Displaced communities require a holistic approach to healthcare

There are nearly 60 million people globally who have been uprooted from their communities due to conflict, persecution, natural disasters and other threats- a record high number since World War II[1]. Half of these refugees and Internally Displaced Persons (IDPs) are children under 18 years of age[2].

On June 20th, the world commemorates World Refugee Day.  The day was established on December 4th, 2000 by a resolution of the UN General Assembly to honor the resilience and courage of refugees and IDPs and to raise awareness on the challenges that these vulnerable populations face in trying to rebuild their lives. This year’s Refugee Day comes amidst multiple conflicts in Syria, Iraq, Ukraine, Afghanistan, CAR, Somalia, South Sudan, Myanmar and elsewhere which have led to a 300 percent increase in the number of IDPs since 2004[3].  

Even when conflicts end, very few displaced persons get to return home. The Internal Displacement Monitoring Center (IDMC) estimates that the average time of displacement is about 17 years[4].  During these years, displaced communities need health, education, and sanitation services beyond the emergency humanitarian assistance that is usually available at the onset of displacement. Refugees and IDP communities experience some of the highest rates of under 5 mortality due to diarrhea, malaria, malnutrition and acute respiratory infections and there is little access to reproductive health services for displaced women and girls[5]. In addition, many displaced persons experience psychological trauma but have no access to mental health services.

CHMI interviewed Dr. Deng Mayom Deng, the director of the South Sudan Physician Organization (SSPO). He highlighted the need for a holistic approach to healthcare amongst displaced communities.

CHMI: How does your work impact refugees and IDPs?

Dr. Deng: SSPO works mainly with IDPs living in settlements with little or no access to quality health care. We work with huge populations of displaced people and returnees in the greater Bor community and the Minkaman area.

CHMI: What is SSPO’s approach to providing healthcare to displaced communities in South Sudan?

Dr. Deng: SSPO focuses on primary health care services; we also encourage community-based activities with the help of community health workers and facilitators. SSPO also emphasizes health promotion, preventive care and works with the community to improve access to clean water and proper sanitation.

CHMI: How do you reach displaced communities?

Dr. Deng: We believe that healthcare should be a jointly-owned initiative therefore we engage directly with community leaders in setting priority areas to achieve more impact.

CHMI: What is your target population and what services do you provide them?

Dr. Deng: Our main target populations are children under 5 and pregnant mothers. We provide them with mosquito nets (LLINs), health education on how to prevent diarrheal diseases which are responsible for high mortality in children under 5. We have also joined hands with partners to address obstetric emergencies in the camps.  Although children under 5 and pregnant mothers are our priority, we also engage the general community through door-to-door information sharing about the importance of immunization, the availability of referral systems and general health messages. Additionally, we are looking to start a private health service clinic in order to deliver quality primary health care in the camps.

CHMI: What are the most needed services by refugees and IDPs?

Dr. Deng: In the initial phase, during conflict, these populations need the basics such as food, medicine and shelter but later on there is need for improvement of water and sanitation, people want education for their children as well as a way to earn their livelihood.

CHMI: What are some of the challenges that you face in reaching displaced communities?

Dr. Deng: One of the major challenges is financial support to carry out the necessary activities. Often, we rely on volunteers to help but this is not a sustainable way of running things because they end up leaving and we have no one to replace them. Another challenge is the constant movement of IDPs which makes follow-up by community health workers very difficult. Also, the lack of infrastructure in the settlements means that we often have to work in tents of under trees in the intolerable heat. And evidently there is a problem of insecurity and we often can’t reach our patients due to safety concerns.

To view more organizations providing essential care for refugees and IDPs, click here.

Photo: A mother holds her infant child during a medical examination at a newly reopened clinic.
Photo ID 439939. 16/06/2010. Seraf Jedad, Sudan. UN Photo/Albert Gonzalez Farran. www.unmultimedia.org/photo/

This blog was authored by Jessica Muganza, intern at the Center for Health Market Innovations. 

[1] UNHCR Global Trends 2014 http://unhcr.org/556725e69.html#_ga=1.225701913.2095888809.1417795315

[2] Ibid.

[3] Global Peace Index, 2015 http://economicsandpeace.org/wp-content/uploads/2015/06/Global-Peace-Index-Report-2015_0.pdf

[4] IDMC, The Global Overview 2014 http://www.internal-displacement.org/assets/publications/2014/201405-global-overview-2014-en.pdf

[5]Hynes M, Sheik M, Wilson HG, Spiegel P. Reproductive Health Indicators and Outcomes Among Refugee and Internally Displaced Persons in Post emergency Phase Camps. JAMA. 2002; 288(5): 595-603.