No justice in sight: The mental health and wellbeing of West Papuan refugees

West Papua is a close regional neighbour of Australia, yet there is limited local or international awareness of the decades’ long history of persecution and displacement of the indigenous population by Indonesian military and police. We draw on our research findings in Australia and Papua New Guinea (PNG) to consider the history of traumatic experiences of West Papuan refugees and mental health profile of the community.

Indonesia occupied West Papua in 1963, annexing the territory in 1969 following a referendum which was widely regarded as unrepresentative. Although access by external researchers to West Papua is restricted, international agencies have documented widespread human rights violations perpetrated against the indigenous people during the course of the prolonged low-grade resistance war against the occupation, a conflict that has claimed the lives of more than 500,000 citizens, prompting allegations of an ongoing genocide (Brundige et al., 2004). Evidence suggests that the occupying military has perpetrated widespread abuses including arbitrary incarceration, torture, ‘disappearances’ and burning of villages, resulting in mass displacement of whole populations (Rees and Silove, 2007).

Waves of West Papuan refugees have fled to PNG, with up to 8000 displaced persons currently living in temporary camps along the border and smaller numbers resettling in the capital, Port Moresby, where they live as stateless persons with no rights to land tenure or ownership and with limited access to employment, health services or humanitarian aid (Tay et al., 2015). Approximately a thousand West Papuans have risked treacherous sea voyages to seek asylum in Australia.

The Psychiatry Research and Teaching Unit (PRTU), University of New South Wales, has documented both the experiences of conflict and displacement and the mental health status of West Papuan refugees living in Australia and Port Moresby (Rees and Silove, 2007, 2011; Tay et al., 2015). The reports of both communities provide a window into the types of persecution experienced by the indigenous population of West Papua, including exposure to political murders, atrocities, physical assault, combat situations, torture and forced separation from family members. The Port Moresby community reported post-migration problems associated with the conditions of poverty and deprivation in the makeshift settlements, including exposure to alcohol and illicit substance use, lack of employment or access to welfare and pervasive safety issues, particularly affecting women. Common stresses reported by Australia-based refugees included long-term separation from family, worries for the safety and health of kin remaining in West Papua, obstacles to returning home in an emergency, communication difficulties, fear of repatriation and difficulties with employment (Rees et al., 2013). Refugees at both sites experienced symptoms of post-traumatic stress disorder (PTSD), depression and a range of related stress reactions. Only a minority had received any mental health treatment in Australia and none in PNG (Rees and Silove, 2011).

A chronic sense of injustice appeared to be central to many of the feelings of distress that plagued West Papuan refugees. The idiom of distress, ‘Sakit Hati’ (literally ‘sick heart’ in Bahasa Malay, the lingua franca of the community), encapsulated a constellation of symptoms, including chronic brooding, resentment and anger that West Papuans felt in relation to the legacy of past and ongoing human rights violations they had experienced. A combination of factors appeared to perpetuate Sakit Hati, including the failure of local authorities (in PNG) to recognize the refugee status of displaced persons, and more generally, neglect by the international community both in acknowledging the injustices being perpetrated in West Papua and the right of the indigenous people to assert their national independence (Rees and Silove, 2011). Importantly, those experiencing Sakit Hati reported that their brooding could be triggered into anger by news of further violations in West Papua, resulting in a potentially vicious cycle of mental distress and interpersonal difficulties. In that sense, Sakit Hati illustrates a culturally understood response in which individual and interpersonal suffering is closely linked to ongoing conditions of political persecution.

Our research initiative has provided a foundation for developing local pathways for West Papuans to access medical and mental health assistance at both sites. In addition, each community has established its own representative organization which aims to promote cohesion and a sense of common purpose among exiled West Papuans. As mental health academics we have a duty to galvanize our professional bodies to raise concerns about the mental health impacts of the injustices West Papuans continue to experience. Knowledge can be a powerful instrument for change, and joint advocacy for greater access to undertake population-wide research in West Papua may assist in establishing more generally the impact of the ongoing conflict and the mental health needs of the indigenous population.