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  • Writer's pictureIsabella Jabbour

Refugees and COVID-19: A Public Health Response

Millions of refugees are subject to violence, family separation, and cultural hostility. The coronavirus pandemic uncovers a new threat to refugees, one that could prove to be more traumatic than the circumstances that forced them to flee their home in the first place.

As wealthy countries such as the United States continue to tally a record number of Covid-19 cases and deaths from the coronavirus, medical professionals and experts stress how the virus can also devastate the tens of millions of displaced people in refugee camps. Across Africa, the Middle East, and Asia, refugee camps have limited access to healthcare and sanitation, the perfect conditions for a contagion to spread. Families are packed into tarpaulin shelters, where each family shares one mask.

The CDC recommends some restorative practices that lower the risk against COVID-19, including handwashing, social distancing, and wearing a mask. These interventions are not easily accessible to refugees, which increases their risk of contracting the potentially deadly virus. Many displaced people lack access to clean water and are confined to overcrowded, all-too-often dirty camps.

"The one thing that everyone is stressing in combating the coronavirus is to create social distance, but that is precisely what is impossible for refugees," said Deepmala Mahla, the regional director for Asia for CARE, a humanitarian aid agency. "Where do you go to create space? There is no space." If fundamental sanitation is inadequate, then effective hand hygiene is almost impossible.

Cox's Bazar, Bangladesh, is a refugee camp holding over 600,000 Rohingya refugees. They reckon that a COVID-19 outbreak could deplete their medical resources while overburdening their hospitals within 58 days, leading to a rise in the number of deaths from various infectious diseases.

The World Health Organization foresees that refugees suffering from COVID-19 and other infectious diseases may have unsatisfactory treatment results. WHO's prediction is distressing, given that infectious diseases such as tuberculosis and malaria abound among refugees. Noncommunicable diseases, including type 2 diabetes, which increases susceptibility to COVID-19, are also common in refugee populations. The situation refugees face and their limited access to healthcare, testing, and treatment cause it to be nearly impossible to take the necessary measures to stay afloat during the pandemic.

Many refugees share a common fear of being isolated in quarantine and separated from loved ones. This explains the low reported numbers for testing among refugees in Rohingya camps. COVID-19 stigmatization against refugees exacerbates the problem. The general public often perceives refugees as dangerous or threatening; this fear, compounded with COVID-19, reinforces discrimination against refugees.

The social stigma surrounding the virus promotes illness secretion, delays detection and treatment, causes distrust in medical authorities, and lowers the chance of adherence to health protocols and recovery. One of the biggest impediments for public health officials in Iraq is that the stigma is deeply established, and many distrust the government. People are ashamed to be tested, deter their family members from reaching testing, and procrastinate in seeking medical help until they become fatally ill. News media outlets report that stigma is a significant obstacle to preventing and treating the virus in countries of asylum.

Furthermore, the handling pandemic continues to require funds from governments, organizations, and humanitarian agencies. Without access to government support, the refugees depend on deficient cash assistance from the humanitarian agencies, and most will not have jobs waiting for them. According to the United Nations High Commissioner for Refugees, only 35% of Syrian refugees in Jordan will have a stable job after COVID restrictions are lifted. As the refugee's economic hardships intensify, so do their mental health conditions. Challenging mental health conditions further obstruct COVID prevention practices.

In Singapore, 93% of COVID-19 cases arose in dormitory housing of migrant workers. In Bangladesh's refugee camps, a single COVID-19 patient brought about 2,040 to 2,090 deaths.

The COVID-19 pandemic has also exposed existing social inequalities as public health authorities delayed addressing the needs of the most vulnerable communities. Humanitarians aiding refugees continue to emphasize the consequence of global support for countries that receive asylum-seekers so they can pursue economic aid, medical care, and support to refugees. Epidemiological risk assessments and the rapid deployment of outbreak response teams in refugee camps ensure that no one will be left behind during the COVID-19 pandemic.

"When we are suddenly concerned about our safety, it might help us understand what a Rohingya woman might be feeling," said Ms. Mahla of CARE. "Regardless of our financial status, our borders, our caste, color, or gender, we are all in the same boat, fighting the coronavirus."

This virus disproportionately overwhelms the poor and marginalized. That is why local and federal governments need to incorporate refugees into their pandemic response plan. Portugal has exemplified a comprehensive perspective, giving all migrants and asylum seekers with pending applications access to the healthcare system temporarily.

In order to address a pandemic successfully, everyone needs to be protected. The health of all determines the health of each person. Organizations such as UNHCR and the WHO have given assurances to supplying masks, hand sanitizer, testing, tracing, treatment, and vaccines to refugees. However, ending this crisis requires a safe, effective, and widely distributed vaccine, which now seems quite possible.


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