Dadaab, Kenya: Return of refugees to Somalia in current conditions ‘inhumane & irresponsible’

Thursday, October 13, 2016 — NAIROBI – As the announced closure of the world’s largest refugee camp draws closer, and thousands begin the return to war-ravaged Somalia,[1]Doctors Without Borders (MSF) is calling for other alternatives to be urgently considered by the Government of Kenya and the UNHCR, supported by donor countries.

In a report released today by MSF, ‘Dadaab to Somalia: Pushed Back Into Peril,’ more than eight out of ten refugees surveyed say they do not want to return, with the main concerns cited including fear of forced recruitment into armed groups, sexual violence and the non-availability of healthcare. [2]

In the report, MSF also highlights the severe medical consequences of such a massive return. 

It is clear that refugee camps are not the best way to manage a protracted 25-year crisis but closing them now without offering other durable solutions pushes them back to a conflict zone, where medical care is dangerously absent,” says Bruno Jochum, MSF General Director. This decision is yet another blight on refugee protection globally, where again we see total failure in providing safe haven for people in danger. The UN itself has recently declared that five million are at risk of hunger inside Somalia. Sending back even more people to suffer is both inhumane and irresponsible.”

Somalia: an acute lack of medical care
In Dagahaley, one of the five camps which make up Dadaab, MSF medical teams have seen children arriving from Somalia having not been vaccinated against a range of preventable diseases, a telling indication of a health system torn apart by more than two decades of war where even basic care is barely existent. Pregnant women will have minimal care, putting their own lives and their unborn babies under threat. People with chronic medical conditions are also at risk - whether they are diabetics who need life-saving insulin, or people with hypertension who need ongoing treatment.

Additionally, mental health patients are in danger. In Dagahaley, 70% of MSF’s mental health patients are on medication. “If a patient with psychosis is forced to come off their medication, their cognitive function and behaviour development goes into reverse. Stuck in a country where mental health services are basically non-existent would put their lives in severe jeopardy,” says Liesbeth Aelbrecht, Head of Mission for MSF in Kenya.

A call to Kenya, the UNHCR and donor countries: other solutions urgently required
Eighty-six percent of surveyed refugees in Dagahaley do not want to go back to Somalia. Fears around insecurity were acute with nearly all - males and females - stating that the risk of sexual violence is high. MSF is therefore questioning the ‘voluntary’ nature of the returns that the UNHCR is helping facilitate.

“The fears that the refugees tell us about are real,” says Aelbrecht. “It is crucial that any return is voluntary, and refugees must have all necessary information about the services and conditions which will meet them in Somalia.”

MSF reiterates that setting up Dadaab style camps across the border is shifting responsibility and abandoning the protection of refugees. Other more durable solutions, such as smaller camps in Kenya, increased resettlement to third countries, or integration of refugees into Kenyan communities, should be urgently considered. Additionally, MSF appeals to the international community to share the responsibility with the Government of Kenya.

“It is unacceptable that – without any other solution being offered - thousands are essentially being pushed back into conflict and acute crisis: the very conditions they fled,” concludes Aelbrecht.”Kenya should not shoulder this burden alone. Funding from donor countries needs to be directed to providing sustained assistance in the country of refuge, not to supporting what will essentially be a forced return to a warzone.”

MSF does not accept any government funding for its project in Dadaab – all funding is provided by private donors.

MSF first started working in Dadaab in 1992 and is currently the only provider of medical care in Dagahaley camp. Staff are working in the 100-bed hospital in Dagahaley camp and at two health posts, providing outpatient and mental health consultations, surgery, and antenatal, HIV and TB care. Overall in 2015, teams carried out 182,351 outpatient consultations and admitted 11,560 patients to the hospital.

 

[1] Some 30,000 refugees have returned to Somalia since a tripartite agreement on voluntary repatriation between the Governments of Kenya and Somalia and the UNHCR was signed in November 2013. The majority of these  - 24,000 - have left during the course of 2016.

[2] To understand the refugees’ concerns and needs, in July and August 2016 MSF conducted a series of discussions and interviews, and a household survey, with refugees in Dagahaley camp about their current situation and the prospect of a return to Somalia. Focus group discussions involved 75 people (42 male and 33 female) in Dagahaley camp. Interviews were carried out with 31 people including patients, MSF incentive workers and community members. The survey polled 838 heads of households (53% male and 47% female) in Dagahaley camp, with households totalling 5,470 individuals.

Sahara Abdirahman, a Somali refugee in Dagahaley camp, Dadaab. <br/><br/>"I fear repatriation to Somalia because I know the kind of life I have passed there. I know how much I had been fleeing. I fled from Mogadishu to Luq and from Luq to Kismayo and from Kismayo to Mogadishu and from Mogadishu to Kismayo. I was a refugee inside my own country between 1992 and 2008. <br/><br/>There is nothing in Somalia. Let us not lie about the situation. I hear the news in the media. I do not live in luxury here, but at least I sleep peacefully." Photographer: Mohamed Ali
Mohamed Farah Abdi arrived in Dadaab in 1992. He is pictured with his seven year old disabled son. <br/><br/>“When we fled, I was still a small boy. I don’t see where I can go back to. I have fled from conflict, and now I have a disabled son who cannot even sit by himself. If I leave here, where will he get care? In Somalia, you will not find the services that we have here.<br/><br/>We will not be able to find proper health centres. If you are poor, you will require a lot of money to get healthcare. There are government hospitals to rely on for free medication.” Photographer: Mohamed Ali
Kamal is a diabetic patient receiving treatment from MSF in Dagahaley camp, Dadaab. His reaction to the announcement of the closure of the camp: <br/><br/>"I am a worried man. I sleep very little since I received the announcement. Because in Somalia, I will not receive medical care, and it is not safe.. <br/>People who are diabetics like I am are so worried too. If I go back, I don’t know where I will get medical care." Photographer: Mohamed Ali
Dr Sarah Kasoga works with MSF in Dagahaley hospital, Dadaab. <br/><br/>"Regarding the repatriation, all I can say is that our patients have shown a lot of anxiety. They really don’t know what to expect and there is a general feeling that they may not get access to services that they were getting while they were refugees in Dadaab." Photographer: Mohamed Ali
A mother prepares to return home after she successfully delivered a baby boy at the MSF hospital in Dagahaley, Dadaab. Each month, there are approximately 285 deliveries in the maternity ward. Photographer: Mohamed Ali
Nurse Salma attends to a patient in the maternity ward of MSF's hospital in Dagahaley camp, Dadaab. Photographer: Mohamed Ali
Asho and Halimo are two pupils at El nino primary school. They were both born in Dagahaley refugee camp, one of the five camps at Dadaab refugee complex. Photographer:  Abdullahi Mire
An MSF palliative care team provides treatment for a patient at his home in Dagahaley camp, Dadaab. Photographer: Mohamed Ali