Mental health policy and services in England
This briefing provides an overview of mental health policy in England.
A Backbench Business debate on the ‘Effect of the Covid-19 pandemic on refugee communities’ has been scheduled for Thursday 12 November 2020. The debate will be led by Rushanara Ali MP.
Effect of the Covid-19 pandemic on refugee communities (291 KB , PDF)
In an August 2020 speech, the UN High Commissioner for Refugees Filippo Grandi said:
“the coronavirus disease (Covid19), knows no borders, no language barriers. It threatens everyone on this planet – including refugees and other displaced people”
This was part of a call to boost funding for the UN refugee agency, UNHCR, to help priority countries hosting large populations of refugees prevent and respond to the coronavirus.
UNHCR funding
UNHCR has requested US$745 million for the Global Covid 19 Emergency response.
To date (28/10/20) it has received US$468 million or 63% of the total requested.
The UK is the fourth largest donor
United States $186.3M
Germany $62.7M
European Union $32.4M
UK $25.7M
Japan $25.1M
African Development Bank $18.3 M
UNHCR notes that:
“Refugees and other displaced people belong to the most marginalized and vulnerable members of society. They are particularly at risk during this coronavirus disease outbreak because they often have limited access to water, sanitation systems and health facilities.”
However, there are reports that for the first six months of the pandemic, case rates among refugees remained far lower than expected. While low testing rates in refugee camps could explain why so few cases have been reported, experts say that many camps’ isolation from host communities as well as the imposition of strict lockdown measures initially curbed the spread of the virus.
The NGO, International Rescue Committee, said people in refugee camps in Syria, Greece and Bangladesh face a heightened risk of coronavirus due to living in more densely populated conditions than the Diamond Princess—the cruise ship where transmission of the virus was four times faster than Wuhan
The most effective interventions to protect against Covid 19 – frequent hand washing, adherence to social-distancing guidelines, and wearing a mask – often are unavailable to refugees. Many of the world’s forcibly displaced individuals lack access to clean water or soap, let alone health care. They often live in cramped tents in overcrowded camps. An entire family may share a single mask.
This puts refugees at heightened risk of contracting – and dying from – the virus. In one hotel in southern Greece, 148 asylum seekers tested positive for COVID-19. In Singapore, 93% of COVID-19 cases occurred in dorms housing migrant workers.
UNHCR is particularly concerned about the socio-economic consequences of COVID-19, including loss of income, evictions, school closures, denial of access to health and social services as well as rising xenophobia. For refugees, losing jobs could mean returning to dangerous situations, including in their countries of origin.
Over 80 per cent of the world’s refugees and nearly all the world’s internally displaced people are hosted in low- and middle-income countries. These countries do not have the level of economic resources to respond to the implications of the pandemic on people’s livelihoods.
Due to the social and economic impacts of COVID-19, UNHCR is deeply concerned about the heightened risk of refugees and other displaced populations resorting to negative coping mechanisms. These include child marriages and the risk of displaced (or stateless) women being forced to resort to survival sex as a result of lost livelihood opportunities.
South Sudanese refugees
Amid increasing violence and deteriorating conditions, the situation in South Sudan has escalated to a full-blown humanitarian emergency. The total number of South Sudanese refugees has now passed 2 million, it is the largest refugee crisis in Africa, and the third largest in the world, after Syria and Afghanistan. Sadly, 63 percent of South Sudanese refugees are under the age of 18.
The majority of those fleeing South Sudan are women and children. They are survivors of violent attacks, sexual assault and, in many cases, children are traveling alone.
Uganda and Sudan both host over 800,000 refugees from South Sudan, totalling to over half of all South Sudanese refugees. Most of these refugees reside in crowded camp settlements with limited access to their basic needs including water and sanitation items, making them even more vulnerable to Covid-19
Rohingya in Bangladesh
Since August 2017 Muslim Rohingya refugees have fled violence in Rakhine State, Myanmar, into Bangladesh. Over 850,000 refugees are now living in highly congested conditions in 34 refugee camps around Cox’s Bazar the world’s largest refugee settlement. Alongside the refugees are the host communities, which number around 440,000 people. Humanitarian groups like the International Rescue Committee are concerned that people living in refugee camps face a heightened risk of Covid-19 due to the crowded conditions and lack of sanitation facilities.
The latest statistics from humanitarian groups suggest that the cumulative totals for confirmed Covid-19 cases since the outbreak began are 277 cases in the refugee camps, and 4,635 cases in the host community. So far there have been 8 Rohingya refugee fatalities due to Covid-19, and 70 fatalities of host community members.
The refugees’ fear of being isolated in quarantines and separated from their families, or even killed to slow the pandemic, can explain why aid workers in Rohingya camps report minimal testing among residents with Covid-19 symptoms. Covid-related stigmatization adds to this challenge.
Fears of refugees in the general public may be compounded by Covid-19 fears, increasing discrimination against these groups. The social stigma associated with Covid-19 may encourage illness concealment, delay early detection and treatment, increase distrust in health authorities, lower the likelihood of compliance and prolong recovery.
In July, the Government said that the UK has allocated £21 million to tackle the Covid-19 outbreak in Bangladesh. At an international summit in October, the Government pledged a further £47.5million in new UK aid to support Rohingya refugees and help Bangladesh deal with coronavirus and natural disasters.
Syrian refugees and coronavirus
Conflict raging since 2011 has driven more than 11 million Syrians from their homes. 5,554,915 Syrian refugees were registered with the UN High Commission for Refugees in August 2020, making Syria the largest refugee crisis in the world. Many more Syrians are unregistered refugees, living alongside their compatriots in Turkey, Lebanon, Jordan, Iraq and elsewhere.
Internally displaced persons (IDPs) and refugees are particularly vulnerable to the pandemic because of cramped conditions, poor hygiene facilities and lack of access to medical services.
Turkey
Turkey hosts about 3.6 million Syrians registered as refugees, the largest Syrian refugee population of any country. 98% of these people live in urban areas alongside Turks, generally in cramped living conditions.
Access to health care and other essential services is hampered by language difficulties, lack of information and the refugees’ poverty.
Turkey’s 2016 deal with the EU prevented Syrians entering the EU from Turkey, in return for increased EU funding for the refugees in Turkey. The deal expires in 2021.
Lebanon
In Lebanon there are about 1.5 million Syrian refugees, of whom some 900,000 are registered. Nearly half of whom live in tents or other temporary structures.
Lebanon has been undergoing a financial crisis since 2019, making the economic situation of refugees even more vulnerable. Already before the coronavirus outbreak, half of Syrian refugees were surviving on less than $2.90 per person per day. When the pandemic struck in 2020 many refugees’ fragile subsistence was destroyed; one Syrian father told a food NGO: “What scares me most is that we could die of hunger”.
Jordan
Jordan hosts around 658,000 registered Syrian refugees, although the real total of Syrian refugees is estimated at around 1.3 million. Most refugees do not live in camps. Those living in official camps continue to receive basic help from the Jordanian Government and aid agencies. They may be better off than those outside camps, whose efforts to earn a living have been complicated by the pandemic.
In September, the UN confirmed that the virus had entered the Za’atari refugee camp in Jordan, home to well over 50,000 Syrians and the largest Syrian refugee camp in the world.
Some 10,000 refugees, mainly women and children, are stranded in the unofficial Rubkan camp, in a military no-go area near the Syrian border. Humanitarian agencies have been denied access to the camp since the arrival of the pandemic.
Iraq
Iraq hosts about 245,000 registered Syrian refugees. Iraq, too, is in an acute economic crisis and has recently undergone major civil unrest.
For further information on the covid 19 situation in different countries UNHCR hosts a database.
Effect of the Covid-19 pandemic on refugee communities (291 KB , PDF)
This briefing provides an overview of mental health policy in England.
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