Intended for healthcare professionals


The Ukrainian refugee crisis and the pathology of racism

BMJ 2022; 376 doi: (Published 11 March 2022) Cite this as: BMJ 2022;376:o661
  1. Simar S Bajaj, student1,
  2. Fatima Cody Stanford, associate professor of medicine and pediatrics2
  1. 1Harvard University, USA
  2. 2Harvard Medical School, USA

War has catastrophic impacts on human health, but the risks facing those fleeing violence are made all the more dangerous when compounded by racism, say Simar S Bajaj and Fatima Cody Stanford

In just the first 12 days of the Russian invasion of Ukraine, more than two million people fled the country, with the United Nations High Commissioner for Refugees (UNHCR) estimating that millions more could be displaced in the coming weeks.1 The European Union has proclaimed that member states will welcome these refugees with “open arms,” and neighbouring countries, like Poland, Hungary, and Romania, have taken in millions of Ukrainians since. However, these borders have not been opened equitably.

African and South Asian citizens living in Ukraine have faced particular difficulties fleeing the war torn nation.23 Numerous stories have emerged of these refugees being pushed off buses and trains, forced to make the long, hazardous journey on foot. Upon reaching the border, they have reportedly been forced to wait in segregated groups as Ukrainian nationals cross first.4 Other accounts have described how Black and Asian refugees have been met with violence, with border guards beating them with sticks and pushing them to the back of the queue.56 A spokesperson for the Border Guard Service of Ukraine has said, “there is absolutely no division by nation, citizenship, or class at the border.”3 Yet on-the-ground reports, as well as a recent admission from the UNHCR that “there are instances where it [the differential treatment of Ukrainians and non-Ukrainians] has happened,”7 show a systemic devaluing of people from ethnic minority communities. In the midst of conflict, racism has once again emerged as pervasive and pernicious, exacerbating Ukraine’s humanitarian crisis.

Such blatant racism is unacceptable, especially because it will further threaten these refugees’ health. Refugees represent one of the most vulnerable populations in the world, bearing the physical and mental toll of trauma as they flee persecution, war, and violence. With little access to healthcare, housing, and high quality food, refugees are at a higher risk of experiencing unmanaged chronic conditions, infectious diseases, nutritional deficiencies, and mental illnesses.8 This baseline vulnerability makes the spectre of racism even more alarming: racial trauma, or race based traumatic stress, can compound underlying stressors, causing refugees further physical and mental harm.9 Indeed, we’ve already heard how, prevented from leaving, African and South Asian people have been forced to brave subfreezing temperatures at border towns where there is little food, water, or blankets, with reports of shops selling supplies only to Ukrainian nationals.2 They are being discriminated against, abused, and assaulted, treated as if their lives are disposable instead of as refugees in need of protection.

This facet of the Ukrainian refugee crisis reflects a broader history of institutionalised racism. The United States, for instance, built its national identity on immigration and the ideals of the American Dream, yet it has long excluded what it deems to be “undesirable” immigrants, from the 1882 Chinese Exclusion Act to the more recent “Muslim Ban.” Similar racist sentiments enveloped Europe in 2015 and 2016 when millions of refugees, mostly from the Middle East and Africa, fled war and persecution to find safety in Europe. In stark contrast to the present situation, many European countries closed their borders, detained refugees, and conducted mass deportations. The fingerprints of this xenophobia can still be found in the media’s coverage of Ukraine today, with reporters and commentators emphasising the whiteness of the Ukrainians seeking refuge.10 Alongside the threat of conflict, African and South Asian refugees in Ukraine face the danger of a racist pathology that frames their lives as less valuable.

War has catastrophic impacts on human health, causing more mortality and disability than any major disease.11 The trauma people experience as a result of displacement and conflict is singularly horrific, but it is made all the more harrowing when compounded by racism. The international community has banded together to stand with Ukraine, yet this solidarity is undermined by a deadly legacy of racism. War is not a time to divide the world into the worthy and unworthy, but to recognise our shared humanity and responsibility to protect all alike. The same dignity and empathy must be afforded to every person fleeing conflict, no matter the colour of their skin. We cannot neglect equity in times of conflict. After all, that is when we need it most.


  • Competing interests: None declared.

  • Provenance and peer review: Not commissioned; not externally peer reviewed.