As the global community tirelessly fights to contain the spread of Covid-19, I am worried about the fate of hundreds of thousands of urban refugees living in Uganda; a country with an ailing healthcare system that is largely characterised by drug stock-outs, shortage of health workers, limited access to health services, and limited coping capacity.
That notwithstanding, Uganda hosts approximately 1.4 million refugees fleeing persecution, conflict, devastating effects of climate change, and human rights violations from neighbouring countries such as Burundi, DR Congo and South Sudan, among others.
Out of 1.4 million refugees, 66,464 of them reside in Kampala (Kampala Central, Makindye, Kawempe, Nakawa, Nansana, and Rubaga).
Non-recognition of their status as refugees, especially Congolese, demonstrates their unique legal, social and economic vulnerability, which threatens their basic human rights, including access to healthcare. In addition, living conditions among urban refugees are nothing but a dire representation of the stage already set by the healthcare system; with inadequate access to soap and clean water, crowded housing, and shared bathrooms reigning commonplace. Such a population is disproportionately vulnerable to the virus and unable to practice ‘social distancing’ and ‘self-isolation’.
What then, does the onslaught of coronavirus spell for urban refugees’ right to healthcare services?
That, the right to health is universally recognised is without doubt. Uganda, being a signatory to several international human rights instruments, as well as under its 1995 Constitution, is obliged to respect, protect and fulfil the right to health. May be most conspicuous in the circumstances is the international core obligation to ensure access to health facilities, good quality health services and goods to all without discrimination. In the context of urban refugees, this translates into taking all reasonable measures to ensure that such people attain their highest standard of health amid the spread of Covid-19.
Uganda registered the first Covid-19 case on March 21 . Since then, there has been a gradual increase in the number of patients testing positive for the deadly virus. As of April 5, confirmed cases had hit 52 across seven districts; Kampala, Wakiso, Kayunga, Masaka, Iganga, Adjumani, and Hoima. Consequently, the President imposed a 14-day total lockdown in an attempt to flatten the curve and mitigate the spread of the virus.
People across Uganda are urged to stay at home, practice social distancing, avoid mass gatherings, and use of private and public passenger vehicles is prohibited. These directives have left thousands, particularly refugee women and unaccompanied children, even more vulnerable to the health effects of the pandemic.
Such unprecedented times remind us that pandemics like Covid-19 do not discriminate and that they are borderless; yet, our collective health is only as strong as the person’s next to us. Covid-19 is a brutal reminder that we should be mindful of vulnerable persons like urban refugees who are at a greater risk if the virus spreads, given the conditions they are in. We should also make a reflection on the overall living conditions among urban refugees in the post Covid-19 crisis; the importance of ensuring sustainable progress with respect to social rights – particularly access to healthcare among urban refugees.
Considering the transnational health challenges paused by the virus, it is time for a renewed global solidarity. A coordinated and aligned strategy across multilateral donor agencies could be more effective to strengthen provision of goods and services among overlooked populations such as urban refugees to ensure that any response to Covid-19 is in line with UN 2030 Agenda of “leave no one behind”. Therefore, UN agencies, international NGOs and national networks should support robust country-led community engagement and communication efforts to ensure that urban refugees are aware of the potential risks of Covid-19, receive accurate information, have access to health services and that health workers can access all relevant supplies.
In the meantime, government has a duty to protect and promote socio-economic rights of urban refugees. The duty calls for all key stakeholders to place this vulnerable population at the core of Covid-19 public health measures, strategies, and policy design so as to encourage them to stay within their designated residences to avoid further spread of the virus. Such critical steps could include; distribution of basic hygiene essentials (soap and clean water), tone down restrictions on movement to ease access to healthcare facilities, psychosocial support and dissemination of information in an appropriate format and language on the nature of the virus, its prevention and treatment.
The State should ensure that its Covid-19 response is human rights compliant and safeguards the rights of those most at risk in contexts such as this. We can flatten the Covid-19 curve only when each and every one of us is protected.
Ms Sumayah Musoke is an East African public interest lawyer