Reflections on Mahama Refugee Camp
The phrase “refugee camp” elicits various questions in people’s minds: What happened to the refugees that end up here? How long will they be around for? The list goes on. Within the first few months of my Global Health Corps fellowship, I was assigned a project that would require me to spend 90% of my working hours in a refugee camp. I was very excited to have a tangible project to engage in, especially because I prefer to be out in the field than to hypothetically solve problems from my office desk. However, I was still unsure on numerous levels about what I was getting myself into.
Refugee crises are some of the most complex and large-scale problems that even the best strategic thinkers of our time cannot simplify. There are simply no easy best practices that can be applied to each crisis in each context, despite the best intentions of do-gooders to tackle the seemingly impossible. These issues are usually bigger than any country’s endeavors — let alone any solitary organization’s efforts. Nonetheless, the Government of Rwanda established the Mahama Refugee Camp in April 2015 as in response to the Burundian refugee crisis that was sparked by political instability. Today, the camp houses over 56,000 refugees, and the number keeps increasing as the birth rate currently surpasses the mortality rate and new arrivals reach the camp daily. The United Nations High Commission for Refugees (UNHCR) proposes three solutions to refugee situations: voluntary repatriation, local integration, or resettlement. None of those three solutions are viable yet for Burundian refugees in Rwanda, but there are mutually beneficial ways in which the camp and the host community co-exist.
I work with Gardens for Health International (GHI), and our model consists of integrating nutrition education and targeted agriculture support into the clinical treatment of malnutrition in Rwanda. Working with refugees is still a new area that the organization is addressing, but it is an important one — despite great efforts made by international organizations such as the World Food Programme, refugee camps are historically notorious for failing to meet basic nutritional needs with food rations and supplements. The rations normally consist of corn, beans, and soy, and although they provide sustenance in the short term, they lack essential micronutrients that are crucial for children’s healthy physical and cognitive development. The 2015 demographic and health survey indicates that the national average of chronic malnutrition in Rwanda is still as high as 38%. While the national rates already indicate a dire situation, the standardized expanded nutrition survey (SENS) by UNHCR indicates that in Rwandan refugee camps specifically, 57% of households have inadequate food consumption which leads to severe malnutrition among children. Normally, GHI’s work focuses on chronic malnutrition, but, given Mahama’s emergency situation, we began targeting families whose children were diagnosed with either severe acute malnutrition or moderate acute malnutrition.
So, what did I learn in the two months I spent working in Mahama?
Here are my three most important key takeaways:
1. Learn to collaborate: The camp hosts a conglomeration of various NGOs. Despite having years of experience in the nutrition/agriculture space, as a new organization joining the rest, GHI had a lot to learn about being flexible in its methods. Even though being invited to work in the camp by the Ministry of Refugees Affairs and UNHCR might give any organization an illusion that its “innovative solutions” are the missing piece to the puzzle, our arrival did not have the messianic effects that were felt at the outset. I learned that it is better to come in quietly and spend a few days learning from the experts while doing your homework of assessing how your programs would fit in this particular setting. In Mahama, it is crucial to collaborate with the existing NGOs, lest we duplicate our efforts and the refugees get hurt in the process of these organizations trying to prove themselves. More importantly though, it is essential to collaborate with the refugees themselves. If you want to get anything off the ground, bottom-up is the way to go. This approach is not just the most intuitive, it also reminds us that we may not be the experts here. As an organization, we would not have accomplished our work without the help of the Burundian health workers, also known as abaremeshakiyago. They helped us advance the work and their presence in our programs communicated a message that mere expertise could not.
2. Balance the humane and the professional: This lesson was a tough one for me, as I revolve around extremes of emotions naturally. Either I am metaphorically crying all day out of despair or I am unconcerned walking around distracted by my headphones. As a human working in a refugee camp setting, you can’t help but have your heart break because it places you face-to-face with tragedy — you hear stories of young children who have been separated from their families and countless other heartbreaking stories of loss. However, the art of collecting oneself quickly and going back to work is key to master. You do want to — and need to — be human, but, at the same time, there is work to be done. A simple example to demonstrate the above is the camp rule that if a staff member wants to give candy to one child, they need to make sure they have enough for all the children in the camp. This means that, for the sake of the camp situation, one might need to restrain themselves from their natural propensity to share, and be reminded that there is a bigger picture behind all this.
3. Realize that it is not all gloomy and lugubrious: On so many occasions, my eyes would come off the big picture of wondering what the future holds for the refugees, as I tried to solve the more immediate problems in front of me and simply just enjoy being in the camp. Are things perfect? No! But do people still cook brochettes, watch movies, and embroider wedding dresses? Yes, indeed. Sometimes life just continues on, and we watch one season simply replace another. I enjoyed passing by children who were busy with their homework, teenagers playing basketball, and cobblers mending broken shoes. Life happens. Those moments would remind me that there is a shared humanity to all of us, and we are all doing the best we can with the cards life handed us. I have learned a few Kirundi words and spent hours laughing at words that mean completely different things in our sister languages. I give these examples to underscore that sometimes we can fall into our own confirmation bias, and we walk around looking for that which is sad, or that which does not deviate from our ideas of what life in a refugee camp should be. People in refugee camps might be walking around with piles of emotional baggage, like all of us, but working there reminded me of an important truth: the human spirit is resilient enough to find and embrace life in the midst of the unthinkable.
Anysie Ishimwe is a 2017–2018 Global Health Corps fellow at Gardens for Health International.
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