Most recent estimates place the number of refugees, displaced people and asylum seekers at over 70 million across the world. Over 50 million have been internally displaced because of conflict or disasters, with 84% being hosted by low or middle-income nations.1 2 3 A crisis within a crisis is beginning to unfold as host countries already burdened by refugees and IDPs come under further strain due to the ongoing COVID-19 pandemic, with infrastructure and facilities close to breaking point. It is these vulnerable groups that will take the brunt of not only the virus itself but also the consequences of the countermeasures imposed to stem the infection rate. The International Organisation for Migration has voiced concerns that measures put in place to stop COVID-19 will ‘inhibit our ability to deliver humanitarian assistance’ and both this organisation and the United Nations High Commissioner for Refugees have been forced to suspend refugee resettlement plans as a result of state-imposed travel restrictions.4 5 This article, therefore, will explore the issues faced by the vulnerable refugee and IDP communities using Burkina Faso, Bangladesh and Colombia as case studies before seeking to address solutions.
Since the beginning of the current coronavirus outbreak, public health experts have voiced concerns about the potential of rapid infection rates in refugee camps, many of which make use of informal settlements where social distancing is impossible.6 The extent to which social distancing cannot be observed is illustrated by the conditions within the refugee camps in Burkina Faso, which sees 15 to 20 people sharing one shelter alone. Further to this, those in the camps are unable to follow the COVID-19 prevention measures recommended by the World Health Organisation (WHO) due to severe shortages in water supplies. Additionally, a report by Oxfam has shown that these measures are simply impossible to follow as not only can water not be wasted on washing one’s hands but soap is rationed to 400g a month and thus does not allow for frequent hand washing.7 Within Burkina Faso, the United Nations Office for the Coordination of Humanitarian Affairs has also highlighted the suspension of education as well as interrupted food and commodity supply chains as issues exacerbated by COVID-19, which will cause future social tensions.8
Alike Burkina Faso, Bangladesh is also feared to be at risk of a major COVID-19 outbreak. With close to 900,000 refugees living in the camps that make up Cox’ Bazar, one of the world’s biggest and most densely populated refugee camps.9 Within Kutupalong-Balukhali, one of the camps comprising Cox’s Bazar, there are five hospitals run by non-governmental organisations serving 600,000 persons with 340 beds. Modelling suggests that, in an outbreak situation, capacity would be exhausted within 58 days and is likely to result in 2,000 deaths. Although, these figures are very likely an underestimate.10 Whilst the possibility of COVID-19 is greatly increased by the lack of adequate services for ‘detection, testing, diagnosis, contact tracing and care’ this is not the only issue COVID-19 presents to refugees and IDPs.11 The Internal Displacement Monitoring Centre (IDMC) has also found that IDPs, regardless of age, are more likely to suffer from poor health than non-displaced persons and have higher mortality rates due to communicable diseases and under-nourishment.12 This, combined with the likelihood of quickly overwhelmed hospitals during a camp outbreak, has the possibility to lead to increased mortality rate from other diseases such as malaria.13 Alexandra Bilak, the director for the IDMC has stated that refugees’ already precarious living conditions are further compromised by limiting ‘access to essential services and humanitarian aid’.14 In addition to physical health, the virus has also taken its toll on mental health. Research has shown that IDPs are at a greater risk of suffering forms of distress such as anxiety or depression, which ‘can become exacerbated by the psychological impact of quarantine and the global health crisis’.15 Regrettably, as part of measures to control the spread of COVID-19 programmes within the refugee camps, including education and mental health counselling, have been cut or reduced. This greatly limits refugee camp residents’ capacity to cope with this pandemic.16
As a middle-income country, the problems facing Colombia differ in regards to COVID-19 but are still present. Currently dealing with a refugee crisis, Colombia is now host to 1.8 million Venezuela’s who have fled the ‘political turmoil, socio-economic instability and the ongoing humanitarian crisis’ of their country.17 As part of its strategy in dealing with the spread of COVID-19, Colombia has closed its formal borders. Not only has this forced Venezuelans trying to get into Colombia to take more dangerous routes, often controlled by armed groups, it has also imposed restrictions on NGO’s operating within the country, reducing their ability to shelter and aid refugees.18 19 This has resulted in the closure of essential migrant support services that many rely on for food and basic medical services.20 Whilst officially Venezuelans have the right to free emergency healthcare in Colombia, over half of those who are refugees in the country lack a regular legal status and are frequently neglected or stigmatised leading to difficulties in accessing these health services.21 22 Venezuelans without legal status are also unable to access formal employment and many have chosen to make the journey back to Venezuela after losing their jobs due to the COVID-19 lockdown.23 24 Loss of employment has been a prevalent issue for those in the IDP and refugee communities with many having to depend on informal employment as a result of not having access to government safety nets.25 In a recent Danish Refugee Council survey in Jordan, only 3% of 867 Syrian households said that they currently had a family member employed, this is down from 65% before the COVID-19 pandemic.26 Furthermore, the International Labour Organisation has predicted the COVID-19 pandemic to wipe 6.7% of global working hours off the second quarter of 2020, accounting for 195 million full-time workers, with those in the IDP and refugee communities at a higher risk of facing unemployment and underemployment.27
The financial requirements laid out by the UN for a COVID-19 Humanitarian Response Plan is $2.012 billion and it is important that refugee and IDP populations are considered when drafting future epidemic preparedness plans. In order to do this effectively the implementation of these plans need to take into account civil society and both the refugee and IDP communities, something which the international community has failed to do when responding to COVID-19. As a result, measures in response to COVID-19 have disrupted essential humanitarian supplies and the ability for organisations to aid the most vulnerable in society.28 The measures taken have, in some cases, also reduced the ability for states to monitor those crossing borders by forcing the desperate to take informal routes.29 It is obvious that lessons should be learnt from the international response to COVID-19 and that in preparation for future instances plans must be made to incorporate the needs of all those in society, including those who live on the fringe.
