 79-year-old refugee in Delhi, told me. “Recently, I was sick for two weeks because of the flu and some people from my church came together and gave me around six boxes of IV drips and took care of me. I don’t know who paid for my care. Right now, I am feeling better.”

The absence of Indian government ID cards also threatens the livelihood of refugees. “Burma people are very poor and now we don’t have any jobs,” Chemi said. “It is not easy but as long as I am alive, I am surviving. I don’t have any work but UNHCR gives me a monthly stipend of Rs 3,800. This is not enough for my rent but only for my food. So, my rent is paid by my friends and well-wishers. I live on people’s grace and sympathy. People bring me food. God feeds me.”

Ngin Khan Do, a 61-year-old Chin refugee had a similar story. “We are struggling because of the lockdown,” Do told me. “Two of my children were working but they got laid off. One worked in a restaurant and the other worked in a small factory. They are our main breadwinners. We need to pay rent on top of that. Especially if we are sick, we cannot afford to buy food.” Do said he had been living in Delhi for ten years. “The young and old of the refugee community are not able to secure jobs in established organisations and companies due to the lack of an Indian identification card,” Do said. “Thereby, they have to resort to jobs that do not require us to have an ID such as an Aadhar card, Pan card or Voter ID. These jobs don’t pay well.”

The impact-assessment report published by Vijay Rajkumar and the CRC also noted that the lack of government documents had impoverished the Chin refugee community. “Young boys and girls are compelled to start working at  the age of 14-15 years working as helpers, waiters and waitresses to ensure the survival of the families,” the report noted. “Most refugees in this age group are working. They lose out on a chance for a proper education and being able to invest in their future. Physical and verbal harassment is common. Efforts to support continuation of education including financial to ensure they continue their education at least till class IX is an urgent priority.” It continued, “Young girls start working at the age of 14-15 years, many of them were working in banquet halls, working as waitresses prior to the lockdown getting Rs 500–600 per night to support their families. They have to wear short skirts and skimpy clothes and face sexual harassment on a daily basis.”

“When our youth go for interviews in any good company, if they have no ID and cannot provide an Aadhar card, they start facing problems,” Em Naulak, the secretary of a wing of the CRC that works with the Zomi community, told me. “Even to work in call centers, if they don’t have an Aadhar card, they are not accepted. Another requisite is to have bank accounts and to create a bank account, one needs a PAN card as well as an Aadhar card. As a result, the majority of our youth work in hotels and restaurants and other odd jobs. It is not possible to have a stable position in a good company.” Naulak told me that since most refugees worked in restaurants and in the unorganised sector, the lockdowns to curb the COVID-19 pandemic had hit them particularly hard. Naulak said that donations to the CRC have also reduced this year. “In other years we receive aid from other countries but this time since Myanmar is under crisis, those who want to help have concentrated their donations to Myanmar so that is our situation right now,” he told me.

Fanai told me that he had no hope of getting help from either the UN or the Indian government. “So far five of our people have passed away due to COVID-19,” he told me. “The last one was found dead in his room with no care received at all. The Delhi Mizo Welfare has helped us in providing oxygen to some of our members who needed it. There is nothing that can be done from the UN at this point, we don’t know if they are afraid or what other reasons they have to not help us. We are just dependent on Mizo welfare, there is no point depending on the UN.”