Kenya’s Dadaab refugee camps on the brink of a health catastrophe

MSF calls for immediate action from donors and aid agencies to address the unsanitary conditions and overcrowding in the camps.

Kenya 2023© MSF

More funding is urgently needed to prevent a health catastrophe in Kenya’s Dadaab refugee camps, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today. A cholera outbreak in the camps has so far affected 2,786 people, and there is an imminent risk of outbreaks of other gastro-intestinal diseases. MSF calls for immediate action from donors and aid agencies to address the unsanitary conditions and overcrowding in the camps.

The three refugee camps that make up the Dadaab complex in Kenya’s North Eastern Province are home to more than 300,000 refugees, most of whom fled neighboring Somalia. The population of the camps has grown rapidly in recent months due to an extended drought in Somalia, leading to severe overcrowding and putting increased pressure on existing services, including supplies of drinking water and latrines.

“The gravity of the situation demands urgent attention, particularly in the areas of water, sanitation, and hygiene,” said Hassan Maiyaki, MSF country director in Kenya. “We have already seen the worst cholera outbreak in five years and the risk of other epidemics breaking out is high. If this occurs, it would [strip] medical capacity in the camps, with potentially catastrophic consequences.”

The current cholera outbreak is linked to reductions in essential water and sanitation activities in the camps, including providing clean water, distributing soap, constructing and repairing latrines, and organizing waste management. Today, according to humanitarian organizations working in the camps, almost half people living in there have no access to functional latrines, leading to open defecation in and around the camps, which raises the risk of disease outbreaks.

The Kenyan Ministry of Health and humanitarian agencies, including MSF, carried out cholera vaccinations and health promotion campaigns to help people protect themselves from the disease, but curbing the outbreak will require improvements to water and sanitation infrastructure.

“Despite our health promotion activities and vaccination campaigns, controlling this cholera outbreak remains [impossible] without [prioritizing] resources towards sustained preventive water, sanitation, and hygiene interventions,” said Dr. Nitya Udayraj, MSF medical coordinator in Kenya. “If they are not improved in quality and scale, it is just a matter of time before we see other epidemics erupt in the camps, such as Hepatitis E.”

MSF runs a hospital in Dagahaley, one of the three camps in Dadaab. In Dagahaley alone, MSF teams have reported more than 1,120 cases of cholera and two deaths since the start of the outbreak in November 2022.

MSF water and sanitation teams are currently trucking 50,000 liters [about 13,200 gallons] of drinking water each day to the outskirts of the camp. In recent weeks, MSF teams have built 150 communal latrines, both within the camps and on the outskirts, where around 9,000 newly arrived refugees have set up makeshift shelters in the surrounding desert. So far, MSF has provided around 1,000 of these households with plastic sheeting, mats, and liquid soap. But much more needs to be done to meet people’s needs and prevent a humanitarian crisis.

The Kenyan government has announced plans to reopen a fourth camp, called Ifo 2, to accommodate new arrivals and alleviate the strain on resources in the existing camps. MSF is calling for these plans to be enacted as a matter of urgency, and to include increased funding for water and sanitation across all four camps.

“The relocation to Ifo 2 should be hastened to ease pressure on the existing camps,” said Maiyaki. “All efforts to ease the overcrowding must include significant investment in the water, sanitation and hygiene sector to ensure a minimum standard of living for refugees in all the camps.”

MSF calls on the international community, donors, and aid agencies to respond urgently to the unfolding crisis in Dadaab, taking immediate action to address the alarmingly unsanitary conditions and prevent the further spread of disease. In the longer term, MSF calls on the Government of Kenya and the UNHCR to find durable solutions for the refugees confined within the camps at Dadaab.

MSF activities in Dadaab

The three camps of Dadaab—Dagahaley, Ifo, and Hagadera—currently host more than 245,000 registered refugees, many of whom have lived in the camps for more than three decades. The camps also host more than 124,000 unregistered refugees, including 67,000 who arrived in 2022.

In January, MSF set up two more health clinics to provide healthcare to newly arrived refugees on the outskirts of Dagahaley camp. MSF has been providing medical care in and around Dadaab for most of the camp’s 32-year existence. Currently MSF’s activities are focused in Dagahaley camp, where teams provide comprehensive health care to refugees and host communities in two health posts and a 92-bed hospital. As well as general health care, MSF teams provide sexual and reproductive health care including emergency obstetrical surgery, medical and psychological assistance for survivors of sexual violence, mental health care, at-home insulin care, and palliative care