Nearly 187,000 refugees in Malaysia are registered with the United Nations High Commissioner for Refugees (UNHCR) as of January 2024. Despite the UNHCR’s efforts to provide a safe haven for these individuals, access to essential services, particularly healthcare, remains a significant challenge. This issue is especially critical for pregnant refugee women, who face maternal mortality rates that are almost double the national average. The high mortality rate highlights the urgent need for systemic changes and enhanced support.

One of the primary obstacles is Malaysia’s non-signatory status to the 1951 Refugee Convention, which means refugees are not legally recognized. This lack of legal status forces them to navigate a healthcare system designed for citizens, often securing low-paying, unstable jobs that offer little financial security. Even with a 50 percent discount provided by the UNHCR, healthcare costs for refugees remain prohibitively high—ten times what Malaysian citizens pay. This financial burden severely restricts access to necessary maternal healthcare services.

Social factors further complicate the situation. In some refugee communities, child marriages are common, leading to high rates of teen pregnancies. These young mothers face increased risks of complications such as hypertensive disorders, yet many do not receive the care they need. According to estimates from Doctors Without Borders (MSF), only a small fraction of these high-risk pregnancies are adequately monitored, placing both mothers and infants in jeopardy.

Fear also plays a significant role in deterring refugees from seeking healthcare. Refugee clinics in Malaysia can only offer basic primary care, and for more advanced treatment, refugees must approach larger hospitals. However, Malaysian policy requires healthcare providers to report undocumented migrants, fostering a climate of fear that prevents many refugees from seeking the medical attention they need. As a result, conditions that could be prevented, such as postpartum bleeding and hypertensive disorders, often go untreated, contributing to a maternal mortality rate of 62 per 100,000 live births among refugees—much higher than the national average of 36.

Non-governmental organizations like MSF are working to address this gap by providing free basic healthcare services to refugees, but their resources are limited, and they cannot reach everyone in need. This leaves many refugee women without essential maternal care, underscoring the need for a more comprehensive and sustainable approach to healthcare for this vulnerable population.

To effectively address the maternal healthcare crisis among refugees in Malaysia, a coordinated effort is required. Solutions should include financial assistance to make healthcare more accessible, public awareness campaigns to foster a more welcoming environment, and language support to overcome communication barriers. Additionally, healthcare providers must be trained in culturally sensitive care to better meet the specific needs of refugee communities. The limited maternal healthcare available to refugees in Malaysia is a pressing issue that demands immediate and collective action. By breaking down financial barriers, reducing fear, and ensuring culturally sensitive care, we can uphold the fundamental human right to healthcare for all, regardless of legal status, and create a future where refugee mothers and their newborns can thrive.

References:
https://www.doctorswithoutborders.ca/malaysia-lack-of-access-to-maternal-healthcare-services-puts-refugee-women-at-risk/
https://msf.org.au/article/project-news/lack-access-maternal-healthcare-services-puts-refugee-women-risk
https://codeblue.galencentre.org/2022/10/06/refugees-need-minimum-rm5000-for-treatment-at-public-hospitals/
https://reliefweb.int/report/malaysia/lack-maternal-healthcare-puts-refugee-women-risk-malaysia
https://www.fairplanet.org/story/digital-literacy-whatsapp-rohingya-refugees-myanmar/
https://www.unhcr.org/my/what-we-do/figures-glance-malaysia
https://www.unhcr.org/my/media/saving-maternal-and-newborn-lives-refugee-situations-evaluation-summary