There has been a media campaign dubbed "luquluqu" for the greater part of 2019 sharing stories about victims of forced displacement and their journeys. The initiative strives to highlight the plight of refugees and the altered lifestyles due to displacement. Much of the material I came across was on war displacement victims in Africa trying to resettle.
Officially, Kenya is the second largest refugee-hosting country in Africa after Ethiopia. It could be different taking into account undocumented numbers.
Daadab refugee camp alone has 217,108 registered refugees. Nairobi also has a sizeable chunk of refugees or voluntary migrants for economic reasons.
In 2015 at the commencement of the Syrian war, a street sign in Frankfurt across the European Central Bank read "Keine Mensch ist Illegal", German for "No man is Illegal" was photographed. The graffiti was painted by human rights activists to draw attention to the fact that no one willingly leaves the comfort of their country and home to go to another. Mostly, people move out of fear or coercion.
The ongoing Middle East, Somalia, DRC and South Sudan unrest has created a host of refugees and asylum seekers. Away from the actual direct conflict mortalities and morbidities, one of the biggest challenges displaced people face is accessing health services.
Those in war zones, health systems that take years to build are broken down overnight and creating an environment for disease spread. Medication is oftentimes 10 times more expensive, access to healthcare workers is difficult as they flee for shelter.
One statistic indicates one surgeon serves 500,000 residents compared to a pre-war ratio of 50. Curative services become non-existent since hospitals are closed. However, it is the breakdown of public health systems that is most affected as these require extensive collaborations, logistics and build-ups to function.
I had a chance to interact with refugees over the last few weeks. Without income, lacking identification documents, most are locked out of formal health systems. As a starting point, most refugees end up in informal settlements where health services are usually of low quality and cash-based. Without money, they end up forgoing care.
Of concern is communicable diseases such as TB, pneumonia, gastroenterology and reproductive health issues. Women and children traditionally form the bulk of care needs. Displacement also means most families lack a parent.
For health system monitors, increased effort is required with a holistic approach to ensure trickle down of services to displaced communities.
In particular, the structure of interventions should embrace the unique challenges that bar patients from accessing health services.