* Any views expressed in this article are those of the author and not of Thomson Reuters Foundation.
The ongoing refugee crisis continues to stretch the abilities of humanitarian organisations through its sheer scale, its complexity and the level of misery it is causing.
Around the world, around 60 million people were displaced by war, conflict or persecution in 2014 – and the UNHCR believes worldwide displacement has now hit an all-time high.
Teams of people are dedicating their time to trying to prevent loss of life, others are focusing on providing food and clothing to those left trudging into the unknown while mental health professionals work tirelessly to try and limit the effect of the trauma on migrants. In an exceptional situation, standard responses seem to fall short.
An area of vital importance is that of water, sanitation and hygiene provision – and this focus is one that has seen a response woefully inadequate for the needs of those at the centre of this crisis.
In December, I was part of an International Medical Corps technical team that visited Greece to conduct a comprehensive assessment of conditions across the islands facing refugees, with a particular emphasis on water, sanitation, and hygiene (WASH) conditions in reception centres and transit camps.
What I found was confusion and disorder.
Work to prepare for the cold winter months wasn’t taking place fast enough. There was no hot water. Life vests and other discarded items littered the shores and the roads. People were forced to defecate in the open due to a lack of appropriate toilets.
The needs of the refugees were rapidly changing all the time, and humanitarian assistance was not keeping up.
There are a number of reasons why this was happening – primarily due to the vast mix of cultures and socio-sensitivities that need to be considered, and partly due to the lack of experience of European countries in receiving refugees in such numbers. Add to this the fact that these vulnerable people are constantly on the move, and the global community faces a unique situation which requires a whole new approach to aid.
We need to remember that many of these refugees have had to abandon standards of living which we would recognise as normal across the West – where electricity, washing machines and running water were the norm rather than the exception. Doctors, engineers, teachers and skilled professionals face using ‘bucket showers’ and substandard toilet facilities that were simply unimaginable in their previous lives. Cultural differences also need to be considered, with most refugees who come from Middle Eastern countries used to washing – not wiping – after using the toilet. To be forced into a new approach to such matters causes discomfort, embarrassment and adds to the already prevailing misery.
The fact that many are constantly moving adds another dimension to the problem – the hygiene kits which are designed to help the families stay healthy – containing toothpaste, soap, shampoo and towels – can weigh up to 5kgs each. As people try to limit the burden they carry on their backs, often half of these kits end up dumped by the side of the road.
I watched as a family, lucky to have been sanctioned travel to Athens, prepared to board a boat and begin the next stage of their journey. As they waited, they began to remove items from their possessions and place them in a rubbish bin. Curious, I approached the bin – inside was a waterlogged sleeping bag, a pair of soaking wet sneakers and a jacket heavy with water alongside a bag full of hygiene items. All of these items were vital to their existence – and if sufficient laundry and drying facilities had been in place they might have been able to hold onto them. I hated to think about the decisions parents had to make in such circumstances.
Things are improving. Since my visit to Greece I have watched as the WASH provision has improved, and the situation there is already far more acceptable than what I witnessed on my trip a few short months ago. As borders close, and the transit of many migrants grinds to a halt, new camps are being established which will hopefully make it easier to provide the right toilet facilities, the correct washing equipment and the appropriate laundry provision to help these people. In Greece alone, 15 new hosting areas have been set up in the first two weeks of March – this will help nearly 17,500 people while the UN plans to construct camps for an even greater number. However, a lot remains to be done.
International Medical Corps is working to step away from the ‘traditional’ approach of hygiene and sanitation intervention, to create a bespoke response for this very specific crisis. Using our experience of responding to major humanitarian crises over the last thirty years – and our experience of working in the countries from which many of these refugees come from – we are assessing the unique and complex needs of the refugees coming to Europe and responding accordingly. Rather than kits, we are distributing essential hygiene and winterisation items individually to provide the best possible help both in terms of solving problems and remaining portable.
We need to ensure that all humanitarian organisations work together – coordinate our efforts and use our experience to push the response to new levels. This is the only way we can give these people the support they need in the form they need.
We are working in an exceptional set of circumstances, and we need – as a group – to make sure our response is just as exceptional.
About International Medical Corps
Since its inception 30 years ago, International Medical Corps' mission has been consistent: relieve the suffering of those impacted by war, natural disaster and disease, by delivering vital health care services that focus on training. This approach of helping people help themselves is critical to returning devastated populations to self-reliance.
International Medical Corps is working with local partner organisations in Serbia and Greece to deliver first aid and primary health care services, implement vital WASH activities, distribute essential supplies, offer psychosocial support and provide other essential services to the thousands of people striving to find safety and stability in Europe.
