Doctors Without Borders (MSF) mobile clinics outside Dagahaley Camp

Worsening humanitarian conditions in overcrowded Dadaab refugee camps

Hospital admissions of children suffering from severe malnutrition have spiked in Dagahaley, one of three refugee camps in the Dadaab refugee complex, amid worsening humanitarian conditions in the overcrowded camps, says Doctors Without Borders (MSF).

In 2022, MSF treated a record 12,007 patients – an overwhelming majority of whom are children – in its pediatric ward and inpatient therapeutic feeding centre (ITFC) in Dagahaley, a 33% increase from the preceding year. Consistent with the alarming surge in child admissions, MSF data also shows a gradually increasing trend in the global acute malnutrition (GAM) rate among children in Dagahaley camp, which reached 8 percent during mid-upper arm circumference (MUAC) screening in December 2022. This marks a 45 percent increase compared to the previous screening in July 2022.

Children at an MSF mobile clinic outside the Dagahaley camp
Children at an MSF mobile clinic/outpost set up outside the Dagahaley camp for new arrivals. MSF has opened two medical outposts, built 50 latrines, put in place two water tanks and distributed plastic sheeting and floor mats for some 800 newly arrived families residing on the outskirts of the camp.

Several complex factors are aggravating the humanitarian situation in Dagahaley and stretching the healthcare capacity in the camp. An ongoing cholera outbreak declared at the end of October 2022, has gripped the refugee camps as well as communities in Garissa and Wajir counties. A crippling drought and prolonged conflict continue to displace people in the Horn of Africa in search of food and water. And inadequate humanitarian response as a result of scarce funding adds further pressure, deepening wide-scale gaps across sectors including water, sanitation and hygiene (WASH), nutrition, health, and protection.  
Worryingly, forecasts paint a grim outlook for refugees this year.  The United Nations Office for the Coordination of Humanitarian Affairs (OCHA, Dec 2022) has predicted a sixth consecutive failed rainy season from March to May 2023, exacerbating the scale and severity of the humanitarian emergency in the Horn of Africa. Humanitarian actors are concerned over expected funding cuts for refugees, which would force them to further downscale operations at a time when needs are rising fast.  

Refugees from Somalia in Dadaab

MSF, in coordination with the host community and humanitarian actors, has stepped up its emergency support beyond comprehensive healthcare in Dagahaley camp. MSF has opened two medical outposts, built 50 latrines, put in place two water tanks and distributed plastic sheeting and floor mats for some 800 newly arrived families residing on the outskirts of the camp. Despite MSF’s efforts to target the most vulnerable refugees living on the fringes of Dagahaley camp, the current humanitarian crisis in Dadaab urgently requires wide-scale response to avert further deterioration. 

MSF calls on donors to rapidly release financial assistance, which is critical to meeting surging life-saving assistance and protection needs. The UN Refugee Agency (UNHRC) has made appeals to donors to mobilize resources for the re-opening of the IFO 2 site, initially closed in 2018, to accommodate up to 80,000 refugees from the congested camps ahead of the approaching dry season when more people are expected to make their way into Dadaab. Unless the donor appeals materialize and urgent action follows up, the incoming influx of refugees can tip the crisis beyond the levels humanitarian organizations can manage with currently allocated resources.

 Refugee shelters in Dadaab
View of refugee shelters outside Dagahaley Camp, Dadaab, Kenya

Refugees in Dadaab have been locked in a 30-year protracted emergency. Even as the immediate priority is to respond to the escalating needs in the camps, it is equally vital to implement the durable solution agenda for refugees – embedded in the Kenyan legal framework, notably the 2022 Refugee Act – as its de-facto application in Dadaab has trailed. 

Dadaab currently hosts over 233,000 registered refugees, many of whom have been living in the camps for over three decades (UNHCR, July 2022) and more than 80,000 unregistered refugees. In 2022 alone, over 50,000 people arrived in Dadaab, yet to be officially registered as refugees. 

MSF has been delivering healthcare in and around Dadaab for most of the camp’s 30-year existence. Our current programmes are focused in Dagahaley camp, where we provide comprehensive healthcare to refugees and host communities, including basic and specialist care through two health posts and a 92-bed hospital. Our medical services include sexual and reproductive healthcare including emergency obstetrical surgeries, medical and psychological assistance to survivors of sexual and gender-based violence, mental health, home-based insulin care and palliative care.