Distribution of face masks in Kakuma refugee camp during a pandemic: Legal obligations and responsibilities

This article argues that the inhabitants of the Kakuma refugee camp are in a special relationship with the state, resulting in an increased duty of care of the latter towards the former. The effect of this increased duty of care ultimately results in a positive obligation to provide face masks to the inhabitants to protect them from COVID-19, based on the right to the best attainable standard of health and the right to life. The article then turns to the question of who is responsible to provide such face masks in the camp. After first analysing the situation on site, the article argues that a shift of responsibility of the host state to the UN Refugee Agency took place. © 2022, Pretoria University Law Press. All rights reserved.

The appropriation of African Indigenous Knowledge System in WASH activities by Women at Tongogara Refugee Camp, Zimbabwe

Migrations, whether forced or voluntary, are often characterised by cultural insecurities for immigrants, refugees and displaced persons. This study focuses on the appropriation of African Indigenous Knowledge Systems (AIKS) in the implementation of water sanitation and hygiene (WASH) activities by women at Tongogara Refugee Camp (TRC), Zimbabwe. It argues that despite the impact of modernist predispositions on personal and collective identity, refugee women continually tap from their indigenous epistemic cultural memories in the context of their place-based social amenities and alternatives supplied by refugee camp authorities. Informed by a Feminist Political Ecology (FPE) theoretical framework;and drawing from a qualitative research method, the study used interviews, focus group discussions and participatory observations as the major data collection tools. The study established that in the face of resource scarcity in the camp, women creatively utilized strategies anchored on AIKS to enhance water sanitation and hygiene. In addition, the research noted that very little is being done towards the promotion of AIKS in the camp as the prevailing structures favour western innovation and technological advancements in WASH activities. The study concludes that it is praiseworthy and fundamental to resuscitate AIKS and blend it with modern scientific knowledge to resolve the vicissitudes of refugee women in the era affected by Cyclone Idai and the COVID-19 pandemic.

ASSESSMENT OF THE ROUTINE IMMUNIZATION PROGRAM DURING THE COVID-19 PANDEMIC AT THE MAIN HEALTH CENTER, IN UNRWA'S BAQA'A REFUGEE CAMP, JORDAN

The WHO pulse survey found that 80 out of 105 countries reported varying disruptions to their health services sector. During the COVID-19 pandemic, many governments implemented lockdowns, which subsequently affected residents' daily lifestyles and access to essential health services. In April 2020, the Jordanian government implemented one of the world's COVID-19's strictest lockdown. This study assesses the effect of such measures on the routine immunizations program at the main health center in the Baqa'a refugee camp, managed by UNRWA. Our assessment of the program's performance quantifies the gap in service provision using the number of vaccine doses provided. The gap was compared to the COVID-19 mitigation measures quantified through the OxGRT Stringency Index. Therefore, a LOESS regression model was developed to represent the predicted values for 2020, using data from the previous years. Our model was then compared to the observed 2020 doses provided through the health center. We found a correlation between the increase in the stringency index and the increase in the gap, where the strictest values of the index were associated with the highest gaps. Additionally, the 2020 values were much more dispersed with a wider range than our predicted model, reflecting the effect of the mitigation measures and the countering activities conducted by the health center staff. Overall, using the monthly values, a gap of 1199 doses (8.75%) in 2020 was calculated between the predicted and observed values. Furthermore, we found that the first dose of the 3-dose hexavalent vaccine showed a higher and earlier peak than the other doses after the lockdown period. In conclusion, the implemented activities by UNRWA's health center staff, use of a mobile application, and refugeesembracing health systems have successfully minimized the gap in service provision and provided alternative outlets to maintain an overall high coverage of routine immunizations.

"This Is Not Our Disease": A Qualitative Study of Influencers of COVID-19 Preventive Behaviours in Nguenyyiel Refugee Camp (Gambella, Ethiopia).

The COVID-19 pandemic has infected more than 263 million people and claimed the lives of over 5 million people worldwide. Refugees living in camp settings are particularly vulnerable to infection because of the difficulty implementing preventive measures and lack of medical resources. However, very little is known about the factors that influence the behavioural response of refugees towards COVID-19. There is an urgent need for field evidence to inform the design and implementation of a robust social and behaviour change communication strategy to respond to the threat posed by COVID-19 in humanitarian settings. This study examines factors influencing COVID-19-related behavioural decisions in the Nguenyyiel refugee camp located in Gambella, Ethiopia using data collected from focus group discussions and key informant interviews in September 2020. The evidence suggests that while a number of factors have been facilitating the adoption of COVID-19 prevention measures, including good general knowledge about the virus and the necessary preventive strategies and the active engagement by community leaders and non-governmental organisations, important structural and cultural factors have hindered the uptake of COVID-19 prevention measures. These include: difficultly staying at home to minimise physical contact; overcrowding in the camp and within home dwellings; a lack of hand sanitizers and masks and of funds to purchase these; inconsistent use of facemasks when available; COVID-19 denial and misconceptions about the disease, and other cultural beliefs and habits. Overall, the study found that refugees perceived COVID-19 to pose a low threat (susceptibility and severity) and had mixed beliefs about the efficacy of preventive behaviours. This study identified gaps in the existing information education and communication strategy, including a lack of consistency, inadequate messaging, and a limited use of communication channels. While awareness of COVID-19 is a necessary first step, it is not sufficient to increase adoption of prevention measures in this setting. The current communication strategy should move beyond awareness raising and emphasise the threat posed by COVID-19 especially among the most vulnerable members of the camp population. This should be accompanied by increased community support and attention to other barriers and incentives to preventive behaviours.

A longitudinal study of mental health before and during the COVID-19 pandemic in Syrian refugees.

Background: The COVID-19 pandemic has resulted in increased anxiety and depression around the world. Refugees may be particularly vulnerable to the mental health effects of the pandemic because of their higher rates of mental health disorders, trauma histories, and daily stressors. Objectives: This study used data from a controlled trial of a brief behavioural intervention for psychological distress in Syrian refugees living in Azraq Camp in Jordan to examine the psychological effects of the pandemic on refugee mental health. Method: A total of 410 participants were randomized to either the intervention or control arms of the trial and were assessed at baseline and 3-month follow-up. Half the sample (199; 48.5%) completed their 3-month follow-up assessment after the pandemic restrictions began in Jordan and 211 (51.5%) completed the assessment prior to the pandemic. Refugees were independently assessed for symptoms of PTSD, anxiety, and depression at baseline and follow-up, and pandemic-related worries were assessed at follow-up for those who completed their assessment during the pandemic. Results: The most commonly reported worries were economic difficulties (82.4%), shortage of essential supplies (71.3%), and infecting others (59.7%) or themselves (51.9%). Refugees who were assessed during the pandemic had less severe PTSD symptoms than those assessed prior to the pandemic. Significant predictors of pandemic-related worries were lower levels of depression prior to the pandemic and greater anxiety during the pandemic. Conclusion: These findings highlight the specific needs of refugees during the pandemic and suggest that pre-existing mental health issues may not necessarily be the key risk factors for who will experience major mental health issues or worries during the pandemic.

Antecedentes: La ansiedad y la depresión alrededor del mundo se han incrementado como consecuencia de la pandemia por la COVID-19. Los refugiados pueden ser particularmente vulnerables a los efectos de la pandemia sobre la salud mental a sus tasas más altas de trastornos de salud mental, de antecedentes de trauma y de estresores diarios.Objetivos: Este estudio empleó los datos del ensayo controlado de una intervención conductual breve para la angustia psicológica en refugiados sirios que vivían en el campo Azraq en Jordania. Se buscó evaluar los efectos psicológicos de la pandemia sobre la salud mental de los refugiados.Método: Un total de 410 participantes fueron asignados aleatoriamente, bien al grupo de intervención o bien al grupo de control del ensayo, y fueron evaluados al inicio y a los 3 meses de seguimiento. La mitad de la muestra (199; 48,5%) completó la evaluación a los 3 meses de seguimiento después de que comenzaran las restricciones de la pandemia en Jordania, mientras que 211 (51,5%) completaron esta evaluación antes de la pandemia. Los refugiados fueron evaluados de forma independiente para detectar síntomas del TEPT, de la ansiedad y de la depresión al inicio y en el seguimiento. Las preocupaciones relacionadas a la pandemia se evaluaron durante el seguimiento en aquellos que completaron su evaluación durante la pandemia.Resultados: Las preocupaciones más comúnmente reportadas fueron las dificultades económicas (82,4%), la escasez de suministros esenciales (71,3%) y la infección de otros (59,7%) o de ellos mismos (51,9%). Los refugiados que fueron evaluados durante la pandemia tenían síntomas de TEPT menos severos que aquellos que fueron evaluados antes de la pandemia. Los predictores significativos de las preocupaciones relacionados con la pandemia fueron niveles más bajos de depresión antes de la pandemia y mayor ansiedad durante la pandemia.Conclusiones: Estos hallazgos destacan las necesidades especificas de los refugiados durante la pandemia y sugieren que los problemas de salud mental preexistentes no necesariamente pueden ser los factores de riesgo clave para aquellos que experimentarán los principales problemas de salud mental o preocupaciones durante la pandemia.

SARS-CoV-2 and Rohingya Refugee Camp, Bangladesh: Uncertainty and How the Government Took Over the Situation.

Background: Bangladesh hosts more than 800,000 Rohingya refugees from Myanmar. The low health immunity, lifestyle, access to good healthcare services, and social-security cause this population to be at risk of far more direct effects of COVID-19 than the host population. Therefore, evidence-based forecasting of the COVID-19 burden is vital in this regard. In this study, we aimed to forecast the COVID-19 obligation among the Rohingya refugees of Bangladesh to keep up with the disease outbreak's pace, health needs, and disaster preparedness. Methodology and Findings: To estimate the possible consequences of COVID-19 in the Rohingya camps of Bangladesh, we used a modified Susceptible-Exposed-Infectious-Recovered (SEIR) transmission model. All of the values of different parameters used in this model were from the Bangladesh Government's database and the relevant emerging literature. We addressed two different scenarios, i.e., the best-fitting model and the good-fitting model with unique consequences of COVID-19. Our best fitting model suggests that there will be reasonable control over the transmission of the COVID-19 disease. At the end of December 2020, there will be only 169 confirmed COVID-19 cases in the Rohingya refugee camps. The average basic reproduction number (R0) has been estimated to be 0.7563. Conclusions: Our analysis suggests that, due to the extensive precautions from the Bangladesh government and other humanitarian organizations, the coronavirus disease will be under control if the maintenance continues like this. However, detailed and pragmatic preparedness should be adopted for the worst scenario.