This week’s key developments:
- Maternal and child health: Indirect impacts could cost tens of thousands more monthly deaths
- Burundi: Government expels WHO officials
- South Sudan: First cases reach overcrowded displacement camps
- Polio: Travel restrictions delay decision on Africa’s ‘polio free’ status
- Afghanistan: Six killed in food aid protest as prices rise
- Bangladesh: Virus reaches depleted Rohingya camps
- Greece: First asylum seekers test positive for COVID-19 on Lesvos
- Italy: ‘Right to stay’ plan for migrant workers approved
- Western Sahara: Aid and travel on hold in Sahrawi camps
- US-Mexico: US plans to extend coronavirus asylum restrictions
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The New Humanitarian is collecting updates about how the coronavirus is hitting emergency responses in vulnerable communities – from refugee camps and disaster displacement sites, to border crossings and conflict zones. Here’s a snapshot of what we’re watching. Look for a new instalment each week.
Do you have information to share or concerns to raise? What have we missed? Email us to let us know.
Maternal and child health: Indirect impacts could cost tens of thousands more monthly deaths
●NEW: A study by Johns Hopkins University researchers, published in The Lancet on 13 May, projects that between 42,000 and 192,000 more children worldwide, as well as between 2,000 and 9,450 more mothers, could die each month due to COVID-19’s indirect impacts on health and food access. The projections were made using statistical modelling and factoring in elements like vaccine availability, antenatal care, and health coverage. (14 May)
Infectious diseases: Outbreaks emerge as millions miss vaccinations
UPDATED: There are early signs of what postponed vaccination programmes may bring: Afghanistan is reporting polio infections in provinces that haven’t seen cases for two decades, according to the UN. Worried that outbreak responses might spread the coronavirus, the board of the Global Polio Eradication Initiative (GPEI) advised countries on 2 April to postpone vaccination campaigns until at least June. Illnesses from other vaccine-preventable diseases like measles and cholera are also expected to rise in the coming weeks as coronavirus restrictions derail immunisation campaigns. More than 117 million children will miss out on measles vaccinations as dozens of countries are forced to cancel immunisation campaigns, a global health coalition said on 14 April. Mexico is already seeing a measles outbreak, with more than 1,300 cases reported this year, as of 24 April. The World Health Organisation says there’s a moderate risk of regional spread, warning that coronavirus-related disruptions will further raise the chances of outbreaks. On the other hand, polio teams in some countries are now working on COVID-19 responses. (9 April, updated 14 May)
Women’s health: Warnings over funding, increased gender-based violence
Resources diverted from sexual and reproductive health could fuel a rise in pregnancy complications, maternal deaths, and unsafe abortions, warns a briefing from the UN Population Fund, or UNFPA. There are similar warnings about reproductive health and gender-based violence (GBV) across the globe: the agency’s estimates in the Philippines, for example, project a jump in birth complications and spousal violence, while aid groups are reporting a rise in domestic violence in Bangladesh’s Rohingya camps amid a lockdown and pared-back services. Data from the International Planned Parenthood Federation (IPPF) shows more than 5,600 mobile clinics and community-based centres offering sexual and reproductive healthcare have shut in 64 countries, from Colombia and Pakistan to Zambia and Zimbabwe. The closures and restrictions affect HIV testing, contraceptive care, abortions, and services for GBV victims. (9 April, updated 23 April)
Funding: Humanitarian price tag soars
The cost of responding to COVID-19’s humanitarian impacts is rising. On 6 May, the UN announced a $6.7 billion appeal, updating the original, half-funded $2 billion plan launched in March. The new tally adds billions on top of existing humanitarian response plans that exceeded more than $28 billion before the pandemic. These pre-coronavirus responses were only 13 percent funded as of early May, but most crises have deteriorated as outbreaks spread, the UN warns. Beyond the immediate humanitarian impacts, the cost of helping the world's most vulnerable to weather COVID-19's socio-economic repercussions could total $90 billion, according to UN estimates. (7 May)
Logistics: Vaccine bottlenecks threaten children’s lives, UNICEF warns
International flight shortages, “exorbitant” shipping costs, and coronavirus lockdowns are fuelling “a massive backlog” in vaccine shipments, UNICEF warns. Last year, the agency shipped 2.4 billion vaccine doses to 100 countries, but its normal tempo has dropped by 70 to 80 percent since 22 March, it said. Operators are charging two or three times the usual prices for air cargo, and many routes require charter flights at even greater expense. (7 May)
Food: Coronavirus could double the number of people in crisis
The number of acutely hungry people worldwide could nearly double from 135 million to 265 million as a result of COVID-19, according to projections from the UN World Food Programme. Many countries facing severe food crises – Yemen, the Democratic Republic of Congo, Afghanistan, Venezuela, Ethiopia, South Sudan, Syria, Sudan, Nigeria, and Haiti, for example – don’t have the resources to stage large-scale coronavirus responses on top of protecting livelihoods and family income, according to an annual report on global food insecurity drafted before the pandemic. (23 April)
Economy: Shutdowns squeeze global remittances
The World Bank projects that global remittances could plummet by $110 billion this year – a fifth of the $554 billion estimated to be sent to developing countries in 2019 – as migrant workers are laid off in economies hit by coronavirus shutdowns. Money sent home by relatives working abroad far exceeds global aid flows, providing income that can help during crises. In Somalia, for example, the value of remittances is believed to be two to three times greater than humanitarian aid funds. Migrant workers typically send more money home during crises. “This time, however, the pandemic has affected all countries,” the World Bank said in a statement. Research shows that remittances stave off poverty, allow better nutrition, and pay education costs. (23 April)
Protective equipment: Shipping channels (and prices) take flight
It will cost aid groups $280 million to store and ship vital protective supplies, as well as to transport humanitarian workers and other personnel, according to the WHO and WFP. Each month, coronavirus responses around the world will need at least 100 million masks and gloves, 25 million respirators, and 2.5 million diagnostic tests, WHO chief Tedros Adhanom Ghebreyesus said. The “substantial” cost of storing and shipping the cargo is on top of the price of buying the supplies in the first place. Individual aid groups are also trying to procure supplies, but costs have skyrocketed. In Uganda, for example, a pack of 50 disposable masks, once $2, now sells for $40, according to the NGO BRAC, which employs some 4,000 community health workers. “This ongoing cost is not sustainable,” the organisation said. (16 April)
Do you have information to share or concerns to raise? What have we missed? Email us to let us know.
Burundi: WHO officials expelled, aid access blocked at quarantine spots
●NEW: Four senior WHO officials, including the organisation’s country representative, were expelled by the Burundian government on Wednesday. No initial reason was given but an unnamed government official who spoke to AFP blamed “interference” in the country’s management of the virus. Mass rallies have been held across the small East African nation in recent weeks ahead of a general election on 20 May. Doctors and nurses in Bujumbura – the largest city – told TNH there are at least 10 times more confirmed cases than the government has made public. Read our latest on the situation. (14 May)
Human Rights Watch released a report criticising conditions at quarantine sites in the country and said several humanitarian organisations have been blocked from providing assistance. More than 100 people were released after falling ill at one site where they had been held “without food or water in appalling sanitary conditions for several days”, the report said. Burundi confirmed its first two COVID-19 cases on 31 March – and its first death on 12 April. (2 April, updated 16 April)
South Sudan: First cases reach overcrowded displacement camps
●NEW: Three coronavirus cases have been confirmed in overcrowded UN-run displacement camps. Two were in a camp that shelters 30,000 people in the capital, Juba, and the other was in Bentiu, in northern Unity State, home to 118,385 people. “The UN continues to urge displaced people in the sites to follow prevention measures such as social distancing, handwashing, and isolating themselves if they become sick,” UN spokesman Stéphane Dujarric said in a briefing. Close to 200,000 people who have fled years of conflict are sheltering in camps across the country.
The spike in coronavirus cases comes as South Sudan enters its post-harvest lean season – when food is in short supply. “There is still a real worry that the measures taken to suppress the spread of coronavirus run the risk of disrupting livelihood activities, delaying access to food assistance, and placing additional strain on poor households’ abilities to buy food, seeds and other essentials,” said Mercy Laker, CARE South Sudan’s deputy country director. “They risk having a particularly bad effect on the urban poor and those living in displacement sites.” (14 May)
UPDATED: South Sudan’s first four coronavirus cases were all UN staff members, which triggered social media-driven xenophobic hate speech. A joint UN agency and NGO initiative has begun “rumour tracking” to capture the coronavirus information being transmitted within communities. (23 April, 14 May)
South Sudanese soldiers surrounded UN peacekeeping bases and humanitarian hubs in Juba and Malakal, in northeastern Upper Nile State, when the news broke of the coronavirus cases in mid-April. As a protective measure, the UN authorised only essential movement by staff. Some non-UN aid agencies are following the same advice. (9 April, updated 16 April)
Previously, the government announced the closure of all airports and land crossings on 23 March. Excluded from the ban are cargo and relief flights, as well as food trucks and fuel tankers. But all drivers are required to undergo medical tests at the border. Upcoming rotations of UN peacekeepers are on hold, and in-country flights have been restricted, according to the UN peacekeeping mission. (26 March)
The strain on staff working under COVID-19 restrictions is a growing concern, said Jeremy Taylor, regional advocacy adviser at the Norwegian Refugee Council. “We spend a lot of time thinking about it, thinking how to put in place psychosocial support for our teams. The strain is particularly bad for national staff,” he noted. “South Sudan is a dangerous place to start with, but layer on top of that this virus and all the fears that come with it, and it’s definitely a concern.” Staff do have a “right to withdraw” if they feel unsafe, but navigating the restrictions, changing the way we operate to keep staff and beneficiaries safe while balancing that with a “stay and deliver mandate”, is a challenge, Taylor said. (23 April)
Polio: Travel restrictions delay decision on Africa’s ‘polio free’ status
●NEW: Africa was expected to be certified as free of the wild poliovirus this year. But coronavirus travel restrictions have delayed a final decision, according to the GPEI. The last wild poliovirus cases on the continent were detected in Nigeria in 2016. The Africa Regional Certification Commission, responsible for verifying polio eradication, had confirmed 43 of the 47 countries it covers were polio-free, meaning no reported wild poliovirus cases for at least three years (as well as high immunisation coverage and other detection and response measures being in place). However, outbreaks of vaccine-derived strains – rare mutations that affect under-immunised populations – continue to circulate and cross borders, leading the WHO’s advisory board on immunisation to declare last year that it had “serious concerns about the overall state of eradication efforts”. (14 May)
Niger: New polio outbreak surfaces
A new outbreak of circulating vaccine-derived polio was reported in Niger in late April, just as the WHO was forced to suspend mass vaccination campaigns amid the coronavirus pandemic. Two children were the first affected – one in the capital, Niamey, another in the conflict-affected Tillabéri region. “The poliovirus will inevitably continue to circulate and may paralyse more children as no high-quality immunisation campaigns can be conducted in a timely manner,” said Dr. Pascal Mkanda, WHO’s polio eradication programme coordinator for Africa. (30 April)
Meanwhile, migrants who signed up for voluntary repatriation are among those stranded in Niger due to the country’s COVID-19 lockdowns. The UN’s migration agency, IOM, says it is helping about 2,300 people stuck due to being quarantined on arrival, or after being abandoned by people smugglers. Most are staying in communal transit centres, including sites set up for migrants stranded by border closures. The centres are at full capacity, and the IOM says it is concerned about the possibility of an outbreak within the facilities. (2 April)
Somalia: Floods, locusts, and a pandemic
Somalia is facing a triple threat – flooding, locusts, and COVID-19. “This is as grim as I’ve seen it in six years,” Justin Brady, the head of OCHA, the UN’s emergency aid coordination office, in Somalia, told TNH. The majority of UN and NGO international staff, including Brady, are working outside the country, and most local staff are “in a restrictive environment” as a result of coronavirus, undermining the humanitarian response. “It’s like we’re looking through a keyhole at this problem,” said Brady. After more than two decades of conflict, Somalia’s response capabilities are basic and reliant on emergency aid funding. “The healthcare system couldn’t be weaker, when the idea is to flatten the curve,” said Brady. (30 April)
Horn of Africa: Locust response hampered
Delays in obtaining pesticides, helicopters, and other vital supplies have set back efforts to combat East Africa’s desert locust outbreak in recent weeks, just as a second generation of the pest has been forming swarms and threatening crops and livelihoods. The UN’s Food and Agriculture Organisation (FAO) told TNH that materials are now arriving and that bottlenecks have been alleviated by diversifying suppliers. But restrictions are still affecting the ability of some NGOs to move around and provide assistance, and further supply chain problems are anticipated. “There are definite impacts on our ability to provide programmes,” said Steven Burak, a coordinator for the Regional Desert Locust Alliance. (26 March, updated 30 April)
Nigeria: ‘Worst fears’ in northeast, as new cases emerge
The monitoring of the porous borders in Nigeria’s conflict-hit northeastern state of Borno remains a problem. Displaced people with unknown health statuses continue to arrive almost on a daily basis in camps and communities in border areas, OCHA reported. On the Cameroon border, checkpoints are being transformed into health posts to screen people for potential coronavirus symptoms. Aid workers fear the impact on the 700,000 displaced people living in the region’s underserviced camps. “We’re making decongestion a priority, but it’s not an easy task,” OCHA spokesperson Eve Sabbagh told TNH. “It really depends on land allocation, and then being able to secure the camps.” (30 April)
The death of a health worker on 18 April was the first confirmed COVID-19 case in Nigeria’s northeastern region. The aid worker had no history of travel outside Borno and worked in a displacement camp in Pulka, on the border with Cameroon. “It’s our very, very worst fears,” said Nigeria’s former chief humanitarian coordinator Ayoade Olatunbosun-Alakija. (23 April)
Aid workers are particularly concerned about the COVID-19 threat to the roughly 800,000 internally displaced living in congested camps throughout Borno State – the centre of the Boko Haram conflict. Handwashing stations are being installed, and “soap and chlorinated solution” distributed where water is not readily available, the UN said in a statement. Aid workers say there are now greater restrictions on accessing Borno’s 229 camps and “camp-like settings” – most of which are poorly serviced. (23 April)
Prior to the first confirmed COVID-19 case, coronavirus had already had a “very significant impact” on aid operations, said Plan International director Hussaini Abdu. Food distributions now take far longer, as crowd sizes are more tightly managed, he said, noting: “What would have taken one or two days, now takes a week.” The Plan director said distribution timetables have also been upended, and “you have to spend time explaining [why]”. That undermines predictability”, which, he noted, feeds into long-established conspiracy theories over alleged corruption and the political agendas of aid agencies. (2 April)
Cameroon: Conflict and COVID-19
Cameroon has one of the fastest-rising coronavirus infection rates in Africa, tallying more than 2,800 cases and 136 deaths as of 14 May. It also has ongoing conflicts in three regions – the Far North, the Northwest, and the Southwest – which is complicating the humanitarian response. “Continuing our medical activities in these areas already marked by massive health needs is an absolute priority,” Albert Viñas, Médecins Sans Frontières (MSF) emergency coordinator for Cameroon, said in a statement. “But the spread of the new coronavirus means, of course, that we had to adapt our projects.” (30 April)
Sudan: UN police deployment blocked
Travel restrictions imposed by Sudan to slow the spread of COVID-19 are delaying the deployment of fresh UN police units in Abyei and the disputed border regions between Sudan and South Sudan. The UN’s peacekeeping chief, Jean-Pierre Lacroix, said the security situation remains volatile, with rising tensions between the rival pastoral Ngok Dinka and nomadic Misseriya communities, but the deployment of an additional roughly 420 police is facing “serious delays”. As Sudan is still on Washington’s list of state sponsors of terrorism, it is ineligible to access the IMF-World Bank’s $50 billion emergency fund to help vulnerable countries fight COVID-19. (30 April)
Southern Africa: Keeping food aid flowing amid questions over urban response
Close to 16 million people in 11 southern African countries are struggling with food shortages as a result of poor harvests last year. “What we don’t know is how many more people will go hungry as a result of coronavirus,” said WFP’s southern Africa spokesman, Gerald Bourke. “It’s a fact that urban folk are going to be hit hard – and that will be a big issue.” Governments will need to expand social safety net programmes, “but how able they are to do that, given their fiscal constraints, is a big question,” he said. One key area of welfare support is school feeding schemes. Children are out of school across the region, and WFP is implementing workarounds in several countries, including providing take-home rations.
“What we don’t know is how many more people will go hungry as a result of coronavirus It’s a fact that urban folk are going to be hit hard – and that will be a big issue.”
Reduced working hours as a result of COVID-19 has cut the number of berths available in regional ports, and warehouses are closing earlier. That is slowing the movement of food, but “these are not insurmountable obstacles,” said Bourke. As the humanitarian community’s logistics cluster lead, WFP is setting up regional hubs in Africa to centralise cargo movements and UNHAS flights. The hubs will serve the needs of all agencies and INGOs – and provide medevac services and clinics for aid workers should they become infected. Two hubs are up and running in Accra, Ghana and Addis Ababa, Ethiopia, and another is planned for Johannesburg in South Africa. (16 April)
The South African government has assured WFP that its food supply chain won’t be affected by lockdowns and border closures. Food movements are continuing as normal through South Africa and on to Zimbabwe, Zambia, Namibia, and eSwatini, said Lola Castro, regional director for WFP southern Africa. At this stage, there is “no need for humanitarian corridors”, she said. (16 April)
In March, WFP asked for three months’ advance funding from donors. “It will allow us to buy rapidly across the world and move the food before any problem happens with shipping lines,” Castro said. WFP is asking donors for “advanced funds, not more funds”, she stressed. “We need to put stocks in-country to allow distribution on time.” WFP is also increasing the number of distribution sites to limit overcrowding. Prepositioning food, and providing two to three months’ rations in advance, will also help reduce crowd sizes. (19 March)
West Africa: Don’t ignore existing needs
Coronavirus is having a deep impact on operations in West Africa, Julie Bélanger, head of OCHA for West and Central Africa, told TNH. “We are reprioritising and looking at what programmes are absolutely essential in terms of life-saving, while making sure aid workers are both safe and don’t spread the virus,” she said. Some aid groups are looking at where cash programmes can be used instead of distributing relief items, in order to avoid large gatherings of people. But there are questions about what will happen if market food prices rise. “We are not seeing it yet, but in some markets there could be a problem with food availability, which will then impact on cash programmes,” Bélanger said. “The food needs to be there to buy.”
“We are not seeing it yet, but in some markets there could be a problem with food availability, which will then impact on cash programmes. The food needs to be there to buy.”
Some aid groups are also warning donors against diverting funding from existing programmes in order to respond to the coronavirus. Current projects will need to be scaled up, not down: an estimated 19 million people are projected to face largely climate-related food shortages from June to August in the Sahel and West Africa. “That’s a 77 percent increase without taking into account the COVID impact,” Bélanger said. (9 April)
Kenya: Refugee camp travel ban
The Kenyan government has banned movement in and out of the country's two main refugee camps – Dadaab and Kakuma – home to 493,000 people. Movement restrictions were already in place, with refugees unable to secure travel passes since March, and aid workers in the camps affected by a lockdown of the capital, Nairobi. The new restrictions also affect host communities in the vicinity of the camps. (30 April)
The coronavirus pandemic has shut down three quarters of the workload of partner organisations of Hivos East Africa, a development and humanitarian grant-making NGO working in Kenya, Uganda, and Tanzania. What’s needed now is “solidarity and trust”, said Mendi Njonjo, the group’s regional director: “Any well-meaning philanthropist must recognise what partners need is operational support. Now is not the time to insist that our partners stick to schedules, but to be flexible, to move to trust-based grant-making.” (9 April)
Burkina Faso: Transport bans and access challenges
Aid groups in Burkina Faso were already struggling to provide assistance to almost 800,000 internally displaced people living in hard-to-reach areas. This is getting harder still as coronavirus cases rise around the country.
In mid-March, the government closed its air and land borders to all but military personnel and cargo, and banned public transport nationwide, including buses. Restrictions on travel to and from towns and cities with confirmed cases have also been introduced, leaving aid groups based in the capital, Ouagadougou, unsure how they are going to access people in need.
Manenji Mangundu, country director for the Norwegian Refugee Council in Burkina Faso and Niger, said the government should make exceptions for life-saving aid: “Protection and emergency assistance need to continue.”
Jackie MacLeod, Burkina Faso country director for the International Rescue Committee, told TNH that international staff members have returned home and not been replaced, while flexible working hours have been introduced to limit the number of people working at the NGO’s office. For more, watch TNH’s recent webinar. (26 March, updated 16 April)
Central African Republic: Stigmatisation and ceasefire calls
The Norwegian Refugee Council said the suspension of both commercial and cargo flights to and from the country is likely to impact humanitarian operations. With 70 percent of health services provided by aid groups, it is “crucial to maintain the necessary infrastructure to allow supplies and personnel into the country”, the organisation said. (2 April)
The UN peacekeeping mission, MINUSCA, announced in March that it would suspend the rotation of blue helmets. It also appealed for residents to stop the “stigmatisation” of foreigners – something that could prove a problem for non-local aid workers, particularly in the capital, Bangui. Armed groups that signed a peace deal last year have been asked to better implement a ceasefire to prevent the spread of COVID-19. (19 March)
The Democratic Republic of Congo: New Ebola case complicates coronavirus response
With the end of Ebola in sight, it was hoped authorities in Congo could shift their attention to help combat the coronavirus pandemic. But on 10 April, just two days before the end of the epidemic was to be officially declared, a new Ebola case was reported in the eastern city of Beni. Health authorities now have to juggle both responses, while also treating people affected by measles, cholera, and Congo’s many ongoing conflicts. (16 April)
Congo declared a state of emergency for the coronavirus on 24 March. Borders have been shut, and internal passenger flights have been grounded. This has impacted aid workers who use humanitarian air services, though some flights are now up and running following negotiations with the government. NGOs had stopped non-essential staff from coming in and out of Congo even before the restrictions. This has made it difficult to bring in additional staff and affected day-to-day operations. “We were supposed to have people coming to support the country office on specific work,” said Benoît Munsch, country director for CARE International. “It could be audit, training, consultancy, and all these kinds of movements have been stopped.” (26 March, updated 30 April)
Some non-essential aid workers have been evacuated from Congo on the assumption that the coronavirus will hit the humanitarian hub of Goma, the largest city in the east of the country, and health structures will collapse. High staff turnover in Goma, the capital of North Kivu province, is triggering concerns that people who leave won’t be replaced.
The governor of North Kivu called aid agencies together in mid-March and expressed concerns about them importing cases, emphasising the risk to refugee populations and the internally displaced.
On the plus side, there have been discussions about using resources from Congo’s Ebola response to tackle COVID-19. Responders had been looking at ways to shut down Ebola treatment and transit centres, for example, but the process has been suspended while they investigate whether the centres could be used for COVID-19. Some NGOs are also seeking to integrate COVID-19 messaging into their current Ebola prevention programmes. (26 March)
Uganda: Refugee arrivals barred
On 25 March, Uganda announced measures to temporarily bar the arrival of new refugees and asylum seekers. Transit and reception centres will also be closed, while flights in and out of the country were grounded and borders sealed following a first case of COVID-19. Uganda currently hosts some 1.4 million refugees – mainly from neighbouring South Sudan and the Democratic Republic of Congo. (26 March)
Do you have information to share or concerns to raise? What have we missed? Email us to let us know.
Afghanistan: Six killed in food aid protest as prices rise
●NEW: At least six people were shot and killed during a food aid protest in central Ghor Province on 9 May, sparking calls for an investigation. The protesters were claiming that government food distributions, set up during the pandemic, were unfair. In a preliminary report, the Afghanistan Independent Human Rights Commission said police fired on the protesters, contradicting reports by security forces that gunmen in the crowd had fired on them. Food aid protests have also taken place in Nangarhar and Paktika provinces in Afghanistan’s east. (14 May)
UPDATED: Food prices continued to rise in early May, fuelled by panic buying and domestic trade disruption. At the same time, purchasing power for casual labourers and others continues to fall. Pakistan has opened its two main border crossings with Afghanistan to commercial traffic five days a week as of 1 May. This relieved pressure on food and aid, but bottlenecks remain. Pakistan’s joint border crossings are a main supply route for food imports and relief supplies, but had been mostly closed for several weeks starting in mid-March, raising concern about food instability. The unpredictable border status was threatening a “pipeline break” of therapeutic food supplies for malnourished children. “The lives of thousands of severely acute malnourished children who depend on these supplementary foods will be at risk,” UNICEF said in April. Kazakhstan, the largest exporter of wheat flour and grains to Afghanistan, re-opened limited exports in April after an earlier suspension, the UN said. (16 April, updated 14 May)
About 9.4 million Afghans rely on humanitarian assistance. Staffing levels are a concern, as some foreign workers have left, while travel restrictions and quarantines prevent others from getting in. Staff from four NGOs in Afghanistan told TNH their organisations evacuated some or all international workers due to liability issues and concern about the local health system. Some groups said they were staying. “We are trying to keep as many of our regular activities running, but some will have to halt,” said Zia Hannan, Oxfam’s country director. Vicki Aken, country director for the International Rescue Committee, noted that most aid workers in Afghanistan, like elsewhere, are local. “Now, more than ever, they need to see that the international community will continue to support their efforts,” she said. Among health organisations, 85 percent of Afghan NGOs and 72 percent of international NGOs continue to operate, according to OCHA. (19 March, updated 14 May)
Simultaneous aid responses are quickly depleting aid supplies, while some important programmes have been put on hold to focus on a coronavirus response. Some livelihood assistance programmes have been postponed, which could become a bigger concern during the upcoming harvest season in a country already facing widespread food insecurity, aid groups say. Stocks of therapeutic food used for children with severe acute malnutrition have been shifted to areas seen as high risk for the coronavirus – leaving potential shortages in places with less risk but high levels of malnutrition, according to the UN. Floods and landslides have damaged or destroyed more than 1,400 homes since the start of the year, and helping nearly 10,000 affected people means non-food kits are being “depleted and will require urgent replenishment”, the UN said. In mid-April, flooding in Nangarhar Province displaced more than 1,000 people. (9 April, updated 30 April)
Afghanistan’s border regions are the main flashpoint for concern – both for containing the virus and the broader impacts on humanitarian operations in a country facing conflict, disasters, and overarching food instability. IOM figures show more than 277,000 Afghans have crossed the border from Iran this year – including a record 150,000 people in March – as Afghanistan’s western neighbour faced one of the world’s largest coronavirus outbreaks. While high return numbers have been common in recent years, those now leaving Iran have far greater humanitarian needs, the IOM says. Nearly all recent returnees need some form of post-arrival help, compared to roughly one in five before the pandemic. (19 March, updated 14 May)
Along the Pakistan border, a surge of more than 70,000 stranded Afghans returning home overwhelmed coronavirus screening measures in April, according to the UN. Aid groups also feared some new returnees might end up in quarantine camps proposed by local governments, which could help the virus spread. The IOM said it is worried about “future uncontrolled waves of returnees”. Many Afghan returnees end up displaced and in need of aid, adding to the country’s many crises. (9 April, updated 16 April)
A UN staff member tested positive for COVID-19, the UN mission in Afghanistan announced on 3 April. (9 April)
Pakistan: Maternal wards closed as coronavirus hits health workers
●NEW: Pakistan has closed multiple health clinics or hospital wards because staff members were infected with the coronavirus, worsening “an already grim situation” for women and girls in particular, Human Rights Watch said. In recent days, the government has closed a maternity ward in the capital, Islamabad, and a gynaecology unit in Peshawar, near the Afghan border, according to local media. Other hospital out-patient departments and immunisation clinics have previously been closed, while public transit shutdowns have made it difficult for people to reach health centres. “Restricting access to health care for already marginalised Pakistani women is not the answer,” Human Rights Watch said. (14 May)
Muslim Aid said social distancing and partial lockdowns have forced the UK-based charity to suspend latrine-building and hygiene programmes for children. The programmes had operated in areas prone to drought and floods. Coronavirus movement restrictions have also forced the closure of several sites that treat children suffering from severe acute malnourishment, according to UNICEF. (9 April, updated 16 April)
Long distrustful of NGOs but facing a growing outbreak, Pakistan’s government in late March eased restrictions on aid groups working on coronavirus responses. It temporarily waived obligations for international NGOs to obtain so-called “no-objection certificates” for coronavirus-related projects as long as the organisation has already been approved by the government. Pakistan has pushed some INGOs out of the country in recent years, and layered onerous requirements onto those that remain – forcing some to scale back programmes. (2 April)
In March, UNHCR suspended its separate voluntary returns programme for registered refugees. In the past, rights groups have claimed the UN effectively incentivised involuntary repatriation by offering cash support to returnees and not criticising Pakistan’s mass forced returns, which peaked in 2016. (26 March)
Cyclone Harold: Lockdowns and quarantines hold back help
UPDATED: Coronavirus restrictions and strict quarantines continue to slow aid and equipment deployment in Vanuatu following April’s Cyclone Harold, which swept through four Pacific Island nations in April. In Vanuatu, one of the worst-hit countries, only 13 percent of households in need had received shelter assistance, aid groups reported on 7 May. Vanuatu is not allowing foreigners to enter, according to UNICEF, and humanitarian cargo goes through days-long protocols before offloading. A shortage of COVID-19 testing is making it difficult to relax restrictions. The Emergency Telecommunications Cluster said its regional coordinator is unable to deploy, while personnel in Suva, the capital of Fiji (also hit by the cyclone), have been on lockdown. The International Federation of Red Cross and Red Crescent Societies intended to deploy a surge team to Vanuatu, but it is instead working remotely. Cyclone Harold caused widespread damage in Vanuatu’s northern islands. The government has set up local distribution hubs, but one doctor in hard-hit Sanma province told Radio New Zealand there is a desperate need for medical personnel. Even restrictions thousands of kilometres away are impacting aid: the Vanuatu Business Resilience Council, which connects local private sector groups with disaster responses, said lockdowns in Australia and New Zealand have slowed relief imports. (23 April, updated 14 May)
Rohingya boats: Coronavirus propels Bangladesh’s controversial island camp plans
UPDATED: On 7 May, Bangladesh’s navy intercepted a boat that had been stranded for weeks, bringing the passengers to Bhasan Char, a disaster-prone island near the mouth of the Meghna River. Rohingya refugees have previously refused to relocate to a hastily built camp on the island. Over the past several weeks, a migration crisis has unfolded in the Bay of Bengal. Multiple boats carrying Rohingya refugees were unable to dock because of coronavirus restrictions around the region. Malaysia’s air force said it pushed back a separate boat carrying 200 people on 16 April, citing coronavirus border closures. Bangladesh’s government earlier announced it plans to turn away future arrivals, but instead has taken boat arrivals – many of whom departed from the camps earlier this year – to Bhasan Char. Aid agencies and rights groups are drawing parallels to the 2015 Andaman Sea crisis, when thousands of migrants and refugees were stranded. In April, some 400 malnourished Rohingya arrived in Bangladesh by boat; those on board said at least two dozen people had died, while survivors had spent weeks at sea after being turned away by Malaysia. (23 April, updated 14 May)
Bangladesh: Virus reaches depleted Rohingya camps
●NEW: Two people, including a Rohingya refugee, tested positive for the coronavirus, Reuters reported on 14 May. It’s the first confirmed case in Bangladesh’s densely packed camps. Refugees and aid groups fear it will be difficult to contain an outbreak within the settlements, which are home to roughly 900,000 people. Extremely limited hospital isolation and treatment beds also complicate response efforts. (14 May)
Government-imposed coronavirus restrictions were already threatening critical services in the camps, Human Rights Watch warns. There have been “drastic” service reductions and humanitarian staff access has been scaled back by 80 percent, which could hinder swift health responses and affect essential services like food and water, the group said. Refugees in four camps told HRW that food rations hadn’t been replenished and drinking water supplies were running low. The government earlier asked aid groups not to bring in new staff, and to limit travel between the camps and the nearby town of Cox’s Bazar, several aid workers told TNH. MSF said a third of its foreign staff meant to be deployed are stuck outside the country. (30 April)
UPDATED: The “massive and rapid reduction” in aid staff and volunteers in the camps has prompted confusion among some refugees who worry they are being “abandoned” or that services might end, according to a summary of focus group discussions. In late March, Bangladeshi authorities ordered the suspension of relief work apart from essential services like health, nutrition, and food distribution. Makeshift schools have been shut, and authorities have urged Rohingya refugees to stay home. The restrictions were seen as necessary, but the costs are mounting: education NGOs were set to begin a long-awaited formal schooling programme using the Myanmar curriculum. UNICEF said the restrictions will “cripple” other basic services and ramp up the risk of other diseases. Case work for severe acute malnutrition has been constrained by limits on aid workers entering the camps, while groups working on sanitation and hygiene say they’re dipping into their regular budgets to respond to COVID-19. At the same time, fear of contamination and movement restrictions within the camps have kept people from accessing health facilities, where consultations have dropped by half since mid-March. (26 March, updated 14 May)
Humanitarian groups were already reporting an increase in gender-based violence and child marriage as services shrink and movement restrictions escalate. “During this emergency situation, gender issues have been often deprioritised or not seen as life-saving,” the groups said in a statement urging changes and greater consultation with women and girls. (16 April)
“During this emergency situation, gender issues have been often deprioritised or not seen as life-saving.”
With aid stripped back, humanitarian groups are warning that the upcoming monsoon season could be particularly dangerous. Relocations from high-risk areas have been delayed, and site development work, like clearing drainage and emergency shelter repairs, has been suspended or reduced due to government-ordered coronavirus lockdowns. “There could be life-threatening consequences if annual monsoon preparations cannot be completed on time,” UNHCR said. The camps’ aging tent homes are fragile at the best of times, and floods and storms are a frequent threat. Heavy rains will also increase the risk of diseases like cholera. The monsoon season in Bangladesh typically gets underway by June, while cyclone risks tend to peak in May and November. (23 April, updated 14 May)
Jeremy Wellard, Asia representative for the International Council of Voluntary Agencies, an umbrella group of NGOs, said the risks to refugees – and global travel restrictions – are forcing aid groups to re-assess when travel is actually essential. “It has been a moment of reckoning for the sector,” he said. “We can still do much of our work remotely without actually putting bodies on the ground.” But, as the coronavirus pandemic continues, this will also mean looking at how funding and support – which move slowly at the best of times – can be shifted to help local responders already doing much of the work. (19 March)
Myanmar: Conflict hits food supply lines and aid workers
More than 63,000 migrant workers have returned to Myanmar from China and Thailand, adding to humanitarian needs in a country with multiple ongoing conflicts and a weak health system. The coronavirus has disrupted services across the board in Myanmar’s conflict areas, which are home to some 350,000 displaced people and many more with limited aid access. Prevention and outreach services for gender-based violence have been suspended in Rakhine, Karen, and northern Shan states, for example, according to OCHA, along with all education programmes in conflict areas. Some schools have also been taken over for use as quarantine and isolation centres, which could make it harder for classes to resume (and have a lasting impact on children learning in places that might be used to treat coronavirus illnesses or deaths), aid groups say. (23 April, updated 7 May)
There are widespread demands for a nationwide ceasefire, but conflict in parts of western Myanmar’s Rakhine and Chin states continues, threatening food supply lines. WFP trucks transporting emergency food supplies came under gunfire in Chin on 2 May, according to OCHA. On 20 April, a WHO driver was killed while transporting coronavirus samples from Rakhine. The government blamed the April attack on fighters with the rebel Arakan Army, which denied involvement. (23 April, updated 7 May)
The Philippines: A ceasefire shatters; Mindanao displacement rises despite lockdowns
The ceasefire between a commnist rebel group and the Philippine army has collapsed, snuffing out an albeit tentative early bright spot amid the pandemic. The Communist Party of the Philippines announced a ceasefire on 24 March, but this expired on 30 April. The party said its armed wing, the New People’s Army, would resume “an offensive posture” while continuing a public health response in areas it controls. The government called the ceasefire’s end “the final nail in the coffin”. Clashes appeared to continue even during the truce, according to the Armed Conflict Location and Event Data Project (ACLED). Conflict involving the New People’s Army has killed an estimated 43,000 people over decades in parts of the Philippines. (26 March, updated 7 May)
Access has been an early constraint as COVID-19 cases rise nationwide. Local governments have imposed strict community quarantines to contain the spread of the virus, but these are also delaying a swathe of response programmes – most notably a polio vaccination campaign. “This is a major spanner in the works,” said Mark Bidder, head of office for OCHA in the Philippines. Movement restrictions and safety precautions are also delaying measles vaccinations and other humanitarian programmes. Hundreds of health centres and clinics are reporting reduced or interrupted tuberculosis services and uncertainty over how long TB medicine supplies will last. The Philippines has extended community quarantines in the capital, Manila, and other high-risk areas, but Save the Children Philippines called on local communities to resume suspended health and nutrition services for children and newborns, including immunisations. Oxfam Pilipinas says the coronavirus response must better include reproductive health services. (19 March, updated 7 May)
The coronavirus has put yet another emergency on the Philippines’ radar. Over the last year, the country has been hit with multiple cyclones, earthquakes, a volcanic eruption, dengue and measles outbreaks, and the return of polio after a two-decade absence. The polio outbreak had already delayed measles response operations, and now COVID-19 is disrupting programmes across the board. Coronavirus lockdowns will complicate evacuation and response efforts for Tropical Cyclone Vongfong, known as “Ambo” in the Philippines, which was expected to make landfall by 14 May.
There’s concern particularly in the southern region of Mindanao, where displacement has actually increased despite coronavirus lockdowns. More than 370,000 people are now displaced due to conflict or disasters, with at least 26,000 people uprooted in recent weeks mainly by clan feuding. Some 127,000 people are still displaced three years after the siege of Marawi, where clashes between insurgents and the Philippine army levelled parts of the city. Already minimal services for people in evacuation and transit sites, in particular, have been strained across the board by coronavirus quarantines, according to UNHCR. This includes access to water and hygiene, food, jobs, and even basic information. Local aid groups are trying to continue cash aid programmes, but staff have been under strict quarantine or isolation measures as COVID-19 cases rise. Like aid operations around the world, local groups are moving into uncharted territory. “We hope to be of help as much as we can, but we accept our limitations as we have no experience in responding to this kind of crisis,” said Regina Salvador-Antequisa, who heads the NGO Ecoweb. (19 March, updated 7 May)
South Asia: Malnutrition warnings across the region
Essential health and nutrition services are falling by the wayside as coronavirus lockdowns continue across South Asia, UNICEF warns. Access rates for acute malnutrition, immunisations, and safe deliveries are plunging across the region, according to recent assessments. In Afghanistan, in-patient admissions for children with severe acute malnutrition have dropped by a third, and tens of thousands fewer women in Bangladesh are going to health facilities for safe deliveries, for example. Coronavirus containment measures in Sri Lanka’s Eastern Province are also forcing children suffering from severe acute malnutrition to miss treatment programmes. Services have been maintained elsewhere on the island, but most health and nutrition programmes have been affected in some way, UNICEF said in April. (16 April, updated 7 May)
Indonesia: Papua immunisation programmes continue
Immunisation programmes have been scaled back but are continuing “on a smaller scale” in parts of Papua province in Indonesia, according to the WHO. Papua and neighbouring West Papua provinces have some of the region’s worst health outcomes, and rights groups accuse Indonesian authorities of neglecting Papuans’ basic health rights (in addition to broader violations in campaigns to quash pro-independence movements). In 2018, a case of polio – the first in Indonesia since 2006 – emerged in Papua, while a measles outbreak killed roughly 100 children. (30 April)
North Korea: Cash roadblocks and an aid blind spot
North Korea was one of the first countries to close its borders as the coronavirus erupted in China in January. Donor fears of breaking sanctions and government rules have always made direct aid implementation difficult, but new restrictions and mandatory quarantines for foreigners – reportedly lasting weeks – have made it even harder to monitor. “I don’t think anybody has good visibility over the status of things,” one humanitarian based outside North Korea told TNH. Coronavirus travel restrictions have also complicated efforts to get money into the country: the Red Cross said the restrictions have stopped the “physical transfer of funds”, causing “cash constraints” that will delay the restocking of supplies for the ongoing response to September’s Typhoon Lingling until at least May. Most banks have long been reluctant to transfer money into the country. (19 March)
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Greece: First asylum seekers test positive for COVID-19 on Lesvos
●NEW: Greek authorities confirmed on 12 May that two asylum seekers had tested positive for the coronavirus on the Aegean island of Lesvos, where aid agencies have long warned that the overcrowded and unsanitary Moria detention centre is a ticking time-bomb for a major COVID-19 outbreak. The asymptomatic patients reportedly had no contact with migrants at Moria – which has so far remained coronavirus-free – and were staying at a separate quarantine facility for new sea arrivals from Turkey under a scheme started on the island on 1 March. COVID-19 has ratcheted up tensions on the islands between the local population and the mostly Afghan, Iraqi, and Syrian residents of Moria, effectively Europe’s largest refugee camp. The two asylum seekers were among 70 to arrive from Turkey in two boats, on 6 May and 10 May – the first arrivals to the island in more than a month. Designed to host 3,000 asylum seekers, Moria now holds more than 18,000, spilling out into makeshift tent camps in the surrounding olive groves. The implementation of a controversial EU-Turkey deal, signed in March 2016 to curb migration, requires tens of thousands of asylum seekers and migrants to be contained on Lesvos and a few other small Aegean islands while their claims are processed, which can take years. (14 May)
Italy: ‘Right to stay’ plan for migrant workers approved
UPDATED: Plans to give tens of thousands of illegal migrants in Italy permits to stay and work have finally been approved after weeks of political jockeying. The measure was supposed to pass in April as part of a 55 billion euro ($59 billion dollar) emergency bill, but the Five Star Movement, a member of the ruling coalition, came out against the amnesty. Ministers in favour of the proposals praise the efforts of migrants to care for the elderly and produce food supplies during the pandemic. They also argue that the migrants will be needed to work the fields and keep food on the table as Italy emerges from the crisis in the autumn, and that giving them access to public healthcare will help contain the virus. Up to 560,000 migrants live without papers in Italy, but only those working as labourers or carers will be eligible. Under the plan, each will get a renewable six-month permit. Italy has seen one of largest outbreaks of COVID-19 in the world, with over 220,000 confirmed infections and 31,000 deaths, as of 14 May, and is slowly starting to loosen social distancing rules following a two-month lockdown. (7 May, updated 14 May)
Bosnia and Herzegovina: Stranded migrants hard to help
UPDATED: Aid agencies are warning that strict COVID-19 prevention measures are hampering assistance to many of the 8,000 migrants and refugees stranded in the country as they try to get into the EU. A field study by CARE International in Tuzla, in northern Bosnia, showed that three quarters didn’t have sufficient access to water and were living in unsanitary and unhygienic conditions. Those unwilling to risk the squalid conditions in overcrowded camps fend for themselves on the street, and CARE said it was struggling to reach them with assistance due to the coronavirus restrictions. In late April, the government started relocating hundreds of migrants from an improvised tent camp in the northwestern town of Bihac to an emergency tent facility nearby where they can have more space and better services during the coronavirus lockdown. Local authorities reportedly cut off the water supply to Vučjak camp on 20 April to put pressure on the government and NGOs to speed up the process. As other routes through the Balkans have closed off in recent years, Bosnia has become one of the main arteries for those trying to reach wealthier countries in northern and western Europe, via EU member Croatia. (23 April, updated 14 May)
Mediterranean: Concerns grow over migrant crossings, Libya returns
Italian and Maltese ports are closed due to coronavirus, war is still raging in Libya, and NGO search-and-rescue operations have been curtailed, but migrants are still attempting dangerous trips on small boats across the central Mediterranean. Hundreds reportedly became stranded over Easter weekend. After a week adrift, one boat was eventually rescued by a commercial Maltese vessel but not before 12 of the more than 60 people originally on board – Eritrean and Sudanese nationals – had drowned. In what rights activists described as an illegal pushback orchestrated by the Maltese authorities, the survivors were returned to Tripoli, but had to wait 12 hours before being disembarked and taken to a detention centre. The Libyan capital has seen intense fighting in recent weeks between those allied to the internationally recognised government and eastern forces led by general Khalifa Haftar. Reuters reported that 280 migrants brought back to Tripoli by the Libyan Coast Guard earlier in April had to wait overnight before disembarking due to shelling, raising further concerns about returns. “We have no clarity as to the procedures that are followed or will be followed from now on,” the IOM’s Libya office told Reuters in an email. (16 April, updated 23 April)
The Alan Kurdi, a search-and-rescue ship run by Sea-Eye, a German humanitarian organisation, rescued 146 stranded migrants in waters off the Libyan coast on 6 April but was unable to find a safe place to dock, having been rejected by Italy and Malta. On 20 April, the migrants, along with 34 more rescued by another vessel, began a 14-day quarantine on a ferry moored off the Sicilian capital, Palermo. This quarantine ended on 4 May and there are reportedly plans to transfer most of the migrants to other European countries, although no relocation deal has yet been announced. The Italian government confirmed on 15 April that all migrants rescued from now on would have to undergo similar maritime quarantines before being allowed onto Italian soil. The Alan Kurdi had been the only migrant rescue boat on patrol in the central Mediterranean – the most frequented migration route from Libya to Italy, where at least 16,000 people have drowned since 2014. On 5 May, the Italian Coast Guard impounded the Alan Kurdi, citing “irregularities” after inspecting the vessel. Two other NGO ships, Sea-Watch 3 and Ocean Viking, had their operations suspended in March due to logistical difficulties caused by the coronavirus. Miriam Edding, a volunteer with Alarm Phone, an emergency hotline that supports rescue efforts in the Mediterranean, told TNH a deadly rescue gap had been created. “What we are seeing now is a really dangerous escalation of tendencies we have seen before,” she said. “We are in a special situation, but I don’t know of any law that says if you have a pandemic you’re allowed to let people die in the sea.” (19 March, updated 7 May)
Portugal: Government grants temporary residency rights for migrants
In late March, the government of EU member state Portugal took the highly unusual step of granting full citizenship rights to migrants and asylum seekers until at least 1 July, due to the coronavirus outbreak. In addition to access to the national health service, all those who can provide evidence of an ongoing residency request will receive welfare benefits, bank accounts, and work and rental contracts. (2 April)
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Yemen: Coronavirus ceasefire fails to take hold as separatists declare ‘self-rule’
UPDATED: Fighting has escalated on key front lines in Yemen, despite the Saudi Arabia-led coalition’s announcement of a unilateral ceasefire, made in part to “confront the corona pandemic and prevent it from spreading”. The ceasefire was announced 8 April and extended for a month on 24 April. Houthi rebels called the move a “political and media manoeuvre”, and negotiations over terms have so far been unsuccessful. On 26 April, the separatist Southern Transitional Council declared “self-rule” in south Yemen, including the port city of Aden, and fighting has since broken out in some parts of the south. The first case of COVID-19 was announced in Yemen’s Houthi opposition-controlled north on 5 May. The rest are in the south of the country, where the first case was reported on 10 April: a Somali refugee who died in a hotel in Sana’a, according to Houthi authorities. Five years of war have left 24 million people – 80 percent of the population – in need of aid. Reduced funding for aid projects (including a reduction from USAID on grounds of corruption) is impacting relief operations, including food and healthcare, according to the UN. (9 April, updated 14 May)
UPDATED: A ban on flights in and out of Yemen has already meant the UN has scaled back to essential staff only and stopped already limited medical evacuations for chronically ill civilians. A UN passenger flight from Aden to Addis Ababa was planned for 7 May, a possible start to relaxation of the flight ban, but did not take off. In addition, a key reform that has been demanded by the WFP and donors – the use of biometrics to register aid recipients – may also be further delayed, as Houthi rebels said they have banned the use of fingerprint technology for health reasons. Lockdown and curfew rules vary across the country. (26 March, updated 14 May)
NGOs and aid agencies are also shifting how they deliver aid. ACTED, for example, said it had upped the number of days it gives out food vouchers in the northern province of Sa’adah to avoid creating crowds, and asked people to stick to a schedule it had set for distribution. UNHCR says it has increased the number of payment points for people who receive cash assistance, and added hand-washing stations at larger branches. (2 April, 23 April)
Syria: Border crossings in flux
UPDATED: After Turkish authorities in northern Iraq temporarily closed the border with northeast Syria to NGOs, the main crossing they use has been re-opened one day a week and for emergencies. OCHA says that while supplies are entering once a week, “the volume has decreased and delays are noted.” For its part, MSF said on 22 April that there were still challenges in ensuring personnel and supplies can cross into the northeast. “We have much-needed additional supplies and medical staff ready to travel, but we lack the guarantees that they can enter Iraqi Kurdistan and move on into northeast Syria,” the medical charity said. In yet another challenge to aid in the Kurdish-controlled region, UN agencies have been told to stop funding medical operations carried out by private NGOs that cross the Iraq-Syria border. (16 April, updated 14 May)
After nine years of war, 11 million people are estimated to need aid inside Syria, including nearly a million people who fled the recent government campaign in the rebel-held northwest (an estimated 854,000 of whom have not returned home) and many more who were already displaced. There are now curfews, lockdowns, and in some parts of the country a ban on travel between provinces. The impact of COVID-19 response and preparedness restrictions differs depending on location, as parts of the country are controlled by rebels, others by the government of President Bashar al-Assad, and others still by Kurdish authorities.
In general, schools are closed, including those in camps. In the northwest, many schools had been shuttered before the pandemic, either because of insecurity or because they were being used as emergency shelter. A 25 April update from OCHA and the WHO said there had been delays and disruptions in the delivery of assistance due to COVID-19 restrictions, and previous estimates said this slowdown would impact hundreds of thousands of people in parts of the country controlled by Kurdish authorities. The “most pronounced impact” is said to be in education, programmes that provide psychosocial support, and protection initiatives, which all generally require people to gather and remain on hold. UNFPA says the majority of mobile teams that provided support for gender-based violence are no longer able to move, but it is trying to adapt to the situation by providing some remote services and setting up WhatsApp groups for women and girls who are no longer able to access safe spaces. (26 March, updated 30 April)
OCHA and the WHO have said quarantine requirements and movement restrictions are disrupting aid workers’ ability to deploy in Syria, especially internationals who may be unable to enter the country at all. They added that limits on travel, particularly between urban and rural areas, have impacted aid workers’ ability to reach communities in remote parts of the Syria. (30 April, updated 7 May)
Lebanon: Lockdown spurs refugee healthcare worries, child protection concerns
UPDATED: Lebanon’s government announced the country was going into a strict lockdown starting 14 May, following an easing of restrictions and a spate of new cases.
NGOs working in Lebanon said even the previous restrictions, combined with a months-long economic crisis, had been impacting their ability to deliver aid to the estimated 1.5 million Syrian refugees in the country and others who need help. Schools are shut, along with school meals, and almost all “non-essential” programming has been put on hold, including “non-formal education” and many protection programmes, such as those related to children and sexual and gender-based violence. One survey of organisations that work on child protection suggests COVID-19 restrictions meant that the reported difficulty in accessing their services jumped from 14 percent in March to 93 percent in April. Overall, OCHA says that NGOs face “sporadic access issues” across Lebanon due to countrywide and local restrictions on movement. (26 March, updated 14 May)
According to a survey conducted by Plan International, 83 percent of women and girls said they were not accessing sexual and reproductive health services because they feared COVID-19 transmission. Thirty-five percent of all Lebanese and Syrian adolescent girls said they could not get menstrual pads, and 69 percent of those were Syrian refugees. Even more girls – 66 percent – said they could not purchase pads. (7 May)
●NEW: Human Rights Watch said on 11 May that people with disabilities were having trouble accessing medication and medical care because of restrictions on movement, and that some people who need ventilators for conditions not related to COVID-19 were having trouble finding them. In addition, the watchdog said those schools that had set up distance learning had not accommodated the needs of children with disabilities. (14 May)
With the police and army helping to enforce the lockdown, there is ongoing concern that Syrian refugees are also not seeking help when they need it, including regular healthcare services beyond the coronavirus. Aid groups also fear refugees won’t look for treatment if they develop symptoms, especially given that many municipalities have put in place restrictions specific to the Syrian population. The rules include restrictions on the hours of the day refugees are allowed to visit a supermarket or pharmacy. In at least one municipality, refugees have been told they are barred from leaving their homes at all. UNRWA annnounced the positive test in one of the country’s official Palestinian refugee camps on 22 April, and since then several more cases have been recorded. (9 April, updated 14 May)
UPDATED: Instability in Lebanon’s banks due to both the country’s economic crash and COVID-19 is having an impact across the aid sector. NGO sources told TNH the country’s economic crash had made it difficult to buy medical supplies, including personal protective equipment (PPE), even before the pandemic. Banks have closed some ATMs, limited their opening hours, and introduced new charges, making it harder for refugees to access cash aid. This has also made it harder for NGOs to send that aid, as well as pay suppliers and their employees. (26 March, updated 14 May)
Jordan: Clinic access cut off for refugees in border encampment
UPDATED: Jordan, which registered its first COVID-19 case on 28 March, has closed its land, sea, and air borders, and eased one of the world’s strictest lockdowns in late April in an effort to begin re-opening the economy. Some movement restrictions, including a nighttime curfew, remain.
The border closure has led to people at Rukban – an encampment in a desert no man’s land between Syria and Jordan – being cut off from medical care at a UN-funded clinic located inside Jordan. UN relief chief Mark Lowcock told the Security Council on 29 April that patients cannot access the clinic without prior COVID-19 screening, which does not exist in Rukban, while a recent OCHA update said that “negotiations to evacuate medical cases are ongoing.” It is not known exactly how many people remain at Rukban after a series of returns to government-held parts of Syria, but recent estimates put the population at around 12,000 (down from 70,000). Aid is infrequent, and conditions are often described as “desperate”. Jordan hosts more than 656,000 Syrian refugees: 81 percent live in urban areas like the capital, Amman, and the rest mostly live in official camps. (9 April, updated 7 May)
UPDATED: NGO access to refugees outside of camps had been hampered by the lockdown, but this may change as movement restrictions are lifted. A new assessment on the impact of COVID-19 on women and girls in Jordan says that gender-based violence has increased since the start of the pandemic, and it has become more difficult to access help because of closures. Some women said they had been using new virtual services for GBV and sexual and reproductive help, but adolescent girls (10-17) were more likely to use the technology than older age groups. (9 April, updated 14 May)
Libya: Curfews and clashes restrict access
UPDATED: Aid groups say ongoing clashes – as well as curfews, requirements for special permits, and other coronavirus-related travel restrictions – are hampering access and movement for aid and medical workers. On 12 May, OCHA said it had begun a temporary “deconfliction” mechanism to help avoid delays and risks, which will see UN agencies and international NGOs notify the competing centres of power of their movements. The Tripoli-based, internationally recognised Government of National Authority (GNA) and forces loyal to the Khalifa Haftar-led Libyan National Army have been fighting for control of Libya for over a year. The WHO says the work of 80-90 percent of primary healthcare centres across the country has been impacted in some way by COVID-19, with many closing altogether. (9 April, updated 14 May)
UNHCR has restarted the provision of some aid, including cash, at two facilities in Tripoli, by appointment only. The agency previously had to suspend work more than once because of restrictions on movement. (9 April, updated 14 May)
Authorities in Libya’s internationally recognised government announced the country’s first confirmed coronavirus case on 24 March. A “humanitarian pause” to combat the threat of COVID-19 failed to take hold. It was declared mid-March and ostensibly welcomed by both the recognised government and Haftar’s eastern forces.
The UN announced on 17 March that it would pause refugee resettlement travel around the world due to concerns and restrictions related to the COVID-19 pandemic. This appears to include the evacuation flights that had enabled some vulnerable asylum seekers and refugees to leave Libya – a country with an estimated 645,000 migrants and nearly 400,000 internally displaced people that is struggling under the weight of more than a year of fighting. (26 March, updated 14 May)
Western Sahara: Aid and travel on hold in Sahrawi camps
●NEW: With COVID-19 cases confirmed in Algeria’s Tindouf province, all aid activities have been suspended other than basic services and food distribution, and travel between the five camps that house Sahrawi refugees has been banned. This has led to concerns about food security as day labour and taxi driving – some of the few available sources of income in the camps – are on hold.
Although counts vary, it is estimated that more than 170,000 Sahrawi refugees live in camps in Tindouf – part of a territory claimed by both the Algeria-backed Polisario Front and Morocco. For decades, most people in the camps have depended heavily on international aid for their basic needs. (14 May)
Iraq: Concerns about future cash aid
NGOs say restrictions on movement are hampering their ability to deliver aid for the COVID-19 response and other programmes. Lockdowns and movement restrictions differ between Iraq (where a strict curfew has been eased) and the northern Kurdish region, as well as sometimes between provinces.
UNHCR and its local partners are going door to door, or tent to tent, to distribute cash and hygiene kits to refugees and displaced people in Iraq’s camps. But, according to a 26 April OCHA update, aid groups are still struggling to reach people in need, in part due to COVID-19 related rules, especially on movement. The report highlighted problems accessing displacement camps, and said “thousands of highly vulnerable” displaced people in camps, as well as returnees, may soon not be able to get planned cash or in-kind assistance due to store closures, problems using financial service providers, or the inability of aid workers to get to the camps. An OCHA report published at the end of April said “humanitarian access significantly deteriorated in Iraq” in the first quarter of 2020. (2 April, updated 7 May).
Some 1.4 million people are still displaced in Iraq because of the so-called Islamic State. Even before COVID-19 restrictions, the continuing fight against the group – along with new government rules on how access permissions are given out – meant aid organisations have for months had trouble reaching the displaced, and others who need help across the country. (19 March, updated 16 April)
Occupied Palestinian Territories: Lockdowns, violence feed a ‘mental health crisis’
Both the West Bank and Gaza have registered cases of COVID-19, raising concerns about the potential for quick spread – particularly in the latter territory, where many of the 1.9 million population live in densely populated refugee camps and urban areas.
MSF said on 24 April that the West Bank lockdown and its financial implications on families, combined with ongoing violence, is exacerbating a mental health crisis. The medical response charity has had to suspend group and face-to-face mental health sessions, but has switched to providing psychological support by phone. (7 May)
There are quarantines and curfews in both areas, many workplaces are shut, and schools and other social services are closed. Early on in the outbreak, the UN said these measures, coupled with overcrowding and uncertainty, “are expected to increase mental and psychosocial distress, particularly among children, as well as gender-based violence”. It said these concerns are magnified in Gaza, where Israel has imposed a blockade since Hamas took control of the strip in 2007. There are regular violent flare-ups, and 33 civilians were killed by Israeli soldiers in 2019 during weekly protests at the border. (26 March, updated 7 May)
COVID-19 has led the UN’s agency for Palestine refugees, UNRWA, to adjust the way it distributes food aid in Gaza. Between the end of March and 23 April, the agency said 73,000 families received food parcels that were delivered to their homes, rather than asking people to pick them up at distribution centres. UNRWA is also now sending medication to patients with diabetes or who are older than 70, and has set up health and telemedicine hotlines to compensate for a drop in patients at primary health centres. (2 April, updated 7 May)
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US-Mexico: US plans to extend coronavirus asylum restrictions
●NEW: The United States plans to seal its borders to asylum requests indefinitely, intending to extend restrictions meant to contain the coronavirus pandemic, The New York Times reported. Rights groups say the US has effectively shut its borders to those seeking safety. Since 23 March, the country has allowed only two refugees who entered via the US-Mexico border to stay, the Independent reported, citing unpublished immigration statistics. Meanwhile, migrant shelters on the US side of the border are beginning to empty, according to the Arizona Republic. Shelter directors attribute the fall in numbers to coronavirus social distancing rules in the shelters, and many families choosing to return home or not travel. Since late March, US authorities have turned away some 20,000 migrants from the US-Mexico border. Another 60,000 Latin American asylum seekers had already been turned back under an earlier policy, known as “Remain in Mexico”, which means that asylum seekers can no longer stay in the US while their claims are adjudicated. Those asylum hearings and processes have also now been suspended indefinitely due to the coronavirus. (14 May)
US coronavirus-related immigration rules force migrants caught illegally crossing the border to be processed and deported rather than questioned on US soil. Over a two-week period from late March to early April, nearly 400 migrant children intercepted at the US-Mexico border were swiftly deported by US authorities, Reuters reported. Some 120 of the minors were sent back to Guatemala, Honduras, and El Salvador; it was unknown whether the remainder were returned to Mexico or sent back to their home countries. (9 April)
On the other side of the border, Mexico has nearly emptied its government-run migrant shelters by deporting people – mainly back to Guatemala, Honduras, and El Salvador – according to official data published 25 April. Only 106 people remain out of 3,759 held in shelters at the end of March, according to data from the National Migration Institute (INM), the government department that oversees migration. The INM said the move to release migrants was aimed at following coronavirus health and safety measures. None of the remaining migrants have tested positive for COVID-19, the INM statement said. Even as deportations rise, however, asylum seekers continue to seek safety in Mexico itself. UNHCR said on 28 April that asylum requests in Mexico increased 33 percent during the first three months of 2020 compared to the same period last year. Mexico is now considered a destination country by many in the region fleeing violence and poverty, a spokesperson for the refugee agency said. (30 April)
While government facilities are emptied, Mexican shelters run by NGOs and volunteer groups continue to host migrants. However, many of these shelters along Mexico’s northern border have also closed their doors to newly deported migrants, citing an inability to maintain adequate hygiene and social distancing, according to the Mexican news site Animal Politico. Fifteen migrants in a shelter in the border city of Nuevo Laredo tested positive for COVID-19, Mexican authorities reported in mid-April. The cases are believed to be linked to a shelter resident previously deported from Texas. (23 April)
Haiti: ‘A perfect storm’ of unrest, fractured healthcare, and food insecurity
UPDATED: Days after a Haitian government panel asked the United States to suspend deportation flights until the coronavirus pandemic was over, a flight chartered by US Immigration and Customs Enforcement arrived in Port-au-Prince with 50 passengers, including 14 with criminal backgrounds, on 11 May. This was half the original passenger list, which had included five people who tested positive for COVID-19 and later removed, according to the Miami Herald. Only 111 beds in four hotels are available in Haiti to quarantine people suspected of being infected with the virus, the newspaper reported.
While confirmed cases of COVID-19 are relatively low in Haiti, Clarissa Etienne, director of the Pan American Health Organisation (PAHO) warned that a large-scale outbreak could lead to civil unrest. “There is a real risk that growing food insecurity will result in famine,” the public health chief said on 5 May. Etienne said the supply of essential health and sanitary equipment has been complicated by political instability, describing the situation as “a perfect storm approaching”. (7 May, updated 14 May)
The first cases of COVID-19 have been a major cause for concern in Haiti, the poorest country in the western hemisphere where months of protests over corruption and food and fuel prices had rocked the government even before the coronavirus. A lockdown has gone into effect but will be hard to enforce in the teeming capital of Port-au-Prince, where many people live in slums and informal settlements. The Caribbean country suffered a cataclysmic earthquake in 2010 that flattened the capital and nearby Léogâne, claiming between 160,000 and 300,000 lives. Some doctors and nurses have reportedly refused to show up for work at hospitals because of a lack of equipment and infection fears. A 2019 study by the Research and Education Consortium for Acute Care in Haiti, a Haitian-led group of doctors and nurses, found an “insufficient” level of critical healthcare services. For a population of 11 million, the country has only 124 ICU beds and perhaps as few as 20 working ventilators. (26 March, updated 16 April)
Haiti reported its first COVID-19 death on 5 April, but only 218 tests had been carried out at the time. On 7 April, the United States deported 61 Haitian migrants after the foreign ministry negotiated with US officials not to include on the flight anyone with a criminal record. Haiti is considering plans to thin out its overcrowded, unsanitary prisons, where an outbreak of the virus could be particularly lethal. (9 April)
Guatemala: US accused of ‘exporting’ COVID-19 through deportation flights
UPDATED: Health officials in Guatemala said nearly all the deportees on a 14 April US deportation flight tested positive for COVID-19. On 11 May, Erick Muñoz, the vice-minister for health, said 71 of the 76 passengers were infected, a sharp rise from the original number reported. After an 18-day pause, flights transporting deported migrants from the United States to Guatemala resumed on 4 May. Flights are expected to carry an average of 75 passengers each, including unaccompanied children, with returnees being tested by US authorities for COVID-19 before boarding planes, according to Guatemala’s foreign ministry. Upon arrival in the country, the deportees could remain under observation for up to 96 hours before being returned to their communities, an official statement said. (7 May, updated 14 May)
A study by the Centre for Economic Policy and Research, a Washington-based think tank, reported that 40 confirmed COVID-19 cases in detainees deported from the United States to Guatemala originated at an Immigration and Customs Enforcement (ICE) detention facility in Alexandria, Louisiana. The facility is run by a private prison company called GEO Group, the report said. Between February and April, at least 230 deportation flights – like those out of Alexandria – effectively exported the coronavirus virus to 11 Latin American countries, the study reported. (30 April, updated 7 May)
On 19 April, Guatemalan President Alejandro Giammattei said 50 migrants deported by the United States in March and April had tested positive for COVID-19, including 14 on a single flight from Texas. At the time, Guatemala had fewer than 300 total coronavirus cases, including the 50 deportees, Reuters reported. Guatemala’s health minister has blamed deportations for increasing the country’s COVID-19 caseload. The deportations are part of a deal reached between the two governments in 2019 that made aid to the Central American country conditional on continued deportations. (16 April, updated 23 April)
Mexico: Criminal groups distributing aid packages
Mexican President Andrés Manuel López Obrador on 20 April asked drug cartels to stop distributing food packages in regions they control and to instead put an end to violence that last year contributed to a national total of more than 34,500 homicides. In Matamoros, on the border with the United States, a criminal group called Cartel del Golfo was photographed handing out food parcels to local families affected by coronavirus-related lockdowns. Elsewhere, the daughters of imprisoned drug lord Joaquín Guzmán handed out food and toilet paper to the elderly, The Guardian reported. (23 April)
Colombia/Venezuela: Aid access limited as migrants forced home
Sanctions are affecting aid delivery to countries like Venezuela, the head of the International Federation of Red Cross and Red Crescent Societies told TNH. Francesco Rocca, the IFRC president, said the organisation meets regularly on discussions to lift US sanctions amid the pandemic. “But it’s a difficult dialogue,” he said. On 28 April, Jan Egeland, head of the Norwegian Refugee Council, called for the suspension of economic sanctions against countries like Iran, Venezuela, and Syria during the COVID-19 pandemic. “Sanctions… may have all sorts of good motives, but it is undeniably making it more difficult for us to work, to serve ordinary people in this age of the coronavirus,” Egeland said. (30 April)
Venezuela’s first delivery of UN humanitarian aid related to the coronavirus outbreak arrived on 8 April. The 90-tonne shipment included PPE, oxygen, hospital beds, and oxygen concentrators. Venezuela’s economic collapse has seen an exodus of medical staff, the decimation of the healthcare system, and led to shortages of key supplies, including fresh water. (9 April)
Venezuelan leader Nicolás Maduro is under increasing pressure due to the collapse in global oil prices, as the country’s crippled economy relies heavily on oil revenues. On 26 March, the Trump administration, which recognises opposition leader Juan Guaidó as Venezuela’s rightful leader, charged Maduro and other senior officials with “narco-terrorism”, before offering to lift sanctions if he agreed to step aside and let a transitional council govern until fresh elections. There had been one ray of light: Colombia’s left-wing National Liberation Army (ELN) rebel group, which has bases in the two country’s borderlands, declared a unilateral ceasefire for one month from 1 April. The ceasefire lapsed by the end of the month, though the ELN said it would form “only defensive plans”. (2 April, updated 7 May)
Neighbouring Colombia extended its nationwide coronavirus lockdown until 11 May, adding pressure on the many Venezuelan migrants who rely on informal employment. Having lost their sources of income and unable to pay rent following coronavirus lockdowns, thousands of Venezuelan migrants are returning home. With public transport in Colombia shut down, many are making their way back on foot. UNHCR told TNH on 21 April that “conditions in Venezuela cannot allow for large-scale dignified returns”. (23 April)
UPDATED: In Venezuela, the returnees are reportedly being quarantined in towns near the border in unsanitary conditions. On 14 April, A UNHCR spokesperson told TNH that the Venezuelan government has asked the UN system to help with the returns, but added that the agency currently did not have access to border areas where migrants are arriving. Meanwhile, Human Rights Watch called on the US government to grant temporary protection to Venezuelans who may otherwise be deported from the country, due to the “increased risk COVID-19 poses in Venezuela”. The earlier closure of the border with Colombia spurred concerns over how Venezuelans who had relied on buying medical supplies in the neighbouring country will fare, as well as fears that those who need to cross will rely on unofficial and dangerous routes. The 1.8 million Venezuelan migrants who live in Colombia are not covered by the financial aid packages being rolled out to Colombian citizens and have lost income as well as services like soup kitchens and shelters. (19 March, updated 14 May)
Brazil: Mayor in hotspot state pleads for help, while president downplays concerns
UPDATED: In Brazil, the state of Amazonas has seen some of the country’s highest infection rates, which are a risk to indigenous communities in particular. On 5 May, Arthur Virgilio, the mayor of the region’s capital, Manaus, asked world leaders for help in fighting COVID-19, saying hospitals there are on the brink of collapse. At the same time, the country’s leader, President Jair Bolsonaro, continues to encourage Brazilians to ignore social isolation, while downplaying the severity of the disease. Brazil's new health minister, Nelson Teich, said lockdowns may be required in several cities. Coronavirus cases continue to soar, hitting 190,000 on 14 May. A study by Brazilian health researchers based on official statistics reported that coronavirus infections may be up to 15 times higher than the official count. The study estimated the real number of infections at somewhere between 1.6 and 2 million. (7 May, updated 14 May)
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