• 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 •

 

Related Stories

more documents

Public Health

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

Colombia: Life in the Barrios

After more than forty years of internal armed conflict, Colombia has one of the largest populations of internally displaced persons (IDPs) in the world. Well over two million people have been forced to flee their homes; many of them have left remote rural areas to take refuge in the relative safety of the cities.

Displaced families often end up living in slum areas on the outskirts of the big cities, where they lack even the most basic services. Just outside Bogota, tens of thousands of displaced people live in the shantytowns of Altos de Cazuca and Altos de Florida, with little access to health, education or decent housing. Security is a problem too, with irregular armed groups and gangs controlling the shantytowns, often targeting young people.

UNHCR is working with the authorities in ten locations across Colombia to ensure that the rights of internally displaced people are fully respected – including the rights to basic services, health and education, as well as security.

Colombia: Life in the Barrios

Galkayo: Vulnerable in a volatile land

Galkayo, located in Somalia's Puntland region, is home to more than 60,000 displaced people who fled war-torn south-central Somalia and harsh drought conditions in many parts of the country.

The displaced people are scattered around 21 makeshift settlements in Galkayo. Multiple families often share small, rudimentary shelters made of cardboard and plastic sheets. Despite overcrowding and extreme poverty, it is not uncommon for families to take in abandoned children and elderly people who are on their own.

Squalid conditions and lack of proper health care mean that simple ailments can easily develop into complications. There is little employment in Galkayo and most displaced people find informal day labour, such as collecting garbage or washing clothes for the locals.

UNHCR provides basic assistance to Galkayo's displaced people through vocational training and income generation programs meant to improve their livelihoods. The refugee agency also provides temporary shelter and emergency relief items for vulnerable families.

Galkayo: Vulnerable in a volatile land

Crisis in the Central African Republic

Little has been reported about the humanitarian crisis in the northern part of the Central African Republic (CAR), where at least 295,000 people have been forced out of their homes since mid-2005. An estimated 197,000 are internally displaced, while 98,000 have fled to Chad, Cameroon or Sudan. They are the victims of fighting between rebel groups and government forces.

Many of the internally displaced live in the bush close to their villages. They build shelters from hay, grow vegetables and even start bush schools for their children. But access to clean water and health care remains a huge problem. Many children suffer from diarrhoea and malaria but their parents are too scared to take them to hospitals or clinics for treatment.

Cattle herders in northern CAR are menaced by the zaraguina, bandits who kidnap children for ransom. The villagers must sell off their livestock to pay.

Posted on 21 February 2008

Crisis in the Central African Republic

A Floating Clinic for RefugeesPlay video

A Floating Clinic for Refugees

Medical care is often a luxury that few refugees can afford or access. A new floating clinic launched by local authorities and UNHCR will now bring health care to refugees and locals in a remote corner of Ecuador.