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RESPONDING TO FEMALE GENITAL MUTILATION

by Ian Patrick

Introduction

Policy development and implementation in a multicultural context are both complex and challenging. This is particularly so where cultural issues are controversial and simultaneously deemed to transgress human rights standards. Female genital mutilation (FGM) is one such issue. It has tested the capacity of Australian policy makers to develop appropriate responses that are sensitive to the cultural backgrounds and beliefs of those affected while delivering a clear message that the practice is unacceptable to the host community. While policy makers are unanimous in deploring FGM's serious physical and psychological consequences, there is less agreement about how the issue may effectively be addressed.

FGM has become a controversial issue in Australia following the arrival of refugees and migrants mainly from northern African countries but also parts of the Middle East and Asia, where the practice is common. Australian responses to the issue reflect, inter alia, commitments to United Nations conventions that protect the rights of women and children; they also form part of a wider international movement coordinated by the United Nations seeking to curtail the practice.

In Australia, under the aegis of the Commonwealth Department of Health, the National Education Program on Female Genital Mutilation (1996-2000) operates on a `holistic', social model of health. The program, implemented at a state level, has tested a variety of strategies to address FGM, ranging from community development to the training of health professionals. Such initiatives complement other legal and welfare programs by government and NGOs. I here examine those initiatives in order to identify the elements of effective policy responses to FGM. In so doing, I place the Australian responses in the context of those found in other countries of settlement, as well as broader international programs.

FGM can neither be effectively understood nor addressed without consideration of a complex of inter-related gender, cultural, migration, health and human rights issues. In particular, examination of the practice highlights issues about the status of women in countries where it originates. The lives of women, particularly in the developing countries of Africa where FGM is most prevalent, are strongly affected by gender norms and belief systems. An appreciation of these norms and beliefs yields insight into cultural patterns that have supported the perpetuation of the practice. Equally, sensitivity to the cultural context of FGM is integral to the educative, awarenessraising approach that is most effective in curtailing it.

Devising policy on FGM is particularly complex where refugee and migrant communities have settled in countries with significantly different cultural, medical, social and legal traditions. Migration in itself presents many challenges for adaptation; and these are exacerbated for refugees where relocation is associated with trauma and loss. Health issues then, whether arising from FGM or other causes, appear as part of a constellation of competing needs and priorities for the new arrival.

FGM defined

The World Health Organisation (WHO) defines female genital mutilation as `all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons' (WHO 1997: 3). Female genital mutilation is a strongly value-laden term. It identifies the practice as intrinsically an infringement on the physical and psychosexual integrity of women and girls and as a form of violence against them. Health and other professionals counsel that the choice of terminology be handled sensitively especially with those who support or have experienced the practice (RACOG 1997: 6; Adamson 1998; Brady 1998: 52).

Together with the definition, WHO has also produced a standardised classification system of four different kinds of FGM (WHO 1996a: 6). The first involves removal of the prepuce (clitoral hood), sometimes together with part or all of the clitoris; in the second, the clitoris and prepuce are removed, together with part or all of the labia minora. These two are the most common forms of FGM, making up around 80% of instances. The third type, commonly referred to as infibulation, is the most extreme and comprises about 15% of instances. It involves removal of part or all of the external genitalia and stitching/narrowing of the vaginal opening. The final type encompasses a set of unclassified operations on the external genitalia such as pricking, piercing or incision of the clitoris and/or labia. In practice, there may be a lack of clear distinction between the above categories as the actual procedure carried out `depends on the sharpness of the instrument used, the struggling of the child and the skill and eyesight of the operator' (Armstrong 1991:42).

Incidence and prevalence

Assessment of the prevalence of FGM today is limited by the paucity of systematic surveys. This in turn reflects scientific neglect and political and cultural sensitivity about the issue (WHO 1998: 37; WHO 1996a: 3; Dorkenoo 1996: 144). Estimates suggest there are between 100 and 132 million girls and women who have been subjected to FGM, with an additional estimated 2 million at risk every year.

FGM is mostly found in 28 African countries from the East to the West coast, in the northern and central parts of the continent. Much lower rates obtain in the Gulf States, and some in India, Indonesia and Malaysia among Muslim communities. FGM is increasingly found in migrant populations in industrialised countries. This follows political and civil turmoil in Africa and increasing settlement in Europe, Canada, the United States, Australia and New Zealand (WHO 1996a: 3).

In Africa, the rate of incidence of FGM amongst women varies widely among the 28 countries in which it is found. Estimates suggest that the range is from 5% to 98%. In over 60% of these countries the incidence is 50% or greater. Countries with the highest estimated incidence of FGM are Somalia (98%), Djibouti (98%), Eritrea (90%), Sierra Leone (90%), Sudan (85%), Egypt (80%) and Gambia (80%) (Hosken 1993; Toubia 1993).

In Australia, as in other countries of settlement, it is not possible to reliably gauge the incidence of FGM. Although increasing, the numbers of settlers coming from African and other countries where FGM is practised are low. The incidence of FGM is therefore also likely to be low. Based mainly on anecdotal evidence such as statements made by community members and reports from schools, it has been suggested that some forms of FGM are probably practised in Australia (Family Law Council 1994: 17). The existence of anecdotal rather than clinical evidence reflects in part the serious consequences for those who carry out the practice.

The age at which FGM is carded out varies widely, but is most common between the ages of four and 10 (WHO 1996a: 2). FGM is typically performed by traditional practitioners, usually elderly women, but increasingly is being carded out by trained health personnel such as midwives and doctors. WHO and health activists have strongly condemned the `medicalisation' of FGM, as the mantle of professional support both perpetuates and condones the practice (WHO 1996a & b; Dorkenoo 1994; Hosken 1998b).

Consequences

The consequences of FGM for women's health are severe, both in the immediate and longer term. The available literature is more informative on the short and longer-term physical effects of the practice, with much less known about the psychosocial impacts, especially its effects on child development (Baker et al. 1993; Toubia 1994; Kiragu 1995; American Medical Association 1995; WHO, 1996a & b; WHO 1998; Nyinah 1997; Elchalal 1997; American Academy of Pediatrics Committee on Bioethics 1998).

Immediate complications of FGM include severe pain, as the procedure is usually carded out without anaesthetics. In extreme cases, haemorrhage and shock can lead to death. Other complicating factors include urinary retention, a failure to heal, and the risks of transmission of tetanus and HIV. Longer-term complications of FGM, especially in the case of infibulation, include ongoing bleeding as a result of infection, the formation of cysts and tough scar tissue around the wound, problems with urination, reproductive tract infections and chronic pelvic pain. The chances of infertility are heightened. There are often difficulties with menstruation, pregnancy and childbirth. Repeated de-infibulation and re-infibulation in childbirth can cause blood loss and anaemia.

FGM is also associated with a range of psychological and psychosomatic disorders (Baasher 1979; Toubia 1994:715; WHO 1996a: 10). Girls may experience disturbances in sleep patterns, mood and cognition. Such difficulties extend into adulthood with `feelings of incompleteness, loss of self-esteem, depression, chronic anxiety, phobia, panic or even psychotic disorders' (WHO 1996a: 10). Sexual dysfunction may result from painful intercourse, or reduced sexual sensitivity following removal or damage to the clitoris (Toubia 1994: 714; Dorkenoo 1996: 143; Knight et al. 1999). Physical and psychosocial complications interact and reinforce each other.

The cultural context of FGM

The precise origin of female genital mutilation is not known. The practice predates Islam, Christianity and other major religions (Walker and Pratibha 1993). In Africa, FGM is mainly practised by Muslim communities, though also by some Christians. Some Muslim groups believe that the practice is endorsed by Islam, but Islamic religious leaders both internationally and in Australia have condemned FGM and stated that it has no basis in Islamic teaching (WHO 1996c; Al Naggar 1995).

The belief systems that have sustained the practice of FGM are both complex and strong, with justifications varying from society to society, reflecting specific historical and ideological contexts. Most often, proponents of FGM cite a desire to maintain tradition as reason for maintaining the practice. FGM is seen as normal for women, and a rite of passage marking a girl's transition to womanhood. Other reasons include religious conviction, specifically among those who identify FGM with Islam; a desire to reduce the sexual urges of women; and improved health for women and children (Dorkenoo and Elworthy 1994:1 3-15; Family Law Council 1994: 9; Morris 1996).

Sociologically, the practice of FGM is interpreted as `part of the socialization of girls into acceptable womanhood' (Toubia 1994: 714). FGM occurs in a context where great social importance is placed on the marriageability of women. Virginity and chastity are, in turn, perceived prerequisites for marriage. FGM is considered as an appropriate and necessary means of maintaining the virginity and reputation of a girl prior to marriage. Some may feel that a girl's marriageability is further enhanced by FGM as it is believed to increase fertility and the sexual pleasure of a husband (WHO 1996b).

Critical interpretations of FGM see it as means to exercise social control over women in societies which are highly patriarchal and patrilineal. In this context, women's status and identity are severely contained, and largely derived from that which they obtain in marriage. Women's reproduction is controlled through infibulation, while their sexual pleasure is curtailed through clitoridectomy (Toubia 1994:714). FGM is viewed as an expression of a misogynist culture that curtails female pleasure and freedom; and expects women to be docile and compliant (RACOG 1997:16).

Other explanations for the perpetuation of FGM include economic motivations, especially of the older women operators. These women profit financially, and also reinforce their power and status from the practice. They may bring to bear considerable pressure on families through networks of older women in the community (Aldeeb Abu-Sahlieh 1994). The lack of visibility of FGM, as compared with other forms of abuse, has also contributed to its neglect. It has been carried out with relatively little public scrutiny and without data or records of the distress or dangers associated with it (Dorkenoo and Elworthy 1994:14).

In countries of settlement, the available evidence suggests that FGM remains an intensely private and sensitive subject (Maggi 1995; Nkrumah 1995; Morris 1996; Eyega and Conneely 1997). Discussion of FGM is likely to be discouraged, particularly in public, as it might be considered disrespectful and potentially embarrassing to the whole community. FGM is not necessarily viewed as a health issue or problem even some years after settlement. Some women do, however, express varying degrees of disquiet about having been subjected to FGM, but without suggesting that it had encouraged, say, depression or other states indicative of psychological ill-health.

Many affected women indicate distrust of what people from outside the affected community state about FGM, and are similarly distrustful of media treatments of the subject (Schinella and Aboud 1994; Nkrumah 1995: 17). There is also a general sense of disquiet with being portrayed as `victims', as well as with the attitude of Western feminists involved in the issue who, they believe, want to `define their oppression for them and then liberate them from it' (Eyega and Conneely 1997:178). In Melbourne, similar issues were highlighted in the response of African community groups to the activities of the `Women Lawyers Against Female Genital Mutilation' group which supported efforts to stop FGM through formal prosecutions (Ominous 1994: 138). African community groups advocated an educative rather than litigious approach (Edwards 1994).

The human rights context

Since the early 1950s, the United Nations has paid increasing attention to the issue of FGM and bodies such as the WHO, United Nations Population Fund (UNFPA) and the United Nations Children's Fund (UNICEF) have released statements calling for the elimination of the practice (e.g. WHO 1997). These statements refer to, and draw support from, such international human rights instruments as the Convention on the Elimination of all Forms of Discrimination Against Women, to which many countries, including Australia, are signatories.

While the notion of international human rights standards has broad support, it is also controversial. Drawing on the tenets of `cultural relativism', critics have argued that differences between cultures and their constituent social institutions are so great that universal standards cannot be meaningfully applied. From this perspective, it is argued that concepts of appropriate standards and values are best derived from individual societies. This leaves open the possibility of variations in human rights standards and their interpretation between countries (Donnelly 1984). Others maintain that international human rights standards in reality are based on specifically Western philosophical and social values, their imposition on non-Western countries and cultures constituting a form of neo-colonialism (Fraser 1994).

In their application to FGM, such arguments might be used to justify the practice with the suggestion that it may be culturally mandated (Swensen 1995: 27; Davis 1998: 148). The approach reflected in the Australian National Education Program on female genital mutilation is to uphold universal human rights, but remain respectful of diverse cultures, neither condemning or romanticising the particular culture involved.

The WHO, in cooperation with other United Nations organisations, has promoted a multidisciplinary, multi-sectoral, integrated response to FGM (Dorkenoo and Elworthy 1994:17-21). This approach has necessarily moved beyond that of a simple medical model of disease control to incorporate a set of educational, advocacy and policymaking functions, including work to sensitise and motivate policy makers, medical and other professionals; provide information and raise community awareness; and build coalitions of support through international networks and promoting the involvement of NGOs. These initiatives have gained wide acceptance and influenced policy and program development in both developing and countries of settlement.

Developing country initiatives

In Africa, the key actor has been the Inter-African Committee on Traditional Practices Affecting the Health of Mothers and Children (IAC). The IAC has built support for action on FGM among policy makers in Africa; established national chapters in countries where FGM is practised; worked closely with the UN and donors; and operated effective community based information and training campaigns (Magarey and Evatt 1990; IAC 1997).

A small number of African countries have implemented bans on FGM. Although such action is a necessary step in combating the practice, there is considerable scepticism about the ability and commitment of most African governments to implement and follow through with effective programs (Dorkenoo 1996: 142). This constraint, combined with the resistance of community leaders, is in good part responsible for the very slow progress in eradicating the practice in many parts of Africa (Thomas 1998). Opposition to FGM comes mainly from the educated, urban elites, many of whom, however, are reluctant to incur the wrath of traditional communities if they openly oppose FGM or support prosecution of those who practise it.

Country of settlement initiatives

In the countries of settlement, two sets of distinct needs have shaped policy and legislative responses to FGM. These are the need to prevent FGM being transferred to the new context; and the need to assist women and children who have already experienced FGM. Initiatives taken cover legal sanctions, child protection, community development and general medical policy. Countries with relevant programs include Australia, New Zealand, the United States, Canada, France, Denmark, Sweden and the United Kingdom.

The legislative approach to curbing FGM is generally recognised as an adjunct to community education rather than as a solution on its own (Liverani 1994a; Keuneman 1994; Hughes 1995). The availability of strong coercive measures is necessary in case the educative approach fails. Legal measures additionally provide support to those community members who wish to resist the practice.

Where specific FGM legislation exists, as in Britain, Sweden, Canada (Buhagiar 1997) and the United States (Gibeau 1998; Messito 1998), it largely remains untested. France is the only country of settlement to have instituted legal proceedings against those carrying out FGM (Gallard 1995; Hosken 1998b). However, as legislation has only been relatively recently introduced, its overall effects also remain unknown; its impact will depend on prosecutorial discretion, and the interpretation given to laws by the courts and other authorities (Key 1997). Many European countries address FGM through their criminal laws dealing with intentional or negligent assault, or the unlicensed practice of medicine (Morgan 1997).

In Australia, legislative initiatives regarding FGM have been taken at the state level. New South Wales, South Australia, ACT and Victoria have introduced special legislation which all prohibit FGM, also making it illegal to aid or abet the practice (Dixon 1996; Cvjeticanin 1998). The other states and territories of Australia either consider that their current criminal codes cover FGM, are currently considering the merits of specific FGM legislation, or respond through existing child protection legislation.

A minority view has been critical of this kind of legislative response, some suggesting it could be misinterpreted by the affected communities, driving the practice underground (e.g. Aboud & Johnson 1994; Liverani 1994b; Schinella & Aboud 1994; Ierodiaconou 1995). Others have argued that legislating against a culturally-mandated practice threatens the values of tolerance which underpin a multi-cultural country (Buhagiar 1997). On balance the best approach might be to establish ethical, humane and culturally-responsive services for migrant groups, but to retain publicly endorsed legal standards which widely signal the inappropriateness of FGM as a form of abuse (Hughes 1995; Ortiz 1998; Gibeau 1998).

Another form of legal intervention, as just noted, involves child protection programs. Most countries of settlement rely on existing child abuse and neglect statutes which provide scope for child protection investigations and court action in relation to incidents of FGM. The underlying rationale is that sensitive community education and social work intervention are more effective in dealing with FGM, prohibitive steps to be used only as a last resort (Webb & Hartley 1994: 443). This is the practice, for example, in the United Kingdom, principally under the aegis of the Children Act of 1989. Similarly, French authorities give priority to the provision of support and education in addition to monitoring (Gallard 199:5: 1593). And in the United States, the need for clear guidelines for professionals on FGM and child abuse has been identified `in order to avoid prejudicial assumptions regarding intent and guilt under the law' (Key 1997:180).

In Australia, all states and territories have jurisdiction under their child protection legislation to respond to incidences of FGM as a matter of physical abuse. In Victoria, the Interim Practice Guideline on FGM (DHS 1997a) stresses the need for interagency collaboration to ensure effective monitoring of children at risk. In addition, the guidelines stress that the main emphasis of intervention must be on educating parents against the practice, removal of the child to be avoided if at all possible. Consistent with the position of other countries of settlement, legal measures are viewed as a course of last resort.

Community development initiatives are widely advocated as a means of addressing FGM. This approach emphasises collaboration and participation through information dissemination, awareness-raising and integration of this with general issues of settlement. In short, issues relating to FGM are dealt with in the context of an overall strategy to improve the health and well-being of the migrant group in general -- as opposed to a more targeted or blunt response that could be seen as culturally hostile and confronting (Webb & Hartley 1994: 442).

The focus may seek to encourage community members to approach appropriate health and welfare services. Alternatively, programs may directly target service providers to increase their sensitivity, knowledge and skills to respond to the cultural and medical needs of the affected communities (Dorekenoo 1994:142; Dorkenoo 1997: 5; Ortiz 1998: 126). In larger initiatives, like the Family and Reproductive Rights Education Program (FARREP) implemented by the Victorian Department of Human Services, both approaches are promoted simultaneously (DHS 1997b). Welfare workers from the affected groups based in community health centres, women's health agencies and hospitals represent a two-way link between those affected and service providers. Community workers based in women's hospitals additionally assist in the development of protocols and procedures for women affected by FGM particularly in relation to childbirth and sexuality. In a broader health context, hospitals (Bayly 1998; Denholm 1998; Knight et al. 1999) and professional associations (Royal College of Nursing 1994; RACOG 1997) have developed policy and procedures for dealing with FGM and related concerns of people from affected communities.

Debates about minimising harm

There is, perhaps, an instructive comparison to be made here with arguments for adopting a harm minimisation strategy in the field of substance abuse, as encapsulated in the National Drug Strategic Framework 1998/9-2002/3 (Ministerial Council on Drug Strategy 1998). The term `harm minimisation' in the area of alcohol and drug abuse refers to strategies that reduce the adverse health, social and economic consequences of misuse of alcohol and other drugs, by minimising or limiting the harms and hazards of drug use for both the community and individual, without necessarily eliminating them, or in any way sanctioning the abuse. The approach involves an integrated perspective and includes prevention, early intervention, education (including about safer drug use) and, of course, treatment. Harm minimisation therefore includes anticipating potential harm as well as reducing actual harm. Explanations of, and solutions to, drug abuse require consideration of three inter-related factors: the characteristics of the individuals and communities involved; their social, cultural, physical and economic environment; and the drug itself (Ministerial Council on Drug Strategy 1998: 21).

The parallels here with FGM lie in the emphasis on the reduction of all aspects of harm, and the employment of a `holistic' approach which incorporates preventative, early intervention and educative approaches. With these parallels in policy responses come common and perplexing ethical difficulties. There is an inherent dilemma in the adoption of a harm minimisation approach as to the extent to which the community can allow or tolerate the existence of a practice, no matter how well it is managed. At the same time, there is the question of the extent to which an individual's desire to behave outside societal norms should be accommodated in a tolerant society. These debates have been well illuminated in recent proposals for the development of safe injecting rooms. The concern in relation to policy responses to both issues of substance abuse and FGM is that society has difficulty in expressing its tolerance and managing these situations sensitively and holistically rather than punitively.

Refugee settlement and FGM

In order to promote an integrated approach to policy, initiatives on FGM need to dovetail with that guiding refugee settlement programs. Settlement issues which have affected refugee communities in Australia, such as those from Africa, include pressing concerns with survival, and meeting broader health and welfare concerns.

Australian government policy on refugees is generally based on a concept of `settlement' that involves initial strong support leading to increasing self-sufficiency (DIMA 1997: 33). The emphasis on increasing autonomy overlaps with more controversial shifts in social policy which stress a reduction in the role of the interventionist state and increasing focus on individual freedom and the free market (Bryson 1992; Dalton et al. 1996). Such trends place pressures on the resources required to fund the intensive, longer-term settlement programs which are required to support vulnerable groups.

African refugees settling in Australia face multiple levels of disadvantage, particularly as the majority are women and their children, relocated under the Department of Immigration and Multicultural Affairs Women At Risk Program. As a group, they are among the most vulnerable of migrants, with limited English, a refugee background, low levels of education and skill, high visibility, significant cultural differences from the Australian community, and few established community structures and resources (Jupp et al. 1991: 66). Many have also experienced torture and trauma. It is only in recent years that Australian health authorities have developed a capacity for recognition and treatment of torture and trauma syndromes amongst refugees (Jupp 1994: 59; DIMA 1997: 36; Victorian Foundation, for Survivors of Torture 1998). The effects of torture and trauma often necessitate the involvement of services such as therapy, counselling and the provision of emotional support (Pittaway 1991: xiv).

Other critical settlement issues for African refugees include employment options, suitable accommodation, language skills, culturally accessible educational systems, adequate child-care services, financial ,services and information and reception services (Batrouney 1991; Maggi 1995; Buechler and Talarico 1998; Ssali 1998). Problems like domestic violence, alcoholism and drug abuse have also emerged in African communities in part because of the absence of extended families and financial pressures, especially from unemployment and general insecurity. Racial discrimination is also pronounced and affects Africans in employment, social life, accommodation and media representation. In the face of these difficulties, the questions of FGM and reproductive health are often ignored.

Insufficient attention is, arguably, paid by service providers to the centrality of family and gender issues among African refugee communities (Batrouney 1991: xvi). Migrant women in general under-utilise health and community services, despite levels of morbidity and disability that are at least as high as the those of Australian women generally. A major cause of this under-utilisation is the structure and functioning of service agencies, including communication barriers and the ethnocentric cultural practices of the professionals working with them. These barriers are true as much of government as of private medical services (Alcorso & Schofield 1991: ix; Morris & Hamilton 1994: 1).

What makes for effective policy on FGM?

Major programs to address FGM have been established only recently, largely as a response to growing global concern over the medical and human rights implications of the practice. There has also been a corresponding increase in United Nations and other donor support for programs in developing countries, and efforts to address problems associated with FGM in countries of settlement. Based on this limited experience, several reports have distilled the underlying principles of a successful response to FGM (WHO 1996a, 1996b; Dorkenoo 1996). However, the major focus so far has been on developing countries themselves, with relatively little attention paid to policy and program development in countries of settlement. In Australia, such initiatives as the National Education Program on Female Genital Mutilation provide an opportunity to utilise and rectify this deficiency and guide future policy and program development. Moreover, there is an opportunity to integrate this with the findings of other settlement initiatives for refugees and migrants, and related experience in health, legal and welfare programs.

Our available knowledge suggests that FGM policy is and will be most successful where the following principles are followed.

* First, FGM policies and initiatives in countries of settlement are best coordinated as national programs of action, but implemented at the state or community level. FGM is an international issue which has crossed many borders but which, in practice, has to be dealt with locally and with full regard for the specific needs of individual communities.

* Second, the issue should be addressed within the context of an integrated approach to health. As noted, female refugees and migrants have a complex array of settlement needs. While FGM policy sits appropriately in the health field, other aspects of settlement impinge on the question and any effective policy must be based on the specific settlement needs of affected communities and coordinated with other forms of service provision.

* Third, FGM policy-makers will have to take full account of the cultural and development context in which the practice (for any given community) originated; and the impact on consequent cultural expectations of the new norms that obtain in the country of settlement. This involves addressing the belief systems and social structures which have supported the practice in the past; the nature of health practice and awareness among different social groups in the affected communities; and changes in community, family and gender relations that may be expected to evolve after arrival. Policies are effective where they promote change by recognising these social relations and working with families and communities `within the relevant terms of reference. Affected communities have distinct views on FGM, and react to the settlement country context where the practice is illegal and the subject of controversy and media attention. Policies need to be, culturally responsive, and incorporate the community's distinct perspective.

* Fourth, initiatives should aim to be primarily collaborative and educational. This type of participatory approach promotes the community's capacity to address its own issues, rather than imposing predetermined programs from outside. Although clear and effective legislation is important to delineate community standards, promoting change through coercion is less effective. Excessive concentration on coercive measures may inhibit identification and support of affected individuals, and even drive the practice underground. An essential part of the collaborative process, of course, is the involvement of men.

It goes without saying that much more investigation is required to refine strategies for developing effective policy in a multicultural context, with a specific focus on disadvantaged refugee communities. This is particularly significant given Australia's commitment to refugee resettlement, and the pattern of protracted ethnically based conflict in various developing countries.

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Dr Ian Patrick is a Research Fellow with the International Development Studies Program, School of Social Science and Planning at RMIT University.

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