Bhutanese Refugee Populations in Nepal and the United States

James McClure

As a result of government discrimination of the Nepali people in the 1980s, approximately 100,000 Nepali-speaking Bhutanese fled Bhutan by 1993. While the majority of the refugees have been resettled in either Nepal or the United States, up to 18,000 refugees remain displaced in camps as of 2015, according to a United Nations report. The unsanitary conditions and lack of access to adequate medical care within refugee camps facilitates rapid disease spread. When refugees are resettled in a nation granting them asylum, there is potential for pathogens acquired within camps to be introduced to susceptible hosts in the new nation. A study from 2019 highlights that multidrug-resistant bacteria were found in resettled Bhutanese refugees in Ohio. According to the conclusions of these researchers, “population mobility imposes threats to the distribution of antimicrobial drug-resistant organisms”. When refugees lack proper access to healthcare in spaces of transition such as refugee camps, there is risk of the introduction of infectious diseases to novel environments.  

According to an Infectious Disease Surveillance study of six Bhutanese refugee camps from February 1991 through June 1996, leading causes of death within the camps consisted of “measles, diarrhea, and acute respiratory infections”. While the burden of these communicable diseases was significant within the camps, it is also possible that these diseases were introduced to communities that the refugees inhabited after being resettled. Researchers found that disease control interventions, such as routine measles vaccination and Vitamin A supplementation, reduced mortality rates by 75% less than 4 months after implementation. By improving conditions within camps, disease spread amongst refugees and potentially non-refugee populations was greatly reduced.