Coronavirus and refugees: opportunity or death sentence?

On Tuesday 24 March the European Union called for the urgent evacuation of overcrowded refugee camps in Greece to save as many lives as possible, in the words of the very committee appointed by the European Parliament to monitor and report on this situation. The lives of over 42,000 refugees are at stake (in this area alone) due to the rapid spread of the coronavirus, and above all because these refugee camps, like most in the world, do not meet the minimum requirements set by the WHO:

- Minimum Health Services (test to locate infected people)

- Continuous hygiene

- Sufficient insulation to prevent spread.

In another geographical point of the planet, not far from the island of Lesbos, we have a very clear example of the defenseless: the situation of the Syrian region of Idlib, with about 3 million inhabitants and due to the military attacks received in recent months with the health facilities reduced to rubble by the bombing and with hardly any basic medical products. These attacks by the Syrian regime and Russia in the region have precipitously displaced about 1 million people, sending this crowd to possible camps without facilities of any kind and in indescribable sanitary conditions. Idlib has 1.4 doctors for every 10,000 inhabitants.

There are more than 70 million displaced persons and refugees in the world living mostly in camps and overcrowded spaces (a few thousand are currently homeless, as is the case with those recently displaced by the Idlib conflict on the border with Turkey). But the current restrictions on movement (and therefore on food and health, human and economic resources) imposed by the various states in an attempt to contain the spread of this virus are increasing the shortages and significantly worsening the conditions of most of these people, and therefore increasing the chances of unparalleled health disasters, from which it would not be easy to escape because of the context in which they would take place.

If the first wave of COVID-19 infection was China, and the second wave is being what we know as the countries of the West, there is no doubt that the third wave, and perhaps the most devastating one, will be that of the most vulnerable and defenceless, among whom are undoubtedly the displaced persons and refugees.

The Moria Camp on the island of Lesbos, where there are some 20,000 refugees, having been built to house some 3,000, is a clear example of how difficult it is to follow the hygiene and isolation guidelines currently being carried out by most States where the virus has already appeared. In this camp, the simple fact of washing one's hands is an odyssey due to the lack of taps and soap, if we add the living together in tents (or semi-permanent structures) of very large families, and in some cases of several families sharing a roof, makes it impossible to maintain the minimum distance necessary to avoid the contagion.

If the prevention of contagion alone is already difficult in this context, we have to think what would happen if contagion were to occur in these crowded camps for refugees and displaced persons. Healthcare resources are very limited and even more so if we talk about emergencies (on the island of Lesbos there are only 6 beds for intensive care to be shared between residents and all asylum seekers, and this would be the case in Greece, in the case of Syria, Yemen, Iraq... the healthcare situation is even more complicated). ) The spread would be very rapid and by the time the alarm goes off, hundreds if not thousands will have been infected.

The solution to this problem that is approaching us is very complicated, more so if we take into account that we hardly find it for our own nations, where we enjoy reasonable health, economic means and information. But we should begin with solutions in the field. Increasing the number of masks and gloves that are currently being distributed in the camps is a fundamental aspect in order to avoid massive contagion, as well as carrying out temperature controls on the inhabitants of the camps (and of course for the arrivals of new refugees), to rule out people who are already infected and to carry out all possible COVID-19 tests in order to put all those infected into quarantine, which means that we would have to increase human and technical resources considerably without further delay. The transfer of those over 60 years of age to less exposed places where they can be better attended to in the event of contagion would be another necessity, together with special measures for unaccompanied minors, who pose a very significant problem due to the lack of control that these cases entail and because they also represent a significant number within these camps (of the 7,500 refugees living in the camp on the island of Samos, 400 are unaccompanied minors).

But, above all, the fundamental tool for this case is information. Just as in the case of migration, refugees and migrants need to have all the information they can in order to make the best decision in terms of route, climate, asylum laws in the host country, etc., in the case of COVID-19 they need to know as much as possible about the virus; ways of contagion, how to prevent it, where to go in case of doubt.

Without information at the right time and by the right means, migrants and refugees can make decisions that put everyone in danger, because the feeling of fear that is taking hold of many of them, leads them to think that it is much better to escape from the camps and die in the attempt than to stay and die because of the pandemic, because they know that in case of uncontrolled contagion, a very high percentage of the inhabitants of the refugee and displaced camps will be condemned to death. These desperate escapes would mean the uncontrolled entry of people who could be carriers of COVID-19 into other countries, opening up new sources of infection and starting again, in those receiving countries, the process of isolating and quarantining possible new cases. Initiatives to keep refugees informed are interesting, such as the Singpost or Miggapp mobile applications, designed in principle to provide information to migrants and refugees on migration routes, regulations in countries of asylum, etc., and which have been adapted in part to keep displaced persons informed about all matters relating to COVID-19.

NRC.no or Norwegian Refugee Council gives us a number of clues in the form of data on the reality of displaced persons and refugees in the world and which we should take into account when we form an opinion on how to deal with the situation of this group with regard to the COVID-19 pandemic:

- Of just over 70 million displaced people in the world, 29 million are refugees and 84% live in countries with low or medium economies.

- The health system in these host countries is already weak for residents, to which refugees should be added. This automatically weakens the countries hosting displaced persons.

- These host countries often have porous or difficult-to-control borders, making it difficult to control who enters and leaves the country. In a case like this pandemic, border control becomes very important to control all outbreaks of the virus.

- Refugees are a particularly vulnerable group to Covid19 , due to their instability, geographical mobility, overcrowded conditions, lack of health, sanitation.

- This group is not usually included in government plans for pandemics, so a priori they do not receive much information. 
They are the first to be accused of spreading any virus or disease. This group is a resource widely used by politicians and populist groups to gain followers.

But how to fight a pandemic like this in places like Iraq, Afghanistan or Syria where war and conflicts have destroyed most of the hospitals and health structure? There are several areas where there are large concentrations of refugees and they are scattered around the globe: Bangladesh with about 900,000 Rohingya refugees from neighbouring Myanmar, Greece with a significant part of the Afghan and Syrian refugees who tried to cross the Mediterranean in 2015 and 2016. In Yemen, some 3.6 million displaced persons are surviving in mostly temporary camps and in practically non-existent hygienic conditions. In Colombia we have about 1.6 million Venezuelan refugees who have fled their country...Syria, Lebanon, Bosnia, etc.

The situation on the border between Turkey and Syria is particularly dramatic, where there are already an estimated 4 million displaced people and has overtaken Gaza in the most densely populated region of the Middle East. Here it is no longer a question of the bureaucratic obstacles of the pandemic limiting humanitarian aid, but rather that in many areas of this Syrian region aid is not arriving directly due to the conflict that has been frozen for a few months, and the lack of determination of the West to improve the situation of these displaced persons.

The role of the NGOs has always been the main pillar on which refugees and displaced persons have relied to live in the camps in the most dignified way possible and to maintain most of the infrastructure around this group, whether it be administrative tasks, rescue tasks, information tasks, facilitating asylum, etc. Governments, on the other hand, and despite the fact that most of these organizations are private, have also "delegated" many of their functions with respect to refugees and migrants to Non-Governmental Organizations, relying on them for most of the support and management of government resources for this case, but the truth is that, as is happening with doctors and health workers all over the world, the number of volunteers is falling for fear of contagion, and on the other hand, a part of those who still carry out tasks with this group is becoming infected, so that assistance to these people is being reduced in every way. Some NGOs are desperately asking for volunteers in view of the worsening situation in the reception camps in general, where less food and supplies are arriving in general, in addition to having to try to improve the hygiene and sanitary routines of the displaced. 

Therefore, the situation of refugees and displaced persons will tend to worsen significantly in all respects, as governments will have to "take charge", at least partially, of the situation in the camps and their normal functioning in addition to preventing the spread of the Covid.19 Obviously, the situation in which the Greek government and the European Union have to take measures, which they are already taking, is very different from the situation in Iraq, Syria or Yemen where, in addition to the fact that there is hardly any infrastructure, refugees and displaced persons are an added problem to the crisis situation.

Populisms are also asking for their share of the limelight. "This pandemic is asking for borders," said Laura Huhtasaari, Finland's presidential candidate for the far-right Finns Party in 2018, because, as we saw earlier, migrants and refugees are a breeding ground for far-right parties and anti-immigration movements. The Italian president has also linked illegal migrants crossing the Mediterranean to the spread of the virus, and of course, the American president Donald Trump has called for the total closure of borders so that migrants cannot pass on Covid19 to American citizens.

The lessons learnt from the 2015 migration crisis, which left us with a Schengen that was quite badly affected with permanent controls in several European Union countries, a Brexit that has just become a reality, and a strong increase in Europeans to the extreme right-wing parties, tell us that part of what is happening in Western countries as a result of the pandemic will be blamed on the most vulnerable and on refugees and displaced persons. 

The current situation of the most vulnerable and of refugees and displaced persons is, to say the least, very serious. To the impossibility of the communities where the most vulnerable people live and the camps for refugees and displaced persons to carry out the minimum standards of hygiene and coexistence to avoid the contagion of the Covid19 , we are adding the lack of necessary supplies, not only to prevent and fight the pandemic, but also of the basic products to survive, due to the closing of borders and the restrictions to move goods and humanitarian aid that are being experienced in almost all countries of the world. 

In addition, the lack of volunteers, partly for fear of contagion, partly because they have already been infected and cannot continue to help this group, is worsening the general situation in the camps, leading to this extreme situation in which some inmates are considering escaping from the camps and risking reaching other regions or countries, with the consequent risk to themselves and to the residents of the host communities. 

The spread of COVID-19 in some of these camps would be a real drama due to the difficulty, due to the general lack of means, of stopping the bloodshed that this disease would cause in an overcrowded place and without the necessary health support. The question that nobody wants to ask is what will we do when the virus reaches an overcrowded refugee camp without the possibility of sufficient medical care; will we close it and leave them to die to prevent the spread of the virus, or will we find a way to save as many lives as possible? Certainly, this question can be extrapolated today to cities and regions of the world that are currently experiencing a critical situation due to the number of people infected, such as Italian Lombardy, although the main difference would be the spread, in addition to the virus, of panic, and of all the situations that this exacerbated fear could produce in the camps.

We will be able to speak of OPPORTUNITY for refugees and displaced persons if governments and supranational organisations treat these communities as an integral part of nations and count on them to develop any type of national or international plan for the pandemic, whether it be for prevention, or for medical care for those infected, as well as promoting the integration of all displaced persons in this situation in host countries and acting in a determined manner in areas of conflict where humanitarian aid is not permitted. Or we can talk about CONDEMNATION OF DEATH if we completely disregard the problem and do not include this group in the contingency plans to fight the pandemic that are being carried out in most countries of the world.