Refugee camps across the Middle East, Africa and Asia have so far avoided becoming Covid-19 hotbeds, but winter may change that and meanwhile inhabitants' livelihoods are being devastated by economic collapse.
Aid groups working with refugees and internally displaced people across the region said predictions that the new coronavirus would tear through crammed camps have yet to be borne out.
Effective disease surveillance and rapid quarantine for cases appeared to have stifled outbreaks in some of the world's largest camps, though officials said a lack of testing made the picture unclear.
Yet aid groups warned that falling temperatures heading into the winter held the risk of more cases. Refugees are also facing poverty and hunger. Most live not in camps but in cheap accommodation or settlements within the host country and have found their livelihoods have collapsed during precautionary lockdowns.
Low testing rates have made it difficult to gauge outbreaks, but so far “it is the case that the disease has not yet run rampant [in camps],” said David Miliband, former Foreign Secretary and now chief executive of the International Rescue Committee.
"Our experience in Cox's Bazar, in Bangladesh, is that some of the bespoke local infection prevention and control measures have made a difference,” he said.
The United Nations own refugees agency said it had recorded 1,000 cases in camps in the Middle East and North Africa, where millions have been displaced from Syria, Yemen, Iraq and Libya.
“What we know is that there are cases, but despite the fact that in some of the countries it has got a lot worse now, it hasn't reached proportions that are more dramatic than for the rest of the population,” said Andreas Kirchhof, spokesman for the UN High Commissioner for Refugees.
Outbreaks in the Zaatari and Al-Azraq camps for Syrian refugees in Jordan had been spotted an managed, he said. Al-Azraq, east of the capital, Amman, had recently recorded 28 cases, but testing had been increased and those infected had been isolated.
“This is maybe a model case on how major consequences have been avoided so far, and I say so far because we don't know what the future will bring,” he said. In Yemen, where fighting restrict access and there is little testing, he said the picture was less clear.
The UNHCR records some 16 million refugees, displaced people and returnees in north Africa and the Middle East. They will face sharply dropping temperatures as winter approaches sparking fears the virus will spread more easily in cramped housing and tents.
“It's certainly a risk factor, people being crammed in insufficient shelters, in the cold and in some of the places where Syrian refugees are staying, it gets well below zero,” Mr Kirchhof said.
Economic slowdowns due to the pandemic have also hit refugees particularly hard. Many scrape by in their host countries and join the poorest levels of society where lockdowns have devastated earnings.
Research by the Norwegian Refugees Council last week reported nearly four-out-of-five surveyed had either lost their job, or seen their earnings cut since the pandemic started.
“The pandemic and governments’ responses to it have tipped many people into a downward spiral that will be difficult to reverse,” the research concluded.
International calls for aid are so far only 25 per cent funded, the council said.
Mr Kirchof said: “They are hit as hard as the poorest part of the population and often they have less recourse either to social safety nets or family links, so they are in a difficult situation.”
He went on: “Many refugees to whom we talk say they are more worried about having no income, having nothing to eat, than by the immediate health consequences of Covid-19.”
- Additional reporting by Anne Gulland
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