With global displacement numbers at a record high, it is time to once again analyze the “temporary” communities of refugees, communities that lack the basic social institutions necessary to permanent settlements. The over 15 million refugees and just under 30 million internally displaced peoples living around the world (IDPS) are victims of makeshift institutionalism— the concept that health problems in refugee camps are treated with short-term and curative solutions, instead of the long-term and preventative measures crucial to the maintenance of a stable society.
More often than not, refugees are disproportionally affected by contagious and rapidly-spreading infectious diseases, caused by a dangerous cocktail of factors including their geographic origin, ethnic vulnerability, and deteriorating living conditions in underfunded refugee camps. Coupling these contextual hazards with the traumatic conditions faced by refugees—whether inflicted before their arrival at their respective camps or acquired upon living inside them—reveals how medical aid and health care systems, which should not only battle diseases but should also prevent their outset, are truly lacking in places where they are most needed.
Political barriers to self-sustenance and re-integration further harm these victims’ access to healthcare. Go give just one example, the two factors that have racked Palestinian refugees in Lebanon are insecurity and poverty. Since 1982, there has been no improvement in any aspect of well-being, participation or the group autonomy allocated to citizens of established nation-states. Moreover, the government of Lebanon uses methods that increasingly close off access for refugees to become reintegrated into a better and stable society—keeping refugees mired in foundering living conditions—including the denial of nationalization rights and strict rules governing refugees’ movement. 44 percent of Palestinians make less than $2,500 a year, and woman-headed households in refugee camps are the most likely to be among the 15 percent of households classified as “ultra-poor,” unable to sustain even the livelihood of one of its many roof-sharing relatives.
Poverty has crippled refugees’ abilities to care for themselves, and is the cause of many of the unsanitary conditions that lead to poor hygienic or health conditions. But whereas refugees continue to drop into a downward spiral leading to complete dependence on foreign aid, one would expect such aid to adequately provide for its recipients. This, sadly, is not the case. Since camp refugees in Lebanon depend on UNRWA as a main health service provider, health conditions in camps parallel the increase or decrease of aid to their parent agency. The huge problem with UNRWA, as well as other agencies that assist refugees in deteriorating health conditions, are their fluctuating budgets, and the fact that services cannot go beyond the most basic of medical procedures. Cancer victims resort to soliciting NGOs, charities, and patrons, resources for which are extremely limited in areas isolated from outward communication. More complicated medical procedures are simply not performed,.
For refugees, this situation is particularly difficult to overcome because many in the international community see the state of refugee as temporary, even when longstanding conflicts in refugees’ home states have stalled their return for decades. Over three-fourths of those registered with the UN High Commissioner on Refugees (UNHCR) have been away from their homes for five years or more. Those living in limbo find their numbers steadily increasing, but are faced with the same constant perception: that their statelessness is a temporary problem that will eventually pass, just like a storm. For many whose home countries have increased persecution instead of lessening it, such as the persecuted Rohingya Muslim group in Myanmar, that storm hasn’t passed. The real danger of refugee camps, then, isn’t just based on their almost complete dependency on the unpredictable agencies that provide them with care but also on the off-putting attitude with which camps are overlooked. So long as countries crucial to supporting international aid networks continue to view health systems in refugee camps as temporary institutions, they will fail to maintain even the most basic standards of global health amongst communities who need it most.
Furthermore, due to staggering costs and the inability of agencies to penetrate deep inside the problems of refugee camps, only a small fraction of refugee camps have had comprehensive surveys of refugee morbidity carried out, studies that are vital in eliminating common health risks. Agencies and NGOs are unwilling to invest in something that they deem unnecessary, a perception yet again stemming from the old definition of refugee status as temporary. At best, health coverage in camps provide depended-on and barebones services. At worst, refugees have no access to health care whatsoever, or are barred completely from medication or medical procedures by prohibitive causes. In between, a rampant unwillingness to establish more permanent solutions and ignorance towards the rapidly changing definition of being a refugee have all but eliminated stable health services.
But the situation does not need to stay as dark and dim as has been painted above. If agencies and multilateral organizations begin to recognize the developing societies, not just temporary outdoor camps, in which more and more refugees find themselves, they can change the nature of aid that is given. Until such a movement towards concrete, developmental solutions and away from simple band-aids—both literal and metaphorical—is initiated, refugees in camps will continue to face worsening health conditions, trapped in an underserved, underfunded limbo.