The Privilege of Staying at Home
COVID-19’s Impact on Refugees & Migrants
This is part one of a two-part series exploring the impact of COVID-19 on migrants, refugees, and other vulnerable and displaced populations.
On March 11, the World Health Organization declared the spreading of SARS-CoV-2 a pandemic. Health systems across the world, including those of developed countries, struggled to keep up with the rising number of cases. Official statistics show that over 20 million people have been infected and mortality rates vary from one country to another. Millions struggle under lockdown and stay-at-home orders. But what about the millions who were driven from their homes by war or famine or conflict even before COVID-19 arrived on the scene?
While refugees, asylum seekers, migrant workers, and internally displaced people (IDPs) are contributing to the battle against COVID-19, the disease threatens to further isolate them and infect them at higher rates than other populations. These populations have been excluded and overlooked by governments implementing wide-scale emergency measures without much regard for those living on the outskirts of borders.
Conditions in Refugee Camps
First, a lack of basic resources is very common in settings where migrant populations gather. Globally, 84 percent of refugees and IDPs live in developing countries with weak health systems and low coverage. For example, Rohingya refugees living in camps with abysmal sanitary conditions in Bangladesh do not have access to water or the internet.
Camp-like settings also generally lack quarantine capacities and thus limiting large gatherings is very challenging. In these conditions, infectious diseases other than COVID-19 are likely to surpass prior rates given enhanced movement restrictions and reduced access to adequate housing arrangements. This can lead to co-morbidity factors complicating COVID-19 infections, potentially turning what could have been mild cases into severe ones.
Testing and treatment for COVID-19 is also severely lacking in these communities, and it is unreasonable to expect impoverished moving people to self-report symptoms without promising them insurance coverage and protection. Furthermore, in the absence of government intervention, detrimental rumors circulate and promote the avoidance of medical settings, even where treatment may be available. In Lebanon, for example, there is a spreading rumor in refugee camps that anyone with COVID-19 symptoms will be taken away and killed. With all these factors taken into consideration, we can expect the mortality and morbidity risk associated with the virus will surpass global averages for displaced populations.
High Unemployment Among Migrant Populations
Most refugees in developing countries are informal workers who live on wages earned on a day-to-day basis. These populations are among those with the highest levels of unemployment and are suffering from financial expenses which prevent them from seeking treatment. In Lebanon, only one-third of all refugees have regular work and the majority are in debt. This has led some to break curfew restrictions in search of work and others to turn to exploitative services such as trafficking and online sexual exploitation, thus jeopardizing government efforts to control the spread of COVID-19.
The economic exclusion of migrant communities from the labor market already predisposes them to becoming impoverished and ensures their dependence on aid. People in these communities are usually undocumented and this usually makes them ineligible for stimulus packages or financial assistance from the government. Very few places, like Portugal, have temporarily granted citizenship rights and benefits to refugees and migrants. More often, refugees and migrants are left waiting for cash assistance from organizations such as theUnited Nations High Commissioner for Refugees (UNHCR), which rely on funding from donors who are now focused on funding COVID-19 initiatives. But rising food and rent costs are putting more pressure on displaced populations, which can again negatively impact health outcomes because of malnourishment and compromised immune systems.
COVID-19 has already impacted the lives of thousands of displaced people. It just isn’t in the news.
Gaps in Emergency Response Policies & Interventions
COVID-19 has demonstrated that global and national governance mechanisms have failed to incorporate humanitarian operations to ensure accessible health services for all displaced persons. As countries struggle to contain and prevent their outbreaks, governments have been reluctant to divert resources away from voting citizens to refugees, migrants, and IDPs, especially with populism garnering increasing support in many nations.
Many countries have also refused to allow medical humanitarian aid workers to continue serving refugee camps or providing makeshift housing arrangements for IDPs. Migrant populations that depend on foreign aid have experienced the emptying of clinics because of the restricted return of staff.
What’s worse, the disruption of global supply chains in addition to restrictive goods movement has limited these communities’ access to essential medical equipment and critical food supplies. The International Refugee Committee has already seen two-thirds of its global programs lack personal protective equipment for its essential workers. Procurement efforts have been almost impossible given price hikes of goods combined with low amounts of donations. This puts workers, displaced people, and entire nations at a higher risk of infection.
These policy failures will, of course, directly affect the immediate and future health outcomes of migrant people. But COVID-19 has underscored how closely we are all connected. An outbreak in any refugee camp, given their already well-documented poor and unhygienic conditions, would be a humanitarian disaster that would likely extend far beyond the borders of the camp. Numerous health leaders have responded to the pandemic by advocating for universal, publicly-financed health reforms — and have called for the COVID-19 vaccine to be offered as a public good. But Singapore has universal health coverage and still found itself victim to the resurfacing of the disease — exactly because it did not extend universal health coverage to vulnerable, migrant workers within its borders.
In these difficult times, politicians are leveraging COVID-19 to advance their agendas instead of expanding social welfare. This will not be sustainable in the future, as refugees and migrants’ health and well-being are inextricably linked with the health and well-being of entire societies.
The lives of refugees, migrants, and IDPs lives are intimately interlinked with those of the citizens and residents in the surrounding communities. Outbreaks of COVID-19 solely require a spark of one infected, undetected case. It will take collective action to change the fates of displaced populations during the COVID-19 crisis and beyond. Hopefully, we finally learn the lesson that conflicts and crises necessitate inclusive, comprehensive responses that safeguard the human right to health for all.
Mohamed Ramy is the Strategy & Partnership Lead at Generations for Health.
Would you consider yourself a refugee or migrant? Take this WHO survey to help speak up and make the world understand your concerns and the pandemic’s psychosocial impact on you.
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