African countries need to ensure that the health of refugees is protected during the COVID-19 pandemic

Author: Omotunde Enigbokan
Centre for Human Rights, University of Pretoria

The protection of the right to health for refugees in Africa requires urgent attention, especially in this period when evidence shows that new variants of the coronavirus are spreading. As we celebrate World Refugee Day on 20 June 2021, and against the backdrop of the UNHCR’s theme ‘Together we heal, learn and shine’, it is pertinent that we interrogate how African countries are ensuring that the right to health for refugees, is guaranteed. This is particularly important with the development of COVID-19 vaccines worldwide, and in the onset of the administration of these vaccines in Africa.

Challenges faced by refugees in Africa

Existing research underlines the need for heightening refugees’ access to health facilities.  Research further shows that refugees have been particularly hard hit by the COVID-19 pandemic in Africa. This situation is further compounded by the fact that many refugees live in overpopulated camps or reception centres, where they lack adequate access to health services, clean water and sanitation. This makes them more vulnerable to contracting COVID-19.    

Prior to the pandemic, xenophobia in health facilities and lack of legal status were revealed as the most significant barriers to refugees accessing health care in South Africa. These barriers have been exacerbated by the pandemic, thus heightening the risk of poor health amongst refugees. Refugees, particularly women, are still faced with the challenge of accessing healthcare services such as COVID-19 testing. This has led to the fear of approaching hospitals for testing, and has affected their emotional well-being and mental health.

The President of the Republic of South Africa Cyril Ramaphosa delivered a speech on 1 February 2021 where he assured that the vaccine roll-out plan would include migrants. Prior to the President’s speech, the Minister of Health had in several speeches on the vaccine roll-out, only made reference to South African citizens.

Till date, the Department of Health has failed to provide any direction about vaccination arrangements for non-citizens. This has led to various responses from civil society orgainsations demanding that the Department of Health provides clarifications.

In Kenya and Uganda, studies show that many refugees do not have access to tailored, trustworthy information about COVID-19. This has led to constant exposure to rumours, harmful and incorrect information which can have severe effects on the continued spread of the virus. The impact of the first wave of the pandemic had a devastating effect on the lives of refugees in Uganda. Since the lock down last year March 2020, refugees in Uganda struggle to access health care service which has led to the loss of lives. This situation continues till date.  The complaints of refugees in Uganda in regard to accessing basic information about the vaccine shows a backlog on the part of the government in addressing this.

In Mali, the most distressing sexual and reproductive healthcare challenge women face are in the areas of accessing family planning, pre- and postnatal care, and assistance for victims of gender-based violence (GBV). The COVID-19 pandemic contributes to these challenges faced by women. For example, the fear of contracting COVID-19 has caused a low turnout of women in hospitals.  The pandemic has also caused a decline in accessing healthcare since public health advisors have become limited. Moreover, most funding is targeted at the COVID-19 response measures, and many experts are unable to operate at an optimum as a result of travel bans.

Refugees in the Democratic Republic of Congo still struggle with accessing quality health care services as many of these refugees reside in communities that lack health facilities, or with ill-equipped and under-staffed health centres that face frequent shortage of drugs. In Libya, refugees who are ambushed while crossing the Mediterranean Sea and eventually taken to detention centres are not guaranteed access to health care services. These refugees are supported by humanitarian organisations, but such support is limited since these organisations have a limited presence in Libya.   
The African Charter on Human and Peoples’ Rights sets out in article 16 that ‘every individual shall have the right to enjoy the best attainable state of physical and mental health.’

The African Commission in its 449 Resolution highlights that human and peoples’ rights are central pillars of successful response to COVID-19 and recovery from its socio-political impacts and urges states to ‘observe the principle of non-discrimination in accordance with article 2 of the African Charter by ensuring that protection is extended to refugees.’ The African Commission in its Resolution on the Protection of Refugees, Asylum Seekers and Migrants in the fight against the COVID-19 pandemic in Africa  also ‘condemns all violations of rights to which asylum seekers, refugees and migrants have been directly or indirectly subjected in the context of the management of the COVID-19 pandemic in states parties to the African Charter and its Protocols.’

Since the outbreak of COVID-19, the World Health Organisation and the United Nations have adopted guidelines and checklists regarding the protection of human rights. This includes access to health care during the enforcement of COVID-19 measures and addressing inequality in vaccine-roll outs.

The UN Secretary General made a statement on Twitter where he stated that ‘Vaccine inequity is not only unjust it’s also self-defeating.’ In this regard, governments should incorporate the vaccination of refugees in their national policies and programmes on COVID-19 mass vaccination. This should include every person notwithstanding their citizenship status. Inclusion should go beyond just speaking and preparing for COVID-19 vaccines and should be seen in practice.

Governments can also ensure fairness in the distribution of the vaccine by preventing health care authorities from distributing the personal information of refugees to immigration officers. This will protect the refugees from the risk of deportation, therefore creating trust in the system, encouraging refugees to come out for vaccination.

In order to allay the fear of refugees and encourage them to seek health care services, correct information about the spread of COVID-19 should be circulated and safety measures must be ensured in health facilities.

About the Author:

Omotunde Enigbokan is an LLD Candidate at the Centre for Human Rights University of Pretoria. She also works at the Migration Unit of the Centre for Human Rights.

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