Millions of Refugees at Risk as Virus Spreads

This Syrian refugee girl lives in one of 5,000 tents among 31,500 refugees at Arsal on the Lebanese-Syrian border. March 25, 2019 (Photo by Fundacja PCPM) Creative Commons license via Flickr

By Sunny Lewis for Maximpact

GENEVA, Switzerland, March 24, 2020 ( News) – The UN Refugee Agency has airlifted 4.4 tonnes of urgently-needed medical supplies to Tehran to support the COVID-19 response in Iran. The Airbus A330-200 arrived at Imam Khomeini Airport from Frankfurt, Germany Monday afternoon with masks, gloves, essential medicines, soap, and thermometers aboard to help address critical shortages in Iran’s health care system.

Further flights are scheduled in the coming weeks to transport additional aid items, medicine and personal protective equipment (PPE) for health workers in Iran who are battling the novel coronavirus sweeping the world and the deadly illness it causes, COVID-19.

Iran is the country with the sixth highest number of cases of COVID-19 in the world – 23,049 cases as of March 24 in all of Iran’s 31 provinces. Refugees, most of whom live side by side with host communities in villages, towns and cities, are at the same risk of catching the COVID-19 as Iranians.

Iran’s Industry, Mining and Trade Minister Reza Rahmani has tested positive for the coronavirus, COVID-19, the Iranian online news site Asriran reported Wednesday. Dozens of Iranian officials have tested positive for the virus to date. Rahmani remains in the intensive care unit at Tehran’s Imam Khomeini Hospital.

There are about one million refugees in Iran who have access to the same health services as the host community and are covered under the national health response. But hospitals and health centers are struggling to cope with the soaring number of people urgently needing help.

In Iran, the UN Refugee Agency, formally known as the UN High Commissioner for Refugees (UNHCR) is seeking US$9.5 million for its COVID-19 emergency measures and for its support of the national health care system to which refugees have access.

“These aid items are a vital lifeline for improving health care in Iran, benefiting refugees and their hosts,” said Ivo Freijsen, UNHCR Representative in Iran. “We stand in solidarity with the people of Iran and are fully mobilized to help contain the spread of COVID-19 and mitigate the impact on the most vulnerable, amongst them refugees.”

Already during the early stages of the pandemic, UNHCR, in coordination with the Government of Iran, distributed basic hygiene items to some 7,500 refugee families living in refugee settlements across the country and to government and NGO partners providing assistance to refugees.

“We are thankful to our donors, particularly the European Civil Protection and Humanitarian Aid Operations (ECHO), who have rapidly rallied around Iran and UN agencies in this crucial moment,” said Freijsen.

Now the UN Refugee Agency is under even more pressure to respond as the first case of coronavirus was today confirmed in Syria.

“Nine years of conflict have left Syria in shambles,” said Nirvana Shawky, CARE’s regional director for the Middle East and North Africa. “Not only are many vulnerable people living in tents and makeshift shelters, but civilian infrastructure, including hospitals and health care centers, have been decimated. With many healthcare professionals having either left the country or become displaced, providing sufficient medical assistance at scale is nearly impossible.”

“Illnesses do not know borders and a likely outbreak in Syria will overwhelm the already stretched aid response, Shawky said. “A pandemic requires a global responsibility to act. We must act quickly and collectively by stepping up preventative measures and the transfer of medical supplies to spare Syrians even more suffering and avert a humanitarian catastrophe.”

During a videoconference on Wednesday, UN Secretary-General António Guterres called for a “an immediate global ceasefire in all corners of the world” so that everyone can focus on defeating our “common enemy, COVID-19.”

United Nations Secretary-General Antonio Guterres calls for an immediate global ceasefire so that everyone can focus on defeating the novel coronavirus, which causes the disease COVID-19. March 23, 2020 (Screengrab from video courtesy UN) Posted for media use

“The virus does not care about ethnicity or nationality, faction or faith. It attacks all, relentlessly,” Guterres said.

“Meanwhile, armed conflict rages on around the world. The most vulnerable – women and children, people with disabilities, the marginalized and the displaced – pay the highest price. They are also at the highest risk of suffering devastating losses from COVID-19,” he said.

“Let’s not forget that in war-ravaged countries, health systems have collapsed. Health professionals, already few in number, have often been targeted. Refugees and others displaced by violent conflict are doubly vulnerable,” said the secretary-general.

“The fury of the virus illustrates the folly of war. End the sickness of war and fight the disease that is ravaging our world. That is why today, I am calling for an immediate global ceasefire in all corners of the world,” Guterres said. “It is time to put armed conflict on lockdown and focus together on the true fight of our lives.”

20 Million Refugees at Risk

“From Bangladesh to Chile, from the Sahel to the Middle East, from Africa to Europe, UNHCR and its partners are helping governments step up preventive and preparatory measures for possible outbreaks of #COVID19 affecting refugees, displaced people and host communities,” Filippo Grandi, the UN High Commissioner for Refugees, tweeted Sunday.

Globally, more than 70 million people have been forced by persecution, conflict, violence and human rights violations to flee their homes. More than 20 million of them are refugees. Of these, 84 percent are hosted by low or middle-income nations which have weaker health and water and sanitation systems than those in wealthier countries.

The UNHCR is contributing to epidemiological surveillance, reporting, contact tracing and investigation of alerts in collaboration with ministries of health, WHO and partners, including at points of entry and refugee sites.

UNHCR is strengthening communications with refugee and internally displaced communities, particularly regarding hygiene and sanitation measures. These materials are being adapted to suit local linguistic and cultural needs.

UNHCR is also looking at issues such as adequate access to clean water, waste disposal and soap in health facilities, collective shelters and the wider community and training staff to ensure infection control in health centers.

The UNHCR is urgently seeking an initial US$33 million to boost preparedness, prevention and response activities to address the immediate public health needs of refugees and host communities threatened by the spread of COVID-19 around the world.

Grandi said, “With the world mobilizing to combat the spread of COVID-19, many countries are rightly adopting exceptional measures, limiting air travel and cross-border movements. And for many people around the world, everyday life has come to a standstill, or is being transformed in ways that we had never envisaged.”

“But wars and persecution have not stopped,” said Grandi, “and today, across the globe, people are continuing to flee their homes in search of safety. I am increasingly worried by measures adopted by some countries that could block altogether the right to seek asylum.”

“Solutions exist,” he explained. “If health risks are identified, screening arrangements can be put in place, together with testing, quarantine and other measures. These will enable authorities to manage the arrival of asylum seekers and refugees in a safe manner, while respecting international refugee protection standards designed to save lives.”

But “The Guardian” newspaper reports today that hundreds of refugees forced to leave a UN-run center in Libya earlier this year are among those scared they will be cut off from aid in the coronavirus outbreak.

Last week, the UN Refugee Agency announced it would suspend some of its activities in Libya, including work at a Tripoli community day center and a registration center where new arrivals can sign up for help. The UNHCR says it will stop making visits to detention centers until staff are given personal protective equipment, although a spokesperson said the agency will increase phone counselling and outreach to refugee community leaders.

Both UNHCR and the International Organization for Migration (IOM) have halted resettlement flights for refugees and migrants globally “out of concern that international travel could increase the exposure of refugees to the virus,” UNHCR said.

IOM is the global lead of the Camp Coordination and Camp Management humanitarian cluster. With more than 430 offices and 14,000 staff members across the world, and thousands working on health and community engagement, IOM says it is uniquely placed to provide support in international public health emergencies.

Since January, the IOM has assisted governments with COVID-19 preparedness and response, such as providing donations of protective suits, gloves and masks for Wuhan, China, the monitoring of flows of people in Ulaanbaatar, Mongolia, and the secondment of IOM staff for disease surveillance in Afghanistan.

NGOs Express Concern, Rush to Help

“Vulnerable children and their families living in informal settlements such as refugee and displacement camps, and areas with already weak health systems, cannot be forgotten as the world fights to contain the coronavirus outbreak,” the nonprofit charity Save the Children warns.

Around the world, there are more than 12 million child refugees, many living in overcrowded conditions with limited or no access to health care. Refugees and forcibly displaced children are already vulnerable to infectious diseases in a number of ways, including reduced access to health care, water and sanitation systems and weakened immune systems.

Save the Children teams across the world are preparing for potential outbreaks in countries with weakened health systems. In Cox’s Bazar in Bangladesh, site of the largest refugee settlement in the world, there is currently no system in place to screen or test for COVID-19 and there are no intensive care units for the nearly one million refugees, half of whom are children. With cramped conditions compromising people’s ability to self-isolate, the virus could prove catastrophic.

“Even though at present there are no confirmed cases of COVID-19 in Cox’s Bazar, we’ve kept an isolation unit with 15 beds in our primary health care center in one of the camps specifically for isolation as needed,” said Dr. Shamim Jahan, deputy country director for Save the Children in Bangladesh.

“If COVID-19 should spread widely, we’d still be able to keep running our primary healthcare center alongside the isolation unit which is crucial to saving lives but there is a risk we could become overwhelmed,” Dr. Jahan said. “The center normally treats children for pneumonia and offers pregnant women with vital maternal healthcare services.”

In Idlib, Syria, where conflict has forced nearly a million people to flee into inhumane living conditions in camps stretched far beyond capacity, self-isolation would be practically impossible during an outbreak of coronavirus with potentially devastating consequences for families living through the tenth year of the Syrian conflict.

In Sub-Saharan Africa, which hosts more than a quarter of the world’s refugee population, cases are rapidly being confirmed. With just 0.2 doctors per 1,000 people, it’s the region with the fewest number of medical professionals per capita in the world, putting both refugees and host communities at risk as the virus spreads.

By contrast, East Asia and the Pacific, where the majority of confirmed cases of COVID-19 have occurred, has 1.6 doctors per 1,000 people.

The nonprofit NGO Oxfam is very concerned that COVID-19 might establish itself in poorer countries with weak public health systems and whose populations are already facing multiple threats to their health and livelihoods.

“We are also concerned that if the disease hits refugee camps and other places where people are already struggling to access health care or food, it will become even more devastating,” Oxfam said in a statement.

Women especially are likely to be hardest hit – 70 percent of the world’s health workers are women who’ll be on the frontline of infection risk – and women shoulder the vast burden of unpaid care which is bound to increase, whether caring for sick relatives or looking after children at home because schools are closed.

“It is crucial that the international community support these poorer countries now in making the strongest-possible preparations,” Oxfam pleads.

The NGO CARE has established an Emergency Surge Fund for distributing soap, water, and other health care items, and is installing 10,000 handwashing stations to protect the most vulnerable from COVID-19 and other deadly diseases.

Donations to any of the organizations mentioned here proactively saves the lives of vulnerable refugees in places like Bangladesh, Syria, and Yemen.

CARE estimates that:

  • $35 can provide a hygiene kit with soap and water containers for a family.
  • $50 can provide a handwashing station to keep children safe at school.
  • $150 can prevent the spread of an outbreak by equipping a community with multiple handwashing stations.
  • $175 can help provide safety for five families with hygiene kits.

Last week, Michelle Bachelet, the UN High Commissioner for Human Rights, and Filippo Grandi, the UN High Commissioner for Refugees, co-authored an article that highlights why the world must meet the health needs of refugees quickly and thoroughly.

“The health of every person is linked to the health of the most marginalised members of the community. Preventing the spread of this virus requires outreach to all, and ensuring equitable access to treatment,” Bachelet and Grandi wrote. “This means overcoming existing barriers to affordable, accessible health care, and tackling long-ingrained differential treatment based on income, gender, geography, race and ethnicity, religion or social status.”

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