More than 250,000 refugees from the Central African Republic are living in eastern Cameroon, having fled unrest, violence and civil war in the country in several waves since the early 2000s.
Dwindling humanitarian funds for Cameroon, and the prospect of a huge influx of arrivals if Central African Republic plunges back into full-blown conflict, are fuelling fears among aid agencies for the future of the country's refugees.
Here are their main needs, according to aid agencies working in the region.
DOROTHY MADISON-SECK, CATHOLIC RELIEF SERVICES (CRS) COUNTRY REPRESENTATIVE IN CAMEROON
"Most refugees are not ready to go home. One of the main reasons cited by those who are reluctant to return is uncertainty pertaining to the security situation. Another is that many have lost their homes and their land. When pressed on what conditions could make a return feasible, one refugee cited a laundry list of concerns, boiling down to 'needing something to return to'.
He stated completed disarmament, demobilisation and reintegration process, peaceful elections, reopening markets and boosting the economy, psychosocial support to deal with trauma, the ability to work again as a herder, among other conditions.
Another refugee said that there is nothing to go back to. His kids are in school and he has a small piece of land in Cameroon, so why would he go back? The most pressing humanitarian needs are access to health services, like immunisations, and nutrition services. Of the few local health services available, people often don't have the means to access them."
KHASSIM DIAGNE, CAMEROON REPRESENTATIVE FOR THE U.N. REFUGEE AGENCY (UNHCR)
"We are concerned about the ongoing violence in some parts of Central African Republic close to the Cameroonian border, resulting in new arrivals. Since the beginning of this year, 6,901 civilians fleeing violence have arrived in Cameroon. Central African refugees living offsite (not in camps) are spread across over 300 villages, often deep in the forest and difficult to reach, especially during the rainy season.
This makes it challenging to ensure wide and coherent coverage of adequate assistance and protection activities. While almost all health assistance is provided in the camps, it is severely limited outside of these sites, where there is a lack of human resources and of supplies (medication and medical equipment) to cover all the villages hosting refugees. This is depriving more than 180,000 refugees from access to appropriate health care."
ROGER KADIMA, COUNTRY DIRECTOR FOR THE INTERNATIONAL MEDICAL CORPS (IMC)
"Health, protection, shelter, food security and income generating activities are the most pressing humanitarian needs, especially for those living outside of the refugee sites. Be they newly arrived or long-term refugees, their psychosocial needs are still a priority given that healing from trauma caused by war and factors like rape takes time.
The IMC is also trying to curb sexual violence and the practice of survival sex as a coping mechanism by teaching skills including knitting, embroidering, sewing, baking and soap making, holding group discussions and by raising awareness. The future of these refugees is very uncertain because of persistent fighting back home and the lack of integration in the host country, Cameroon. Despite all these challenges, the crisis is being forgotten – more needs to be done."
FELICITE TCHIBINDAT, CAMEROON REPRESENTATIVE FOR THE U.N. CHILDREN'S AGENCY (UNICEF)
"The influx of refugees has put huge pressure on a region that is already stretched and struggling with poverty. We are trying to help children recover and regain their lives by providing psychosocial support and education. The level of education is low in Central African Republic - only 12 percent of child refugees in eastern Cameroon went to school back home as many are from herding and farming families.
Teachers, community workers and local partner organisations are providing psychosocial support. But this is a basic level, we really need more professional support. Yet it is difficult in a region with so few teachers, social workers and psychologists. We are working in communities to raise awareness and encourage families to send their children to school. For girls, the end of primary school is often the end of the road as they get married - very few make it to secondary school."
RICHARD DESGAGNE, SPOKESMAN FOR THE RED CROSS (ICRC)
"To enable refugees to be more independent and less dependent on humanitarian aid, support for activities to ensure they can have sustainable livelihoods should be established. Most refugees do not want to return home. Those who go back are often stigmatised by those who stayed behind. Some who have returned were allegedly assaulted and had to be escorted back to the border, once again, to take refuge in Cameroon.
A sustainable solution has yet to be found. The worsening impoverishment of refugees and their resistance to local integration are factors. Resettlement in a third country is not really possible. A lack of financial support is damaging the future of these refugees from Central African Republic. Ignoring their present conditions carries the risk of creating a situation similar, if not worse, to the emergency after the 2013 conflict."
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