United Nations High Commission for Refugees - IDIA
PhilMUN 2010 1 Policy Dilemma Refugee camps are temporary camps built to receive an influx of refugees and are designed to provide basic human needs for only a short time. However, long-term problems and conflicts prevent refugees from returning or resettling elsewhere. Consequently, camps have to be considered somewhat permanent settlements. The Middle East in particular has a very high number of refugees and as a result many camps. About one-third, or 1.3 million, of registered Palestinian refugees live in 58 recognized refugee camps in Jordan, Lebanon, the Syrian Arab Republic, the West Bank and Gaza Strip. 1 There are, however, a small number of unofficial camps. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), established in 1949, has played a major role in providing basic services to registered Palestinians in refugee camps. A refugee camp is considered to be a traditional setting in which the UNHCR has worked in the past, since refugee camps are circumscribed areas where refugees can be registered and easily provided with services. One important challenge is ensuring and maintaining good long-term public health in these camps. Public health is simply defined by the Institute of Medicine (IOM) as “what we do as a society to collectively assure the conditions in which people can be healthy.” 2 Any public health system involves the activities of governments and the associated efforts of private and voluntary organizations and individuals. 3 Public health is meant to maintain the health of a community or population; in this case the population of interest is refugees. Community health is the health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health. 4 Good public health measures include health prevention, sanitation and environmental health, health education and surveillance, and 1 “Where Do the Refugees Live?”. UNRWA. http://www.un.org/unrwa/refugees/wheredo.html 2 Institute of Medicine (1988). The Future of Public Health. Washington, DC The National Academies Press. 3 Ibid 4 McKenzie, James F. An Introduction to Community Health. Jones and Bartlett. Sudbury. 2008.
PhilMUN 2010 2 access to proper healthcare. These measures are relevant to all major determinants of health. The lack of resources and investment, and the nebulous authority over refugee camps make it difficult to create the conditions necessary to maintain the health of refugees. While some camps do have proper infrastructure and access to public services, the conditions in most camps have continued to deteriorate to resemble slums. Many of the water and sewage systems are unstable and in need of upgrading; poor sanitation in these camps pose severe health risks. It is not uncommon for refugee camps to have very poor infrastructure, overcrowding, poverty, unemployment, and very limited access to the government’s public health and educational facilities. Often, there is no access to public social services. 5 “Palestinian refugee camps are a model of poor environmental conditions and lack of green and planted areas or open spaces lacking. 6 Overcrowding of the camps is a severe issue with around 40 percent of households having three or more persons living per room. 7 Not only does overcrowding contribute to mental health problems, but it also significantly increases spread of disease. Many of the diseases that afflict refugees in these camps result from poor diets, sanitary conditions, and lack of ventilation. Stress is also a contributing factor, especially in a conflict zone such as Gaza. 8 The rates of chronic and non-communicable diseases such as hypertension, diabetes, cancer and cardiovascular diseases have also been on the rise in the refugee camp population; these are most often due to the lack of sufficient nutrition. 9 “Birth rates are among the highest in the world and intervals between births are short, thus affecting women’s health.” 10 In addition, diarrhea and intestinal parasites, 5 “Refugee Camp Profiles”. UNRWA, http://www.un.org/unrwa/refugees/camp-profiles.html 6 Al-Khatib, Issam A., Arafat, Rania N. and Musmar, Mohamed(2005)’Housing environment and women’s health in a Palestinian refugee camp’,International Journal of Environmental Health Research,15:3,181 — 191 7 Dumper, Michael. The Future of Palestinian Refugees. Lynne-Reinner. 2007. Colorodo (p. 45) 8 Cook, Richard. Palestinian Camps and Refugees in Lebanon: Priorities, Challenges and Opportunities Ahead. American University of Beirut. http://www.aub.edu.lb/ifi/Documents/public_policy/pal_camps/memos/02/ifi_pc_memo02_cook.pdf 9 “Refugee Health Today”. UNRWA. http://www.un.org/unrwa/programmes/health/refugee.html 10 Ibid