Why is refugees’ health a human rights issue?
According to the United Nations, human rights violations are a major factor in causing the flight of refugees as well as an obstacle to their safe and voluntary return home. Therefore, the protection of refugees’ human rights in their countries of origin is critical both for the prevention and for the solution of refugee problems. Similarly, the UN also states that the safeguarding of refugees’ human rights in countries of asylum is also essential for their life and liberty.
The right to health applies to everyone, including refugees and internally displaced populations. Thus, victims of armed conflict should have access to health-related services at a similar level to those of host communities. In order to stay healthy, they need to be able to access essential and affordable health services, food, water, sanitation, etc.
What are the relevant global sources?
The human rights of refugees are well-established in international human rights law. The most prominent are the 1951 United Nations Convention relating to the Status of Refugees, and its 1967 Protocol relating to the Status of Refugees. Others include the Geneva Conventions, Covenant on Civil and Political Rights, Convention on Elimination of Racial Discrimination, Convention Against Torture, and Universal Declaration of Human Rights among others.
The 1951 Refugee Convention in Article 23 states that refugees should enjoy access to health services equivalent to that of the host population. The Universal Declaration of Human Rights of 1948 (Article 25) and the International Covenant on Economic, Social and Cultural Rights (Articles 11 and 12 of) also call for all people, including refugees and displaced populations, to enjoy the right to a standard of living adequate for the health and well-being of themselves and of their family, including food, clothing, housing and medical care and necessary social services.
What are the relevant issues related to refugees’ health and human rights?
Refugees face many challenges to their health. In a report on the health of refugees and internally displaced persons, the World Health Organization (WHO) highlighted the following as key threats:[1]
- Mental health. Violence and displacement cause an urgent need for mental health services, especially for women and children. Unfortunately, most refugees are unable to access mental health services because there is a severe lack of mental health professionals in countries hosting large refugee populations.
- Reproductive, maternal and child health. The displacement and poor living conditions that refugees experience hamper their access to antenatal care, result in high rates of child diarrhea due to limited access to safe water, and expose children to acute respiratory diseases. In addition, children who are refugees or are internally displaced often do not have enough food, which leads to acute malnutrition and micronutrient deficiency, such as iron deficiency.
- Non-communicable diseases (NCDs). According to the WHO, NCDs constitute a major health threat for refugees. Many refugees suffer from hypertension, cardiovascular diseases, diabetes and cancer, which require costly, long-term treatments that are not available in emergency situations or areas affected by conflict.
- Communicable diseases. Communicable disease outbreaks also affect refugee and displaced populations. Unfortunately, areas affected by conflict or other crises often experience vaccine shortages and stockouts of medicines, which increase the risk of communicable disease outbreaks.
- Injuries. Injuries are a considerable burden among refugees. Some types of war wounds require costly surgical treatment and long-term rehabilitation services that are not usually available in emergency settings. The WHO has pointed out that training local health professionals in war surgery and the treatment of burns remains a challenge.
As explained above, the WHO and other international health organizations have confirmed extremely high rates of mortality and morbidity, generally from preventable causes, among refugees. The major causes of death in refugee settlements have been identified as undernutrition, measles, diarrhea, pneumonia, and malaria. The priority activities to address these causes of morbidity and mortality include the provision of adequate food, water, shelter, sanitation, and immunization.
Most of the problems in providing effective health care to refugees and displaced persons are programmatic and institutional. Logistical and administrative difficulties, lack of planning and coordination, limited funding, and the inability to establish sustainable programmes make it difficult to provide refugees with high-quality health services.[2]
What can health workers do?
Health workers can assist refugees in many ways. While specific needs may vary by location, organizations like the International Rescue Committee have ample volunteer opportunities for health workers to assist in the resettlement and integration of refugees. In some countries, licensed doctors, dentists, and nurses train and supervise refugee health workers who can then provide services to other refugees. Health workers can also help develop guidelines and toolkits that highlight best practices and other information that might be helpful for safeguarding the health of refugees.
Other organizations, such as HealthRight International, have opportunities for licensed physicians and mental health professionals to provide forensic services to asylum seekers who have suffered torture and abuse in their country of origin.
For people who are able to travel and work in areas in crisis, Médecins Sans Frontières has opportunities for licensed health workers to provide lifesaving medical and technical assistance to people who would otherwise be denied access to health care. A listing of these opportunities can be found on the MSF website.
This page was written by Tara Ornstein in January 2018.
References
[1] World Health Organization. Refugees and Internally Displaced Persons in the Eastern Mediterranean Region: A Health Perspective. Geneva, 2015. The WHO’s Fact Sheet on Displaced Populations also provides helpful information.
[2] American Public Health Association. The Health of Refugees and Displaced Persons. Washington, 1992.