When most people think of refugees, they think of tent cities on the African savannahs, the communities of Cambodians and Burmese that sprung up on the Thai border, or the cramped shacks of Gaza.
But at a time when war, fraying national borders, and even the early impacts of climate change are triggering human exoduses into neighboring countries, there is a new challenge that the world must understand and confront.
It’s the plight of urban refugees. In fact, about 66 percent of the world’s refugees don’t live in camps, they live among us, often in places where the host community is almost as poor as the refugees themselves. Unfortunately, national governments and international aid agencies are not yet really able to work effectively in these mixed urban settings.
The deepening refugee crises around the world will be on many of our minds on World Refugee Day on June 20. The issue is becoming so acute, that governments, relief agencies and NGOs are now having to place it at the center of all their policy making on humanitarian and aid issues.
The situation is especially acute in the Middle East. The extraordinary humanitarian crisis sparked by the civil war in Syria, and Iraq before that, has seen hundreds of thousands of people flee the fighting, seeking refuge in neighboring nations and Europe.
The news media offers extensive coverage of the camps that have sprung up in Jordan — a country that already carried a huge burden after taking in refugees from the Middle East conflicts of previous generations, but not many people know that only 10 percent of the Syrian refugees who fled to Jordan live in those vast camps. The rest of them are spread across towns and cities.
This is a reality that creates complex challenges for NGOs, the UN, and host governments when they think about how to help refugees. It is also a situation that threatens to create resentment towards refugees from the communities in which they settle.
Think about it for a moment. Refugee organizations often concentrate more on the well-being of refugees than their host communities. For example, the UN High Commissioner for Refugees is mandated to fund refugee relief, but not host community development. This could mean providing vaccines to refugees and not the impoverished local community, fostering resentment, reinforcing segregation, and in some cases sparking violence.
We are just beginning to recognize the emergence of such humanitarian dilemmas that come with changing patterns of refugee migration and settlement. However, we have not yet adapted to what will be a difficult challenge in the years to come.
When I started working with refugees, after shelving my previous career as a civil engineer following some time observing the acute humanitarian suffering unleashed in Sierra Leone by a terrible civil war, I would have assumed most refugees spend only a short time in a camp — six months perhaps or maybe a year.
I was shocked when I found out that all refugees stay in exile for many years, with some of them remaining in exile for more than 20 years (Somali refugees in Kenya, Burmese refugees in Thailand), and those that stay in urban areas tend to stay in exile for even longer and that means of course that not only are host nations struggling to deal with new refugees, they must cope with new generations of refugees who are born in host nations.
Today there are about 65 million refugees or displaced people around the world — 10 million of whom are what we call “statelessly displaced” — jargon for those unfortunates who have no rights, are badly in need of help, and now lack citizenship. Making matters worse, many urban refugees fall into this category.
The biggest refugee crisis right now is in Syria and its surrounding nations. The war has raged for almost six years and is nowhere near resolution. It has killed around 400,000 people so far and created 4.8 million refugees and 6.8 million internally displaced people.
Of the 4.8 million refugees more than a million have made it to Lebanon, 680,000 to Jordan and another 2.6 million are now in Turkey. There are numerous challenges to helping the refugees who live in camps, but we have worked in refugee camps before with success. However, the more diffuse distribution of Syrian refugees spread around towns and cities in neighboring countries creates a problem we are not yet well equipped to deal with efficiently. That’s because if funding is earmarked to deal with refugees, that money cannot be spent on host communities. And if foreign aid is intended to be spent on host communities, it cannot therefore be used to provide care to refugees.
In practice, in places like Jordan and Lebanon, this breeds tensions between refugees and people who live in communities that have taken them in. Before long, this is going to become a very sensitive political issue in the countries involved. That’s why we are going to have to start thinking out of the box. In these communities we should examine the challenge of expanding health care capacity for the local population and care for refugees as a singular challenge.
We owe it to these countries to do something to help. Leaders, policy makers, implementers, funders and academics need to rethink how we balance the healthcare needs of the refugee and host communities. This problem is only going to get more serious and will cause further misery for refugees who already have grim prospects, if the world doesn’t act soon.
For more on Rabih Torbay's insights on how to address the plight of urban refugees, listen to his interview on the Global Health Checkup Podcast:
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