UNHCR response to the UK International Development Committee inquiry into humanitarian crises monitoring: impact of coronavirus
The refugee protection situation, immediate risks and threats
Over 71 million asylum seekers, refugees, internally displaced people (IDPs) and stateless people are especially vulnerable to health risks. Refugees and IDPs are overwhelmingly hosted in developing regions where health services are limited, frequently in remote areas where national coverage is non-existent. Refugees and IDPs face specific obstacles to accessing health care: inaccessibility of services; language and cultural barriers; cost; a lack of inclusive health policies and other barriers. Many live in overcrowded camps, settlements, makeshift shelters, urban areas or reception centres, and lack access to adequate health care and sanitation. They face particular risks including inability to practice social distancing or isolation; limited availability of water for hygiene; sub-standard sanitation; poor nutrition; and already under-resourced general health services. Distribution of in-kind aid is complicated by social distancing and disrupted supply lines.
Wherever possible, refugees should be included in national responses, with international support, but where this is not feasible, targeted humanitarian programmes for refugees and their host communities must be rapidly stepped up.
International investment is also needed to help host countries decongest sites, add durable health infrastructure and step up services both for refugees and local communities. Ongoing humanitarian and development programmes must be sustained, and additional resources made available for the COVID response. Otherwise existing health and socioeconomic vulnerabilities will be dramatically deepened, increasing exposure to potential harm.
As well as being a health crisis, COVID also represents a protection and humanitarian crisis for the forcibly displaced; this global emergency exists on top of existing emergencies like the Venezuela situation, Bangladesh, the Syria situation, Libya, Yemen, Lake Chad and the Sahel, to name a few.
A long-term risk posed by COVID-19 is that the adoption of emergency laws and policies may become entrenched. When the pandemic has passed, adherence by many in the international community to democratic principles and human rights will have regressed, potentially taking many years to rebuild. We need to be especially vigilant in upholding the rights of refugees to protection. A critical concern is the general threat to the foundations of refugee law developed over the last 70 years and to the rule of law overall. UNHCR estimates that about 167 countries have fully or partially closed their borders to contain the spread of the virus, with some 52 states making exceptions for access for asylum seekers.
UNHCR has seen a diminution in respect for refugee norms with widespread pushbacks, deportations and forced returns to territories with weak or non-existent systems. Quarantine is leading to restriction of movement and more detention. There is restricted access to or total suspension of asylum procedures in some territories and services and social isolation may mean a loss of access to rights and critical protection services. While there is a clear duty of sovereign states to exercise executive power to manage the crisis domestically, that must be balanced against ensuring refugee rights and respect for refugee law.
UNHCR believes it is possible to do both with reasonable and proportionate measures that can compatible with international refugee protection. Measures should not result in closure of avenues to asylum, or of forcing people to return to situations of danger. If health risks are identified, screening arrangements can be put in place, together with testing, quarantine and other measures. Denial of access to territory without safeguards to protect against refoulement cannot be justified on the grounds of health risks.
Beyond the broader normative issues is the medium and long-term impact on socio-economic trends. Evidence based collection of information shows critically important trends that may have an impact over the next few years, in particular:
One immediate impact of COVID-19 is access, which restricts UNHCR’s ability to protect. In this environment, UNHCR has had to suspend resettlement due to airline passage restrictions. We are continuing with telephone interviews and documenting refugee status determination (RSD) as much as possible in the context of UNHCR’s ‘stay and deliver’ policy; however, the reality is that resettlement transfers cannot currently take place. Access to other services has also been hindered i.e. psycho-social counselling, child friendly spaces, and critical case management of the elderly, persons with disability and LGBTI. Humanitarian staff are working remotely using video conferencing, phone calls, hotlines, radio broadcasts and call centres to communicate with and listen to refugees and empower the communities in protection activities. It is vitally important to include refugee communities in decision-making and we are strengthening community networks and volunteers.
The economic downturn is having a devastating effect on many urban refugees. Already living in precarious socio-economic circumstances, many are now rapidly sliding into destitution as informal work opportunities vanish and they are unable to benefit from national safety nets. Women, elderly, children, and people with disabilities are particularly exposed. Over time, the impact may deepen and be exacerbated by other risks including restricted movement and potential aid reductions. Even though many countries had made positive moves in recent years to include refugees in the national economy and allow them to work (for example Ethiopia, Uganda), the assumed severe downturns in the domestic economy are likely to adversely affect these initiatives in practice, triggering further economic hardship and negative copying strategies. This underscores the need to redouble longer term development support for refugees and hosts to improve livelihood opportunities as laid out through the Global Compact on Refugees.
Middle East and North Africa
Across the region, countries continue to intensify border restrictions, with many operations reporting restricted/curtailed movement as a key challenge for persons of concern and the UNHCR workforce, affecting UNHCR activities and overall access to beneficiaries. Access to territory is being impacted by border closures in many countries, with asylum procedures suspended in most countries in the region. Voluntary returns to Syria from neighbouring countries have come to a halt. UNHCR operations in several countries are following up on cases of detention of persons of concern in violation of curfew laws. In some countries with tight movement restrictions, access to livelihoods and basic services is proving increasingly challenging for displaced populations, further raising their exposure to negative coping mechanisms.
There has also been an increase in evictions or threats of evictions reported in some countries due to limited financial means to pay rent and the economic needs of landlords. Female single parents reported challenges as they can no longer be assisted by relatives. UNHCR has already identified a spike in domestic violence and psychological distress among people of concern in this region arising from isolation or loss of income, and has received reports of more families reverting to negative coping mechanisms. National health systems across MENA continue to be the primary responders to all recognized refugees. However, this can be challenging due to the health system capacities, the financial resources of refugees, and other compounding factors.
In Libya, with the significant escalation of fighting in the past weeks, the situation is increasingly deteriorating, with COVID-19 posing an additional threat to the already worrying situation for asylum seekers, refugees, migrants and Libyans. The ongoing conflict has severely impacted the country’s health system and medical services. UNHCR and partners are providing medical equipment and tented clinics in support of local health-care services and are raising public health awareness, aimed at mitigating the risks of exposure to the virus.
Despite the difficult circumstances faced by many countries due to COVID-19, rescue at sea remains a humanitarian imperative and delays in rescuing people in need cannot be justified. The primary focus must remain the preservation of life. Rescue at sea and subsequent disembarkation in a place of safety can be managed in a manner which respects international human rights and refugee protection standards, including the principle of non-refoulement, while sensitive to legitimate public health considerations, through quarantine and health checks. Those few states who are regularly allowing disembarkation should be able to count on the solidarity of others through an effective relocation mechanism, as well as support for reception facilities. Efforts should continue to capacitate the coast guards units of the countries neighbouring Libya to continue undertake rescue operations whenever required.
As the number of new cases steadily rises, the COVID-19 situation in the region continues to evolve, leading to action by governments to slow the spread of the virus. This results in frequent changes in border/entry restrictions and limitations on internal movement. UNHCR’s response is focusing on: infection prevention and control by ensuring access to clean water, hygiene supplies and waste disposal in refugee communities; strengthening communications on hygiene measures with displaced communities through national and community education programmes; and supporting the training of health workers in refugee sites on case definitions, disease identification/management, in line with WHO and government guidelines. Operations are seeking ways to enable electronic cash distribution for the most vulnerable impacted by loss of livelihoods. Issues around modalities of electronic distribution revolve primarily around the fact that persons of concern often do not have access to national banking services. Communications with refugees throughout the region suggest that most are now quite well informed on COVID-19 prevention measures, and the steps to take if ill. Issues of concern raised are primarily focused on the socio-economic impact of COVID-19.
In Bangladesh, the enormous challenge of limited health services on the ground is being addressed as far as possible with new supplies of sanitary products, additional PPE and other medical supplies, extra training of staff and refugee volunteers, information provision campaigns and the construction of a 150-bed isolation and treatment centre. The congested nature of the Kutupalong settlement makes it a particularly worrying situation.
West and Central Africa
The region is facing a rapid increase of confirmed cases, leading to the closure of borders or limited access for humanitarian operations. Although restrictions are not targeted at refugees and asylum-seekers specifically, UNHCR has expressed concern that measures could see people in need of international protection attempting even more risky and dangerous border crossings. In addition to the unstable security situation in the region (especially in the Sahel and the Lake Chad Basin), the restrictions on movements are already hindering UNHCR’s ability to implement key activities, including case management, that require direct contact with beneficiaries. The situation in overcrowded camps and sites makes social distancing and basic preventive measures such as handwashing very difficult to implement in many locations where the situation was already acute before this crisis. UNHCR has scaled-up the distributions of soaps and sanitary products in all operations, improved access to water and sanitation (WASH) facilities and supported governments with infection prevention and healthcare response, including through the provision of medical equipment and supplies. One of UNHCR’s priorities in West and Central Africa is to ensure women, girls and other groups at heightened risks of GBV are consulted on preparedness plans and interventions. To try to adapt to the COVID-19 crisis, online and phone consultations are being planned across the region. Some field teams have been able to restore remote GBV case management and interventions, including integrating urgent cash assistance for women at risk and GBV survivors. Clinical management service providers remain accessible through established GBV referral pathways.
East and Horn of Africa and the Great Lakes
The COVID-19 situation in the East and Horn of Africa, and the Great Lakes region continues to evolve rapidly, with new cases reported daily. Measures by governments to contain the virus lead to frequent changes in entry restrictions or limitations on internal movement. Securing medical supplies and PPE has proven challenging as several countries have put strict export restrictions on products, but procurement is underway. To comply with the physical distancing measures issued by the WHO, several operations have worked to decongest shelters and/or relocate refugees such as in Djibouti, where 570 families (4,500 individuals) were identified as living in overcrowded shelters. In a number of operations, including Uganda and Kenya, isolation facilities have been identified in camps and refugee hosting areas. In Kenya, an increasing number of persons of concern in urban areas are reporting difficulties with meeting their basic needs, particularly as work in the informal sector has been severely impacted due to restrictions. UNHCR in Uganda is for now carrying out only critical activities due to the presidential directives on COVID-19.
The Southern Africa region has currently the greatest number of confirmed cases on the continent, with the pandemic evolving rapidly. In camps and settlements throughout the region, UNHCR and partners are establishing isolation centres and training health workers to identify and refer cases. UNHCR has also reinforced measures at points of entry to refugee camps, IDP sites and transit centres, including temperature-screening and handwashing stations. UNHCR and partners are limiting the number of people present at any given time during distributions of sanitation and core relief items (CRIs), such as blankets, kitchen sets, and jerry cans to lessen the risk of contagion. The new arrangements are communicated through awareness raising efforts, designating special times for the most vulnerable, and extended distribution times.
Many refugees and migrants from Venezuela face stigmatization and negative perceptions from host communities, associated with a fear of spreading the virus. Despite current curfew and quarantine measures throughout the region, many persons of concern remain on the streets, often because the crisis has cost them their jobs and they can no longer afford rent. This affects in particular those relying on daily incomes and work in the informal sector.
Weekly meetings of the Intersectoral Coordination Group led by UNHCR and IOM are identifying priority activities for the sectorial response in the region. UNHCR is producing guidance on shelters and reception centers, and operations are seeking additional shelter to fill the gaps amidst increasing evictions. UNHCR also distributes soap, hand sanitizer or sanitary items in Mexico, Ecuador and Chile.
UNHCR is very concerned about systematic and rapid expulsions of persons, including asylum-seekers, crossing U.S. land borders who are receiving no protection or health screening. UNHCR is concerned that amongst deportees are some who did not have the opportunity to seek international protection. UNHCR is implementing a series of measures in Mexico including: assisting Mexican authorities to decongest detention centers with the alternative to detention program for asylum seekers; and working with civil society organisations to expand shelter capacity and deliver cash-based assistance.
Some countries have temporarily suspended registration for new arrivals. The inability to register an asylum claim results in a lack of access to safe reception conditions, including accommodation and health care.
In the region, where national health systems are generally the primary responders to the medical needs of persons of concern, the virus spread has been stretching the capacities of most of these systems for all populations. Additional concerns have been raised about the lack of health services for undocumented persons and persons staying irregularly.
UNHCR continues to provide support to the efforts led by national authorities to ensure the inclusion of refugees and other persons of concern in national COVID-19 preparedness and response plans. UNHCR is also putting forward recommendations to States to support them in maintaining access to territory, registration and safe reception conditions for asylum-seekers, while at the same time protecting public health. A number of countries have adopted measures to train or allow qualified refugees to perform certain public health functions.
Outreach to refugee communities is being enhanced across all operations through hotlines, social media, digital platforms and other means of communication. In Italy, for example, UNHCR and INTERSOS have launched a digital capacity building platform for refugee-led organizations on topics such as project management, communication and international protection during the health crisis.
Where reception conditions gave reasons for concern prior to the COVID-19 pandemic, the present situation compounds health risks, notably in overcrowded centres and shelter. The situation is particularly worrisome in Cyprus, where authorities have transferred asylum-seekers from hotels to the first reception centre (to a tented area with no electricity and sanitation facility). Many of the transferred show psychological or health conditions.
On the Greek Aegean islands, thousands of asylum seekers at island reception centres were already facing crowded and dire conditions and high risks to their health. UNHCR is scaling up support on the islands to assist the government, providing core relief items, cash card top ups, communication with and mobilisation of communities and establishing medical response facilities.
UNHCR is also reiterating its call on the Greek government -- with enhanced support from the EU -- to increase the transfer of asylum-seekers from the islands to appropriate accommodation on the mainland; additional reception capacity must be found quickly through all possible means, including apartments, cash for shelter and hotels near urban centres which are not operating due to COVID-19. EU and Member State support is crucial to boost Greece’s response in ensuring the immediate protection of those most at risk, including unaccompanied children and people with specific needs, through continued resources, capacity, and responsibility-sharing through relocation.
The COVID crisis has brought life to a standstill for many people across the globe. But wars and persecution have not stopped, and life-saving aid remains essential.The Global Compact for Refugees is directly relevant to the COVID-19 pandemic. The fundamental values of responsibility sharing, support for host countries and communities, and enhancing refugee self-reliance have been tested in ways hard to imagine several months ago.
It is important for governments to have a holistic approach by maintaining existing levels of humanitarian assistance and not rediverting planned funding to COVID response activities. Governments must advocate with international financial institutions for additional funds for COVID-19 to include refugees and IDPs.
As part of the broader UN Global Humanitarian Response Plan, UNHCR has issued an Emergency Appeal requesting US$255 million for life-saving interventions and preparations in response to COVID-19. The response from the UK has been very positive contributing £20 million to UNHCR’s response. This is the highest unearmarked contribution to UNHCR’s appeal giving the agency the flexibility to respond to shifting priorities in a rapidly evolving situation.
This appeal focuses on protecting all forcibly displaced populations and prioritizing situations and contexts with large populations of refugees, IDPs, stateless persons and other people of concern to ensure that health and WASH systems and services are shored up, reinforced and quickly adapted. Activities will focus on continuing, adapting and increasing delivery of protection, assistance and ensuring access to essential services, particularly in areas with high concentrations of refugees, IDPs, and host communities. Immediate interventions to prevent infections will be prioritized. This will include extra distributions of shelter material, core relief items such as jerry cans and kitchen sets, as well as materials for WASH support. Ensuring accountability to affected people through communication and through existing and strengthened community networks will be ramped up. The objective will be to offer guidance and fact-based information on prevention measures, such as handwashing, social distancing, isolation from infected people and where to access healthcare services. Cash-based assistance will be used as a quick and efficient means of getting assistance to people, empowering families to make the best decisions on how to care for themselves.
For this appeal, UNHCR is focusing in particular on 31 countries assessed as high-risk, taking into account the priority countries outlined in the Global Humanitarian COVID Appeal. The best way to support UNHCR’s appeal is through flexible funding supporting the global COVID-19 prevention and response efforts. Such quality funding is key in allowing a timely emergency response to the evolving needs wherever required, across regions and operations and according to priority needs. It will also allow UNHCR in its cross-cutting work to strengthen advocacy, improve protection, bolster coordination and communication efforts, and support the regional and country offices on the front line of the response.