* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Social distancing and hand washing are hard for migrants and refugees in overcrowded conditions - what can be done to help?
Sonja Ayeb-Karlsson is a senior researcher at the United Nations University's Institute for Environment and Human Security (UNU-EHS), and the author of a recent article on self-isolation in refugee camps.
Approximately one billion people around the world live in slums, including roughly 30-50% of the urban population in the global South. People on the move often settle down in urban informal settlements after facing environmental, financial and livelihood stress back in their rural homes.
Meanwhile, people fleeing war, conflict and persecution may end up in refugee camps such as in Cox’s Bazar (Bangladesh), Lesbos (Greece) or Calais (France). Refugees are unable to return home due to fear of persecution, while migrants move for a variety of reasons.
Informal settlements and refugee camps share some commonalities making them more vulnerable to COVID-19 outbreaks; they tend to be overcrowded, lacking sufficient access to clean water, sanitation and public health services.
In one of my study sites, Bhola Slum in Dhaka, Bangladesh, households may contain up to 15 people living in tin sheds without closable windows or doors. Public bathrooms are shared between the settlers make contact tracing close to impossible.
Most people in informal settlements depend on casual work and cannot work from home. People sell fruit and snacks on the streets, clean car windows or work as day labourers on construction sites, living day to day without savings or assets to buffer against income losses.
Meanwhile, refugees fleeing persecution may have lost legal documentation or been stripped of citizenship, making it harder to access healthcare services.
COVID-19 has already entered many of these ultra-vulnerable settings. The World Health Organization (WHO) recommendations to physically distance and practice frequent handwashing will not be enough. We may see catastrophic impacts in refugee camps and urban slums across the world.
In addition to these challenges, misinformation and rumours spread fast among already conflict-traumatised populations and may constrain people from seeking medical attention: “If anyone gets infected, the authority has to kill them. Because if (s)he stays alive, the virus will transfer to another person’s body”, stated a respondent in Cox’s Bazar.
Traumatic experiences, social exclusion, marginalisation and stigma can damage trust in the government, its law enforcement agencies and civil authorities. People in informal settlements may already have experienced forced evacuation, while refugees may be terrified of lacking legal documentation or returned back to what they have fled from.
Based on my experience of working with extremely vulnerable populations, we should ensure that we are:
- Providing immediate financial and social support to safeguard people who cannot pursue their income-generating activities.
- Setting up frequent and free hand washing stations, and urging for investments to improve access to clean water, sanitation and waste management.
- Communicating through trusted figures, such as religious and local leaders, NGO workers and volunteers, as well as social media groups, how hand washing and physical distancing can prevent spreading the virus and where people who are experiencing symptoms can seek medical attention.
- Setting up mobile clinics around these vulnerable locations to be able to provide immediate testing, isolation and treatment of people who test positive.
- Develop human rights-based response plans, including non-traumatic temporary evacuation plans of settlements in the event of an outbreak to nearby safe areas to avoid family ruptures. This includes ensuring that people can move with their loved ones, bring valuables and safely return home after the outbreak. The new area would need to have sufficient space for people to carry out physical distancing and self-isolate if necessary.
As countries grapple with the effects of the pandemic, we must ensure that migrants and refugees are not forgotten. The way forward should protect and safeguard vulnerable people through a human rights- and dignity-based approach.
Immediate international efforts in line with the Global Compact for Migration and the Global Compact on Refugees protection strategy can save lives, promote health and ensure dignity for all.
All human beings have the right to a dignified and secure life free of the threat of disease, displacement, family break-up and risk of death. These human rights are manifested in the right to safe food, drinking water and sufficient sanitation, adequate housing, healthy working conditions and the right to prevention, treatment and control of diseases, as well as available, accessible and acceptable public healthcare services.
The Global Compact for Migration intends to reduce the risks and vulnerabilities migrants face, while disease prevention and health promotion are encouraged in the Global Compact on Refugees.
We need to ensure that human right frameworks, already in place, are followed throughout the pandemic – migrants and refugees must be protected.