Dadaab: Walking the fine line between helping refugees and risking lives

News Stories, 28 November 2011

© UNHCR/S.Aguilar
Ibrahim and his family in Dadaab.

DADAAB, Kenya, November 28 (UNHCR) Ibrahim held up an X-ray of his broken thigh bone, taken when he first arrived in the Dadaab refugee complex of north-eastern Kenya. Five months later, he still cannot walk.

"I fell off a car when I was heading to Kenya from the Bay region [in southern Somalia]," the 31-year-old explained, sitting at the entrance of his white tent in the red earth. "When I arrived in Dadaab, I went to the hospital. But I left because I was afraid they would amputate it."

UNHCR field officer Henok Ochalla rebuked him for not using crutches, and called for an ambulance to take the father of six to the nearest camp hospital. "If only we had an extended presence in the camps, we would be able to assess the situation of families and to refer medical cases like Ibrahim's," said Ochalla.

He and his colleagues were going from tent to tent in Dadaab's Ifo 2 camp, visiting families and noting down the details of people affected by the recent floods. This was the first time in weeks that UNHCR staff had been able to walk more or less freely among the blocks of Ifo 2.

Escalating insecurity including the recent discovery of two improvised explosive devices and the kidnapping of three aid workers has forced humanitarian agencies to scale down their work in Dadaab. Life-saving aid such as food distribution, water trucking and urgent medical aid is continuing, but less urgent services have been temporarily suspended.

"It is challenging for agencies to balance humanitarian assistance and define an acceptable threshold of risks to the lives of staff on the ground," said Dominik Bartsch, UNHCR's head of operations in Dadaab. "Despite recent security incidents, we have worked intensively on a feasible way to maintain life-saving activities, especially for the most vulnerable refugees."

The increased presence of policemen in Ifo 2 has allowed aid agencies to gradually resume activities in the camp. Last week saw the drilling of a new borehole, the building of a drainage system to prevent floods, and the installation of a 10-tent temporary hospital. A measles vaccination campaign is continuing.

However, the combination of floods and several weeks of reduced services is taking its toll. An outbreak of acute watery diarrhoea, including some cases of cholera, has affected more than 360 refugees across the camp so far. Symptoms of malnutrition are becoming more visible in children, with at least 300 refugees approaching the health post every day.

While UNHCR and its partners strive to respond within a shrinking operational space, the refugees themselves have stepped up to the daily challenges. Trained professionals such as health promoters, teachers and community peace and security teams have ensured the continuity of services in these uncertain times.

Ugandan refugee Walter helped to set up the new school in Ifo 2, a UNHCR-tented hall that hosts 1,000 students in 11 classes. He had arrived at Dadaab as a 15-year-old, completed his secondary education and received his teacher's certificate. Looking around the school he helps run, he said, "We have been working every day because it was critical for the kids doing their exams. They had a hard time fleeing Somalia, and we owe them this effort."

UNHCR's Bartsch affirmed, "The refugees are contributing to their communities and providing a safe environment in the camps and for the humanitarian agencies. We fully support this valuable work they do day after day."

With the fragile security situation in and around Dadaab, this partnership between refugees and aid agencies will continue to be crucial in preserving some sense of normalcy in the camps. Dadaab is the world's biggest refugee camp, home to some 460,000 refugees, more than 150,000 of whom arrived this year after fleeing drought and conflict in Somalia.

Meanwhile, Ibrahim was not fully convinced he should see the doctor as advised. Perhaps his leg will never recover after these long months of inaction. Perhaps he will eventually be able to hobble around with the help of crutches.

For now, he sits smiling as a UNHCR worker promises to bring him a new sleeping mat next week if nothing prevents him from doing so.

By Sonia Aguilar in Dadaab, Kenya




UNHCR country pages

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

Crossing the Gulf of Aden

Every year thousands of people in the Horn of Africa - mainly Somalis and Ethiopians - leave their homes out of fear or pure despair, in search of safety or a better life. They make their way over dangerous Somali roads to Bossaso in the northern semi-autonomous region of Puntland.

In this lawless area, smuggler networks have free reign and innocent and desperate civilians pay up to US$150 to make the perilous trip across the Gulf of Aden.

Some stay weeks on end in safe houses or temporary homes in Bossaso before they can depart. A sudden call and a departure in the middle of the night, crammed in small unstable boats. At sea, anything can happen to them - they are at the whim of smugglers. Some people get beaten, stabbed, killed and thrown overboard. Others drown before arriving on the beaches of Yemen, which have become the burial ground for hundreds who many of those who died en route.

Crossing the Gulf of Aden


In February 2005, one of the last groups of Somalilander refugees to leave Aisha refugee camp in eastern Ethiopia boarded a UNHCR convoy and headed home to Harrirad in North-west Somalia - the self-declared independent state of Somaliland. Two years ago Harrirad was a tiny, sleepy village with only 67 buildings, but today more than 1,000 people live there, nearly all of whom are former refugees rebuilding their lives.

As the refugees flow back into Somalia, UNHCR plans to close Aisha camp by the middle of the year. The few remaining refugees in Aisha - who come from southern Somalia - will most likely be moved to the last eastern camp, Kebribeyah, already home to more than 10,000 refugees who cannot go home to Mogadishu and other areas in southern Somalia because of continuing lawlessness there. So far refugees have been returning to only two areas of the country - Somaliland and Puntland in the north-east.


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