Transforming Refugees


The point of this article is not to argue that bio-medicine has become a mechanism for establishing political or cultural identity for refugees entering the United States. Neither does it claim that modern bio-medicine influences define the character and needs of immigrants. Rather, it seeks to establish that each verifies the other and it seeks to present bio-medicine as a mediator of physical realities that gives nation-states justification for domination and control of immigrants and refugees. We will first trace the emergence of the “gaze” in a historical context to its formation as a classificatory concept and agent of power relations. Then, we will discuss the central role of cultural citizenship and its impact on the processes of immigration and assimilation.

The Middle Passage

I arrived at the airport in Qui Nhon, South Vietnam early because I wanted to make sure that I would be able to get a seat on the first available plane heading to the naval base at Cam Ranh Bay. My two years in a war-torn country almost completed, I was happy to be going back “across the pond.” After checking in and finding a comfortable place to put my bags and sit down (there is no baggage check when “hopping” a free ride on an Air Force military plane), I could not help noticing a young Vietnamese woman with a baby sitting with a young white GI. Apparently, she was married to the GI and he was going back to the states with his Vietnamese wife and Amer-asian child. Again, I could not help noticing how every two hours or so, the GI would go back to the counter and check to see if a plane had come in with available seating for him and his family. Repeatedly, the white GI behind the counter would tell him that nothing had become available and assured the traveling GI to just wait. I had come out of the field two weeks early and had been in the “rear” waiting for orders to go home and had become somewhat accustomed to waiting long hours. However, I noticed that the GI with his family seemed to be somewhat impatient. It never occurred to me at the time that he had been there for days trying to get a flight out and was only getting the run-around. Finally, after about six or seven hours later my name was called. I went to the counter, showed my ETS (Expiration Term of Service) orders and was given a pass and instructions on which flight to catch and where. I mentioned the white GI and his family and that I could wait a little longer because they had been there before me. It was then that they told me that he had been there for a few days trying to get a flight (in a snickering kind of way) and that it would be a long time before they gave “them” one. So, I gathered my bags and as I left the airport’s transportation waiting room, I could not help thinking that the only reason the GI was getting the run-around was because he was white and married to a Vietnamese woman. This was my first encounter with racism of a different sort and my first introduction to the difficulties inherent in gaining entrance into the US, custom requirements, and “screening processes.”

When considering modalities of citizenship making, we must necessarily examine the criteria by which nation-states regulate processes of selection and the relations of power politics used to normalize and adjust subjects rendering them loyal, governable citizens. The ability of the state to invent consciousness, establish boundaries, and conceive traditions, enables it to increasingly determine the lives and activities of humans as citizens and subjects. It seems plain enough that in the course of Western history the use of nationalistic ideologies, albeit ambiguously disguised as custom or tradition have been successful in soliciting compliance from members of society and influences the affairs of human beings by altering the terms of their self-understanding. Notwithstanding, the role of bio-politics contributes to this scheme of power relations by domesticating in one sense or marginalizing in another transcendental subjects. However, this is not some new sociopolitical mechanism. Since the late nineteenth-century, the biomedical “gaze” as an ideology has assisted nation-states in the expansion and control of non-European civilizations and formulated explicit discourse that articulates a certain imagery carrying with it a pervasive perspective on the relationship of the human body. Indeed, the dialogues of colonialism fostered images about the dangers of the “unclean” body and its threat to the decency, cleanliness and health of the colonial order. Consequently, bio-medicine provided new conceptualizations and became inextricably bound up with the politics of power in a conceptual scheme for the control of individuals and social bodies.

The fusion of scientific investigation, the rise of colonialism, and the spread of western cultural ideals constitute the essential elements founding the rationale for relations shaping what is often referred to as the “normative gaze.” Indeed, imperialistic expansion armed with the biological theories of influential European scholars such as Petrus Camper, George Cuvier, and Johann Friedrick Blumenbach thrust upon the world concepts that dictated fixed and unchanging attributes of humanity for the nineteenth century. In this space, structures were laid that determined the discourse on what we now term “race.” Moreover, this space configured the fundamental system of relations responsible for concepts and beliefs in racial types that condensed into the language of scientific racism that would mature during the early twentieth century.

Cultural imperialism drew its influential form from Europe’s early encounters with the non-European world. European science articulated a conception that was formulated by expeditions of missionary crusades into Africa, India, and Asia. The effects of disease on the early missionaries and the subsequent reports sent back to Great Britain created a disdainful reaction by bourgeois society. Robert Moffat (1842), the father-in-law of David Livingston an early pioneer of the London Missionary Society received a report that stated:

“Africa still lies in her blood. She wants…all the machinery we possess, for ameliorating her wretched condition. Shall we, with a remedy that may safely be applied, neglect to heal her wounds? Shall we, on whom the lamp of life shines, refuse to disperse her darkness?”

Here we see and example of the cultural logic of the “civilizing” mission. Moffat went on to publish his Missionary Labours and Scenes in Southern Africa in 1842, which made him an imminent figure in British society. Livingston’s writings went on to receive tremendous circulation in the scientific and popular media of the times. The implications of these writings, confirmed and reinforced by “scientific evidence” from what was believed to be laboratories on the colonial frontiers, transmitted a well-enforced European mythology about the nature of the bodily form of non-Europeans.

The two-dimensional space of classificatory medicine during the late nineteenth century took on a very paradoxical quality. On the one hand, the well-founded corpus of medical knowledge proceeded down a path that made visible the definition of the relationship between body and disease. On the other hand, it proceeded toward that which conceals it. In his important work on the medical gaze “Birth of the Clinic,” Foucault states that “…one of the tasks of medicine, therefore, is to rejoin its own condition, but by a path in which it must efface each of its steps, because it attains its aim in gradual neutralization of itself. The condition of its truth is the necessity that blurs its outlines. The obscurity that Foucault posits is the historical conditions of the medical discourse that transformed from reason to unreason, from a system of words that uncovers the rational order of disease and illness to a system that is complex and intermingled with politics. This “medicine of epidemics” changed not only the social importance, prestige and power of doctors; it facilitated a politics of health and disease – a politics regulated by power. The basis of this perception, that is where the gaze meets the individual and the individual meets the State, is the space of bio-politics.

Southeast Asian refugees were viewed, in terms of the gaze, as the “contagious others” and efforts to treat and transform them were undertaken. During the communist regime of Pol Pot in 1979, millions of Cambodian peasants and intellectuals were exterminated precipitating a massive escape of Cambodians to refugee camps near the Thai-Cambodian border. Agencies were set up to screen and “socialize” refugees through programs for resettlement into host countries. As part of this effort, US Immigration and Naturalization Service (INS) officials began selecting Khmers for resettlement in the United States. However, thousands of refugees were rejected based on a series of administered tests that were made more complicated by problems in translations, body language, and ideological and medical fears on the part of INS officials. As part of the Overseas Refugee Training Program (ORTP), ideologically motivated strategies were initiated to identify those refugees with mental illness, to instruct others to speak good English, to be employable, and to willingly accept public welfare (provided they passed the screening tests), in America.

Bio-medicine was used as a source of socio-political power in the control and regulation of discourses and practices related to refugee socialization processes. Foucault wrote quite extensively about this form of power in many of his publications particularly with regard to deduction. In his work, The History of Sexuality, he states, “deduction has tended to be no longer the major form of power but merely one element among others, working to incite, reinforce, control, monitor, optimize, and organize the forces under it.” One such bio-medical concept termed “immigrant psychology” was created by INS officials who unfortunately lacked cultural and political sensitivity and knowledge when constructing “psycho-cultural” models for refugees in the resettlement camps of Thailand. In the early 1980s, tools were used for assessing mental disorders among refugees such as the Depression Rating Scale, the Children’s Global Assessment Scale (CGAS), and diagnostic tools for determining Post-Traumatic Stress Disorder (PTSD) in refugees. Aihwah Ong addresses this issue in her book Making the Biopolitical Subject. By controlling, Ong said, “ the medical terms and practices, and seeking to instill them in patients, academicians and medical workers is part of an overall scheme of power that defines the form and content of refugee illness and well-being…” Thus, it was neither for humanitarian reasons nor the health of the United States that politicized medicine was trying to protect when turning away thousands of deserving refugees. Rather, the clinical gaze provided a configuration of power to authenticate a kind of false cultural purity.


The institutional context into which cultural citizenship is framed in schemes of globalization is often defined in terms of “racial” difference or economic worth. Citizenship has become a bifurcated process of self-identification and being invented within the realm of power relations and conditions of nation-states and civil society. Paul Gilroy maintains that this is a new form of racism that is characterized by shifting constructions of racial politics capable of accommodating various institutional structures. Clearly, global conflicts have provided a framework for massive waves of immigrants from Latin America, Africa, and Asia and caused economic and demographic restructuring in the United States.

As a result of the political ambiguity of their status, refugee-processing centers singled out US bound Cambodians for lower-class status. As mentioned earlier, political conflicts and the withdrawal of US troops from Southeast Asia precipitated massive migrations into the United States. The perception that many Cambodian refugees were Khmer Rouge communist trying to gain entry into the US stigmatized their political status from the very beginning. In the camps, they were only taught “survival” English skills and were socialized to expect very limited occupational positions, welfare, and to behave in a subservient manner. These highly politicized processes constructed them as “minorities” and forced them into economic situations similar to that of other refugees from third world countries. Upon their arrival in the US, ideology and policy positioned them for low-wage employment and welfare dependency. This form of ethnic politics succeeded in inventing social and economic citizenship that placed Cambodian refugees at the bottom of the socioeconomic ranking, placing them in relative comparison to the status of refugees from other poor countries. The analytical consequences of their status make them what Renato Rosaldo calls the “culturally invisible.” In his book, Culture & Truth: The Remaking of Social Analysis, he states “seen from a distinct but related angle of vision, the conceptual difficulties that have created zones of relative cultural visibility and invisibility derive in large part from tacit methodological norms that conflate the notion of culture with the idea of difference. This implies that immigrants become culturally invisible because they are no longer what they once were and not yet what they are trying to become.

Cultural differences that impact adjustment for immigrants provides its own set of internal difficulties. The newcomer, according to Salman Akhtar, faces three very distinct variables in their attempts to assimilate: 1) the nature of the host population’s existing community; 2) the historical era in which the migration takes place; and 3) the nature of any preexisting relations between countries. For instance, if the nature of the host population is made up primarily of immigrants to begin with, then assimilation into this community does not present a threat. If, on the other hand, the community is made of ethnically similar, homogenous group, then the task is much more difficult. Similar, the state of affairs in terms of the historiography of political relations at any given time influences the attitudes and opinions of the host community. Finally, the terms and conditions of political affinity between the nation of the immigrants and the host country impact the context of their immigration. Regardless of lived cultural states, that is whether defined as an immigrant or refugee, dominant ideologies distinguish and classify various immigrants assigning them value based on relations of power and ethnic politics.

In modern times, heterogeneity has been perceived as a threat to homogeneous human reality resulting in a need to reduce or transform any experience that is not continuous and coherent. This transformation does not act only as a theoretical discourse or explicit analysis but is practical in nature backed by and made effective by the relations of power. The cultural imperialism of early European colonialism deliberately used the “gaze” to create new objective structures and organized rational language around them. The paradoxical nature of those structures lies in the space in which a dialogue originally aimed at deciphering was transformed into an examination designed to manipulate and control within the regime of bio-medicine. Bio-medicine was and continues to be a complex apparatus that economizes the functions of sociopolitical importance. The resulting institutional frameworks impact processes of racialization, cultural citizenship, ethnic politics, transnational relations and “psycho-cultural” identity making subjects the objects of bureaucratic regulation and control. In this context, refugee and immigrant cultural manifestations are subverted in an effort to reconstruct homogeneous regions of governable subjects. Unfortunately, the relations of domination that these disadvantaged newcomers are subjected to only really succeed in constructing its own heterogeneous forms.

The concept of displaced persons seeking refuge and leaving their home countries because of war, fear of persecution or forced migration has a long history. Notwithstanding, the related concept of political exile also has been around since the early 18th century. The first international coordination of refugee affairs came with the creation of the League of Nations (…which later became the United Nations) in the second decade of the 20th century. For the most part, the practical determination of whether a person qualifies as a refugee or not is left to certain government agencies within the host country. Those that fail to meet the requirements are most often deported, detained or imprisoned. Many NGOs concerned with refugees and asylum seekers have pointed out the difficulties for displaced persons seeking asylum in industrialized countries. The wars that have broken out in Eastern Europe, the Middle East, and the continuing civil conflicts in Africa have displaced tens of millions of people. Unfortunately, immigration policy in some host countries often focus on irregular or illegal migration forcing desperate asylum seekers to undertake often dangerous or expensive attempts at illegal entry into a country.

Sources: Akhtar, S. (1999). Immigration and Identity. Northvale: Jason Aronson, Inc; Anderson, B. (1994). Imagined Communities: Reflections on the Origin and Spread of Nationalism. New York: Verso; Comaroff, John and Jean Comaroff. (1992). Ethnography and the Historical Imagination. Boulder: Westview Press; Cooper, B. (1981). Michel Foucault: An Introduction to the Study of his Thought. New York: Edwin Mellen Press; Foucault, M. (1973). The Birth of the Clinic: An Archaeology of Medical Perception. New York: Pantheon Books; Hobsbawm, E. and T. R. (Ed.). (1983). The Invention of Tradition. Cambridge: Press Syndicate of the University of Cambridge; Manalansan, M. F. (Ed.). (2000). Cultural Compass: Ethnographic Explorations of Asian America. Philadelphia: Temple University Press; Ong, A. (1996). Cultural Citizenship as Subject-Making: Immigrants Negotiate Racial and Cultural Boundaries in the United States. Current Anthropology, 37(5), 737-760; Rosaldo, R. (1989). Culture & Truth: The Remaking of Social Analysis. Boston: Beacon Press.