A population particularly exposed to COVID-19
KEY FACTS AND FIGURES (UNHCR)
The COVID-19 pandemic is disproportionately impacting the world’s most vulnerable populations. Among them are the world’s more than 70 million forcibly displaced people – refugees, asylum seekers, internally displaced people (IDPs) as well as migrant workers, including undocumented migrants.
Many of these men, women and children live in poor conditions all over the world, with lack of access to basic services such as clean water, food, sanitation or inadequate access to healthcare, as well as lack of legal status. The COVID-19 pandemic both exacerbates and is exacerbated by these living conditions.
Many migrants, asylum seekers, refugees and IDPs live in formal and informal camps, reception centres, or in detention centres. Many others live on the streets in informal housing arrangements. In these settings, preventative measures are often not possible. How can we ask people to protect themselves when they don’t have easy access to water or soap? Or to self-isolate when they live in cramped tents side by side with 10 other people? Physical distancing is very difficult, if not impossible, in overcrowded camps and dense urban settings, where people live side-by-side in small-congested shelters with many family members. Having to queue for water points and food increases the risks of viral transmission.
COVID-19 related curfews and restrictions on freedom of movement also impact heavily on these groups, who are already excluded from most employment opportunities and who have even less access to assistance and protection.
In many settings, displaced people live in insecurity and face the risk of arrest or abuse. They may be stigmatised as ‘disease carriers’ against a backdrop of increased xenophobia and have limited access to reliable information. Some populations are fully dependent on humanitarian aid. In many areas, such aid is limited.
Others trapped in detention centres and camps in areas of ongoing conflict, violence or war not only face the threat of COVID-19 but also are exposed to indiscriminate attacks and shelling.
COVID-19 increases the needs and reduces access to assistance
Lockdowns, travel bans, quarantine and border closures on public health grounds create challenges and disruptions for everyone – refugees, asylum seekers, IDPs and migrants are among the most vulnerable. In the context of the pandemic, it is to be expected that their needs for safe and dignified conditions, mental health services, adapted information and health promotion activities and specific pathways to detection and care will be exacerbated.
Additionally, outbreak control and emergency measures are disrupting many essential services and humanitarian support that is provided by NGOs, volunteers and civic associations, including the provision of basic healthcare and food. The role of the police or military in enforcing emergency measures can also push people further underground and stop them from seeking medical care if they fear they will be harassed, arrested, detained or deported while walking in the street.
Harsher border measures, asylum restrictions, criminalization, xenophobia and stigmatisation
While some border closures are understandable, we are seeing a disturbing conflation of COVID-19 outbreak control with politically motivated migration control measures. Measures such as medical screenings at borders or quarantine upon arrival can be put in place to preserve public health while still ensuring protection to refugees and asylum seekers. Yet in many places, the pandemic is being used as an excuse to punish people on the move, and those that seek to care for them.
At least 167 states have fully or partially closed their borders to contain the spread of COVID-19 – of these, 57 make no exception for people seeking asylum (UNHCR). People seeking safety and shelter are being turned away at land and on the sea – often returned or transferred to countries where they may face serious threats to their life or freedom.
No public health emergency should deny asylum seekers and refugees protection. Yet many states are purposely denying entry to asylum seekers or indirectly preventing their access under the guise of border closure measures in order to limit the spread of the outbreak. There is no evidence that a ban on asylum seekers or returning people would improve public health, indeed it is likely to be counterproductive. We know from our extensive humanitarian medical experience that when a person seeking refugee protection is refused it puts them at further risk.
Several countries have announced restrictions to their asylum systems because of COVID-19. Some have suspended the registration of asylum claims which is denying asylum seekers access to legal status, reception and access to basic services including healthcare. Others have only suspended or limited the processing of claims. Additionally, many asylum seekers have been left to fend for themselves which asylum reception centres closing their doors to newly arrived.
Several states have adopted concerning measures against refugees, asylum seekers and migrants in transit, such as targeted restriction of movements, forced relocation in camps, the prohibition of transportation of migrants and mass arrests in parks.
Key recent examples:
US, Central and South America
- The US closed its border to all asylum seekers crossing through Mexico and put all asylum proceedings on hold, but deportations from the US to Mexico, Central America and South America have continued. This is despite the fact that the US is right now the epicentre of the epidemic and is potentially exposing people to COVID-19 in detention centres before deporting them to countries with fragile health systems (Guatemala, Honduras, El Salvador or Haiti).
- Brazil has restricted the entry of foreigners at its land borders, including the Venezuelan border that hundreds of Venezuelan migrants and refugees used to cross daily.
- Since early May, Malaysia has conducted several immigration raids under the pretext of containing the spread of COVID-19. This has affected hundreds of migrants, including Rohingya refugees and children. While documented refugees are generally released after COVID-19 testing, undocumented migrants end up in detention.
- Boats carrying Rohingya refugees heading to Malaysia have been turned back. Most recently a boat carrying around 500 Rohingya was denied entry into Malaysia and up to 100 people on board are thought to have died before the boat was eventually allowed to make landfall in Bangladesh.
- We are seeing humanitarian efforts being blocked in the name of COVID-19 – for example, civilian search and rescue efforts are being blocked as states use discriminatory and disproportionate application of public health control measures. Germany asked NGOs to cease search and rescue activities, while Italy and Malta closed their ports to rescued people, implementing a system of “floating quarantine vessels” suspensive of people’s right to disembark in a place of safety.
- France continues to pushback refugees, asylum seekers and migrants to Italy.
- Belgium, Denmark, Italy and Greece have suspended or limited the processing of claims, such as of interviews.
- In Libya, the detention centre in Kufra expelled nearly 900 men and women from April 11 to 15, taking them by truck or bus across hundreds of miles of sand and leaving them either in a remote town in Chad or at a Sahara border post in Sudan.
- Uganda has also closed its borders and announced the temporary suspension of refugee law for emergency reasons.
- In the midst of the COVID-19 crisis, deportations of Ethiopian migrants from Saudi Arabia were halted briefly in March and resumed in early April. However, around 3,000 people were deported in about ten days in April, amid calls from the UN and MSF to stop deportations or space them out. Deportations are now again on hold. Arriving migrants are sent to a quarantine centre at a university in Addis Ababa.
What can we do to protect these especially vulnerable populations?
Protection of vulnerable refugees, asylum seekers and migrants: Refugees, asylum seekers and migrants should not be stigmatised or painted as a “threat” during times of COVID-19. The virus has no borders and all humans are potentially at risk. Everyone must be equally included in the outbreak response for the response to be efficient. They must not be discriminated against through exclusion, criminalisation and discrimination by authorities - this is counterproductive to the efforts to stop the outbreak. States should also take adapted measures that are responsive to the specific needs of these particularly vulnerable groups of the population.
Access to healthcare must be ensured: Refugees, asylum seekers, IDPs and migrants must be assured access to healthcare. COVID-19 control measures should not come at the cost of access to urgently needed healthcare. This means border closures must not stop urgently needed medical and humanitarian supplies, as well as medical and humanitarian staff, from coming into countries and governments must ensure restrictions in camp, detention or reception settings do not block people from accessing healthcare. In Cox’s Bazar, travel restrictions introduced in response to COVID-19 are affecting access to healthcare for both local Bangladeshis and the Rohingya. It is much harder for people with ‘invisible’ illnesses to prove they are sick and eligible to travel to facilities for treatment, and face interruptions and a possible deterioration in their conditions. It is important that any government restrictions on asylum systems must not result in denying asylum seekers access to legal status, reception and access to basic services including healthcare. All refugees, asylum seekers, IDPs and migrants need to have access to health information (in their own language) on prevention, isolation and treatment measures.
COVID-19 must not be used as an excuse to enforce deadly migration control policies: Governments must not use COVID-19 as an excuse to enforce further restrictive migration control policies and evade international obligations towards refugees, asylum seekers and migrants. Governments must not cynically leverage this public health emergency in order to shut the door to those in desperate need of protection. This includes decisions to suspend all possibilities to claim asylum, deliberate targeting of migrants of asylum seekers with a negative effect and complete closures of borders with no exceptions for entry to asylum seekers or to indirectly prevent their access to the territory. As an emergency medical humanitarian organisation responding to the pandemic globally, MSF understands the serious challenges presented by COVID-19. However, safeguarding the wellbeing of those in your own country and upholding your international obligations towards refugees, asylum seekers and migrants are not mutually exclusive principles.
Governments must continue to allow people to follow legal processes to request asylum, providing for non-discriminatory screening and referral to health facilities as necessary. Reception centres must be organised and managed in such a way to limit the risks related to the virus (no overcrowding, ensuring access to water and medical care etc). More than ever the detention of people because of their migration status should be avoided and alternatives to detention should be sought, protect people’s ability to practice physical distancing and be given the right to apply for asylum.
The rights of migrants and refugees must be respected in the time of COVID-19: Governments must not use COVID-19 emergency public health measures to directly target refugees, asylum seekers and migrants. All restrictions on rights must be strictly necessary, based on scientific evidence and neither arbitrary nor discriminatory in an application. They must also be of limited duration, respectful of human dignity, subject to review, and proportionate to achieve the stated objective. Further, no limitations and restrictions can apply to certain human rights such as the right to life or the right to be protected from torture. These concepts of proportionality and necessity are open to interpretation by states. In contexts where states already restrict access to certain rights to a minimum – such as the right to seek asylum – there is a real risk that these rights are further eroded.
Lockdowns and mass quarantining cannot be cut-and-pasted or discriminatorily applied: Given the rapid spread of COVID-19, along with evidence of asymptomatic transmission, mass lockdown and other restrictive measures have public health justifications. Measures that are the least intrusive or restrictive to rights should be privileged and should not be discriminatory. Clear ethical and public health principles, as well as domestic and international legal frameworks (most notably, the Siracusa Principles), must guide any restrictions imposed on personal freedoms.
MSF is calling for quarantine and lockdown measures to apply equally to all without discrimination; for those who are quarantined to be provided with healthcare, social and psychosocial support, and basic needs such as food, water and other essentials; for mass quarantine to be avoided and; where possible for the immediate transfer of asylum seekers to places where all the preventive measures can be applied. Forcing people to live in overcrowded and unhygienic camps was always irresponsible but now more than ever due to the COVID-19 threat. Furthermore, states must not criminalise undocumented populations. People cannot be sanctioned for not respecting emergency measures when they have no means to do so. Outbreak responses only work with the trust of communities, with the inclusion and participation of all in the population. Measures intended to stigmatise and criminalise and push people underground are counterproductive and only increase the vulnerability of those they target.
Displaced people at risk should be evacuated whenever possible: Viruses thrive in poor living conditions, without adequate water or sanitation. Refugees, asylum seekers, IDPs and migrants living in overcrowded conditions, on the streets, in makeshift camps, in reception or detention centres or substandard housing are at particular risk. European prevention methods cannot be simply applied to refugee camp or reception or detention settings. We have to find other ways to help people keep themselves protected such as mass distributions of soap, water, building water and handwashing stations and delivery of food and other essential items.
While it is not possible in every setting (for example in refugee and IDP settings in Tanzania and South Sudan where there are tens or hundreds of thousands of people), where possible, MSF is calling for the relocation or evacuation of vulnerable refugees, asylum seekers and migrants. For example, in Greece on the island hotspots, MSF is calling for the evacuation of people the most at risk (people above 60 years and those with respiratory conditions, diabetes, or other health complications) as well as the continuation of efforts to decongest the camps, including the agreed relocation to other EU member states of unaccompanied minors and sick children. In Libya, MSF is calling for the international community and the European governments to put in place direct humanitarian evacuation corridors for the most vulnerable refugees, migrants and asylum seekers exposed to the most imminent life-threatening risks, including those trapped in detention centres across Libya and other places of captivity.