No Safe Place: Refugees and the Coronavirus

Poverty and overcrowding leave refugees especially vulnerable to Covid-19.

Physical distancing, washing our hands with soap for 20 seconds throughout the day, wearing masks, and minimizing how often we touch our faces are all cornerstones of the global strategy to slow the spread of the coronavirus. They’re great preventive methods and the evidence base for their effectiveness is rapidly growing, as we learn more about how the virus is transmitted.

But how useful is it to ask people to engage in physical (social) distancing or wash their hands with soap and water when they live in crowded refugee camps or detention centers filled beyond capacity and lacking in the most basic resources, including clean water and soap?

For families living side by side in overcrowded tents in densely populated refugee settlements, social distancing is unrealistic. It’s simply not an option. Nor is it viable for people to maintain six feet (two meters) of interpersonal distance when they are held in tightly packed detention centers, awaiting indefinitely a hearing on whether they will be granted safe haven from violence in their homeland.

Describing the camps for Rohingya refugees in Bangladesh, Sadiya Ansari, writing in McLeans, observed:

“The refugee camps in Bangladesh are among the most crowded-in one of the most densely populated countries-in the world. Although efforts have been made to improve housing, many families in the camps live in cramped, makeshift shelters, with bamboo poles holding up plastic sheeting. Their children go to school in the camp, though these have been shut down since March 16. There is not much room to socially distance. Everyone waits in long lines for water, food rations and other essential services.”

For most of the 70 million people displaced by violence, access to clean water and soap is extremely limited, or simply non-existent. As the New York Times noted in a recent article, in the impoverished conditions of many refugee camps, “People often stand in line for hours to get water, which is insufficient for frequent showers, much less vigilant hand washing.”

Psychologists are knowledgeable about behavior change strategies. But you don’t need a degree in psychology to know that advocating methods of behavioral change that people simply can’t enact is likely to be counterproductive. In fact, raising awareness of a looming pandemic while offering unrealistic preventive methods may heighten people’s fear and deepen their sense of vulnerability.

Who are the people who are out of reach of most of the world’s preventive measures?

• Afghans fleeing the violence and poverty of their war-torn homeland, who have crossed land and sea at great peril only to languish in camps in Pakistan, Greece, and Italy, or in detention centers in a host of other countries.
• Syrians living in crowded refugee camps in Lebanon, Jordan, Turkey, and elsewhere, increasingly unwelcome guests, refugees of an extraordinarily violent war the world has largely forgotten about.
• Guatemalans, Hondurans, and Salvadorans who have made their way north by foot, bus, and train, using their families’ savings to pay a coyote, so that they might escape being killed by gangs. All this, only to find themselves held like criminals in crowded centers, with very little access to basic hygiene or nutrition, at the mercy of guards whose abusive behavior has been well-documented.
• Rohingya, who were already living in poverty in overcrowded camps in Bangladesh before the pandemic struck, after escaping with their families from ethnic cleansing in their homeland of Myanmar.
• Somalians in Dadab, a massive, barren refugee camp in Kenya, home to over 200,000 displaced people living in a state of perpetual homelessness.
• And on and on and on.

The world’s refugees and asylum seekers are people remarkably like you and me, caught up in disastrous events beyond their control, struggling to stay safe and every bit as frightened of this pandemic as everyone else. Perhaps even more so, because while social distancing and frequent hand-washing may be inconvenient for most of us, these reliable strategies are not even options for most of those displaced by violence. As Bob Kitchen of the International Rescue Committee aptly stated, “Refugees do not have the luxury of social distancing.”

What can we do?

• We need to get clean water and soap to refugee communities as quickly as possible. The United Nations High Commissioner for Refugees (UNHCR) is working on getting basic hygiene kits to refugee communities, which include soap, face masks, and other items. Other organizations are working to do similar work. You can support any of a host of local or international NGOs working on such efforts. A great start is the UNHCR but there are numerous NGOs in need of support for their efforts to help displaced communities protect themselves against Covid-19. International aid agencies such as Doctors Without Borders, the Norwegian Refugee Council, and the International Medical Corps (IMC) are among those playing leading roles in this effort.
• Hand-washing stations can be installed in refugee camps. This already been implemented in camps for Rohingya refugees in Bangladesh, and should be widely scaled as quickly as possible.
• In settings where water is simply to scarce to allow frequent hand-washing, aloe and alcohol (60% or stronger) can be combined to make effective hand sanitizer. Refugees can form working groups to produce sanitizer if these simple ingredients are provided, along with containers for their distribution.
• Messaging to refugee communities can emphasize the critical role of reducing how often we touch our faces. Touching the face is a key mechanism in the transmission of the virus, far more common than airborne transmission, according to Dr. Dave Price at the Weill Cornell Medical Center. And unlike hand-washing, which requires soap, or social distancing which requires physical space, reducing face touching requires nothing more than constant messaging.
• Parents and other caregivers of children need messages that can help them talk about Covid-19 with their children. They also need support in dealing with their own stress in this time of heightened fear and vulnerability. At War Child Holland, where I work, we are addressing both of these needs by using written and recorded messages that parents can share with their children, as well as recordings of simple stress-management exercises and parenting activities adapted from our Caregiver Support Intervention.
• Messaging, via WhatsApp, online videos, or other media should not only emphasize what people can do to stay safe, but should also dispel rumors that generate unnecessary fear. For example, a rumor was circulating in Lebanon that virus particles stay alive and dangerous in the air for hours after a sneeze or a cough, leading to needless fear of contagion through an unlikely pathway.
• Asylum-seekers held in detention centers should be released immediately if they pose no threat (i.e., if they are not being held due to criminal violations). The vast majority of asylum-seekers fit this criterion; they are simply people fleeing violence and persecution, seeking safe haven outside of their homeland. Releasing the majority of detained asylum seekers will free up room for the humane detention of those who are deemed in genuine need of confinement. The Southern Poverty Law Center recently took the US government to court to demand that detainees either be granted protections against the coronavirus or released. In another case, a court ordered the US government to release detainees from a center, observing that “The nature of detention facilities makes exposure and spread of the virus particularly harmful.” There is a growing number of local efforts to get detained asylum-seekers released. Join in, write an editorial, post messages on social media, and help the movement grow.

Finally, as we settle in for the long haul of this difficult journey, and adjust to the inconveniences of the various restrictions put in place to slow-and hopefully stop-the spread of the virus, let us also remember the millions of people who do not have the luxury of safe space, clean water, soap, or medical care should they become sick. Their struggles offer us an invaluable perspective on our own.