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According to UNHCR, 19.5 million people are recognised as refugees globally, with 53% of these refugees from either Somalia, Afghanistan or Syria. Millions of people around the world have fled their homeland in search of peace – where they may live with safety and security.
The nature of the Refugee Crisis in Europe has changed greatly over the past few months. What was a fluid crisis, with mass movements of people across the Middle East and Europe, has now stagnated and become more static in nature. The closure of borders across the routes taken, namely through the Balkans, has consequently meant that there has been a dramatic decrease in numbers of the people arriving in Europe. Furthermore, the EU-Turkey deal has added to this by encouraging an active decrease in people entering Turkey, and thereby eventually entering Europe. The political climate is one which has left refugees living under a cloud of uncertainty in their search for security.
With the difficulty of finding sanctuary in developed nations and with the absence of alternative options, thousands have been forced into refugee camps – camps where we have an active presence, such as Kambioos Camp in Kenya’s Dadaab, one of the world’s largest refugee camps, and the Softex military-run camp in Greece. Although refugee camps are built to provide temporary shelter, they can often end up residing there for years – sometimes even on a permanent basis, due to the lack of appropriate accommodation elsewhere. Over time, these camps develop into mini communities, with their own micro-economies, social structure and cultural traditions. The harsh realities of war, conflict or oppression may have been left behind, but life inside a refugee camp is not without struggles and difficulties of its own, with issues such as child malnutrition and maternal mortality common.
Even though the number of arrivals in Europe has decreased, there are refugees and migrants still stranded in countries along the route, especially in Greece. Since the closure of Idomeni refugee camp, people have been relocated to military-run camps across parts of northern Greece. Within these camps, they are then registered and granted asylum in central and northern Europe. However, this process is extremely lengthy, with poor basic services and lack of education for children.
In Dadaab refugee camp, which is home to 330,000 refugees, under a third of the population are women of reproductive age. When the time comes to delivering their babies, the women in Dadaab usually opt for home deliveries, in line with their cultural norm. Without the presence of skilled and qualified healthcare professionals, there is an increased risk of injury, disability and even maternal and infant deaths, due to preventable complications surrounding pregnancy and delivery.
AKF’s 24-hour Maternal Health Facility in Kambioos camp in Dadaab was established to provide expectant mothers with all the appropriate medical support they require during and post-delivery of their children. Trained nurses and birth attendants provide mothers with the support and care they require in the safe and sanitised environment of this maternal wing. To date, we have facilitated in the successfully delivery of 367 babies through our maternity clinic.
Terri Harris, Africa Programme Officer for Global One, recently visited the facility in Dadaab and recounts her experience of meeting mothers who had utilised the services for delivery of their children:
“When speaking to these women, I realised that it was the first time that either of them had felt the need to attend a medical centre during their pregnancy. This was not because their previous births were easy-going, but because the thought had never crossed their mind to seek medical support.
“Being from a large Somali community, which also happens to be in one of the world’s largest refugee camp, there are a lot of religious and cultural sensitivities to maternal health, and the limited access to such resources meant that the women were unfamiliar to its importance. For these women, giving birth at home was a norm, their mothers before them did it – their grandmothers did it, and so would they.???
The lack of facilities and medical care for pregnant and vulnerable women in refugee communities contrasts with the experiences of women in the West, especially here in the UK – where medical support and healthcare professionals are present along every step of the way during and even after pregnancy. The reluctance of refugee women in Dadaab to seek the care they urgently require is not solely due to cultural norms, but also transport and practicality.
“Walking around independently is often difficult for many within the refugee camps and security fears are high, so the idea of a lone pregnant woman trying to reach the nearest hospital (10km away) is one trip they’d rather avoid making. Even if they do reach a medical facility, it is often not well equipped to handle maternal health complications. But, the more pressing issue is the lack of educational awareness on prenatal and postnatal care.
Our Maternal Health Facility in Kambioos camp in Dadaab, not only provides women with the care they urgently need within a local setting, but our teams also work to support and educate women on maternal health issues – positively impacting the health of both mothers and their newborns for years to come.
Although resources at refugee camps may expand to accommodate more and more people each year, refugee camps, as the name suggests, remain little but ‘camps’. They are intended as a means of providing only temporary accommodation for the communities fleeing conflict and war, and can be subjected to closure at any time – as we have seen with Idomeni. With discussions about the closure of Dadaab, the future of hundreds of thousands of refugees remains shrouded in uncertainty. This includes the lives of the mothers and their infants, who may suffer if there is an absence of critical care and health facilities.
With European border closures and controversial migrant deals, the political climate in regards to tackling the global refugee crisis has been unpredictable and volatile in recent months. With social services and economies across Europe stretched in the face of austerity, refugees are often blamed by populist politicians for the woes afflicting nations. Though there are valid criticisms of the way the Refugee Crisis has been handled, the outcome of the recent EU referendum poses real questions about the future of the EU’s humanitarian project – which relies on a broad consultative mechanism for implementation.
There are real and lingering questions over Europe’s humanitarian co-ordination and grant funding going forward – for example, in 2014 alone, the EU contributed over £200 million to UK charity funding. There is also the possibility of economic uncertainty leading to less monetary contributions from donors, in addition to questions surrounding freedom of movement – of not only refugees, but also aid workers assisting the pan-European effort. These are just some of the current issues, to which few concrete answers are currently available.
Without AKF’s daily food distributions and medical support in Greece, thousands of refugees would face a shortfall in their very basic daily nutrition and sustenance. Without maternal health facilities, preventable complications surrounding pregnancy and delivery will more likely result in injury, disability and even maternal and infant deaths. This will increase maternal mortality rates among isolated refugee communities.
As World Refugee Day comes and goes, we may have spared a thought or a few moments to consider their plight. However, for refugees, this uncertainty is their daily reality. Something they cannot escape.