Nairobi/New York, October 13, 2016—As Kenya’s government-mandated closure of the Dadaab refugee camp draws nearer, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is urging the government of Kenya, the United Nations High Commission on Refugees (UNHCR) and donor countries to find an alternative to a policy that will send thousands of refugees back to war-ravaged Somalia.
As documented in its report, “Dadaab to Somalia: Pushed Back Into Peril,” more than 80 percent of refugees surveyed by MSF say they do not want to return to Somalia, even if it means remaining in the world’s largest refugee camp. They are primarily concerned with the threat of being forcibly recruited into armed groups, sexual violence, and the lack of access to health care in Somalia—many of the same conditions they fled in the first place. MSF’s report also highlights the probable medical consequences of forcibly repatriating so many people at one time.
“It is clear that refugee camps are not the best way to manage a protracted 25-year crisis, but closing them now without offering other durable solutions pushes people back into a conflict zone, where medical care is dangerously absent,” says Bruno Jochum, MSF General Director. “This decision is yet another blight on refugee protection globally, where again we see total failure in providing safe haven for people in danger. The UN itself has recently declared that five million are at risk of hunger inside Somalia. Sending back even more people to suffer is both inhumane and irresponsible.”
Somalia: an acute lack of medical care
In Dagahaley, one of the five camps that collectively make up Dadaab, MSF medical teams have seen children arriving from Somalia who have not been vaccinated against a range of preventable diseases, a telling indication of a health system that can barely provide basic care. Pregnant women sent back to Somalia will have minimal assistance, putting their lives and lives of their unborn babies at risk. Those with chronic medical conditions—such as people with diabetes who need life-saving insulin, or people with hypertension who need ongoing treatment—will likewise be jeopardized.
As will mental health patients. In Dagahaley, in fact, 70 percent of MSF’s mental health patients are on medication. “If a patient with psychosis is forced to come off their medication, their cognitive function and behavior development goes into reverse,” says Liesbeth Aelbrecht, Head of Mission for MSF in Kenya. “Being stuck in a country where mental health services are basically non-existent would put their lives in severe jeopardy.”
A call to Kenya, the UNHCR and donor countries: other solutions urgently required
Eighty-six percent of surveyed refugees in Dagahaley do not want to go back to Somalia. Fears around insecurity were acute; nearly everyone—women and men alike—stated a belief that they will face a very high risk of sexual violence. MSF therefore questions the “voluntary” nature of the returns being facilitated by the UNHCR.
“The fears that the refugees tell us about are real,” says Aelbrecht. “It is crucial that any return is voluntary, and refugees must have all necessary information about the services and conditions which will meet them in Somalia.”
MSF reiterates that setting up Dadaab style camps across the border merely shifts responsibility and fails to uphold the obligation to offer protection to refugees. More durable solutions, such as smaller camps in Kenya, increased resettlement to third countries, or integration of refugees into Kenyan communities, should be urgently considered. And it cannot be left to the government of Kenya alone; the international community must share the responsibility and the cost burden.
“It is unacceptable that—without any other solution being offered—thousands are essentially being pushed back into conflict and acute crisis: the very conditions they fled,” said Aelbrecht. “Kenya should not shoulder this burden alone. Funding from donor countries needs to be directed to providing sustained assistance in the country of refuge, not to supporting what will essentially be a forced return to a warzone.”
MSF does not accept any government funding for its project in Dadaab – all funding is provided by private donors.
MSF first started working in Dadaab in 1992 and is currently the only provider of medical care in Dagahaley camp. Staff are working in the 100-bed hospital in Dagahaley camp and at two health posts, providing outpatient and mental health consultations, surgery, and antenatal, HIV and TB care. Overall in 2015, teams carried out 182,351 outpatient consultations and admitted 11,560 patients to the hospital.