• Text size Normal size text | Increase text size by 10% | Increase text size by 20% | Increase text size by 30%

Success and challenges as UNHCR tackles neglected health issues

News Stories, 16 July 2008

© UNHCR/A.Webster
A South Sudanese family wanting to repatriate to Sudan from Kakuma Refugee Camp receive medical examinations to ensure they are fit for repatriation.

GENEVA, July 16 (UNHCR) When António Guterres visited refugee camps soon after becoming UNHCR High Commissioner in 2005, he discovered what many staff on the ground already knew: in too many places the agency was not devoting sufficient resources to protect the health of refugees.

The result was "The High Commissioner's Special Project," a fund outside of the normal country budgets. It was established in 2007 to pay for programmes to improve health, nutrition and the response to sexual and gender-based violence (SGBV) in refugee camps in 19 countries showing the greatest need.

Other countries were added this year as the first programmes were incorporated in the annual UNHCR country planning, and by 2009 UNHCR offices in all countries must ensure that these types of programmes are included in their own budgets.

"The High Commissioner saw for himself the conditions. He made it clear this is a protection issue," said Paul Spiegel, who oversees UNHCR's public health programmes from Geneva.

The initiative has produced some dramatic improvements.

Improved food distribution, including an infant-feeding programme, saw a one-year fall in acute malnutrition in Kakuma Camp in Kenya from 20.5 percent to 11.2 percent. In Myanmar, the coverage of complete antenatal care rose from 32 percent to 59 percent during 2007. In Ali-Adeh camp in Djibouti, per capita water supplies were increased from 12.5 litres per day to 16.6 litres.

In Kakuma, providing school uniforms helped raise the daily school attendance by girls from 53 percent to 80 percent last year. Victims of SGBV were given new support in many countries from Azerbaijan to Malta to Panama.

By the end of 2007, more than 95 percent of the US$15.3 million allocated to the new initiative had been spent. The majority, US$11.25 million, went for health and nutrition improvements in four countries in Africa (Djibouti, Ethiopia, Kenya and eastern Sudan) and three in Asia (Bangladesh, Myanmar and Nepal). The rest went on SGBV assistance in 14 countries around the world. The budget for this year is US$7.5 million.

The extent of the problems could not even be identified until UNHCR established functioning health information systems to assess the needs. These failures in protracted refugee situations reflected chronic underfunding that is now being tackled first on the urgent basis by using the High Commissioner's Special Project and then by addressing the needs through incorporating them in annual country budgets.

Spiegel readily admits much more must be done. While the water supply has improved in Djibouti, it still falls below the UNHCR daily standard of 20 litres of water per person. And anaemia rates reflecting an inadequate diet are disturbingly high in several countries. In Kakuma, while other statistics were improving, the rate of anaemia among children rose last year from 79 percent to 83 percent.

"It's not all a success we have problems," said Spiegel. Progress is often uneven, local customs can be formidable obstacles and there are continuing problems in ensuring enough trained staff.

But as the report on the first year of the project emphasized in its first line: "UNHCR's protection responsibilities include promoting refugees' right to the highest attainable standard of security, physical and mental health."

By Jack Redden in Geneva

• DONATE NOW •

 

• GET INVOLVED • • STAY INFORMED •

Public Health

The health of refugees and other displaced people is a priority for UNHCR.

Health crisis in South Sudan

There are roughly 105,000 refugees in South Sudan's Maban County. Many are at serious health risk. UNHCR and its partners are working vigorously to prevent and contain the outbreak of malaria and several water-borne diseases.

Most of the refugees, especially children and the elderly, arrived at the camps in a weakened condition. The on-going rains tend to make things worse, as puddles become incubation areas for malaria-bearing mosquitoes. Moderately malnourished children and elderly can easily become severely malnourished if they catch so much as a cold.

The problems are hardest felt in Maban County's Yusuf Batil camp, where as many as 15 per cent of the children under 5 are severely malnourished.

UNHCR and its partners are doing everything possible to prevent and combat illness. In Yusuf Batil camp, 200 community health workers go from home to home looking educating refugees about basic hygene such as hand washing and identifying ill people as they go. Such nutritional foods as Plumpy'nut are being supplied to children who need them. A hospital dedicated to the treatment of cholera has been established. Mosquito nets have been distributed throughout the camps in order to prevent malaria.

Health crisis in South Sudan

UNHCR and Partners Tackle Malnutrition in Mauritania Camp

The UN refugee agency has just renewed its appeal for funds to help meet the needs of tens of thousands of Malian refugees and almost 300,000 internally displaced people. The funding UNHCR is seeking is needed, among other things, for the provision of supplementary and therapeutic food and delivery of health care, including for those suffering from malnutrition. This is one of UNHCR's main concerns in the Mbera refugee camp in Mauritania, which hosts more than 70,000 Malians. A survey on nutrition conducted last January in the camp found that more than 13 per cent of refugee children aged under five suffer from acute malnutrition and more than 41 per cent from chronic malnutrition. Several measures have been taken to treat and prevent malnutrition, including distribution of nutritional supplements to babies and infants, organization of awareness sessions for mothers, increased access to health facilities, launch of a measles vaccination campaign and installation of better water and sanitation infrastructure. Additional funding is needed to improve the prevention and response mechanisms. UNHCR appealed last year for US$144 million for its Mali crisis operations in 2013, but has received only 32 per cent to date. The most urgent needs are food, shelter, sanitation, health care and education.

The photographs in this set were taken by Bechir Malum.

UNHCR and Partners Tackle Malnutrition in Mauritania Camp

Kuwaiti Funds Provide Vital Medical Aid for Syrians in Lebanon

As the number of Syrian refugees in Lebanon continues to grow, ensuring access to quality health care is becoming an increasing challenge for humanitarian aid groups and the international community. So, Kuwait's unprecedented donation in April of US$110 million for UNHCR's Syria crisis operations this year came at a most opportune time. Slightly more than 40 per cent of the amount has been used to fund programmes in Lebanon, including the provision of vital - and often life-saving - medical care. In the following photo gallery, photographer Shawn Baldwin looks at the essential work being done in just one Kuwaiti-supported clinic in northern Lebanon. The small Al Nahda Primary Health Care Clinic in the town of Beddawi has a staff of seven doctors and one nurse. Between 600 and 700 people seek medical attention there every month and the clinic meets the needs of some of the most vulnerable refugees.

Kuwaiti Funds Provide Vital Medical Aid for Syrians in Lebanon

Cameroon: Refugees from Central African Republic cross river into CameroonPlay video

Cameroon: Refugees from Central African Republic cross river into Cameroon

On March 29 approximately 60 refugees from the Central African Republic made the desperate river crossing into Gbiti in eastern Cameroon. Signs of malnutrition were apparent as they waded through the water and were met by UNHCR staff.
Chad: Health for allPlay video

Chad: Health for all

Refugees in southern Chad receive health care under a European Union-funded programme. A new clinic tackles malaria, malnutrition, respiratory infections and more.
Jordan: Getting Health CarePlay video

Jordan: Getting Health Care

In Jordan's Za'atri Refugee Camp, dust and heat are taking their toll, especially on young children.