Alongside managing the coronavirus pandemic from a health perspective and the economic fallout of lockdowns, governments and international organisations are coping with the ways in which the most vulnerable categories of society will be affected. These include refugees.
But many countries hosting refugees don't have clear plans.
Among the countries in Africa affected by the pandemic, there are three that make the top ten globally when it comes to refugee populations: Uganda (1,165,700), Sudan (1,078,287) and Ethiopia (903,226). Dozens of other African countries host tens of thousands of refugees.
In response to the pandemic, the United Nations refugee agency has appealed for $255 million to curb the risk and lessen the impact of COVID-19.
The money will be used to improve conditions in refugee camps and settlements. This will include expanding primary and secondary health services, establishing surveillance networks, and countering the spread of misinformation.
Aid bodies and human rights organisations also released a joint press statement calling for the rights of refugees to be protected in COVID-19 responses.
In my view there are some critical steps that governments should be taking to ensure that refugees are protected as the crisis unfolds. These range from interventions on the health services front to ensuring that xenophobia doesn't prevent people from seeking treatment.
What more can be done?
At present, the health services made available to refugees in Africa differ from country to country depending on how much money is available. Algeria, for example, is setting up reception and accommodation centres for refugees where they will have access to routine medical checkups and to all national health programmes.
In Ethiopia, all refugees have the right to get basic health services and be treated like their host communities. And in Uganda, refugees are provided with integrated comprehensive health care packages.
Going forward, all host governments in Africa should take the following steps:
Strengthen health facilities: Inadequate health-care care systems prevent refugees from accessing diagnostic testing and medical care. This happens as a result of ongoing conflict like in the Democratic Republic of Congo. Health worker shortages have also disrupted the smooth provision of services to refugees.
In Kenya and Côte d'Ivoire, low immunisation coverage and limited access to health services among refugees and host communities have resulted in outbreaks of diseases such as measles , which are vaccine-preventable.
Provide basic anti-coronavirus support: Space, soap, and clean water are often in short supply in refugee camps and settlements. This makes it hard to take the two precautionary measures such as social distancing and hand-washing .
The UN's refugee agency, International Organisation for Migration, World Health Organisation, and the International Federation of Red Cross and Red Crescent Societies have released guidance outlining COVID-19 readiness and response considerations for refugee camps and camp-like settings.
They are calling on host countries to ensure that refugees have equal access to health services and are included in national responses to COVID-19, including prevention, testing and treatment.
Do more testing: Testing services should be expanded in African countries with large refugee populations. And screening facilities should be set up in camps and settlements. Health care workers and volunteers must also be mobilised and trained to support testing efforts, trace contacts, and identify and isolate people who may have been exposed to the virus in these settings.
Community engagement: Health authorities and their partners should engage communities and disseminate information to ensure that refugees are aware of the potential risks of COVID-19. Already, the UN refugee agency is helping local health authorities to disseminate information about COVID-19 within refugee populations.
While this is not easy to do, it is happening in countries like Ethiopia and Sudan. In Burundi, however, humanitarian operations have been undermined by the government's ineffective communication about COVID-19 both for the local population and for refugees.
Guard against xenophobia: Nationalism and xenophobia can interfere with the effective response to COVID-19 among refugees. If refugees are afraid to seek medical care, like in Kenya , it could become impossible to halt the spread of the COVID-19 on the continent.
Build stronger partnerships: Public-private partnerships are needed now more than ever. Host country governments and key private sector and civil society organisations need to work together . African governments should be seeking stronger partnerships with humanitarian organisations to ensure that refugees are included in national and regional responses to COVID-19.
Africa should also be working on long-term solutions in preparation for future emergencies. Countries must protect and provide for refugees just as they do for nationals. There are a number of ways to do this. One would be to train health workers to meet the health requirements of refugee populations.
There is also a need to seek additional funding to address refugee needs during public health emergencies.
A holistic effort to improve living conditions among refugees will ensure sustained access to essential primary care and to reproductive and mental health services during a pandemic.
Ultimately, world crises require global cooperation . Countries must act multilaterally to protect vulnerable groups. This includes giving them fair access to health care. In this way refugees can be protected from disproportionate harm.
As Africa plans for future emergencies the needs of the most vulnerable in society must be addressed.
Cristiano D'Orsi does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
By Cristiano D'Orsi, Research Fellow and Lecturer at the South African Research Chair in International Law (SARCIL), University of Johannesburg