Political Instability, Inequality

The Refugee Crisis: Health Burdens and Vulnerabilities

~Written by Sanskriti Sasikumar (Contact: sanskriti.191@gmail.com; Twitter: @sanskritiskumar)

Also published on the Irish Forum for Global Health

We are failing the world’s refugees. Today there are 60 million displaced persons in the world as a result of the humanitarian crises of war, epidemics, and natural disasters. In the last two years alone there has been a 25% increase in the number of displaced persons, which is burdening the process of repatriation and local integration. The political inaction in this area has further left a staggering number of individuals in overcrowded camps and in extreme poverty. This has serious consequences on the health of these individuals in terms of disease control and general well-being, so it is increasingly important to be proactive about refugee health measures before the situation becomes too difficult to manage.

Refugees arrive at camps in poorer health than the communities they come from. This is hardly surprising if one recalls the media’s depiction of Syrian refugees tumbling out of overcrowded rubber dinghies as soon as they arrive at European shores. Living in close quarters and under poor sanitary conditions exposes individuals to diarrheal disease, respiratory illness, and malnutrition. Camp residents are increasingly vulnerable to sexual and gender-based violence, child protection violations, as well as human trafficking. Furthermore, there are high rates of sexually transmitted infections and HIV transmission among refugee populations.

For the 40% of refugees that remain in camps there is an established system of aid provision offered by humanitarian organizations like Medicins Sans Frontiers (MSF) and the United Nations High Commission for Refugees (UNHCR). Individuals are provided with access to immunization, nutritional support and medical care. While in the short term camps provide a community setting for refugees, in the long run they create a culture of dependency and become disruptive to societal structures, local economies, and surrounding environments.

Refugee camps are not equipped to take care of the long term needs of its inhabitants. There are several barriers to aid provision. Refugee camps tend to be located in hard-to-reach areas, that are poorly accessible by road and have a limited power supply. Overcrowding further limits access to food and water supply. For inhabitants that suffer from chronic disease, fleeing their homes will have left them without their regular medication and with little money to buy more. Such restricted access to medications and services has ensuing complications, for example, patients with diabetes and high blood pressure suffering from gangrene and stroke. Possibly the most neglected health need among refugees is mental health. Depression, anxiety and post-traumatic stress disorder are common areas of disability among refugees, and tend to persist because most health agencies do not screen for mental illness in refugee camps.

For those refugees who live outside the structured support systems of camps, access to healthcare services is also challenging. A study of Syrian refugees living with host families and rented rooms in Jordan, stated that 3 out of 10 families cannot get the health services they require because they cannot afford them. Half of pregnant women are unable to access antenatal care and around 60% of mothers and their newborns are not in receipt of postnatal care. National laws and policies restrict refugees from integrating into communities, which further inhibits them from receiving care and services sufficient to meet their needs.

Poor health among refugees is a serious consequence of a system’s disregard to the exodus of people fleeing areas of conflict and disaster. Given these circumstances, displaced individuals and groups are also victims of poverty and disease, as they navigate through camps, transit sites, and host communities in search of safety and stability. In particular, refugees are susceptible to complications resulting from chronic diseases as well as mental health issues. With passing time, these persons suffer the costs of debilitating living conditions. Currently, the structures in place to address these issues are limited and unsustainable in the long-term. Beginning to address the dire state of refugee health requires that host nations and international organizations take responsibility and work together to enact permanent measures that not only address the source of displacement, but also the resulting need for eventual repatriation or resettlement.