COVID-19 response in UNHCR country operations in 2020

Afghanistan

Afghanistan - Returnees - Emergency response

COVID-19 negatively affected the protection situation of persons and families with specific needs, in addition to its impact on their health and economic opportunities. UNHCR sought to mitigate emerging protection risks of COVID-19 through an unconditional unrestricted cash for protection programme targeting returnees, IDPs and vulnerable members of host communities. The programme was designed jointly with the Protection Cluster and the Cash and Voucher Working Group (CVWG) to ensure a coherent response to the socioeconomic consequences and protection risks associated with measures taken to contain the spread of COVID-19.

UNHCR assisted 12,507 most vulnerable households (87,549 persons) across the country with a one-time cash protection grant. Due to COVID-19 restrictions and limited face-to-face contact, demographic targeting based on categorical prioritization criteria with data verification and validation via mobile was conducted. 431,278 individuals were assisted with hygiene materials to mitigate the spreading of virus.

In spite of the pandemic, the operation maintained an adequate response mechanism through four encashment centres (ECs) jointly managed by UNHCR and the Ministry of Refugees and Repatriation (MoRR), collecting protection information from returning Afghan refugees. In the context of COVID-19, the operation adopted a procedure to avoid the transmission of COVID-19 amongst returnees and staff including partner staff working in the ECs.


Algeria

Algeria - Refugees and asylum-seekers (urban) - UNHCR global management

Algeria first recorded a case of COVID-19 in late February 2020. A contingency/ response plan was immediately initiated by the Algerian Government, with people of concern included under the plan. Although not clearly mentioned, people of concern suspected of having contracted COVID-19 were treated through the public health sector.

Because COVID-19 particularly affects people living with chronic diseases, UNHCR revised its budget dedicated to the health component in order to provide adequate care to all refugees and asylum-seekers suffering from non-transmissible disease. Thus costs generated by medical follow-up and medication for this category were exceptionally covered through COVID-19 additional funds.

Because of the new situation dictated by the pandemic, i.e. the prioritization of care, restriction of movement and curfew, UNHCR and its health partner opted for a remote approach, with the activation of a network of medical outreach workers in peripheral area of Algiers and non-overburdened medical structures as well as in the private sector.

UNHCR and its health partner organized several outreach visits to the most vulnerable people of concern and distributed masks and sanitation materials to all visited people of concern as well as people of concern coming to the office. Furthermore, three sensitization campaigns were organized on COVID-19 related topics.


Algeria - Refugees from Western Sahara - UNHCR global management

Schools in the camps resumed classes on 13 September 2020. Prevention measures against the spread of COVID-19 were respected by applying a double-shift system and compulsory facemask wearing. To this matter, UNHCR procured 50,000 reusable facemasks for students and teachers in the camps.

With the aim of reaching the rate of "one book per student" UNHCR procured schoolbooks under direct implementation, a process that could not materialize. Thus, by the end of 2020 one book was still shared by three students. However, UNHCR provided school furniture and stationery through its partner AFAD to all schools in the camps. For tertiary education, UNHCR supported 136 Sahrawi students studying under the DAFI scholarship programme in Algerian universities.

Distance learning was not accessible for all students in the refugee camps, as the majority of students did not have adequate devices or encountered connectivity issues. The Algerian National Union of Education Workers estimated that only "80% of the 2020 school programme had been completed in the first two terms". To this end, the averages for the first two terms of the 2020 school year were calculated for the transition to higher levels and the cancellation of the 5th primary teaching exam (5th AP). The National Union of Education Workers proposed to postpone the intermediate teaching exam (BEM) and the baccalaureate (BAC), to the end of August, according to the evolution of the country's health situation.


Algeria - Refugees from Western Sahara - UNHCR global management

The first case of COVID-19 in Algeria was reported in February 2020, reaching the Sahrawi refugee camps in July 2020. UNHCR played a key role in the preparedness and response plan in the camps, maintaining a proactive approach since the start of the pandemic. UNHCR organized a joint UNHCR/WHO and UNICEF technical mission to the camps well before the spread of the pandemic in Tindouf, in early March.

UNHCR led the elaboration of the preparedness and response plan for the camps, along with the list of needs in terms of PPE, medical supplies, human resources, as well as capacity building and community mobilization. UNHCR also coordinated the response plan for health and WASH sectors and daily updated partners on the epidemiological situation and the coverage of needs during the peak of cases in the camps. Additionally, the Office distributed 200,000 masks, resuscitation equipment, medical consultation supplies (e.g. stethoscopes and tensiometers), pulverization equipment, hygiene, and disinfection supplies. UNHCR also covered financial incentives for 150 medical staff directly involved in the COVID-19 response at the community level.

The Office supported community-based isolation of refugees returning to the camps from abroad. Thus, all living conditions (food, water, hygiene and decent accommodation) were provided for more than 4,200 people since the beginning of the pandemic.

Additionally, UNHCR supported the creation and full equipment of a dedicated unit for COVID-19 in the central hospital of Rabouni, where oxygen installations were also carried out. UNHCR also provided all needed supplies and equipment for the COVID-19 clinical management unit (monitors, oximeters, nebulizers etc.).

Furthermore, UNHCR supported the implementation of three community sensitization campaigns, distribution of leaflets, posters, and provided explanations of prevention measures through direct outreach to local media sources and the general public.


Algeria - Refugees from Western Sahara - UNHCR global management

UNHCR prioritised activities in the WASH sector since the declaration of the COVID-19 pandemic and supported Sahrawi-led efforts in this regard, including awareness campaigns. UNHCR equipped all public health facilities in the camps (30 clinics and five hospitals) with additional hand-washing facilities (40 units) to reduce the risk of the spread of COVID-19. UNHCR managed to mitigate the spread of COVD-19 in the camps, thanks to joint efforts made by all partners. Within the Sahrawi refugee community, UNHCR created volunteer units in each camp in charge of disinfecting the trucks that move within the camps for the different distributions and disinfecting those points where the population, despite mobility restrictions, continue with their daily activities (e.g. markets, distribution points, among others). A unit of 100 volunteers (90 people for the five camps and ten people for Rabouni) were charged with disinfection to mitigate the possible spread of the virus in the camps. Disinfection, safety materials and consumables for implementing this activity were provided, and volunteers were identified and trained. Thanks in part to this effort, the COVID-19 situation in the camps remained largely under control for most of the year.


Algeria - Refugees from Western Sahara - UNHCR global management

During the COVID-19 pandemic, all WASH partners contributed to the development of the Preparedness and Response Plan in the Sahrawi refugee camps and the WASH checklist for health facilities in the camps. These materials/tools were crucial in organizing the response to the pandemic and identifying gaps as well as to prepare the joint appeal for COVID-19 preparation and response-related activities. For more efficient water distribution in the camps, UNHCR rehabilitated 6,000 metres of flexible pipe used by families to fill their tanks and distributed and installed water tanks to 626 vulnerable refugee families. In October 2020, UNHCR started the extension work of the water distribution network in Awserd camp through the installation of new components of the water network, including 34,528 metres of HDPE pipeline, 228 water taps (shared tap stands) and a 320 cubic meter tank of reinforced concrete which is replacing the existing rusty metallic reservoir in Awserd camp.


Bangladesh

Bangladesh - Refugees from northern Rakhine State, Myanmar - Emergency response

In 2020, UNHCR stepped up preparedness and response measures to the COVID-19 pandemic by establishing two Severe Acute Respiratory Illness(SARI) Isolation and Treatment Centres(ITCs) in the refugee camps in Ukhiya and Kutupalong with a total bed capacity of 194, as well as an Intensive Care Unit (ICU), High Dependency Unit(HDU) and Severe Ward with a total bed capacity of 38 at the Government district hospital in Cox’s Bazar. At these facilities, 649 patients received treatment, including 223 refugees. By the end of 2020, there were a total of 367 known positive COVID-19 cases amongst refugees and 10 mortalities. Four quarantine facilities with a capacity of 2,000 persons were established for contacts of positive cases and supported through the provision of medical assistance and daily meals. Community Health Workers (CHWs) detected 78,509 individuals with mild and 228 individuals with moderate/severe COVID-19 like symptoms and referred them to COVID-19 treatment facilities for testing and care. Camp health focal points communicated guidelines, developed referral pathways and enhanced coordination with rapid investigation teams, who were established to track and trace the virus.

CHWs conducted 280,485 group awareness sessions reaching more than one million individuals with COVID-19 prevention messages. Households and refugees frequently received multiple household visits by CHWs, who provided messaging focused on signs and symptoms of COVID-19, risk factors of transmission, prevention modalities, quarantine and isolation, COVID-19 treatment and the utilisation of masks. In total, more than separate 4.8 million household visits were conducted. UNHCR undertook large-scale procurement and distribution of personal protective equipment (PPE) in the camps and provided PPE to partners.

Active community engagement helped to counter the misperceptions and false rumours relating to COVID-19, which meant more people understood the effects of the virus and sought treatment and support, where necessary Timely case detection and referral to COVID-19 facilities increased daily testing rates from less than 10 to 180 persons per day during the peak period. Capacity building was provided to 127 participants on COVID-19 preparedness and prevention, 278 participants on community-based surveillance and 100 participants on COVID-19 home-based care. UNHCR supported the Ministry of Health and Family Welfare(MoHFW) with supplies of PPE.

UNHCR, through its leadership of the Community Health Working Group (CHWG), collaborated with the World Health Organisation (WHO) and the Institute of Epidemiology, Disease Control and Research (IEDCR) in the implementation of a COVID-19 seroprevalence study, which was aimed at determining the level of immunity to COVID-19 amongst refugees and the spread of the virus in the camps. The CHWG provided orientation to 120 Community Health Supervisors and around 1,450 CHWs based in the camps. Of these, 136 CHWs were assigned to support the study as team members in identifying refugee respondents and engaging with households to ensure their consent to sample collection.

In support of mental health support, psychologists modified their working modality to tele-counselling to support COVID-19 patients, families and individuals in isolation. Psychologists were allocated to support SARI-ITCs to respond to needs of patients. Based on guidelines developed by the Inter-Agency Standing Committee (IASC) Mental Health and Psychosocial Services (MHPSS) Reference Group (RG) to support the MHPSS response during the pandemic, COVID-19 responders were trained on basic psychosocial skills. The IASC MHPSS RG developed the tool ‘My Hero Is You’ centring on prevention measures and wellbeing to empower children and guide adults to have discussions with children on the pandemic. The tool was translated, and an audio version created with the support of BBC Media Action Bangladesh.


Bangladesh - Refugees from northern Rakhine State, Myanmar - Protection and mixed solutions

Despite the COVID-19 situation, UNHCR’s regular hygiene and sanitation programme continued in UNHCR camps as planned. Activities were implemented throughout the year by all partners, with Oxfam focused on larger WASH projects and other partners continuing with WASH operational and routine activities.

In 2020, as per the Infrastructure Sweep and Knowledge, Attitudes, Practices (KAP) survey data, 1,326 latrines were constructed reaching 19,361 beneficiaries (or 19 persons per facility), in line with the emergency standard of 20. 2,318 number of bath shelters were also constructed covering 10,589 beneficiaries (or 33 persons per facility).

UNHCR WASH maintained a comprehensive view on the whole sanitation chain, with a risk-based approach at each stage of the process: design and construction of latrines, containment, desludging, transmission, and discharge. A community-based operations and maintenance programme was also piloted, with successful results (95% of functional WASH facilities, as per UNHCR 2020 infrastructure sweep) and is now being expanded to all UNHCR camps in 2021. UNHCR also designed a new iron frame latrine and bathing space design which was 25% cheaper, cyclone resistant, did not require “tie-downs”, had standard dimensions, could be fabricated off-site, had clear gender variations and less variety of materials. A pilot programme was implemented from January to June with full implementation taking place in the second half of the year.

40 Women Hygiene Centres were built. These facilities are fenced, gender segregated facilities containing latrines, bathing spaces, a water source and a place for washing and drying clothes.

A WASH area monitoring programme was initiated in the last quarter of the year with hundreds of locations being continuously monitored for a variety of wastewater parameters across UNHCR camps, including drains, ponds, streams, latrines, bathing spaces and treatment plants. An online database is being developed to allow partners to store new and previous data that will be accessible for further analysis. The database will allow UNHCR to track the contamination of human waste in the environment across in the camps and evaluate the impact and efficiency of UNHCR’s sanitation programme.

In 2020, UNHCR initiated the design of new urban-scale, pumped, pressurized intermediate faecal sludge transfer networks (IFSTNs) in all UNHCR camps covering 350,000 people. Constructions are ongoing in Camps 3 & 4 and designs for the remaining camps are being finalised with implementation planned in 2021.

In Camp 4, the construction of a faecal sludge transfer plant (FSTP), covering 80,000 people with a sludge treatment capacity of 120m3/day, was completed. UNHCR has been working on maximizing and optimizing the operation of this FSTP, looking at optimum loading rates for each phase of the treatment, selecting the best plants for the planted drying beds and developing the pumped sewerage network (IFSTN). In collaboration with MSF and Oxfam, the design of a second FSTP, with a sludge treatment capacity of 180m3/day, was finalised and its construction was initiated in October. With coverage of 120,000 people, this will be the largest FSTP in any refugee context globally.

UNHCR ensured protection of the de-sludging teams through the provision of PPE, clothing storage, washing of clothing and showers. To improve the efficiency of sludge conveyance, eight new faecal sludge vacuum tankers (vacutugs) were purchased, with each camp now having its own vacutug.

A new de-sludging strategy has been developed to improve the approach by collecting and monitoring baselines in a more systematic manner. The monitoring systems will be implemented to estimate the volumes and locations of sludges as well as its destinations.

UNHCR’s regular hygiene promotion programme was delivered throughout UNHCR camps as part of the prevention and mitigation measures during the COVID-19 pandemic.


Brazil

Brazil - Refugees, asylum seekers and other persons of concern - UNHCR global management

UNHCR works with various partners to support the socioeconomic integration of refugees and migrants in Brazil by promoting access to public services, financial services, training programmes and employment. In addition, the Office carries out awareness raising with the private sector to promote access to employment for refugees and other people of concern to UNHCR.
 
The Office increased efforts to provide multilingual information on accessing the national emergency subsidy. A joint campaign with the Ministry of Economy called “Protect the Work”, reached over 11,000 people with information on labour rights. Despite measures implemented by the Brazilian Government to mitigate the socioeconomic downturn caused by the pandemic, new challenges reduced self-reliance opportunities for refugees and migrants from Venezuela. For example, the validation of diplomas was suspended when universities were closed in March 2020.
 
To enhance financial inclusion, the Brazilian Central Bank, in cooperation with UNHCR, disseminated information on bank account opening, and trained 60 community leaders in financial literacy so they could further share the knowledge. Some 10,000 people accessed the Empresas com Refugiados (Companies with Refugees) online Platform, which contributed to raise awareness among the private sector on refugee employment. Along with the Tent Foundation, UNHCR developed and distributed guidance material on refugee employment to over 1,000 delegates of companies. The key results include:

  • Approximately 50 refugee entrepreneurs received microcredit loans as a result of partnerships with financial institutions.
  • In partnership with Compassiva, 13 individuals revalidated their diplomas. In addition, additional 31 revalidation requests processes were initiated across the country.
  • To improve support provided to refugees to find a job, UNHCR trained one hundred delegates of NGOs and signed an agreement with the specialized job-placement company Levee. As a result, 4,052 people were counselled on labour market opportunities and 2,236 were registered in job placement services.
  • 1,242 refugees and asylum-seekers received Portuguese as a second language classes and 1,389 people received vocational training.
  • UNHCR and partners provided 494 people with support and training on entrepreneurial skills.

UNHCR works to reinforce progress towards the SDGs through self-reliance and livelihoods activities, namely (SDG 1) to end poverty; (SDG 5) achieve gender equality and empower all women and girls; (SDG 8) promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all; (SDG 10) reduce inequality within and among countries; (SDG 16) promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels; and (SDG 17) strengthen the means of implementation and revitalize the global partnership for sustainable development.

In order to carry out all these activities, UNHCR partnered with various organizations, including: Banco Central do Brasil Banco Pérola, Banco do Povo Crédito Solidário, IFC, ILO, IOM, Subsecretaria de Inspeção de Trabalho de Ministério de Economia, the Tent Foundation, the UN Global Compact Network of Brazil, UNICEF, and UN Women, in addition to UNHCR’s implementing partners.


Brazil - Refugees, asylum seekers and other persons of concern - UNHCR global management

In response to the COVID-19 emergency, UNHCR provided lifesaving assistance in the form of core relief items, cash assistance and personal protective equipment. The basic domestic and core relief items mainly targeted people in emergency shelters, half of them girls and women, including almost 17,000 people in Roraima, 3,000 in Manaus and 4,000 people in different states in Brazil.  These interventions were complemented with 23,262 ready-to-eat meals and food rations.
 
Given the increased instability of supply chains in the context of the pandemic, UNHCR prepositioned lifesaving contingency stocks to prepare for a potential mass influx once borders open.
 
Since the onset of the pandemic, the Office supported local and national authorities in health prevention and response efforts. UNHCR scaled up its support to help mitigate the threat of the virus among refugees, migrants and local host communities by strengthening the health infrastructure and providing cash assistance, hygiene items and life-saving information on prevention measures.
 
UNHCR supported the creation of an emergency hospital in Boa Vista, called the Protection and Care Area, which had the capacity to treat and isolate up to 1,782 COVID-19 confirmed and suspected patients. UNHCR donated 2,000 beds, 180 intensive care unit beds and medical items and delivered 250 refugee housing units to allow for the proper isolation of suspected and confirmed cases. Through this support, a total of 3,873 individuals received support in the facility, of whom 1,028 received regular care and 77 intensive care. Moreover, 90% of the population assisted in the hospital were part of the host community and 10% were refugees and migrants. Of the refugees treated, 8% were indigenous.
 
The COVID-19 pandemic increased the level of vulnerability among refugees as many lost their jobs or small businesses, with many families facing an imminent risk of eviction, forcing them to resort to negative coping mechanisms to survive. A total of 2,549 families were supported with cash assistance for one to three months to cover their basic needs. Registration and case management in UNHCR’s corporate tool, proGres V4, were carried out remotely. Prepaid cards used to deliver cash assistance for new beneficiaries were delivered through appointments with the attendance of only one household member in order to mitigate COVID-19 exposure, while top-ups to those already holding cards were delivered remotely.
 
A new cash assistance feasibility assessment was carried out in light of the changing context and showed that it is was one of the most appropriate tools for delivering assistance during the pandemic.


Burundi

Burundi - Refugees and asylum-seekers - Emergency response

As part of the implementation of the COVID-19 response plan in the refugee camps, 20 temporary latrines and 20 temporary showers have been built at the isolation facilities, 407 handwashing facilities installed in community centres and camp neighborhoods. 162 handwashing tanks were repaired: 12 in Musasa; 40 in Bwagiriza; and 110 in Kinama as part of the prevention of COVID-19. Awareness meetings on hygiene and sanitation were held in all the camps. Awareness sessions were held in all the districts of the 5 camps on the methods to fight against COVID-19.

Through World Vision's DUSENEZA project, 10 seated toilets were installed in the new latrines for persons with special needs, 10 blocks of latrines and 2 blocks of hard standing showers were built.

Despite these efforts, old refugee camps still have dilapidated infrastructure and sanitary facilities. Indeed, the construction system for latrines and showers must consider the specific needs of each camp. The Kinama and Musasa refugee camps have emptiable latrines and the emptying is done by the refugees themselves. In the case of Bwagiriza, both systems are functional, although it should be noted that Bwagiriza has individual family latrines, while Bwagiriza II has raised, emptiable latrines to avoid the effect of a flush water table.

Hygiene and sanitation maintenance activities were carried out in all 5 camps, with 48 temporary latrines dug and built in Nyankanda and 69 latrines and latrine blocks in the refugee camps.

In order to strengthen COVID-19 prevention and overall hygiene in the refugee camps, UNHCR has increased the quantities of soap distributed to the people of concern. Awareness-raising sessions were conducted in all the neighborhoods of the 5 camps on the methods of fighting against COVID-19.


Burundi - Refugees and asylum-seekers - Emergency response

The epidemiological situation in the country was marked by COVID-19 and measles outbreak and their preparedness response plan. Preventive measures (isolation centres, personal protective equipment, thermostats and training of medical staff, hand-washing points) were put in place in all refugee sites in the country. The COVID-19 pandemic has negatively impacted the normal functioning of health structures in the country and disrupted the international drug and equipment procurement. During the post emergency plan, and thanks to COVID-19 funding, UNHCR and its partners have strengthened and enhanced the prevention measures (isolation centre, hand washing point in the 5 refugee camps, strengthening the capacity of the medical partner to respond to all COVID-19 emergencies (personal protective equipment, medicines, ambulance, thermostats, training, recruitment of 89 additional staff and motivation bonuses).

Even though no confirmed positive cases were detected among the refugees, all suspected cases received adequate care and the situation was well under control. Additional staff were recruited, and bonuses were granted to strengthen and encourage the teams to remain prepared for the management of massive outbreaks. Various supervisions were carried out in the field. A combined supervision had been carried out, in collaboration with the emergency cell, from June 3 to 5 and aimed at: 1) Strengthening the capacities of the providers in the camps on investigation methods, tracing and contact follow-up. 2) Assessing the level of preparedness and response to COVID-19 in the 3 refugee camps (Kavumu, Bwagiriza and Nyankanda).

Normal funding for health sector compounded with the special funding for COVID-19 have enabled UNHCR to reinforce the health intervention of partners, GVC and the Ministry of health. The measles and rubella vaccination programme, with financial support from the UNHCR for the expanded programme on immunization (EPI), has enabled 20,227 children aged between 9 months and 14 years to be vaccinated in the five refugee camps and the surrounding villages, i.e. 92% of vaccination coverage. It should be noted that despite the epidemiological emergencies reported, health interventions have been carried out in the five refugee camps and the surrounding villages. In line with the public health strategy 2019-2020 for UNHCR operations in Burundi, the health sector remained dominated by the reduction of morbidity and mortality (with a low global mortality rate (1/1000/month) as well as for children under 5 years of age (1.2/1000/month), strengthening immunization coverage, prevention and community mobilization against epidemics (COVID-19, Ebola, Cholera, Malaria) at the level of refugee reception areas (camps and urban) in the country. At the level of the 5 health facilities in refugee camps, 158,331 consultations were carried out within the framework of curative health care compared to 181,819 consultations in 2019 and in mental health, more than 3,276 consultations (new and old cases) were recorded in 2020.

In urban areas, as was the situation in 2019, health services are provided by two health facilities that have agreements with the GVC partner that the refugees benefit from. The principle is that UNHCR assists the most vulnerable at 50%, 100% on a case-by-case basis and the other vulnerable urban refugees pay for these services themselves. In 2020, more than 11,518 urban refugees received medical assistance, of which 8,223 had special needs (chronic diseases, emergency hospitalization, etc.) at 100% and 3,295 at 50%.

Under the Expanded Programme of Immunization (EPI), all children and pregnant women had completed their vaccinations at their respective health facilities. As regards children absent during vaccination campaigns, the outreach was carried out as part of routine vaccination in the 5 refugee camps.


Burundi - Refugees and asylum-seekers - Emergency response

Over the 2020 school year and according to Operation Contingency Plan (OCP), schools were planned to close in order to prevent the spread of COVID-19 in the camps. However, in order to allow optimal access to education, UNHCR and partners have put in place some preventive measures that allowed to limit the spread including social distancing within the classrooms through the construction of 35 classrooms in the camps: 5 classrooms in Kinama; 15 classrooms in Nyankanda; 15 classrooms in Kavumu. In addition, money for two neighborhoods was transferred to build 3 classrooms. 28 board classrooms were repaired: 4 in Kinama and 24 in Bwagiriza. 6 adobe classrooms were rehabilitated in Musasa.

As an overall impact and actions merged with the received COVID-19 funding, as improving of access to education, UNHCR with its partner JRS have constructed and rehabilitated 115 classrooms in camps which allowed the reduction of the pupil / classroom ratio from about 100 to 70-80 pupils per classroom; Enrolment of 23,634 pupils aged 3 and over, including 11,461 girls (48.4%) in refugee camps and 2,154 pupils (47% girls) attending the Public Basic Schools in urban (Bujumbura), from grade 1 to grade 9. In the year 2020, the global girl’s enrolment rate in primary schools in camps was 49.8% while in secondary schools it was 45% due to dropouts caused by a variety of reasons most prominent among them being early marriage, early pregnancy or the lack of resources forcing young refugees to prioritize income generation for their family over their education.

Children were assisted with school supplies; 235 children with specific needs, including 131 boys and 104 girls were assisted in medical consultation and purchase of spectacles. Other children with specific needs (74 unaccompanied minors and 16 with disabilities) were identified in order to facilitate their access to education in 2021. An assessment of the capacities of institutions offering specialized education was conducted in November 2020 in order to plan the enrolment of children with specific needs in specialized education not available in camps; and in the context of preventing school dropouts, 211 refugee students (108 girls and 103 boys) in urban (Bujumbura) were sensitized on the importance of education. 1,994 girls were assisted in hygienic kits composed of soaps and reusable washable towels, including t-shirts. In order to improve the quality of education, 413 teachers were trained on pedagogy and schools in camps were equipped with schools materials including recreational kits. 1,690 camp based primary students (including 810 girls and 859 boys) did the National Examination and 89% passed; 274 camp based secondary students did the National Examination (65 girls and 209 boys); 122 ongoing students wre beneficiaries of the DAFI programme, including 38 girls (31%). 20 new students were selected in December 2020 to start university studies in January / early February 2021 under the DAFI Programme, including 10 girls. Concerning the protection of refugee student identities at school, 110 refugee students (59 girls and 51 boys) were supported to harmonize their names in their respective schools (their names in schools differ from their names in proGres). Training in pedagogy for 30 girls who are finalists in secondary school and who have passed the State Examination (Examen d’Etat) in the camps in order to increase their chances of being recruited into education and to increase the rate of female teachers. Although exact data is not available, there were cases of school dropouts, especially among girls in camps and in urban area, due to the lack of monitoring by their parents, to spontaneous departures to Bujumbura and the DRC, resettlement, unwanted pregnancies and early marriages.


Burundi - Refugees and asylum-seekers - Emergency response

In 2020, the supply of drinking water was reinforced in the five refugee camps through the installation of additional water tanks. However, the refugee camps experienced some difficulties in the supply of drinking water. The Bwagiriza and Kavumu refugee camps are supplied with water by gravity flow, while those of Kinama and Musasa are supplied by the pumping system. This pumping system raises the problem of very high costs due to the quantity of fuel consumed. It would be advisable to set up a solar pumping system for these to alleviate the costs.

The COVID-19 top up funding has enabled the operation to support the water trucking, purchase pumps, generator and laying pipes to supply the water points in the new districts of Musasa and Nyankanda over a distance of 1,100 linear meters and 300 linear meters to supply the water storage tanks in the camps as part of the prevention against COVID-19. In addition, UNHCR and its partner have built 19 pedestal supports and installed 19 water storage tanks (10 of 5,000 litres and 9 of 2,500 litres) as part of the prevention of COVID-19. 22 stand-pipes were also built in the isolation centres. Water quality analysis was carried out twice a year.

Globally, in order to reach the standards of 20 l /person/day and guarantee access to drinking water to the beneficiaries, hydraulic infrastructures have been built and maintained (386 faulty taps have been replaced in Kinama, Bwagiriza, Kavumu and Musasa camps. There have been additional installations of 50 new taps in Kinama, Musasa and Nyankanda camps). The solar pumping system has been installed in Musasa camp, which has solved the water problem in this camp once and for all. Within the framework of the good cohabitation between the refugees and the host population, the UNHCR via its partner WASH has set up a water source in Kavumu and 2 fountains which have been opened to serve the host population of these different refugee camps.


Cameroon Multi-Country Office

Cameroon Multi-Country Office - Central African refugees (in East and Adamawa) - Protection and mixed solutions

Health assistance for Central African refugees has been provided through 31 FOSAs. This enable to cover 70% of the beneficiaries in the operational area. However, the COVD-19 context did not allow all refugees to have access to health facilities given the travel restrictions that had been imposed by the government and the stigmatizing prejudices of the disease.

The crude death rate is 0.13 deaths / 1000 pop / month and that of children under 5 is 0.34 deaths / 1000 pop / month. Although the crude mortality rate has reached the set target (<0.3 deaths / 1000 refugees / month), efforts still need to be made to further improve the mortality indicators, especially for children under 5 years old, in particular by improving the quality of health care, increase in the number of health facilities to be covered, revitalization of the community component in order to reduce community deaths.

With the COVID-19 situation, free curative care for all refugees was effective in 31 FOSAs. Indeed, thinking of starting the targeted support with the implementation of user fees; the onset of the pandemic involved access to free healthcare for any category for a period of six months so that any positive COVID-19 cases not listed in non-priority categories do not escape the health system. After a drop in COVID-19 cases, the last quarter of 2020 was marked by a resumption of access to care for the following vulnerable categories: children under 5, pregnant and breastfeeding women, people over 60 years, chronically ill, life-threatening emergencies, people with special needs certified by the UNHCR community service. These different accesses were effective through the framework agreement which allows UNHCR to pay 70% of the cost of the curative care received by the refugees at the level of the partner FOSAs.

In addition, 07 COVID-19 care centers have been set up at site level. These were attached to Government health structures in their area, which have made it possible to take care of 19 COVID-19 cases and nearly 489 people quarantined. Around 300 masks have been produced by refugees through UNHCr Livelihood partner and disctributed to CAR refuges and host communities in the three regions. Generally speaking, medical assistance has covered a total of 119,028 curative consultations and 3,397 medical referrals for the year 2020, ie 71% of the planned target for medical referrals.


Cameroon Multi-Country Office - Central African refugees (in East and Adamawa) - Protection and mixed solutions

In 2020, the COVID 19 pandemic accentuated the need for improved access to drinking water both at household level and in public spaces and services. Due to a drastic budget reduction, the emphasis was placed on the maintenance of the existing water supply systems in the sites and on the reinforcement of self-management and maintenance capacities of the refugees. However, the following actions were understaken to enhance potable water provision :

  • 06 refugee sites and 02 integrated health centers were reinforced with drinking water points and the construction of 07 new boreholes to improve access for refugees and host populations and strengthen hygiene measures in hospitals.
  • The Meiganga District Hospital is actually equipped with an autonomous solar energy water supply as part of the Blueprint 2020 pilot initiative.
  • The daily water supply capacity of Gado site has been improved thanks to the rehabilitation and  the replacement of pipes and equipments.
  • The drinking water supply systems of the sites are functioning full time. 287 repair / maintenance interventions were carried out by refugee WASH committees with the funds collected with households as water consumption cost.
  • 14 public primary schools have been fitted with new water wells as part of the "Educate A Child (EAC)" project and the learning conditions for pupils have been improved.
  • 02 capacity building workshops for WASH actors (UNHCR, WASH managers of decentralized territorial communities, the Ministry of Water and WASH partner NGOs) and refugee self-management committees were organized (01 on maintenance management the municipal hydraulic heritage and 01 on the mechanisms for appropriation, management and maintenance of the drinking water supply of the Gado site). These workshops enabled 80 people to be trained.
  • 65 WASH committee members and 21 pump repair workers were trained / retrained during 2020.
  • UNHCR Cameroon has an updated WASH strategy, adapted to its context and shared with its partners.

The impacts of these 2020 results are perceptible both in terms of changes in the indicators of access to drinking water for refugees and host populations and in the improvement of health care in public service welcoming refugees :

  • The overall average ratio of people per water collection point in the sites has been improved from 450 to 385.
  • The average daily quantity of drinking water supplied has increased from 13.5 Liters / person / day to 15.7 Liters / person / day.
  • The quality of the water supplied is regularly analyzed and monitored and the incidence of water-borne diseases has decreased.
  • The queue and waiting times at water points have been considerably reduced thanks to the construction of mini water distribution networks and standpipes.
  • The control of the management of infrastructure and drinking water supply installations by the refugees has improved and the transfer of responsibilities and skills is on track (65% of the costs of maintaining and repairing water points are incumbent on to users “refugees families”).

Cameroon Multi-Country Office - Nigerian refugees - Protection and mixed solutions

The construction of 226 mobile latrines, the rehabilitation of latrines, support for beneficiaries in the self-construction of 20/20 latrines, emptying of 1,094.4 m3 of sludge for 900 latrine doors, i.e. 1,059 m3 under UNHCR funding, 0.8 m3 with the participation of hygiene auxiliaries, and 34.6 m3 under LWF funding. An endowment of 06 schools with sanitation equipment and maintenance products and the revitalization of 07 school brigades of 06 primary schools and the bilingual high school of Minawao. A total of 70 members (10 raised per school) were revitalized. Regarding solid waste management, 441.1 tonnes of non-biodegradable waste were taken to the landfill site 3 km from Minawao camp located on the Zamay –Gawar axis. To improve the capacity on the site a faecal sludge treatment tank at the waste landfill site was built. This basin is in addition to the 2 basins built in 2019 with the objective of improving the waste management capacity at Minawao camp.

UNHCR, through its partner LWF, has carried out several activities in the context of promoting good hygiene practices in the various intervention areas. To this end, a series of actions were carried out with the participation of refugees and the involvement of host communities. These include: Installation of In response to COVID 19, 400 UNHCR hand washing devices were installed in the blocks and assembly areas of the Minawao camp as part of the fight against the spread of the pandemic at the camp. Likewise, COVID 19 discounts.

6 barrier kits were sent to the directors of the 06 primary schools in the camp as part of the Covid 19 barrier measures during the correction of the end-of-year exams.

The partner provided training and capacity building (role and responsibility of the hygiene assistant; Awareness techniques; community mobilization; Data collection and information sharing) of 102 Hygiene auxiliaries respectively 82 in the Minawao camp, in 20 in the off-site. Also, a revitalization of 82 WASH committees distributed in the four sectors of the camp of Minawao was carried out.

These activities carried out on both sides as part of the improvement of good hygiene practices reached 200,868 people out of 60,500 people targeted. The themes addressed on barrier measures against COVID-19, water hygiene, sorting household waste have enabled refugee and host communities to adopt good behavior in respect of hygiene rules, thus limiting risk of contamination from oral-fecal diseases in the camp and its surroundings. Daily awareness is one of the factors that has limited the occurrence of COVID-19 and cholera cases in Minawao camp and its surroundings. Thanks to the sanitation campaign initiated by the hygiene and sanitation team in early December, there has been a marked improvement in the sanitation of the blocks and public spaces of the camp.

In general, 296 latrines were constructed out of 296 planned latrines (226 mobile latrines, 20 self-constructed shower-latrine blocks, and 50 latrine renovations) for a completion rate of 100%. These achievements made it possible to reach a ratio of 23 people / door at Minawao camp, which is still far from the UNHCR standard in post-emergency which is 20 people / door. Note that the emptying of 900 latrines associated with the construction of 296 latrines helped to facilitate access to health infrastructure for 27,508 refugees in the camp, and consequently limited the proliferation of water-borne diseases in the camp and its surroundings.

As part of the direct response from UNHCR, 200 m3 of sludge was emptied from sustainable latrines and public spaces in the camp, which improved access to latrines in a healthy environment. Also, to meet the peak of the water need going from April to July, the UNHCR made use of Water trucking which also contributed to the increase of the water ratio of 14.52 litres per person per day. 


Central African Republic

Central African Republic - Internally displaced - Emergency response

In 2020, the Central African Republic is still facing one of the world's most serious humanitarian crises. The violent conflict that broke out in 2013 resulted in the forced displacement of more than a quarter of the country's population. By the end of 2020, nearly 682,000 people were displaced across the country, and nearly 623,400 Central Africans were living in CAR's neighbours such as Cameroon, the Democratic Republic of the Congo (DRC), Chad, Sudan, the Republic of the Congo and South Sudan. It is noted that during the presidential and legislative elections, CAR faced a second phase of severe instability when a very large part of the territory fell under the control of the PCC group, forcing additional forced displacement of Central African citizens. With reference to the Humanitarian Response Plan 2020, 338,000 IDPs were in need of humanitarian assistance. A total of 243,000 IDPs were targeted, including 91,000 living in informal settlements and 152,000 living with host communities.

As co-leader of the merged Non-Food/Shelter Cluster and Camp Management and Coordination, UNHCR played an important role in assisting 13,112 displaced households over the course of the year, representing a total of 26% of targeted IDPs in CAR. These distributions took place mainly in the prefectures of Kaga Bandoro (51.19%), Bambari (23.89%), Birao (15.01%), Bria (5.3%) and Bangui (3.8%). Each basic household kit consisted of two mats, two fleece blankets, a collapsible jerry can, a sturdy plastic bucket and a cooking set. The kits were purchased through UNHCR's stockpile in Douala, Cameroon, and transported to Bangui by road, before being shipped to each field office where UNHCR has storage capacity managed by AIRD, UNHCR's logistical implementing partner. In the field, our partners INTERSOS and ASA - were the main actors in distributing these kits under the supervision of UNHCR staff.

Due to limited funding, UNHCR prioritised assistance to the most vulnerable households, namely large families, families with chronically ill and/or severely disabled people and/or elderly people without support. Immediately after the first cases of COVID-19 in CAR, UNHCR actively collaborated with local authorities to provide support by supplying soap, cleaning materials such as chlorine and gel, surgical masks or water containers. These items were massively distributed to the most vulnerable beneficiaries living in informal settlements. In total in 2020, more than 316,000 bars of soap and over 12,000 surgical masks were distributed to local authorities, IDPs living in informal settlements, returnees and host communities.


Chad

Chad - Central African refugees - Protection and mixed solutions

Livelihoods interventions reached 1,846 households, 70% of which were refugees and 30% locals, in the provinces of Logone Oriental, Békan sub-prefecture, Mandoul and Moyen. The activities were identified based on the AGDM survey and the Etats Généraux workshop on livelihoods in the southern part of Chad. It should be noted that this PPA 2020 came at the time of the COVID-19 crisis. A strategic partnership agreement for knowledge transfer with the Agronomic University of Sarh on innovative market gardening practices of high economic value crops was developed, to enable the rapid recovery of economic activities following the COVID-19 crisis.

An improvement in the productive capital (agriculture, livestock and IGAs) of the refugees and host population was obtained, leading to enhanced sustainability despite the negative effects of the COVID-19 crisis on livelihoods. Ownership of livelihoods by beneficiaries through the creation of community livelihoods platforms helped to sustain the gains.

1,846 households of 1,496 refugees and 350 local households received agricultural input support for the 2020 season. This support enabled the production of 2,800 tons of all crops on 2,614 ha, for a monetary value of XAF 838,157,986. This represents an annual family income of XAF 454,040 (XAF 37,837 per household per month).

The agricultural work in community mixed fields provided multiple effects: 227ha of fields of 227 mixed beneficiary households composed of 132 refugees (49 men and 83 women) and 95 local people (49 men and 46 women) located in the Gore and Maro area were cultivated jointly.
Capacity building and the restructuring of groups into seed cooperatives for self-employment were carried out. As a result, three groups in Doseye, Maro and Moissala were supported in obtaining the certification from the National Directorate of Seeds and Plants (DNSP). This initiative was aimed at enabling them to participate in the value chain promoted by the DIZA project.

Support for the restoration of fertility of 500 hectares through the cultivation of mucuna was provided. A quantity of 491 kg of mucuna seed was made available to 420 former producers (152 women 268 men) with degraded fields in the Gore, Maro and Moissala zones.

The promotion of innovative practices for the current market gardening season for high yield of high economic value crops was supported by Sarh University. This enabled 362 producers to produce 3500 kgs for a value of 131,000 XAF for the first two months of the current season.
264 beneficiaries from severely affected livestock-raising households received 1056 small ruminants and 137 income generating activities out of 167 planned received an economic recovery fund.

Follow-up was made on 47 VSLAs with 648 members (577 refugees and 71 locals) with an annual capital of 2,882,900 CFA francs (savings, loans, solidarity fund and fines).


Chad - Central African refugees - Protection and mixed solutions

In 2020, activities took place in a rather complex COVID-19 context, with enrolment and re-enrolment effective but disrupted by the subsequent strikes in the public sector.

The enrolment campaign resulted in the enrolment of 19,140 pupils. This represents a gross enrolment rate (GER) of 44% and a net enrolment rate (NER) of 29% in Goré over a total of 43,106 children aged 3 to 18 in the Progress database. Net enrolment rates were slightly rising.

At primary level, the refugee population aged 3-11 years included 18,763 children, of which 13,935 (6,336 girls) were enrolled, representing a Gross Enrolment Ratio (GER) of 74% and a Net Enrollment Ratio of 47%. Haraze and Moissala schools benefited from 13 water jars being made/purchased.

At secondary level, the total number of school-age children was of 14,975, those enrolled were 3,347 (911 girls), i.e., a GER of 22% and an NER of 11%. The number of girls attending school remained low. This age group attends high schools and colleges located near camps and sites. Consequently, they suffered from the impact of strikes in the public sector and the lack of follow-up in their schooling by the partner.

Pupils from the camps and refugee sites took part in the national exams. 167 candidates (145 girls) took part in the baccalaureate, for which UNHCR contributed 20% of the cost of their applications. For the Brevet d'étude fondamental, 14 candidates from Timbery high school were taken care of. The success rate was 33% for the BAC and 72% for the BEF.

The camps are in the proximity of host villages, with refugee and local students living together. The COVID-19 context affected school attendance and mobilized more effort. The MENPC, UNHCR and its partners provided handwashing and masks to prevent illness.

A total of 110 out of 447 primary school teachers were being supported by UNHCR. The rest were paid for by the Government, the PTAs, and the World Bank. All those in level 1 benefited from the World Bank scholarship for training at the teacher training college.

Schools were mainly community-based, and the PTAs organized 15 general assemblies to strengthen the capacity of the 458 teachers, 143 of whom are women, except for Bekan site.

The primary and departmental education inspections and the social action directorates continued with the pedagogical follow-up of teachers. 7 pedagogical days were organized for 331 teachers (54 women). With funding from the World Bank, level 0 and 1 community teachers were trained for 9 months at the teacher training college.

At the tertiary level, 69 students (instead of 91) in schools and universities had their scholarships renewed for the academic year 2021/2021. 84 received their first instalment of the scholarship in January 2021.


Chad - Sudanese refugees (in East) - Protection and mixed solutions

Child protection is part of UNHCR's overall strategic priorities and requires special attention since the implementation of activities and their enhanced monitoring in the field. Efforts were made to provide quality service to children despite the COVID-19 pandemic which had a negative impact on all planned activities. Multi-sectoral and tailored interventions were implemented to secure access to existing basic social services at the camp/site level. Community-based child protection structures exist in all camps to facilitate identification, referral and response to protection incidents involving children. To respond to protection cases, a Child Protection Working Group (CPWG) consisting of UNHCR and partner focal points is in place. A total of 14 meetings were held.

As a result, a total of 295 Best Interest Assessments (BIAs) were conducted. Regarding Best Interest Determinations (BIDs), UNHCR initiated 12 BIDs by the panel in the framework of searching durable solutions for appropriate actions considering the best interests of the child.
The identification and follow-up activities enabled the handling of 2,521 child protection cases that were referred to the various partners for multifunctional care.

In terms of legal and judicial assistance, 09 children in conflict with the law were registered, monitored and all released after pleas made based on the context of the COVID-19 pandemic.

1863 children at risk were identified, of which 1,800 children were assisted, including 19 children with disabilities who received 17 tricycles and 2 crutches.

In addition, 8 training sessions were organized in the camps for all community structures, including mobilisers, teacher focal points, refugee focal points, AIS monitors and girls' clubs who helped children to better protect themselves. The participants (491) were trained on children's rights, identification, and monitoring of cases.

In addition, 15 sensitizations on several themes including "physical aggression", "hand washing with soap and water", "barrier measures against COVID-19", "dropping out of school and barrier measures against COVID-19" were carried out with 7816 participants. In Farchana, 829 children were assisted with handwashing kits.

Through the training and awareness-raising sessions on child protection that have been carried out within the refugee community, there has been an increase in awareness of child protection through identification and referral and a clear collaboration in their follow-up. All children were treated without discrimination and identified children with disabilities received special support.

The AIS welcomed children of all ages and without discrimination based on their vulnerabilities: persons with specific needs and those with disabilities before their closure due to COVID-19. 14108 children, including 7052 boys and 7056 girls, attended the CFSs and practiced various socio-recreational activities.

Because of COVID-19, the Day of the African Child and the International Day of the Girl Child were celebrated through door-to-door sensitization and radio (Sila) aimed at inviting parents and children to become aware of the pandemic, with a view to ensuring the protection of children against this disease.

130 girls were awarded prizes during an awareness-raising event on the "causes and consequences of discrimination against girls in education".


Colombia

Colombia - Refugees and asylum-seekers - UNHCR global management

UNHCR provided cash assistance through partners and through direct implementation to 16,772 vulnerable Venezuelan families in 2020, according to UNHCR’s revised vulnerability criteria focusing on people with specific protection needs and aligned with the transfer values stipulated by the Government’s guidelines for cash transfers.

The national cash assistance programme with UNHCR’s partner Pastoral Social (SNPS) prioritized the most vulnerable population from Venezuela and provided cash assistance to 1,129 individual beneficiaries. Based on a standard protocol, beneficiaries targeted received unrestricted cash or help for health and funerary costs, and to face costs related to the issuance of documentation allowing them stay in the country, as work visas, passports, or Special Stay Permits (PEPs).

In the context of the COVID-19 pandemic, unrestricted grants were the preferred type of cash delivered by the operation as this allowed UNHCR to support the most affected population to improve living conditions. This programme reached 8,798 households (32,426 individuals) in the following departments: Guajira, Atlántico, Santander, Norte de Santander, Arauca, Antioquia, Chocó, Cundinamarca, Valle del Cauca, Putumayo, and Nariño.

The operation provided cash for livelihoods through the Graduation Model in Medellín, Antioquia, which consisted of supporting financial inclusion and skills development of Venezuelan refugees and migrants for accessing jobs and self-employment. This livelihoods programme to overcome poverty will allow the participant families to meet their basic needs, become self-reliant, come together locally, and contribute to the economy. UNHCR is supporting this programme with its partners Corporación Ayuda Humanitaria, Comfenalco and Comfachocó to improve local integration, gender equality, sustainable livelihoods, savings and financial inclusion, access to Colombia’s Social Protection System, and stronger community protection networks. In 2020, this programme allowed 2,909 individual beneficiaries in Medellin to obtain formal wage employment or self-employment. Likewise, in Arauca and Cucuta, after undergoing a training process, 213 entrepreneurs received seed capital to strengthen or create their familiar business, with the guidance from partner Comfiar.


Democratic Republic of the Congo

Democratic Republic of the Congo - Refugees and asylum-seekers - Capacity building

The COVID-19 pandemic appeared in DRC in March 2020. UNHCR was forced to adapt its deployment and undertook to carry out prevention activities throughout the country.

By the end of December 2020, some of the main achievements with regards to the activities undertaken across the country by UNHCR in response to the COVID-19 pandemic are the following:

  • Over 400,000 refugees and asylum-seekers were reached with COVID-19 related messaging and over 22,858 were reached with gender-based violence messaging linked to COVID-19;
  • Over 1,657 students were reached via remote learning channels (radio, home study packs etc.);
  • Almost 3,000 households received cash and voucher support as part of the response to COVID-19;
  • 104,607 refugees and asylum-seekers benefited from soap distribution for handwashing and hygiene promotion;
  • Over 69,000 individuals received reusable cloth face masks;
  • 14 isolation and quarantine centres were established with the support of UNHCR;
  • 5 health facilities within camps and settlements were supported by UNHCR with protective equipment and supplies;
  • 56 government facilities outside settlements and camps were supported by UNHCR for COVID-19 related response and activities;
  • 1,208 community health workers were trained for COVID-19 response and other 565 health staff other than community health workers also received specific COVID-19 training;

Ecuador

Ecuador - Refugees and asylum-seekers - UNHCR global management

As a consequence of the pandemic impacts, UNHCR substantially modified shelter strategic planning, introducing new priorities such as the technical and material support to the Ministry of Public Health in dealing with the exceptional situation and demand for health services, and the dire need to adequate housing spaces and improve basic services in light of COVID-19 prevention measures. To provide emergency humanitarian assistance and emergency shelter to evicted people of concern unable to pay their rent, UNHCR postponed planned actions to ensure spaces are habitable and facilitate the social integration of people from the Bolivarian Republic of Venezuela in host communities. In 2020, a total of 21,721 people received emergency shelter, 1,367 received cash for rental accommodation, and 36,702 people got hygiene and/or personal protective equipment. UNHCR furthered technical support and specialized orientation for shelters to enable the isolation measures to prevent the spread of COVID-19.

In order to address challenges raised by the COVID-19 pandemic, the Office was active in the following areas:

  • Engagement with the National Emergency Operations Committee (COE) to ensure that the delivery of humanitarian assistance was in line with national and local emergency response strategies and inclusive of people of concern.
  • Training and dissemination of information. During the outbreak of the pandemic, UNHCR rapidly trained partners staff on minimum standards that had to be strictly followed and implemented, according to governmental rules and regulations. The Office designed and disseminated nationwide procedures, standards, methodologies, and key messages in coordination with the Health.
  • Support to the health system capacity and epidemiological control. UNHCR assisted with technical and material support for the installation of 183 Refugee housing units (RHU) as triage and medical assistance areas in 24 hospitals and 80 health centres run by the Ministry of Public Health, contributing to boost the public capacity to respond to the exceptional demand for health services
  • Prevention measures to limit contagion. Guided by results from the continuous needs assessments and protection monitoring exercises, UNHCR identified the most pressing unmet basic needs and delivered 17,601 hygiene kits and 95 portable hand-washing stations to benefit people of concern, but also public agencies, transit and emergency shelters, humanitarian assistance entities, and other public spaces in order to prevent and limit the spread of COVID-19.
  • Moreover, UNHCR promoted the cooperation under two coordination mechanisms in the country: the UNCT emergency team led by OCHA, for the COVID pandemic; and the Refugee and Migrant Response Plan (RMRP), co-led by UNHCR and IOM, for the Venezuelan situation. Since it was not possible to separate the two systems, a back to back coordination mechanism was established in order to avoid duplication of efforts and to improve interventions in terms of considering COVID-19 priorities together with including the population of in assistance and action plans.

Ecuador - Refugees and asylum-seekers - UNHCR global management

UNHCR strengthened cooperation with the Ministry of Public Health to address the challenges faced by refugees and asylum seekers in a pandemic situation that disrupted primary health care and with national capacities limited to respond. Main results in the field of public health included:

  • Support to COVID-19 health response. UNHCR donated 183 refugee housing units to 80 health facilities at national level, which were mainly used as triage and hospitalization areas. Additionally, the organization donated 184 oxygen concentrators, 234 adult pulse oximeters and 43 adult oximeters to 68 health facilities.
  • Infection prevention and control. UNHCR invested $368,882 in personal protective equipment donated to the Ministry of Public Health, partners and other public institutions providing first-line response to refugee and host communities. This ensured compliance with biosecurity and infection and prevention control measures, allowing continuity of critical services during COVID-19 emergency. Additionally, UNHCR facilitated several training processes on infection prevention control for public institutions, refugee- led organizations and partners to strengthen capacity on the prevention and reduction of infections.
  • Community epidemiological surveillance. Relying on community networks, which includes refugee-led organizations, UNHCR promoted the implementation of a national community epidemiological surveillance mechanisms, that allowed community members themselves to identify suspected cases of COVID-19 and safely refer them to health services in a timely and effective manner. The mechanism also included active participation of UNHCR partners and shelters. Under this initiative, over 40 community surveillance centres were identified in 12 provinces of Ecuador, and the network alerted of 470 suspected cases of COVID-19 among refugees and asylum seekers, who were appropriately referred to the public health system.
  • Strengthening of clinical management of rape (CMR) services. In coordination with the Ministry of Public Health, UNHCR Ecuador donated 406 PEP Kits to 203 primary health care units in main localities hosting refugees and asylum seekers. UNHCR also developed information material for health workers on how to administrate PEP Kits.
  • Sexual and reproductive health and rights. In the context of the UNHCR and UNFPA’s “Safe from the Start” project, UNHCR distributed 3,926 dignity kits for women, girls and LGBTI+ population, included to sex workers across the country. UNHCR also developed a “Facilitation Guide for Community Activities related to Reproductive and Sexual Rights in the context of Human Mobility”. The guide was rolled out through a training of trainers for 23 people, including staff from public institutions, UNHCR and partners. Each participant replicated a workshop for members of their own organization and institutions. Additionally, UNHCR and UNFPA carried out 24 workshops on sexual and reproductive health in the northern border for 269 people, including awareness raising sessions with persons of concern and training to shelter management teams.

Egypt

Egypt - Syrian refugees and asylum-seekers - UNHCR global management

Since the beginning of the pandemic, UNHCR supported its health partners to continue monitoring COVID-19 infections among the Syrian population through their community health workers and info line.

Refugees and asylum-seekers had access to COVID-19 treatment and care services provided by the government on a similar basis to nationals. The health partners helped the suspected COVID-19 patients to report to public health facilities designated for COVID-19 treatment, including helping them to call the hotline for ambulance services and coordinating for their hospital admissions. A total of 156 patients from the Syrian community reported COVID-19 symptoms.

At the beginning of the pandemic, UNHCR supported the Primary Health Care project of the health partner Save the Children International (SCI) to provide hygiene kits to vulnerable families and to patients who had reported COVID-19 symptoms to help improve hygiene measures. A total of 20 community health workers were engaged in disseminating health education to the community regarding COVID-19 prevention. UNHCR also contributed to improved hygiene measures in 20 supported MoHP primary health care units through its health partner. Medical staff from these facilities received training on various clinical guidelines in the context of COVID-19.

UNHCR was also an active member of UN country team taskforce for COVID-19 prevention and response activities led by WHO to support the national response efforts. UNHCR supported activities under the three pillars related to “infection, prevention and control”, “risk communications and community engagement” and “essential services sustainability”. As part of UNHCR contribution, 15,000 N95 masks, 160,000 surgical masks and 380,000 pairs of gloves were delivered to MoHP during the first wave of the pandemic. UNHCR also procured 800,000 surgical masks, 50,500 respirators, 50,000 gowns and 360,000 pairs of gloves during the second wave to support both the MoHP and its health partners front line health care workers. In addition, in collaboration with MoHP and WHO, UNHCR helped reproduce 36,000 posters and 1,600 roll-up banners with COVID-19 preventive messages in five different languages spoken widely by nationals, refugees and asylum-seekers, to be distributed in 2021. With the COVID-19 fund, UNHCR provided cash for hygiene to 14,299 Syrian cases (55,204 individuals).

UNHCR also hosted a mental health and psychosocial support (MHPSS) expert recruited by the Dutch Surge Support to support the General Secretariat of the mental health programme at MoHP. The deployment supported the national MHPSS strategy and coordination in the context of COVID-19 as well as inclusion of refugees and asylum-seekers in the national MHPSS coordination and response plan.


Ethiopia

Ethiopia - Refugees and asylum seekers from Eritrea in Ethiopia - Protection and mixed solutions

UNHCR improved the quality of education in collaboration with other partners. To reduce the student classroom ratio, 3 additional classroom blocks, sex segregated WASH facilities and menstrual hygiene management room construction commenced in Shimelba, Adi Harush and Mai Aini refugee camps, funded by UNICEF, through PCA with the Norwegian Refugee Council.

In an effort to continue education amid the COVID-19 pandemic, distribution of reading packs, work sheets and social media applications were used and distributed to primary and secondary students to strengthen remote learning. Similarly, solar radio devices were distributed to primary school students to assist in attending radio lessons broadcasted by the Regional Education Bureau and recorded lessons. Furthermore, 170 students from low-income households were supported with cash assistance from Education Cannot Wait, to increase student retention and ensure their access to remote learning activities.

A comprehensive assessment was undertaken to understand the critical gaps of school WASH facilities that would need to be address to in order to prevent COVID-19 transmission upon the reopening of schools in the refugee camps of Tigray.

Afar refugee camps resumed their teaching and learning activities, following the Government’s announcement to open schools based on the protocols set by the Ministry of Education, while education services in Tigray were interrupted by the conflict. Grade 8 students have also taken regional primary leaving certificate examination for secondary education.

With regard to attendance, a total of 16,868 refugee students and pupils enrolled in the 2019/20 schooling year both in Tigray and Afar as follows: 4,169 in early childhood care and development centers, 11,585 in primary, 1,114 in secondary schools and 292 students in tertiary education.


Ethiopia - Refugees and asylum seekers from Somalia in Ethiopia - Protection and mixed solutions

UNHCR sub-office Melkadida (SOMEL)
In Melkadida, primary health care and 24-hour emergency services for both refugee and host communities were provided. Mortality rates were 1/1000/month. Drug storage was maintained utilizing the Ministry of Health  Health Commodity Management Information System and cold chain storage for vaccines. Mental health professionals provided integrated care in primary health care services for 570 patients – epilepsy (55%) and psychosis (19%). Referral care was accessed at Ministry of Health facilities outside the camp, attending to 494 patients, 194 of whom were emergency referrals. Compared to previous years, total referrals decreased by 50% while emergency referral increased by 30%. Gynecologist, dermatologic, dental, surgical and pediatrics specialists’ visits were organized for 1450, 1059, 210, 218 and 492 patients respectively.

Collaboration with the woreda health authorities and WHO continued in epidemic preparedness and response. As part of a cross border vaccination campaign, mass polio vaccination campaign was carried out in Melkadida with 95% of targeted children under five reached. A measles campaign in Melkadida reached 18,170 children.

UNHCR’s response to the outbreak of the COVID-19 pandemic was supported through the a preparedness and response plan, engaging all actors and stakeholders. UNHCR successfully advocated for the inclusion of refugees into the Regional COVID-19 Response Plan. Community mobilization and response was instituted; 1 triage and 1 isolation centre became operational in each of the camps; and to aid the quality of care, in partnership with the WHO, 106 health professional, and 716 community incentive workers were trained. In collaboration with the Regional Health Bureau and WHO, an assessment of the spread of the disease was conducted in August. 11 partner staff were diagnosed with COVID-19, and all recovered.

2020 showed an increased use of standardized procedures, predictable drug supply, improved client follow-up and engagement of community outreach agents. Community outreach agents continued to be the main pillars of the public health service delivery, through health promotion and disease prevention activities, including house-to-house visits, distribution of IEC materials, environmental cleaning, and sanitation and hygiene campaigns.

Quality monitoring of the services in five health centres through the Balanced Score assessment (BSC) indicated that two of the five health centres met the acceptable score (>=80%) while three required support and follow up (>70%). Vaccination and reproductive health units, and overall organization of the facilities were up to standards.

UNHCR sub-office Jijiga (SOJ)
Despite the COVID-19 pandemic that presented numerous challenges in respect to the provision of primary health services in Jijiga refugee camps, UNHCR and  the Administration for Refugee and Returnee Affairs (ARRA), managed to maintain optimal primary health services to the refugee community, as well as host community in the camps.

By the end of 2020, the average crude mortality rate reported was 0.004/1000/month and under 5 mortality rates was 0.004/1000/month, which is within the threshold and encouraging despite the challenges of the COVID-19 pandemic.

UNHCR exerted relentless efforts to curb the spread of COVID-19. The main activities in this regard included establishing and furnishing three isolation facilities; providing protective equipment to health personnel, as well as other partner staffs; providing material support to the regional authorities in the COVID-19 task force, and conducting awareness raising campaigns including distribution of IEC materials and regular announcements to the refugees in the camp on prevention mechanisms. UNHCR donated two new ambulances to Awbarre and Kebribeyah woredas where the three refugee camps are located. The spread of COVID-19 into the refugee camps has been reduced and mitigated to the extent possible.


Ethiopia - Refugees and asylum-seekers, mainly Sudanese, (in West) - Protection and mixed solutions

The health status of the population improved through implementation of holistic primary health care which included health promotion, disease prevention and curative services. The operation established systems for consultations, continuous risk mapping, surveillance and preparedness that resulted in improved communication and early response to communicable disease. Assosa maintained a 24/7 service utilisation rate at 1.8, with the under-five mortality rate kept within the Sphere standard of less than 1/1,000/month. All three health centres were each equipped with five oxygen cylinders enabling provision of emergency health services. A total of 92,974 (new and repeat) medical consultations were made at the outpatient department. Among these were 20.5% nationals seeking healthcare in refugee health facilities. A total of 1,149 patients were admitted in the camp health centres for inpatient services, and 639 patients were referred to secondary and tertiary health care for further investigation and treatment.
 
Routine immunization coverage for penta-3 and measles was 100% and 94.9% respectively, contributing to reduced morbidity and mortality from vaccine-preventable diseases. A total of 6,611 (98.3%) children aged 9-59 months received measles vaccinations during campaigns. To prevent malaria-related morbidity and mortality, 19,400 insecticide treated mosquito nets were distributed. To prevent neglected tropical disease (onchocerciasis) related mortality and morbidity, UNHCR coordinated with Benishangul-Gumuz Regional Health Bureau and ARRA for mass administration of the Ivermectin drug, reaching a total of 28,455 (80.2%) refugees.
 
A total of 58 health professionals were trained on COVID-19 clinical management, surveillance and community mobilization. Screening of refugees for COVID-19 at health centres, during general food distribution, and at household level was conducted in all three camps. A total of 1,191 refugees were tested for COVID-19. 82 refugees were tested positive, received treatment and fully recovered. No COVID-19 related deaths were registered in the camps.


Ethiopia - Refugees, asylum-seekers and others of concern (urban) - Protection and mixed solutions

During the reporting period, 2,437 households comprising 5,306 refugees (51% female) were assisted under the urban assistance programme with monthly unrestricted cash assistance through CashAssist/Financial Gateway in collaboration with the Commercial Bank of Ethiopia.

In line with UNHCR’s COVID-19 global advisory, changes were made in the Ethiopia Urban cash assistance Standard Operating Procedures to adapt payment cycles, increase transfer value, and reduce the regularity of transfers by providing a two-month increased transfer to urban refugees. To cope with the COVID-19 pandemic, the transfer value for the urban refugee cash assistance was increased from April 2020 by ETB 300 per person to cover additional needs for soap, sanitizer and water. Transfers were made at one instance to cover two-month periods, ensuring that refugee cash recipients could plan and use the cash provided wisely.


Ethiopia - Refugees, asylum-seekers and others of concern (urban) - Protection and mixed solutions

Refugees in Addis Ababa have access to primary, secondary, and tertiary health services within the national health system, including comprehensive maternal and child health services, and HIV/AIDS, TB, gender-based violence programmes. Contractual agreements exist with public health facilities to ensure access to primary/referral health facilities for specialized care. During the year, 2,200 refugees were referred to secondary and tertiary health care facilities by UNHCR’s partner DICAC. Reproductive health and HIV awareness-raising, training on family planning, and other related topics were interrupted due to COVID-19, however other means such as use of printed materials were used to convey information on different health topics.

As part of the assistance programme and in response to the outbreak of COVID-19, refugees received an additional 300 Ethiopian Birr to purchase soap and other sanitary materials. As a COVID-19 prevention measure, cash payments were provided on a two-month basis in efforts to reduce contact and movement of refugees when withdrawing money.

In light of the on-going integrated interventions led by the Government to combat the rapid proliferation of COVID-19, UNHCR’s partner established 6 hand washing points through the installation of 6 water tankers, each with 200 litre capacity and currently functional in Mega Town, providing 5,000 250g bars of soap, 500 150ml bottles of sanitizer and 500 face masks for refugee households, WASH committees, hygiene promoters and youth volunteers trained on COVID-19 prevention.

More than 5,000 refugees and host community members benefited from the water trucking programme in Kenya Borena. Overall up to end of June, a total of 30,660,000 litres of potable water was provided for two refugee settlements. Also during this WASH programme the water point’s cleanness was checked and water tankers washed every two months by WASH committee.


Greece

Greece - POC Arriving by Med Sea (SMI) - Emergency response

In response to the COVID-19 pandemic UNHCR provided a “shielding” intervention of temporary/emergency shelter on the islands, using hotel accommodation and intra-island transportation services for those most vulnerable to COVID-19 complications and their family members until they were transferred to the mainland. UNHCR also supported the establishment of triage/quarantine/isolation areas in all the five islands and Evros, which entailed layout planning, the provision and instalment of prefabricated units and refugee housing units, the associated electric, water and WASH connections, and furniture and equipment. UNHCR supported them by upgrading WASH facilities and improving hygiene by renting and maintaining chemical toilets, showers and sinks, and by trucking water in Chios, installing and connecting new communal WASH facilities, repairing existing WASH containers and providing materials and equipment (WASH, electrical items and solar water heaters). Moreover, in-kind assistance was provided including core relief items (CRIs), solar lamps, hygiene items, personal protective equipment (PPE), and medical equipment to the specialized institutions. UNHCR further supported the authorities with improving the reception conditions in the RICs. In Samos, there were repairs and fixes in the food and CRIs distribution area, as well as large-scale waste collection and disinfestation, and technical work for restoration of the medical area. In Chios UNHCR donated and installed large tents and shade structures at the food and information point, and built an asphalt road and drainage works. Support was also provided to local hospitals and healthcare facilities in Leros, Kos and Evros region in the form of prefabricated units for medical screening and examination and the donation of PPE.

In Lesvos, UNHCR set-up a COVID-19 medical unit adjacent to the Moria RIC plot, which included a triage area as well as an isolation and treatment area for suspected and confirmed cases of COVID-19, and aimed at the improvement of hygiene in the RIC, through the upgrade of the water supply grid and the addition of new WASH units. In September 2020, a series of fires ravaged the Moria RIC. 12,000 people were left homeless and transferred to a new site that was set up by the authorities to host them. UNHCR supported in a multifaceted way, by undertaking groundworks (e.g. graveling to protect tents and common areas from flowing); providing 700 family tents, winterizing them by installing insulation kits, and by constructing custom flooring. UNHCR also installed four large tents for CRI distribution and cash assistance activities. A centralized medical hub was also established in the site which includes areas for health care services as well as COVID-19 screening and isolation. UNHCR worked alongside the national health agency EODY, WHO and other medical actors to create the layout. UNHCR also provided one large tent which was partitioned into seven examination rooms to help ensure patient privacy and confidentiality. In the north of Lesvos, UNHCR focused on setting up the site in Megala Therma for the quarantine of new arrivals. Interventions there included groundwork, installation and insulation/flooring of 45 tents and WASH facilities.

Further to the above, UNHCR ensured projects run by partners were accordingly adjusted with increased hygiene measures, for the protection of people of concern and project staff. Finally, a cash top-up to address immediate hygiene needs was disbursed in all island locations.


Islamic Republic of Iran

Islamic Republic of Iran - Afghan refugees and asylum-seekers - Emergency response

With the pandemic impacting the country throughout 2020, and partial lockdowns in place in different cities, refugees’ livelihoods and traditional sources of income were tremendously impacted, resulting in double the number of direct requests to UNHCR for cash assistance in 2020, in comparison to 2019.

In order to address these increased needs from the start of the COVID-19 outbreak, UNHCR and the Government identified vulnerable refugee households whose well-being and socioeconomic situation were severely affected, either directly or indirectly, by COVID-19. Subsequently, UNHCR initiated three different cash programmes, including, for the first time, joint assistance with the Government in the form of direct transfers into refugees’ bank accounts. Through these programmes, UNHCR was able to support 6,549 vulnerable households (32,238 individuals) with cash equivalent to the Minimum Expenditure Basket of a typical refugee household, for a duration of two to three months. This joint project also enabled UNHCR to expand its outreach by accessing additional vulnerable households, in addition to those who usually approach its offices, by collaborating with the Government to identify and assist people of concern countrywide.

Unmet needs
The needs of vulnerable and at-risk individuals increased exponentially in 2020, while resources available to assist them remained limited, which led to the prioritization of cash assistance as a response. Yet, out of 24,946 direct requests for cash assistance received by UNHCR in 2020, only around 12,000 could be supported with cash assistance.


Islamic Republic of Iran - Afghan refugees and asylum-seekers - Emergency response

The Ministry of Health and Medical Education (MoHME) has been providing Afghan refugees with unhindered access to primary health care, including throughout the COVID-19 pandemic. Refugees’ health needs have significantly increased as a result of COVID-19, rendering many of them vulnerable.

Similarly, additional support was required from the Government of Iran in terms of personal protective equipment (PPE) and medical supplies, in order to support the national health system in better responding to the crisis countrywide, both for refugees and the host population. Such support also helped maintain the Government’s inclusion in COVID-19 testing of refugees and people on the move.

To this end, UNHCR airlifted some 100 tonnes of medical supplies thanks to generous contributions from its donors, which were distributed in medical facilities countrywide, with a specific focus on refugee-hosting areas. The items included masks, face shield, gowns, hand sanitizers, gloves, portable ventilators, personal protective equipment (PPE), and infrared no-contact thermometers. All actions were coordinated with other international agencies. In addition, 10,991 refugee households received hygiene packages (including soap, hand sanitizers, masks and cleaning products), as part of UNHCR’s prevention efforts in both settlements and urban areas. As of end-2020, UNHCR had also pre-positioned some 14,000 hygiene packs as a contingency stock, to be used in the first quarter of 2021.

During the first months of the pandemic, refugees’ access to inclusive health care services was extended to include free COVID-19 testing and treatment, on par with Iranian nationals. However, access to free treatment could not be maintained due to resource constraints, compounded by the ongoing economic downturn in Iran and by the growing numbers of persons requiring treatment. Refugees enrolled in the universal public health insurance (UPHI) scheme could access treatment at subsidized rates. Testing remains free-of-charge at national health centres and for refugees inside settlements. Using addition funds raised for the COVID-19 emergency, UNHCR covered the UPHI fees for an additional 11,399 vulnerable refugees, which allowed for their continued access to secondary health care coverage during this period. This support also allowed the identified vulnerable refugees to access COVID-19 treatment cost at affordable prices, and helped prevent them resorting to negative coping mechanisms to cover health and other basic needs.

Unmet needs
In 2020, resources remained scarce for the Government to maintain its health response. The UN country team and partners provided much-needed support for the management of the COVID-19 crisis in its early phase, as the possibilities of directly bringing in international medical supplies and PPE items into the country were severely constrained. UNHCR Iran’s COVID-19 response was fully funded, and allocated resources were utilized in a timely manner. However, increased transportation costs, resulting from unpredictable border restrictions, forced UNHCR to reduce the quantities being procured. An important mitigation measure was the European Union’s generous support for a Humanitarian Air Bridge to Iran, as well as free services from Qatar Airways to transport PPE and medical supplies into Iran.


Kenya

Kenya - Mainly Somali refugees and asylum seekers - Emergency response

Disease outbreaks usually contribute to an increase in morbidities and mortalities and put a burden on already existing resource constraints. On 30th January, the World Health Organization declared the novel 2019 coronavirus disease (COVID-19) outbreak a public health emergency of international concern (PHEIC). As of 30th March 2020, it was declared a pandemic with 114 countries having reported over 118,000 cases of COVID-19. Kenya reported its first confirmed case on 12th March 2020. This put the refugee operation on high alert considering the vulnerability of the population of concern and the uncontrolled movement along the border with Somalia which was a major route for importation of the disease into the camps. The first case in Dadaab was confirmed on 18th May 2020 and a cumulative total of 272 cases, 254 recoveries and 7 COVID-19 mortalities were confirmed as at 31st December 2020. This constituted 39% of the county caseload with a case fatality rate of 2.5% against the national rate of 1.7%.

The camps, with a total population of over 223,420, were classified as high-risk areas together with 13 other counties across the country prompting the government to put lockdown measures in place. The overarching goal in the preparedness and response interventions was to control the disease by slowing down transmission and preventing associated illness and death. The disease largely caused asymptomatic or mild illness in about 80% of the population, it however causes severe illness in about 16%, requiring specialized in-patient management and ICU equipment. The elderly, those with pre-existing medical conditions and the expectant were the most vulnerable. In the refugee camps, these groups constitute 9.6% of the population (21,000). This significantly large number had a potential to overwhelm the existing health system in the camps should the preventive interventions remain inadequate.

Timely and adequate planning prioritized investment in key areas of preparedness and response interventions which were: (1) Coordination and planning to ensure refugees were included in country-specific national operational plans with estimated resource requirements and to map out staffing capacity and the most at risk; (2) risk communication and community engagement with emphasis on hygiene promotion, handwashing, respiratory hygiene and correct messaging of COVID-19; (3) surveillance; (4) Testing; (5) Infection prevention and control which entailed ensuring adequate PPE prepositioning, modification of health facilities and designation/setting of quarantine and isolation areas; (6) case management; (7) logistics and supplies; (8) maintain essential health services to prevent indirect impact of the outbreak on management of non-COVID-19 healthcare needs.

Effective preparedness and response under the listed intervention gave priority to immediate funding for training of 231 frontline health workers, 200 community health workers, recruitment of additional frontline health workers and community health, 2 COVID-19 dedicated ambulances, setting up of 3 quarantine and 2 isolation facilities and logistical support in procurement and prepositioning of adequate medical drugs, PPEs and other medical supplies.

In response to COVID-19, the health sector implemented a comprehensive set of measures, calibrated to the local context and epidemiology of the disease. Central to this strategy was time-tested, core public health measures that break chains of person-to-person transmission, including (i) identification, isolation, testing, and clinical care for all cases, and (ii) tracing and quarantine of all contacts. As at 31st December 2020, the operation successfully maintained a centralized isolation, quarantine centre, logistical support for sample referral and contact tracing resulting in 1,093 quarantine admissions, 272 cases managed, 5,160 tests and 811 contacts traced.


Kenya - Refugees and asylum seekers of various nationalities in Kakuma camp - Emergency response

COVID-19 pandemic led to the closure of schools in Kenya in mid-March 2020 including in Kakuma camps and the nearby Kalobeyei settlement, disrupting learning for 87,408 students (35,034 female) enrolled across 19 pre-primary, 26 primary and 7 secondary schools. As an immediate measure to support learning continuity for children, UNHCR and education partners in coordination with the Ministry of Education at national and local levels developed an inter-agency education response plan anchored in the Kenya Education Response Plan for COVID-19. The plan outlined strategies and interventions for out of classroom and distance education support, school re-opening protocols and the long-term efforts needed for learning recovery.

With support from donors, pre-recorded educational content and live delivery of lessons were broadcast daily for 5-hours via a local radio station. In addition to the radio lesson broadcast, 5,000 radios were distributed to support connection to the broadcast and data bundles were provided to teachers to support their engagement at the provision of distance learning to learners. 15,000 textbooks were distributed to support home learning, COVID-19 awareness targeted at children was stepped up, psychosocial support through play and physical activities rolled out and communication mechanisms to share available online and offline educational resources established using a WhatsApp communication tree. A total of 44,468 children were supported through the various learning continuity interventions.

As most online and offline digital resources were not adopted for children with disabilities, deliberate efforts were made to provide home based learning support. With adolescent girls facing the risk of early marriage, sexual abuse, and teenage pregnancies due to extended school closure, extensive community awareness and provision of targeted packages of support including the distribution of sanitary materials, solar lamps, and cash grants.

Besides the support for learning continuity, interventions were implemented to facilitate safe school re-opening including set up of additional learning spaces to facilitate physical distancing requirements, improvement of schools water, sanitation and hygiene (WASH) situation and provision of facemasks and thermometer guns which were key to meeting COVID-19 safety protocols. This support enabled safe re-opening of schools in October 2020 for three grades and subsequent full resumption of school for all grades in January 2021.


Lebanon

Lebanon - Syrian refugees and asylum-seekers - UNHCR global management

UNHCR’s COVID-19 response focused on: refugees’ community engagement and awareness raising, containing transmission among refugee communities, and improving treatment and case management. The activities included training of humanitarian staff, refugees community volunteers and frontline workers, in addition to the provision and distribution of hygiene kits for refugee in need.

UNHCR provided technical, logistical and staffing support to the MoPH COVID-19 Hotline Call Centre to increase its capacity responding to more callers, and by end of 2020 the hotline had received 138,435 calls.

Support was also extended to MoPH epidemiological surveillance units across the regions, with additional contact tracing team deployed by UNHCR implementing partner assisting MoPH team in contacts tracing and referrals. The same teams assisted UNHCR and WHO conducting a mass PCR testing campaign in refugee informal settlements and overcrowded settings, with over 3,500 PCR tests within 6 week period. PCR testing and hospitals admission for COVID (regular and ICU) were 100% reimbursed by UNHCR for refugees.

The Hospital Expansion and Capacity Enhancement project strengthened the capacity of selected hospitals across Lebanon to receive and treat COVID-19 patients regardless of nationality. Support provided to 6 hospitals across the country included construction and rehabilitation of COVID-19 wards, installation of negative pressure environment and ventilation, medical gas installation, in addition to donation of medical equipment, medical supplies, medications, and personal protective equipment. The total support throughout 2020 comprised 197 regular beds, 57 ICU beds all with the relevant equipment and supplies including ventilators, central stations, portable digital X-ray, ultrasound machines and syringe pumps. UNHCR supported the facilities with 105,900 surgical masks, 203,800 examination gloves, 508 face shields, and 356 protective gloves.

UNHCR expanded its community mobilization efforts in order prevent and respond to the COVID-19 situation. This included supporting volunteers to carry out outreach activities through covering internet fees to enhance surveillance, monitoring, reporting and evaluation.

In total  1,781 site community groups were set up at IS and CS comprised of 5,291 people who were active in ensuring that COVID-19 precautions were understood and practised at site level, including on isolation procedure and referrals for symptomatic cases.

In total 60 community health volunteers (CHV) were deployed to over 500 sites to share COVID-19 precautions and support residents to apply them. CHVs made 3,362 visits of which 77% were in person and reached around 71,966 people per month. They also referred 171 symptomatic cases to the Rapid Response Team (RRT) and conducted 123 surveys.

In total 1,001,357 people were reached by OVs, with 54.5% of contacts on COVID-19 and mostly online. A total of 39,798 people were reached with COVID-19 awareness at CDC/SDCs, constituting 19% of activities, and mostly online.

454 persons were trained in mask-making and 443 persons were trained in soap-making at CDCs/SDCs through in-person and hybrid modalities, of whom 43% were Lebanese; in addition, 79,384 masks and 67,415 bars of soap were produced at CDCs/SDCs and distributed among refugee and host communities.

Over 85,000 refugee-produced masks supplied by UNICEF/ANERA were distributed to persons approaching UNHCR Reception Centres without masks.

UNHCR provided bars of soap and 32,244 gallons of bleach plus 81,882 litres of sanitizer to UNICEF to ensure a blanket coverage of the refugees living in informal tented settlements. This ensured coverage of 40,941 households. The total of 61,679 refugees and lebanese living in 616 collective shelters received disinfection kits.

In total 68,969 people benefited from 18,383 COVID-19-related hygiene promotion sessions. While wave 1 sessions were conducted face to face, wave 2 consisted of remote sessions through WhatsApp groups and phone calls in addition to the use of social media and the efforts of trained 304 WASH community volunteers.


Mexico

Mexico - Refugees and asylum-seekers - UNHCR global management

As part of the peaceful coexistence and support to host communities’ activities, particularly in the context of COVID-19, UNHCR donated protective and medical equipment to public health institutions in different locations in southern and northern Mexico. The needs were jointly identified with WHO/PAHO as well as local hospitals and health centres. Donations included protective personal equipment in 10 different local institutions in six states, and 20 mechanical ventilators were delivered in Chiapas.

From June to August, a first round of protective products and medical equipment was donated to local counterparts and their communities. With needs growing because of COVID-19, UNHCR allocated additional funds for a second round of donations that started by the end of 2020 and will continue in 2021.

Nearly 90,000 school kits were distributed to students in pre-primary, primary and secondary education in public schools in Chiapas, Tabasco, Veracruz, Oaxaca, and Baja California States, to reduce some of the expenses of local families whose economic situation were affected by the pandemic.

In 2020, UNHCR also started the rehabilitation of IT classrooms in 41 schools (including 33 classrooms in primary schools), in six training centres for employment, and in one centre for over-aged learners, both under the Ministry of Education.


Mozambique

Mozambique - Refugees and asylum seekers in Mozambique - Emergency response

UNHCR successfully supported the design and implementation of one Emergency Response Preparedness plan for the COVID-19 pandemic. During this period of the COVID-19 pandemic, UNHCR became more involved in the district and provincial level technical working groups working on multiple health issues. This helped reinforce UNHCR’s presence and engagement with local health stakeholders including other UN agencies working in the health sector, so that the health of people of concern is discussed at the local, district and provincial health levels.

With the additional resources allocated for the COVID-19 emergency response in 2020, UNHCR provided several assorted COVID-19 related medical supplies to the Maratane settlement Health Care Centre. These supplies included: Azithromycin = 2004 units/250mgs each; injecting Ampicillin = 200 units/500mgs each; Ceftriaxone = 400 units 1g each; and Salbutamol 100MCG inhaler = 200 doses. Several assorted PPE items were also provided including 18,000 surgical masks (type IIR); 3,000 gowns; 250 goggles; 1,500 tongue depressors; and 100 units of hand drying tissue.

Hygiene supply which included: 60 litres of liquid soap and 100 units of biohazard bags for prevention and control of infection were also supplied to the Marantane settlement Health Care Centre.

In addition, UNHCR supported the testing of 127 patients with COVID-19 symptoms inside the Maratane settlement Health Centre, both refugees and residents from the host community.

A total of 12,859 persons (5,029 refuges and 7,830 host community members) benefited from COVID-19 awareness-raising campaigns.

Under the non-medical measures to control/prevent the spread of COVID-19 to people of concern and host community members, the operation trained 20 activists and 23 community leaders to better and effectively respond to prevention of COVID-19 in their communities. This training resulted in 90 awareness sessions conducted on COVID-19 SOPs of which 43 were inside the settlement camp and 47 in the surrounding communities.

As wearing of masks is one of the COVID-19 SOP requirements, UNHCR distributed a total of 13,000 masks to people of concern including members of the host community.


Myanmar

Myanmar - Communities affected by displacement (nationwide) - Emergency response

The COVID-19 situation required a rapid scale-up of prevention and response activities in support of the national response, to protect vulnerable persons including in camp settings as well as returnees. Major contributions to the national response include the donation of four WHO-sanctioned COVID-19 commodity packages, which contain 75 items including various medicines, thermometers, ultra-sound scanners (20), and ventilators (18). To further support case management, the donation also included disinfectants as well as waste management and laboratory supplies. Some 635,200 PPE items (e.g. gloves, masks, face shields, etc.) were donated to protect frontline healthcare workers. UNHCR also donated 60,000 COVID-19 test kits with the support of UNICEF. Working through partners, UNHCR scaled-up cloth mask production supporting protection and livelihoods for tailors –  around 160,000 masks have been made to date.

UNHCR has also extended support to State Health Departments and local authorities in Rakhine, Kachin, northern Shan, Kayin, Kayah states as well as in Bago and Tanintharyi regions to equip more than 400 government-run quarantine facilities. The provision of plastic sheeting provided privacy as well as protection from the monsoon rains, while beds, blankets, sleeping mats, mosquito nets, kitchen sets, buckets, and hygiene kits helped to make the temporary stay more comfortable and safer. In response to a request in Kachin State, UNHCR also contributed 18 heavy duty washing machines for the disinfection of clothes and linen in quarantine facilities across the State.

UNHCR has increased prevention and response activities in displacement sites in Kachin, northern Shan and Rakhine states as well as in the South East. To ensure that internally displaced people (IDPs) have access to accurate information, UNHCR and partners are running awareness campaigns with key messages on prevention, while scaling up health, water, sanitation, and hygiene services in camp settings as well as busy market areas with the installation of new sinks and provision of soaps and hand sanitizer. This included securing and delivering 608,000 soaps bars via a private contribution from UNILEVER. In addition, UNHCR has provided 627 packages of essential hygiene items, including towels, toothpaste, and toothbrushes, reaching over 315 families in five IDP camps in northern Shan state.


Niger

Niger - Malian refugees - Protection and mixed solutions

During the first quarter of 2020, the two primary schools in Intikane had a total of 2,014 students (841 girls and 1,173 boys) before temporarily closing due to the COVID-19 pandemic. The secondary school, which was created by a governmental decree in 2019 thanks to UNHCR’s advocacy had 69 students. Unfortunately, the refugee reception area was attacked at the school reopening, which rendered the area inaccessible for 3 months. To adapt to the limitations posed by COVID-19 and insecurity, booklets were distributed to primary school pupils to cover basic subjects. For secondary school students, only those who fled with their parents at the temporary site of Telemces were able to continue and finish the school year. As a result, a noticeable decrease in the number of students enrolled in schools was observed in June, as only 652 primary students – including those who received course materials – and 46 middle school students were able to study at Télemces college.

In Tillabery, 1,292 students were registered and were all provided with school kits. Eight advocacy meetings were conducted at the field level with the administrative and municipal authorities to facilitate children's access to school. In Ayerou, nine classrooms were constructed through UNHCR’s partners ADES and APBE. A total of 2,307 people were reached through sensitizations on the importance of education, including 966 women, 793 men, 300 girls and 248 boys. Refugee children have access to education in three departments and schools are available. However, the widespread insecurity and the COVID-19 pandemic have negatively impacted the education sector. Nevertheless, thanks to the involvement of UNHCR partner ADES, there has also been a noticeable improvement in access to education. Awareness-raising sessions on education (particularly of girls) and on the prevention of COVID-19 were conducted towards refugee families and the local community.


Niger - Rural Refugees in Maradi Region - Emergency response

At the start of 2020, only 30% of school-age displaced children were enrolled. However, at mid-year this number fell to 8% or 538 children (277 girls and 261 boys) enrolled. 18 classrooms were constructed. This drastic reduction in school enrollment was due to the COVID-19 school closures, incursions of non-state actors disturbing school functioning as well as an increase of persons of concern to UNHCR in the Maradi region. Other constraints were insufficient teaching staff and structural and insufficient infrastructure and school material. Nonetheless, UNHCR was able to achieve the number of results with the goal of expanding access to education for Nigerian refugee children and host communities in the Maradi region. Seven semi-permanent classrooms were constructed in the three opportunity villages for refugees (Garin Kaka, Dan Dadji and Chadakori). A total of 1,231 children benefitted from improved educational equipment, and 1,026 students (54% girls comprising 677 refugees and 349 host community children) benefitted from preparatory and remedial courses. This figure far surpasses the original target of 350 students. Three schools received support in the form of inspections (Guidan Roumdji2 in Dan Daji Makaou and Chadakori in Garin Kaka) by the DREP (Direction Regional d’Enseignement Primaire), and seven schools benefited from technical guidance provided by UNHCR’s partner NRC. 12 teachers benefited from the training as part of the implementation of the preparatory courses’ module. In addition, 20 other teachers – 18 women – benefited from the training on the Safe School Module, training 32 teachers to surpass the initial target of 20.
 
Additionally, 22 members of the Decentralized Management Committees of School Establishments (CGDES) – including 7 women – benefited from a training in Chadakori on their roles and responsibilities.

To increase capacity for displaced children, UNHCR has been collaborating with the Education Working Group to advocate with the government and UN sister agencies for the recruitment of new teachers.


Nigeria

Nigeria - Refugees and asylum seekers in Nigeria - Emergency response

With the outbreak of the COVID-19 pandemic, the already weak health system was put under more strain. UNHCR responded by addressing the communicable disease outbreak. UNHCR supported Government efforts across several pillars of the Government action plan.

UNHCR supported awareness-raising by providing information, education and communication materials for the health facilities, public places in towns, refugee settlements and host communities. The IEC materials were also distributed in border communities to prevent refoulement of asylum-seekers. UNHCR also supported COVID-19 awareness jingles in three radio stations to dispel myths and misinformation.

UNHCR supported 34 health facilities with PPE to respond to COVID-19. UNHCR received 193,700 masks (3ply and N95) and have distributed 82,300 to health care facilities. A stock was pre-positioned for continuous supply to health facilities based on demand. Other items provided to health facilities included scrubs, gloves, disposable plastic aprons, scrub shoes, and hand sanitizers.

UNHCR supported surveillance by providing infra-red thermometers, and cold boxes (Giostyles) to 34 health facilities. UNHCR also procured specimen collection kits to close gaps in case of Government shortfall. UNHCR supported testing in Takum General Hospital, Taraba State, by upgrading the existing molecular laboratory to achieve biosafety, installing a solar inverter, and facilitating NCDC (Nigeria Centre for Disease Control) activation of the GeneXpert for small scale testing. UNHCR also facilitated and supported Abott to activate the large capacity abandoned Abott machine. This laboratory has tested about 2000 samples (including 56 refugees who all tested negative). Testing capacity in Cross River and Benue states is still very poor. To support access to testing, UNHCR awarded contracts for the upgrading of GeneXpert laboratories in Moniaya Hospital Ogoja and General Hospital Adikpo. UNHCR will coordinate with NCDC to activate the laboratories once completed.

A new 10-bed COVID isolation and treatment centre was built in the General Hospital Adikpo, while existing tuberculosis and pediatrics wards were renovated to serve as COVID-19 treatment wards in Ogoja and Takum and converted to COVID-19 isolation and treatment centres. Equipment was provided to support COVID case detection and treatment. Oxygen concentrators were provided to five health facilities. Other items distributed to isolation centres, border health facilities and facilities in communities hosting large number of refugees included 18 pulse oximeters, three nebulizers, 54 pedal waste bins, three stretchers, 12 pediatric ambu bags, 12 adult ambu bags, three suction machines, 30 kidney dishes, 30 galipots, 12 trolleys, six hemoglobin meters, six glucometers, and 54 IV fluid stands.


Pakistan

Pakistan - Refugees and asylum-seekers - Emergency response

UNHCR through partners in Khyber Pakhtunkhwa (KP), Balochistan and Kot Chandna Punjab Province continued its efforts in collaborating with the provincial government to strengthen the public health system, align refugee health services in Refugee Villages (RV) with the national health system and promote efficiency while reducing duplication in service delivery where possible.

Following a health facilities assessment, UNHCR provided personal protective equipment (530,000 masks, 841,000 gloves, 4,000 disposable gowns) and medical supplies/consumables, such as infrared thermometers and alcohol hand sanitizer to health staff working in Basic Health Units (BHUs) and Maternal and Child Health Centres (MCH centres) in the refugee villages (RVs) as well as other community health workers. Some protective equipment was also provided to the Government health facilities near the RVs and to provincial government authorities. In addition, UNHCR supported the provincial Health Departments and Provincial Disaster Management Authorities with 10 well-equipped new ambulances and other medical equipment to respond to emergency situations.

During the COVID-19 pandemic, refugee COVID-19 patients received testing and treatment from the nearby Government-run hospitals on par with nationals. UNHCR partners carried out Risk Communication and Community Engagement (RCCE) activities in the RVs to prevent and mitigate the pandemic effects. UNHCR drafted a Pandemic Preparedness and Response Plan for RVs, with clear referral pathways to the nearest public health facilities.

In health facilities in the RVs, health indicators were within acceptable international standards: under 5 mortality rates were 0.37 and crude mortality rates were 0.14. A total of 117,534 patients were treated. Community health workers referred 45,699 patients to RV Maternal and Child Health (MCH) centres, secondary and tertiary level facilities. From the MCH centres, a total of 4,350 referrals for general ailments and 1,689 Obstetric referrals were made to secondary and tertiary level facilities. At RV MCH centres 15,759 (86%) antenatal and 14,372 (91%) postnatal mothers were provided with reproductive health services. A total of 13,010 (82%) deliveries were conducted by skilled birth attendants. Measles coverage was attained at 100%. Only 6,969 (10.1%) of new family planning clients accessed different family planning services.


Pakistan - Refugees and asylum-seekers - Protection and mixed solutions

UNHCR provided direct support to a total of 54,111 Afghan children (39% girls) enrolled in 145 schools (102 in KP, 35 in Balochistan and 8 in Punjab) in refugee villages in KP, Balochistan and Punjab. The shift from the Afghan to the Pakistani curriculum continues to advance in RVs and is on track having started from grade KG (pre-primary) with the last grade 5 to be transitioned to Pakistan curriculum in September 2021.

Given this transition, 103 additional volunteer teachers were hired for two months in January-February 2020, to facilitate the learning process in RV schools by providing extra coaching classes to students.

In connection to this, the Provincial Institute for Teachers Education (PITE) in Balochistan carried out comprehensive teacher training and refresher courses for Afghan refugee teachers to enhance their capacity in facilitating the inclusion of refugee children into the national education system. One of the key reasons for this transition is to allow Afghan students to access continuous and higher education opportunities while in Pakistan.

From students’ formative assessment scores, UNHCR gleaned that coaching classes it supported had a positive impact on students’ learning. UNHCR rigorously participated in planning meetings for the development of a five-year provincial level national education sector plan. Afghan refugee children were included in the Education Sector Plan in Khyber Pakhtunkhwa Education Sector Plan 2020/2021- 2024/2025). In 2020, school textbooks were procured through UNHCR funds. However, towards the end of 2020 free textbooks from Department of Education for all Afghan children in RV schools were secured for 2021-22 session.

Due to COVID-19, schools were closed from 13 March 2020 to 5 October 2020; nonetheless, UNHCR through the partners continued to remain in touch with communities and all students were promoted to next grades. After the schools’ re-opening, the consolidated curriculum academic plans/ calendars developed by Khyber Pakhtunkhwa education department were shared with RV schools’ teachers for use with students to overcome the loss of learning. At community assisted RV schools 93 teachers and 79 watchmen were provided cash support from May-August 2020 as result of COVID-19 schools’ closure.

The assessment of 33 home-based girls’ schools in Khyber Pakhtunkhwa was conducted with 18 schools converted to Accelerated Learning Pathway centres. The centres were issued new codes and the enrolment of girls was revised according to the Accelerated Learning Programme (ALP) standard age limit. 18 ALP Teachers and 3 ALP staff were trained on ALP curriculum through Provincial Institute for Teachers Education (PITE) in collaboration with UNICEF.

Textbooks, uniforms, lap desks, school bags, stationery items as well as personal protective equipment (PPE) were procured and distributed to all children in UNHCR-supported schools, which helped to improve the quality of education and learning environment.


Pakistan - Refugees and asylum-seekers - Protection and mixed solutions

Building on efforts initiated in 2017, UNHCR continued to strengthen the network of Outreach Volunteers (OVs) which currently stand at 1,634 as per the breakdown below by location:

• 400 in Balochistan (200 male and 200 female),
• 1,012 in Khyber Pakhtunkhwa (551 male and 461 female) and
• 222 in Islamabad and Punjab (168 male and 54 female)

Thanks to mobilization and training, and with enhanced capacity and knowledge of protection concepts and available services, OVs played a key role in the identification of vulnerable refugees and referring them for a timely solution of their problems. In 2020, UNHCR convened 580 meetings with the OVs and their respective communities across the operations. A total of 460 community sessions were held with general community members that were attended by 8,429 individuals with a 49% (4,118) participation of female members.

Alongside community meetings, UNHCR used telephones to remain in contact with the refugees. A total of 865 calls were made to the refugee community during the peak of COVID-19, and 2,227 calls were received on UNHCR’s protection helpline. All calls were appropriately responded to and confidentially treated as appropriate, in line with the community-based feedback and procedures.

With UNHCR and partner support, OVs initiated 33 small-scale community-led initiatives to support their communities to enhance self-reliance and community empowerment.

In addition, 18 refugee Shura (community leaders and elders structures) were established comprising 108 male individuals in Khyber Phakhtunkhwa and in Punjab 46 awareness sessions with 437 community members, OVs, and Shura were held on the importance of education, COVID-19, community coordination, and other communal issues.

A community-level pocket guide was developed in three languages (English, Dari and Pashto) and distributed among these community structures to facilitate timely referrals of identified vulnerable refugees, survivors of gender-based violence and urgent medical cases. With the first-hand updated information and key messages/emergency contact numbers available in the guide, it enabled volunteers and other community workers to ensure maximum support through swift and timely referral of protection cases as well as guide their community members on procedures such as Proof of Card Modification (PCM) and voluntary repatriation.

UNHCR established three new multipurpose model community centres in Punjab and Balochistan. At the end of 2020, the total number of community centres was five (two in Refugee Villages and three in urban areas). These centres offer a wide range of services including spaces for refugee women, girls, men and boys to come together, foster peer network, access information, receive psychosocial counselling and life-skills trainings. As a result, 267 persons of concern to UNHCR were trained in computing, English language, tailoring and other courses.

UNHCR also adopted alternative communication mechanisms to facilitate protection interventions in remote and inaccessible locations. Over 38 WhatsApp community groups were created. UNHCR also encouraged refugees to use UNHCR and its partners’ social network pages such as Facebook to access information.

A complaints database was maintained to record and handle complaints reported by the community through established channels including complaint and suggestion boxes, a confidential email address, helplines and consultation with community support structures as per SOPs developed in 2019.

In addition, the office developed and disseminated 70,000 brochures (in Pashtu, Dari and English) on COVID-19 preventive measures and protection services highlighting how and where to access specialized services in Khyber Pakhtunkhwa (KP).


Pakistan - Refugees and asylum-seekers - Protection and mixed solutions

UNHCR provided livelihood support to refugees and host communities in 2020, even in the unique challenging environment created by the COVID-19 pandemic. Male (70%) and female (30%) refugees were assisted by a variety of suitable interventions which helped them to earn an income and live a dignified life.

Jointly with the Pakistan Poverty Alleviation Fund (PPAF), UNHCR trained 1,502 refugees and provided them with productive livelihood assets under the poverty graduation programme. The eighteen-month project started in January 2020 and will continue to the end of December 2021, assisting 2,500 refugee households in Khyber Pakhtunkhwa and Balochistan. Against the total figures of 2,270 heads of households reported in the mid-year report, only 43 trainees dropped out of the programme.

In Khyber Pakhtunkhwa, 205 refugees were trained in various vocational skills through UNHCR partners and were provided with certificates and tool kits. Even though institutions were closed due to COVID-19, UNHCR was able to adjust its plans and ensure that a maximum number of Afghan refugee benefited from the programme. A six-month diploma course in professional cooking was revised to short trainings focusing on personal protective equipment (PPE) making within a community setting. 60 refugee youth were trained (30 female and 30 male) in making PPE, hand sanitizer and face masks. Upon completion, 7 Afghan youth out of 60 graduates started either their small business or were employed. Employment remained a significant challenge amidst COVID-19.

Various skill training courses were provided to 145 refugees through partners HASHOO Foundation and Sarhad Rural Support Program which included motorbike/mobile repair, home textile, beautician and honeybee farming. 40 home-based businesses were supported with tool kits to enhance their small businesses. 51 skilled refugees who were badly hit economically due to lockdowns in the COVID-19 pandemic were engaged to make PPE. This PPE was handed over to the Provincial Government in Khyber Pakhtunkhwa for further distribution among health care staff. Among the 30 trained refugees in motorbike/mobile repair, 20 trainees started working with local workshops. Similarly, 14 women out of the 20 trained started to earn within the community and the local market. 10 females trained in beautician skills engaged in income generation activities utilizing their skills within their communities.

In Balochistan 425 beneficiaries in Refugee Villages and in Quetta urban areas were provided with certified marketable skills. 325 persons of concern to UNHCR were provided with support in homestead gardening and backyard poultry interventions. All beneficiaries of respective trades received the business start-up tool kits that helped them to improve their employability and income-generating capacity.

UNHCR engaged a private sector partner namely SHAPAR/FNKAsia in 2020 to train 50 refugee artisans and provide them with income generating opportunities. The company trained 50 refugee females in fashion, jewellery making and face mask making skills in Karachi. Upon completion of the training, the refugees are regularly receiving orders from private companies and manage to earn a decent wage in return.

Through the MADE51 project, UNHCR assisted 150 refugee artisan women in Quetta, Karachi, Islamabad, and Peshawar by providing them access to wider markets and the opportunity to capitalize on their artisanal skills. These refugee artisans were linked with five Local Social Enterprises (private business entities) in Pakistan, which enabled them to have access to better manufacturing and input supplies. The selected business entities helped them to produce high quality products and supported them in marketing and access to national and international markets, which helped 150 refugee women in income generating activities by manufacturing crafts and becoming part of commercial supply chains of private sector businesses.


Panama Multi-Country Office

Panama Multi-Country Office - Refugees and Asylum Seekers in Belize - UNHCR global management

UNHCR successfully implemented its portion of the COVID-19 Joint Programme in Belize, funded by the UN Multi-Partner Trust Fund. The purpose of the plan was to assist government and rural communities in Belize in (i) halting the transmission of the COVID-19 in government-selected priority rural areas; and (ii) reducing the impact on human lives, by facilitating access to safe health services.

In 2020, 206,435 people (49% of population) were reached through joint actions, including an estimated 2,823 of people of concern to UNHCR.

UNHCR contributed to upgrading the National Risk Communication and Community Engagement Strategy along with a new repository of ready-to-use COVID-19 messages tailored to the specific target groups, with a growing stock of other communication products available. In addition, progress was also made in occupational safety and health with the completion of the ILO campaigns on COIVD-19 in the workplace.

UNHCR provided safe isolation services to the most vulnerable people, including refugees and asylum-seekers. Through the collaborative identification and procurement efforts of PAHO/WHO and UNHCR, medical equipment and personal protective equipment were handed over to the Ministry of Health and Wellness to be delivered to state-managed regional isolation facilities in the Central Health Region (PAHO/WHO) and Western Health Region. This contributed to strengthening the capacity of the health sector in managing COVID-19 cases. UNHCR provided an additional adjusted package of medical equipment and supplies, emergency beds and space dividers to the isolation area of the Rural Health Centre of Valley of Peace, one of the few community-based COVID-19 isolation facilities in Belize.

 UNHCR delivered 100 out of 250 COVID-19 kits to community health workers for their response and/or referral of vulnerable COVID-19 patients.

Also, UNHCR assisted additional health facilities in Independence, Bella Vista, San Juan-Cowpen, San Isidro, Trio and Santa Cruz that host some 20% of all people of concern to UNHCR in Belize.


Peru

Peru - Refugees and asylum-seekers - UNHCR global management

Physical and mental health was one of the major challenges during 2020, due to the restrictive measures imposed during COVID-19 pandemic. Access to different levels of health care remained limited, giving priority to COVID-19 or critically ill patients. These limitations had an impact on the care of pregnant women and maternal and child health, whose access to services was restricted. In addition, lockdown and social distancing had a severe impact on the mental health of the population of concern to UNHCR. Cases identified with a health need in 2020 included COVID-19, chronic illnesses, critically ill patients, people requiring psychosocial support, and mental illness.

UNHCR and its partners provided over 2,800 health consultations and over 9,400 mental health consultations in different locations in the country. In addition, UNHCR and partners who had access to the system registered in proGres v4 2,011 physical and mental health cases, provided psychosocial support, emergency CBI for medical care (which increased this year as many public hospitals only accepted COVID-19 cases, leaving people of concern to resort to private consultations for even primary healthcare) managed cases and, for those most vulnerable, supported the process of accessing the vulnerability-based migratory card in order to access the Comprehensive Health Insurance (SIS).

Regarding mental health and psychosocial support services (MHPSS), UNHCR along with the Columbia University developed a four-day training in interpersonal therapy , evidence-based, brief, manualized, group intervention that promotes community building, and a sense of belonging among displaced persons. This pilot project, the third implemented worldwide, trained 25 people from UNHCR staff, refugees, state officials and UNHCR partners.

UNHCR and HIAS developed a project plan to evaluate the impact of COVID-19 in mental health of refugees and migrants in Peru that will be implemented in 2021. During the pandemic, UNHCR with specialized partners provided 2,940 psychosocial and socioemotional support sessions, as well as over 9,430 mental health consultations.

In addition, UNHCR and partners provided over 1,690 attentions and 540 psychosocial attentions on gender-based violence. To strengthen capacities of community actors for action in face of psychosocial impact of human mobility, COVID-19, and gender-based violence, UNCHR with partner CAPS trained some 100 community leaders in a six-week course. Training topics included capacity strengthening for the implementation of coordinated mental health actions with community actors and to promote critical analysis of the community situation, and the implementation of collective alternatives.


Republic of the Congo

Republic of the Congo - Refugees and asylum-seekers (urban) - Emergency response

During 2020, UNHCR initiated an emergency response to COVID-19, targeting 144,843 people, including refugees and asylum-seekers and 30% of the citizenry in the department. This project was in line with the national COVID-19 preparedness and response plan and included the following key activities:

  • Some 10,254 households (40,757 people) were reached through sensitization sessions and house-to-house awareness raising about COVID-19 prevention by community health workers.
  • Health education sessions conducted in health facilities and other public areas reached some 7,263 people (4,217 male and 3,046 female). In addition, 37 radio talk shows were organized.
  • Capacity building for health care providers and emergency responders through training sessions organized in collaboration with the Ministry of Health.
  • Two COVID-19 coordination and response teams were established at the departmental level in Likouala and Plateaux.
  • Support was provided to 21 weekly departmental COVID-19 coordination meetings and 19 district outbreak management meetings.
  • A screening and case identification system was established at border crossings in the departments of Likouala and Plateaux.
  • Six community surveillance teams were recruited and trained in Djambala, Gamboma, Bouemba, Betou, Imfondo and Dongou.
  • Some 500 information materials were distributed to health facilities and the community.
    Three isolation centres were established for confirmed COVID-19 cases.
  • Personal protective equipment and hygiene materials were distributed to health facilities in Likouala, Plateaux and Brazzaville. Items included mask, gloves, sanitizers and information materials on prevention and response.

All activities contributed to the prevention of the spread of COVID-19 in the refugee and host communities. During 2020, nine refugees contracted COVID-19, received treatment in isolation, and recovered. No deaths due to COVID-19 were reported in the refugee community.


Republic of the Congo - Refugees and asylum-seekers (urban) - Emergency response

UNHCR is concerned about strengthening protection against the COVID-19 pandemic in all areas of intervention, particularly in Brazzaville, Impfondo, Betou and Bouemba. A total of 20,000 face masks were made by members of the refugee and host communities as part of a cash-for-work project and distributed to some 20,000 vulnerable people. The funds generated by the cash-for-work project have enabled eight people to start small businesses and become self-sufficient. Sensitization sessions on social distancing for refugees and host communities helped to strengthen understanding of the transmission of the disease and strategies to protect against it. In support of the public authorities, 60 removable shelters were built in 20 COVID-19 isolation centres. Thanks to awareness raising about COVID-19 prevention and transmission and the distribution of masks and sanitizers, the spread of the pandemic was slowed in intervention areas.


Rwanda

Rwanda - Refugees (camps) - Emergency response

Over the reporting period, UNHCR and partner managed to maintain 2 health facilities in the camp of Mahama to provide primary care to Burundi refugees. The isolation facility initially dedicated to cholera treatment was rehabilitated with a total bed capacity of 60. The package of services provided include curative care for treatment on common diseases, inpatient care, minor surgery, mental health and psychosocial support, diagnosis and management of non-communicable diseases, prevention and treatment of communicable diseases including malaria and COVID-19. In addition to services provided within health facilities, some refugees were also hired to provide community-based preventive services for both covid and non-covid services. Medical activities related to VolRep were also successfully implemented. As support to service provision, essential medicines, equipment and medical supplies.

As result, 160,771 persons accessed primary health care and 6096 PoCs were admitted and hospitalized in the two health centres in the Mahama camp. A total of 2809 children < 12 months were vaccinated against measles out of 2935 children planned making measles coverage 96% while some couldn’t complete vaccine due to the ongoing repatriation. With support from the government, the camp of Mahama was spread with insecticides as prevention of Malaria (Indoors Residual Spraying).

Following inclusion of refugees in national hepatitis programme, the screening campaign was launch on February 5th 2020 in the camp of Mahama. Of all 34,448 eligible for screening ,76,92% were tested for HBV and HCV. Treatment was initiated to 90,3 and 87,7% of all HBV and HCV respectively eligible patients after viral load measurement.

A total of 3019 PoCs were referred to secondary and tertiary levels for advanced medical care. As part of related volrep medical and nutrition screening were conducted to identify refugees with malnutrition and chronic disease and ensure continue of care in the country of origin. Unfortunately, 113 individuals died from various diseases, making a crude mortality rate and under 5 mortality rates of 0.15 deaths/1000/month and 0.25 deaths/1000/month, respectively.


Rwanda - Refugees (camps) - Emergency response

available soon


Rwanda - Refugees and asylum-seekers (urban) - UNHCR global management

In line with hygiene promotion and prevention measures for spread of Covid-19, the existing handwashing stands were maintained while 844 additional handwashing facilities (HWFs) have been installed and distributed (147 in Kigeme, 100 in kiziba, 42 in Nyabiheke, 85 in Gihembe, 122 in Mugombwa and 235 in Mahama) according to identified gathering areas for many people such as public places, latrines, camp entraces, food distribution corners, marketplaces and offices. For all sites, the maintenance of the existing bathing facilities was ensured, and new showers were commissioned in Kiziba to facilitate personal hygiene of POCs at the rate of 67 people per shower against the standard of 20.

616 additional shower rooms were constructed in Mugombwa, Gihembe, Nyabiheke and Kigeme. In all sites, the package messages for COVID-19 prevention was disseminated in accordance with MoH and WHO regulations. During the mobilization sessions, the messages were disseminated via Public Address systems (PAs) and these hovered around social distancing, increasing handwashing practices and regular wearing of facemask in public. To ensure effective hygiene promotion in the camp, there is a plan to continue establishing/strengthening community health and WASH clubs, if and when covid restrictions are lifted. Continuing the campaigns on best WASH practices, inclusion of WASH activities in Covid-19 prevention measures, management of WASH facilities through promoting ownership and community-based initiatives for WASH interventions are key strategies adopted to ensure sustainable hygiene promotion in the community.

The congestion observed in the camps hinders the practices of social distancing in public especially when delivering WASH servicves. The continuous advocacy for is crucial to overcome the constraints related to limited resources for meeting the standards in WASH. The general community living has not promoted social distance to a great extent.


Rwanda - Refugees and asylum-seekers (urban) - UNHCR global management

The response to COVID-19 in refugee settings focused on internationally known pillars of leadership/coordination, surveillance, risk communication and community engagement (RCCE), infection prevention and control (IPC), entry points, Laboratory, case management and logistics.

At preparedness phase, the operation developed its COVID-19 preparedness and response plan earlier in March before the first case was identified in the country.

For effective implementation of the plan, UNHCR gave green light to partners for urgent local procurement of PPEs and recruitment of additional staff. Activities were conducted in close collaboration with and under the leadership of MINEMA, RBC and district authorities. Technical coordination role was played by UNHCR. In terms of surveillance, the operation relied on various source of information like partners, national authorities, media, etc, RCCE is one of the pillars on which the operation put emphasis: awareness raising messages were spread to PoCs in all camps and transit centres through various means of communication: posters, banners, radio, public address systems, etc by community workers of Health, WASH and Protection partners. IPC measures were also incorporated across all activities in camps: physical distancing, handwashing, wearing mask, advanced distribution of assistance where possible, 2-months medication for persons with chronic diseases, etc. Four (4) quarantine facilities were improvised using existing facilities where possible and relevant (schools in Mahama and Kigeme, a hotel in Gihembe, the Nyanza transit centre for Kigeme and Mugombwa).

In other camps, there was possibility to use district quarantine facilities. All contacts were traced and isolated. Isolation rooms were organised in existing facilities with a total capacity of 84 beds to isolate suspect cases (Mahama: 56; Nyabiheke: 5; Gihembe: 3; Kigeme: 2; Mugombwa: 2; Kiziba: 2; transit centres: 14). Each camp-based health facility also received 2 hospital tents to increase the space for physical distancing or isolation room.

International procurement of medicines, equipment, ambulances, medical supplies including PPEs was launched. This included 7 ambulances, 59 oxygen concentrators, 7 hospital tents, 59 pulse oximeters, thousands of PPEs of different kind, etc. A total of 485,610 reusable face masks were procured locally and distributed to PoCs in 2 rounds (2 pieces/person aged 2 years and above in each round).

Some financial and material contribution were also given by UNHCR to the national response plan. In addition, UNHCR constructed a treatment centre in the district of Nyamagabe and handed over to the government in the interest of refugees and the host community.

Laboratory aspects of the response were managed by the MoH and paid for by UNHCR if needed. In that regard, 129 urban refugees and 8,005 refugees from Mahama were tested as part of the VolRep process. Two (2) testing campaign were organised in Mahama, Kiziba, Gihembe in search of any cluster of transmission in refugee camps. From March to December 2020 a total of 319 positive cases were diagnosed (Mahama: 210; Kigeme: 55; Kiziba: 24; Nyabiheke: 9; Mugombwa:7; Gashora: 5; Kijote: 5; Kigali: 3; Gihembe: 1). Among Mahama cases, 182 were identified during VolRep predeparture screening.

Unfortunately, 2 lives were lost (Gihembe 1, Kiziba 1). Psychological support was given to cases and their family members to reduce stress. Only few cases were admitted in treatment centres. The majority underwent home-based care although feasibility of this strategy remained arguable in congested camps.

Though a feedback mechanism was put in place to hear from urban refugees, we did not get enough information on COVID-19 cases among this group. No information was also shared about them from the CBHI scheme. In terms of impact, among camp-based refugees attack rate was 2.46/1000 while mortality remained approximatively 1 death/70,000.


Somalia

Somalia - Refugees and asylum seekers in Somalia - Emergency response

In Somaliland, a total of 808 households (3,403 individuals) received one-time cash assistance. The beneficiaries were not part of the regular cash assistance programme, and were selected through vulnerability assessments and supported due to loss of livelihoods and other vulnerabilities mentioned in set criteria. To ensure sanitation and hygiene, 1,424 sanitary kits were distributed to the women and girls of reproductive age from 12 to 48 years old through partner DRC in Hargeisa.

In Galkacyo, 160 refugee and asylum-seeker households received a monthly subsistence allowance to respond to COVID-19 challenges to improve the living standard. More than 900 vulnerable households, consisting of 2,083 individuals, also received monthly subsistence allowance in Bossaso field office.

Some 500 refugee, IDP and vulnerable host community households (3,156 individuals) received hygiene kits including handwashing stands, bars of soap, detergent, and reusable face masks. This was done through a whole society approach in north Galkayo, thus protecting their health and ensuring they were able to meet their basic needs.

In South Central Somalia, refugees and asylum-seekers, returnees, IDPs and members of the host community received assistance for their basic needs under the COVID-19 programme: 1,224 women of reproductive age received sanitary kits, 1,200 received hygiene kits, 300 received core relief items and 513 households received unrestricted cash grants.


Somalia - Refugees and asylum seekers in Somalia - Emergency response

In Somaliland, three primary healthcare centres were equipped with medical supplies and laboratory reagents. During COVID-19, hand-washing facilities, PPE and other disinfecting materials were also provided to three primary healthcare centres.

In the Bari region of Puntland, UNHCR facilitated access to free health care services for all refugees and asylum-seekers and supported national health facilities to prevent the spread of COVID-19 and to improve the response to the pandemic. UNHCR, through a health partner, embarked on awareness raising through various methods and sanitation and hygiene promotion. Furthermore, UNHCR supported national institutions by rehabilitating a hospital in Bossaso and constructing quarantine centre and installed 13 hand wash facilities in health centres and reception facilities. COVID-19 awareness campaigns including distribution of leaflets to 2,083 households (6,894 individuals) in Bossaso, Gardo and Garowe. A total of 23 community leaders were trained on COVID-19 prevention and response. Fortunately, there were no COVID-19 cases reported among refugees and asylum-seekers. As a result, protection risks associated with the pandemic were minimized and healthy living and wellbeing was promoted for all.

In South Central Somalia, primary healthcare services provided under the regular refugee programme prior to and during the pandemic were continuously shared under the emergency and regular refugee programme. In addition, UNHCR printed 400 leaflets with COVID-19 messages to create awareness, and procured PPE materials for health workers, CCCM staff and community leaders, and carried out a loudspeaker campaign to disseminate COVID-19 information and reduce infection.

To prevent COVID-19 spread and reduce the risk of infection for returnees, UNHCR provided medical supplies to the waystation in Mogadishu and donated 20 hospital beds and medical supplies to Mogadishu hospitals. A total of 300 refugees and asylum-seekers households received medical kits.


South Africa Multi-Country Office

South Africa Multi-Country Office - Refugees and asylum-seekers (urban) - Emergency response

Social cohesion engagements were among key protection prevention and response activities to strengthen community empowerment and self-reliance.

In the Western Cape, UNHCR’s partner provided nine female community leaders with a small grant of ZAR 2,000 to assist their communities. The proposals were chosen from the many submitted and showed a strong focus on vulnerable women and children who had developed social assistance programmes that included both persons of concern and members of the host community. Utilizing the Together2Learn programme, the partner in Western Cape used DAFI scholars and refugee youth leaders with exceptional academic records to provide physical and online space for youth of different nationalities - including South Africans - in order to access tutoring and peer support during lockdown. The programme was run by four peer mentors (highly accomplished non-national university level students) and 10 tutors (two South Africans and eight non-nationals) delivering 60-120-minute-long tutoring sessions. A total of 46 participants benefitted from tutoring in nine subjects over 78 sessions. Transport stipends and data allowances were provided to facilitate access to the programme and online learning.

In the Northern Cape Province and Mpumalanga, UNHCR engaged with stakeholders in Upington and Kimberley on the importance of fostering positive social cohesion between host communities and persons of concern.

UNHCR’s partner worked in collaboration with Umoja for Africa in Western Cape to manufacture and distribute reusable cloth masks in high-risk refugee hosting communities. This partnership provided a stipend for South Africans and refugee volunteer workers to partake in the project, thereby enhancing social cohesion through training and income-generating opportunities.

Sports-for-Protection programmes were also rolled out through partners COSAFA and Sunnyside basketball club in Nelson Mandela Bay and the City of Tshwane respectively. These programmes promoted the use of sport to bring persons of concern and host communities together: a very powerful tool for promoting social cohesion especially among the youth. Through collaboration with UNHCR's partner in Gauteng, the operational partners Judo for Peace and Xaveri continued to implement social cohesion activities throughout the COVID-19 restrictions. In Western Cape, a theatre collective used members from their youth support groups to put on Kuluna, a play about family, discrimination, freedom, and violence. The narrative focused on a Congolese family living in South Africa. The play was performed at a prominent theatre and a documentary about the film was made.


South Sudan

South Sudan - Refugees and asylum-seekers - Protection and mixed solutions

Through community-based approach, it was possible to construct 2160 latrines without any direct material support. Moreover, through direct material support, 1265 latrines were constructed and made accessible for refugees. During the reporting period, 1142 household latrines were filled up household latrines identified and were decommissioned to avoid any possible cause of disease outbreak of overflowing. And 96% of the refugee households were using household latrines as well.50% of the refugees had access for soap; however, it was only 22% of the household made handwashing practices. And 98% of the refugees were aware of COVID-19 during the year 2020. And 61% of the households were having access to waste management facilities. The construction of 24 VIP latrines were completed at institutions to improve the safe excreta disposal needs. Two flush toilets were constructed at Bunj hospital. And the construction of three placenta pits and two incinerators were completed at Bunj hospital, Gendrassa and Kaya PHCC as well. 16 emergency latrines were constructed more specifically at food distribution centres. It was also possible to train 55 WASH staff on basic hygiene practices and COVID-19 across the camps. Moreover, 20 waste management pits were excavated across the health facilities as well. It was also possible to distribute and install 1252 hand washing facilities


South Sudan - Refugees and asylum-seekers - Protection and mixed solutions

Refugees in Pamir and Ajuong Thok camps were provided with safe water of 23.6 litres per person per day, meeting the UNHCR WASH standard for post-emergency situation. All the 82,094 refugees have access to safe water through 20 motorized boreholes, run by hybrid system of solar power and generators. In addition, 12 handpumps are installed in the two camps as a backup water sources to the main water supply system. In Yida, 8 motorized boreholes (78% solarized) are routinely being maintained by UNHCR and Water Management Committee; and serve 39,386 refugees and over 10,000 host community. In the two camps, refugees’ safe access to water is guaranteed by ensuring 167 water points are functional and located within less than 30 minutes walking distance from each household. Routine water quality monitoring ensured at least 86% of the water have 0.2-0.5 mg/liter free residual chlorine. As part of COVID-19 prevention and control measures, access to water for drinking and handwashing has been increased in health centres and refugee reception areas with construction of additional five waterpoints. In addition, six boreholes were drilled in JamJang and Jau County host community areas, improving access to 3000 people. More than 300 handwashing buckets were distributed to vulnerable refugee households, health centres and other government/non-government agencies.

In Maban, the average daily per capita water access by refugees was 17.01 litres per person per day across the four camps. Three wells were drilled at Kaya camp to ensure the availability of adequate water sources for the camp. Solar system helped to make 35% of the water production across the camps while generator power supported to produce 65% of the water supply to the refugees. Water quality tests were conducted at the water points which more 80% of the samples showed result of free residual chlorine between 0.3- 1mg/lit. The rehabilitation of four solar power systems were done in the camps with target of one per camp. The maintenance of generators, hand pumps, and water taps was conducted to smoothly operate the water supply activities in the camps. The installation of 1.2km water pressure line was conducted in Doro camp to enable more than 1800 refugees and host communities. And 120 WASH committee members were trained across four camps on systems management and sustainability. And 84% of the refugee’s populations were having water storage containers of 10 to 20 liters capacity for safe water management at household level. 100% of the refugees across the camps were collected water from protected water sources.

In Yei AoR, 7 boreholes were repaired. Water quality analysis was conducted for five boreholes in the settlement and water was found good for human consumption. Water purifiers procured and distributed to refugees in Lasu and Yei to enhance access to safe and clean water (621 refugee households in Lasu settlement and 350 refugee housedholds in Yei town benefited). The water management committees around the 7 boreholes in the settlement continued to maintain the boreholes during the reporting period.

Yambio: The project drilled and constructed Yambio COVID-19 Critical Care Centre motorized borehole with depth of 120 meters. This was part of host community COVID-19 response activities and the borehole was handed over to the government/Covid-19 High Level Task Force. UNHCR also drilled and constructed hand pump borehole for Makpandu Community Centre for host community as part COVID-19 response in the community. Constructed 17 Soak- pits at all the water points and the drainage lines for all the water points at Makpandu camp. In addition, the water system at Makpandu health facility was extended. This was to improved hygiene and sanitation around water points.


South Sudan - Refugees and asylum-seekers - Protection and mixed solutions

Primary health care services including promotional, preventive, and curative were provided to the refuges in the camps throughout the reporting period. 129,882 outpatient consultations were made in the four health facilities serving refugees in Jamjang. Through a team of Community health workers who are part of the refugee community, community health services were provided to the refugees at the household level. This made significant contribution to COVID-19 messaging and health education to refugees in the absence of mass gatherings as a COVID-19 preventive measures in the camps. 372 Secondary care referrals were made from camps to Pariang hospital and 3 to Juba for more specialized tertiary medical care. Community and facility-based surveillance was successfully implemented for early detection of any disease outbreaks and there was no diseased outbreak in the camps. The population health indicators of crude mortality rate and under five mortality rates were 0.3/1000/month and 0.7/1000/month respectively which remains within acceptable range. 15% of the outpatients (OPD) consultations in the camps have been to host community. The second round of Indoor Residual Spraying (IRS) was conducted in the camps as malaria prevention and control measure.

Additionally, a targeted distribution of 11,810 long lasting insecticide treated mosquito nets was conducted benefiting 10,245 households in the camps. This has reduced the incidence and morbidity of malaria among refugees in the year.

A total of 308,953 patient consultations were conducted across the four camps. 7812(3%) of consultation was from the host community in Maban. Referral linkages between health facilities were maintained; 794 referrals for secondary and tertiary care were conducted and managed at Bunj hospital during the reporting period. Community based outreach activities maintained and strengthened through capacity building of community health workers, health and nutrition sectoral committee members and care groups. UNHCR and partners conducted two rounds of polio immunization campaigns as part of the National Polio Immunization Days (NIDs), follow up measles campaign integrated with vitamin A and albendazole. This campaign achieved a 109.7% coverage of all under-five children in the four camps, as well routine EPI service maintained.

In Yei, a cumulative total of 2,867 individuals (1,000 refugees and 1,867 host community) were reached with health educations messages including COVID-19 messages at the Lasu PHCC and community while 7,080 medical consultations (2,627 refugees, 4,453 host community) were conducted at the Lasu PHCC by the clinical officers.

10,048 patients (5,468 Refugees and 4,580 host community members) sought consultations for diagnosis and treatment of communicable and non-communicable diseases at Makpandu health facility.

14,654 patients (8,412 refugees and 6,242 host community) were attended to and received health care at the Primary Health Care Centre in Gorom Refugee settlement in the reporting period


Sudan

Sudan - Urban Refugees and Asylum Seekers in Sudan - Emergency response

2020 was a difficult year for education. In Sudan, schools were closed from March 2020 until the end of the year and opened briefly between July and August for students to sit for their end of academic year examinations. Schools opened again briefly in November for exam classes but were closed again by Ministry of Health citing COVID-19 challenges.

Through the cash assistance unit, UNHCR supported 150 Yemeni students with school fees between January and March when schools were operational and enabled the students to stay in school and attend classes. In addition to this, 28 Yemeni teachers received training from UNHCR’s partner Khartoum State Ministry of Education on life skills, Education in Emergencies, psychosocial support, creative thinking and how to establish children’s clubs. 17 students were also supported with tuition fees and allowances in various universities across Khartoum to enable them to continue with their tertiary education.


Syrian Arab Republic

Syrian Arab Republic - Internally displaced and affected populations - UNHCR global management

The health response to COVID-19 in 2020 was challenging given the fragile health system in the country as well as diminished medical personnel and leadership capacity. UNHCR’s COVID-19 response strategy in 2020 focused on: (1) supporting surveillance and referral at 14 existing primary health care facilities in the capital Damascus and in five Governorates (Rural Damascus, Homs, Hama, Aleppo and Hassakeh), 12 basic clinics, and 31 health points embedded in community and satellite centres staffed with 74 community health workers in eight Governorates (Aleppo, Homs, Hama, Tartous, Rural Damascus, Quneitra, Dar’a, Hassakeh). (2) Supporting infection control in clinics and implementing preventive measures in all UNHCR activities for safe access and service delivery. (3) Supporting refugee access to the full package of COVID-19 medical services. (4) Coordinating and collaborating with the health sector as part of the national COVID-19 response plan including through supporting the national health system.

In coordination with the Government and partners, UNHCR Syria:

  • Distributed 483,339 surgical masks, 235,100 examination gloves, 11,189 bottles of hand sanitizer and 1,434 bottles of disinfectant to Government and partner workers and people of concern.
  • 1,000,000 surgical masks and 500,000 FFP2/N95 masks were ordered and will be distributed in early 2021.
  • Provided 63,493 health consultations at medical facilities such as health points.
  • In coordination with the Ministry of Health, provided critical medical equipment such as ventilators and oxygen cylinders worth some $2.8 million to medical facilities. Items delivered included 10 ventilators and 200 pulse oximeters provided to 10 hospitals under the Ministry of Higher Education, 12 pulse oximeters were provided to Syrian Arab Red Crescent clinics, and 1,000 oxygen cylinders were delivered to the Ministry of Health isolation centres in Aleppo, Damascus, Rural Damascus, Hama, Dar’a, As-Sweida, Quneitra, and Deir-ez-Zor Governorates. In addition, 225 medical beds with mattresses and bedding, 225 IV poles and four water coolers were provided to Al Faihaa COVID-19 Centre in Damascus.
  • A further 480 oxygen cylinders, 60 monitors, 300 syringe pumps, 100 hospital beds, 14 computer radiography machines, 20 ventilators, and two oxygen generation stations will be delivered in early 2021.
  • Procured a GeneXpert machine with 100 testing kits and one steam sterilizer to support COVID-19 testing capacity at the Syria-Lebanon border.
  • Provided COVID-19 training to 116 health professionals and community health workers.
  • 203 refugees with COVID-19 benefited from home visits and follow up by 14 medical volunteers and were supported with oxygen cylinders, personal protective equipment and disinfectants.

Turkey

Turkey - Syrian refugees and asylum-seekers - Emergency response

In response to the outbreak of the pandemic in Turkey, UNHCR adapted its response and reached out to the most vulnerable refugees, and in so doing helped to address emerging needs of persons with specific needs. UNHCR launched a one-off emergency cash assistance for the most vulnerable refugees with DGMM, reaching some 80,000 households, and provided personal protective equipment such as masks and goggles for 28 state institutions and hygiene kits to some 160,000 refugees and host community households.

One of the main interventions was DGMM-UNHCR emergency cash assistance during the second quarter of 2020. The assistance targeted 100,000 households of both Syrians under TP and IP beneficiaries as well applicants who were not benefiting from the Emergency Safety and Security Network (ESSN) assistance which assists some 1.7 million refugees regularly. This one-time cash assistance of 1,000 TRY aimed at helping beneficiaries address their most urgent needs during the pandemic. The amount was in line with the similar assistance provided by the Government to the most vulnerable Turkish citizens. The target of 100,000 households derived from an estimated number of refugees of working age and taking into account the households which might have lost or experienced a significant income reduction during this period.

The eligibility criteria agreed upon between DGMM and UNHCR were applied to the lists of potential beneficiaries provided by DGMM and partners, and following data cleaning, verification and cross-checking, UNHCR distributed the cash through the Turkish Post Service (PTT). Out of the total 106,992 households with 499,193 individuals processed as beneficiaries, by the end of the year 79,401 households, over 372,651 individuals, had withdrawn the cash. Amongst the beneficiaries were households which required home delivery because of their specific needs and as required by the pandemic-related measures.

UNHCR conducted a post-distribution monitoring of emergency cash assistance with beneficiary households in three rounds, in July and September 2020, and January 2021. The phone survey of a representative sample of the beneficiary households shows that almost all (97%) reported a positive experience with receiving, withdrawing, or spending the cash. This cash assistance was a key tool during 2020 for the beneficiaries to receive small but much-needed economical support to keep their livelihoods and for UNHCR to reach out to those who are in need.

In addition to emergency cash assistance, UNHCR provided personal protective equipment (PPE) items to 28 state institutions, including but not limited to DGMM, MoFLSS, municipalities, and local governorates. In addition, UNHCR distributed 6.6 million units of items such as face masks, hygiene kits, latex gloves, hand sanitizers, and surface disinfectants, reaching some 159,000 households in 42 provinces benefiting Syrians under TP, those under IP and host communities.


Uganda

Uganda - Refugees and Asylum Seekers in Uganda living in settlements - Protection and mixed solutions

As of December 2020, a total of 555,477 refugee and asylum-seeking children from South Sudan were registered with OPM, out of which the total number of 44,370 include children at risk or unaccompanied or separated children. The existing child protection risks for children from South Sudan remained and have been exacerbated by the COVID-19 pandemic, significantly affecting their wellbeing. The main child protection risks include children being separated from parents, exposure to physical, emotional or sexual abuse, neglect, and other child protection concerns such as child marriage/ teenage pregnancy and child labour.

Within the South Sudanese population, separation of children from family members is a significant concern with a total number of 35,574 unaccompanied or separated children registered in West Nile operations. Government-ordered COVID-19 measures as well as socio-economic constraints within the South Sudanese community have resulted in an increase of long-term separation and child neglect with parents/caregivers unable to return to settlements. Due to staffing and resource constraints, only around 70% of all children under alternative care have been regularly monitored by case workers supported by community-based child protection committee members. Other main risks include exposure to child marriage or teenage pregnancy which was addressed by UNHCR and partners through a multi-sectoral approach and comprehensive case management services. A total of 7,630 children (5,513 newly identified in 2020) received case management services addressing their needs and finding short, medium, and long-term solutions.

The closure of schools and child friendly spaces also led to limited safe access to community spaces for socializing, play, learning and development. Due to closure of spaces as of March, only 1% of all South Sudanese children in the different settlements have had access to safe community spaces for socializing, play, learning activities. In addition, specialized mental health and psychosocial support (MHPSS) services have been limited and often lack a child-focused approach. As a result, the increasing needs of children displaying psychosocial distress and anxiety resulting from measures of COVID-19 containment as well as protection risks have negatively impacted on children’s wellbeing.

Despite the challenges caused by the pandemic, the protection of children was supported through strengthened engagement with the various community-based structures, specifically the child protection committees tasked to identify and monitor child protection risks as well to report children with specific needs to the relevant UNHCR and partner child protection staff. A total of 179 child protection committees have been supported with capacity development activities and material items such as bikes, airtime, weather-appropriate clothing to reach out to children and caregivers and to ensure awareness on COVID-19. Additional, community-based activities such as home play and learning activities were undertaken to meet the psychosocial needs of the children and built their resilience to cope during the pandemic.

UNHCR focused capacity development activities on the shift to comprehensive implementation of Best Interests Procedures and proGres v4 Child Protection module trainings, reaching a total of 407 case managers.


Uganda - Refugees and Asylum Seekers in Uganda living in settlements - Protection and mixed solutions

In the first term of 2020 and before closure of schools to contain the spread of COVID-19, some 459,967 learners (inclusive of 103,122 from the host community) were enrolled in 222 Early Child Development (ECD) centers, 238 primary and 34 secondary schools. The gross enrolment rate (GER) translated to 40% at ECD, 79% at primary and 13% at secondary education. The net enrolment rate (NER) among the South Sudanese was 50% in ECD, 96% in primary and 17% in secondary.

School closures in March 2020 meant children were out of school at all levels. While disrupting learning and resulting in the loss of instructional hours, the protection impacts of the COVID-19 pandemic exacerbated existing vulnerabilities and worsened persistent barriers to education. With support from UNHCR and other development partners, the Ministry of Education and Sports (MoES) developed a COVID-19 Preparedness and Response Plan, inclusive of refugees, to guide the delivery of remote lessons through self-study materials, live and recorded radio lessons, and digital content. At the end of 2020, 478,000 children (49% girls) had accessed distance learning in various forms (home learning materials, radio programmes and payment of teacher salaries continued to support learners facing difficulties in using self-study materials. Upon partial reopening of schools, 12,240 learners returned at Primary grade 7, 2749 at lower secondary and 275 learners at upper secondary level. Some 16% of girls at primary and 20% at secondary that were enrolled before COVID-19 school closures did not return on partial reopening.


Uganda - Refugees and Asylum Seekers in Uganda living in settlements - Protection and mixed solutions

COVID-19 increased gender-based violence risks and, in order to respond, key modifications/adaptations in how prevention and response was delivered had to be undertaken. Increased reliance on community structures as key players revealed a key resource in the community. SASA! and male engagement community mobilisers were trained and capacitated to take on additional roles of case identification, referral and to a certain extent intervention, gradually shifting ownership and leadership from an agency-led to a community-led approach. Door-to-door and peer-to-peer discussions replaced large scale community campaigns. Regular review meetings with community structures offered opportunities for experience sharing, coaching and capacity building as reflections were made on emerging issues and recommendations on remedial actions were made. Rapid assessments demonstrated positive gains in addressing attitudes towards power dynamics in relationships and broader community norms and more resilient refugee communities were evident from the strengthened community responsiveness to gender-based violence, underscoring the empowering outcome of community engagement. Timely response to the reported incidents continued to inspire confidence for more refugees to report cases.

While gender-based violence risks were exacerbated during the COVID-19 emergency, the response to individual cases was optimal with 100% of reported cases receiving at least one form of multisectoral intervention. Referral pathways were reinforced and communicated to beneficiaries to ensure clear understanding of how to access services. Psychosocial support was the most accessed service while the other services were influenced by factors such as delayed reporting, refugees opting not to pursue legal justice, or failure to apprehend perpetrators. Many of these services were accessed at the Women and Girls’ Centres where besides receiving information on various gender-based violence, women also received individual and group counselling as well as skills training and other programmes to help build confidence and resilience. With strengthened community engagement, majority of identification and referral of gender-based violence cases was by community-based structures which made it easier for survivors to report as they perceived the community as being closer to them and more trusted, while accompanying survivors to access service had a huge impact on protecting them from intimidation and stigma and also enhanced communities’ confidence in solving own challenges.

Mainstreaming prevention and response to gender-based violence contributed to the achievement of this objective: provision of locks for toilets; safe location of water points; installation of solar lights; provision of alternative energy; community engagement on location and timing of food distributions and core relief items in ways considered safer for women all contributed achieving this objective; creation of safe environments for women and girls through mass communication and community mobilization including through mobile activities. Survivors of gender-based violence and women at risk received unconditional cash grant aimed at enhancing livelihood opportunities and self-reliance which helped survivors to engage in income-generating activities and meet their household needs hence improved living conditions.

On data management, the operation successfully rolled out ProGres V4 CP/GBV module in all locations and gave numerous trainings and ongoing support to partner staff. However, connectivity remained an ongoing challenge during the reporting period. Consequently, the operation continued relying heavily on Gender-Based Violence Information Management System (GBVIMS) for data and routine monitoring, focus group discussions (FGD), safety audits and partner verified reports to compliment the data.

Focal points for prevention of sexual exploitation and abuse (PSEA) were engaged in creating awareness as well as receive complaints of PSEA. Information, education and communication materials translated into local refugee languages were printed and distributed. At Inter Agency level, PSEA networks were established in all refugee hosting areas under UNHCR’s lead, thereby increasing institutional accountability and strengthening a community-based complaint mechanism.


Uganda - Refugees and Asylum Seekers in Uganda living in settlements - Protection and mixed solutions

A total of 14,678 South Sudanese refugees were registered as new arrivals in the course of 2020 across various settlements. An additional 10,864 new birth registrations were also recorded in the course of the year. This resulted in a total population of 889,054 individuals by 31 December 2020. A total of 37,520 individuals from South Sudan were pending registration at the end of 2020 due to the suspension of registration activities in mid-March 2020 due to the pandemic.

Border closures in March 2020 meant that no new arrivals were officially received in Uganda. However, individuals who were already in the territory continued to be registered by following the COVID-19 registration guidelines once the suspension on registration was lifted. By the end of the year, 96% of the population was individually registered as compared to UNHCR’s original target of 95%.

South Sudanese refugees were also effectively documented in the course of 2020 with 315,396 individuals issued with either refugee attestations, asylum seeker certificates or refugee ID cards. Access to protection, assistance and services was ensured through these documents. ProGres V4 was used as the registration database for South Sudanese and all registration data and statistics were updated and extracted from there.


Ukraine

Ukraine - Internally Displaced Persons in Ukraine - Emergency response

UNHCR reprioritized many of its activities as quickly as possible and dedicated its resources for COVID-19 prevention and response activities on the premise that if the pandemic were to spread in the areas along the contact line, it would have a devastating impact. Those activities were implemented by UNHCR in close cooperation with regional and local authorities and its four project partners. COVID-19 prevention and response activities were instrumental in bringing various governmental and non-governmental organizations/ communities together to enhance protection of conflict affected people in this trying time. UNHCR’s activities included Quick Impact Projects, support to public institutions and support to entry-exit crossing points (EECPs):

Quick Impact Projects: Five UNHCR field offices in GCA and NGCA implemented 17 Quick Impact Projects (QIPs) including six projects implemented at Donetsk and Luhansk NGCA. The implemented QIPs aimed to support and build the capacity of government entities and local institutions in Donetsk and Luhansk regions (e.g. medical facilities in the front-line locations and other social services providers) during the pandemic. The implementation of QIPs was built on UNHCR’s comparative advantage and cluster leadership in the area of core relief item distribution. The majority of projects envisaged provision of personal protective equipment (PPE), including masks, gloves, eyeglasses and gowns, disinfectants and hygiene and cleaning supplies to the institutions serving the population including support with mattresses, blankets, bed linen and towels to the medical and other facilities providing patient care. Some of the projects were focused on improving access to WASH infrastructure and enhancing mobility of social workers by providing bicycles. COVID-19 related QIPs benefited 27,268 individuals, including 17,600 individuals in Donetsk and Luhansk NGCA. In order to support communities living along the contact line during the pandemic, UNHCR implemented smaller Community Support Initiatives (CSIs), with projects for prevention activities (e.g. mask production) and support to community volunteers who bring food/medicine to at-risk people unable to leave their homes (e.g. projects aimed at mobile coverage improvement . In eastern Ukraine, 26 COVID-19 related CSIs were implemented to support communities and projects were implemented in line with COVID-19 protective measures. The initiatives included provision of PPE, masks, sanitizers and other hygiene items, sewing machines and materials for mask production and phone cards. Furthermore, psychosocial support sessions on the coping mechanism in times of COVID-19 were organized on the west side of the contact line in GCA.

In the Kyiv area of responsibility, 33 communities received PPE and basic equipment to sustain their activities (e.g. sewing machines, IT equipment to conduct online activities etc.). UNHCR also provided PPE, washing machines, temperature sensors and other items to 13 safe shelters in 6 regions of Ukraine (2 municipal and 11 run by community-based organizations), which provide support to women in need, persons with disabilities, elderly, gender-based violence survivors and people living with HIV.

Support to public institutions and EECPs: UNHCR distributed PPE, hygiene supplies and bedding (linen, mattresses) to 58 medical institutions (11 hospitals and 47 first aid points) and 25 Departments for Social Protection in Donetsk and Luhansk GCA. Furthermore, UNHCR assisted 40 collective centres for IDPs with 132 kits of hygiene supplies in Zaporizhzhia, Dnipro, Donetsk (GCA) and Kharkiv regions. UNHCR also procured eight large tents to support six entry-exit crossing points. Provision of large tents will enhance EECPs’ capacity for the effective processing of conflict affected population movements through the EECPs.


Ukraine - Internally Displaced Persons in Ukraine - Emergency response

In 2020, a total of 222 people of concern with specific needs benefited from individual protection assistance (IPA) cash in response to increased needs due to the pandemic. Among those, there were 159 women (126 between the age of 18 and 59 and 33 older than 60) and 63 men (47 between 18 and 59 and 16 older than 60 ). 62 (28%) of IPA beneficiaries were persons with disabilities.

Assistance was provided as one-time cash transfer of UAH 7,140 through the Ukrainian National Post Service operator, targeting most vulnerable populations (including elderly, persons with a disability, people of marginalized communities, families with many children, ethnic minorities or those stranded at the EECPs due to closure during the quarantine). UNHCR with support from its partners Proliska, The Right to Protection, Crimea SOS and The Tenth of April conducted identification, verification and approval of the cases through protection monitoring activities and individual assessment interviews. Cash assistance in response to COVID-19-related needs was provided as part of case management, as per standard operating procedures on cash and in-kind assistance. In the process of identification/ interviewing of the beneficiaries’ direct contacts were minimized, in order not to expose them or partner staff to health risks. For the purpose of measuring the impact, only persons with disabilities assisted under IPA cash for COVID-19 have been taken in consideration.

As confirmed through the post distribution monitoring conducted by UNHCR partner Donbas SOS, the IPA cash assistance helped to mitigate protection risks linked to COVID-19 quarantine measures and enabled people of concern to meet their basic needs, especially for food and accommodation when entry-exit crossing points were closed and movement restricted.


Ukraine - Refugees and asylum seekers in urban areas in Ukraine - Emergency response

Services for refugees and asylum-seekers with specific needs remain limited in Ukraine. With the COVID-19 outbreak, conditions worsened and the identified gaps became wider. For example a lack of hygienic items in temporary accommodation centres for asylum-seekers (TACs) posed additional threats to public health. With the quarantine measures put in place by the Government, employment opportunities in the informal sector where the majority of people of concern work became scarce. Persons working in the informal economy could not benefit from the government’s social security support. While asylum-seekers in Ukraine did not have access to free urgent medical care, UNHCR monitored their medical situation during the pandemic and found that refugees and asylum-seekers with COVID-19 symptoms received access to medical care. However, the State did not provide appropriate conditions for isolation of asylum-seekers or refugees with positive COVID-19 results, increasing the risk of contamination for people living in crowded apartments or hostels. Under its assistance programme, UNHCR included medical expenses for asylum-seekers and refugees related to COVID-19 prevention and treatment and simplified its procedures for reimbursement of medical expenses.

UNHCR advocated for inclusion of asylum-seekers and refugees in the Government preparedness and response plan through different instruments, including in the UN Assessment of the Socioeconomic Impact of COVID-19 in Ukraine. UNHCR and partners’ engagement with refugee communities proved essential during the pandemic to ensure access to COVID-19 related information. Innovative communication channels, including chatbot and online channels, were developed so that asylum-seekers and refugees had access to reliable and updated information in a language that they understood, as well as to establish two-way communication and provide feedback on the available assistance. Refugee communities were also mobilized for the production and distribution of face masks, not available at the onset of the pandemic. Persons with COVID-related risk factors (older persons, and those with pre-existing medical conditions) received an additional amount of cash assistance at the very onset of pandemic. In May, UNHCR provided additional financial assistance to cover urgent needs of asylum-seekers and refugees who had been most affected by the socioeconomic and health consequences of the pandemic. In total, 1,271 individuals were supported with COVID-19 related cash assistance. UNHCR also supported refugee families (around 260 individuals) living in TACs with individual hygienic items (including personal protective equipment). UNHCR also provided the TACs with disinfectants for common premises, directly and through mobilization of the private sector (Unilever). An extensive winterization programme was implemented at the end of the year which factored in the findings of the post-distribution monitoring reports conducted after the first wave of assistance, notably the fact that the distributed cash was barely enough to cover food or rent and compensate for asylum-seekers’ loss of income.


Ukraine - Refugees and asylum seekers in urban areas in Ukraine - Emergency response

In 2020, the self-reliance grants programme was adjusted to the quarantine restrictions and the realities of the pandemic. UNHCR provided 34 livelihoods grants (23 business grants and 11 vocational training grants). UNHCR gave particular attention to applicants who demonstrated a clear vision on how to adapt their business activities to the quarantine conditions: 9 out of 11 vocational training grants beneficiaries were supported to cover software development and graphic design courses and assisted with professional equipment for remote studies and further employment.

Following the assessment of the pandemic’s effect on grant beneficiaries, UNHCR provided additional financial support to 33 beneficiaries of the 2018-19 livelihoods programme whose successful projects were negatively affected by the lockdown. This support helped them sustain their businesses during the quarantine. Also, five officially registered refugee businesses received state support during the pandemic. In April 2020, three refugee women, who previously received UNHCR self-reliance grants for sewing businesses, produced facemasks for people residing in the temporary accommodation centres for asylum-seekers, including to the management personnel of those centres, as well as to refugee communities.

The language courses and other life-skills trainings and community activities were moved online to ensure continuity and accommodate the COVID-19 restrictions.


United Republic of Tanzania

United Republic of Tanzania - Burundian refugees and asylum seekers in Kigoma and Kagera Regions - Emergency response

Operational Contingency plan and Camp level contingency plans were developed highlighting roles and responsibilities of all partners for preparedness and response. Weekly coordination meetings were conducted in all camps as per need in collaboration with DMOs, Ministry of Home Affairs and RMOs. Regional and district level meetings were on ad-hoc or need basis. Refugees were included in the regional and national preparedness and response plan for COVID -19. Temperature screening was introduced at the entrance camps along with handwashing facilities.

One temporary isolation facility per camp with the capacity of 19 beds in Nyarugusu, 12 beds in Mtendeli and 10 in Nduta Rearrangement of rooms for isolation was also done. RHUs and temperature screening points at entry points of all health facilities were also installed to monitor temperatures. Waiting sheds were built to facilitate spacing/social distancing during the service provision in all camps health facilities. Partners at health facilities increased the number of clinic days and proposed specific timetable with specific date and time for each villages for RH clinics, and ensuring sitting arrangements at the facilities maintained social distance. Triage system at each health facility in all camps to ensure early detection and referral of cases as well as referral pathway were developed. Incinerators were also constructed in all camps as part of Infection Prevention and Control (IPC) measures.

618 health facility staffs including Government counterparts were trained on disease surveillance in collaboration with R/DMOs. 95 staffs received training on case management, contract tracing, sample collection and transportation and Infection Prevention and Control as part of Rapid Response Team (RRT) for the districts and region. Further, 157 community health workers were trained on community surveillance and awareness. 40 people were trained on safe and dignified burials including 3 were drivers from partners ambulances. 68 hygiene promoters from wash partners were trained to conduct the awareness and sensitization in the camps.

IEC materials were printed in Kirundi and Swahili languages to reach both Burundian and Congolese refugee population. 162,652 IEC materials were printed and distributed at strategic locations in camps. Banners with key COVID–19 messages were printed and posted as well as adapted to respond to the needs of people living with hearing disabilities and children. As a part of community sensitization, public awareness was conducted through partners via PA system with influential and positive messages.
Soap distribution was increased to 500grams/person/month to meet SPHERE standards. 28,832 hand washing facilities were installed in all 3 camps including strategic and public areas.

Essential medicines as well as medical supplies including personal protective equipment were procured for staff, health workers, refugees, and host communities i.e. 1,338 sets of personal protective equipment, 100,000 surgical masks and 14 essential medicines. Further, UNHCR provided 150 sets of personal protective equipment to partners in camps; 150 set of personal protective equipment to Kigoma region, 65 beds and mattresses to refugee hosting districts and capacity building for more than 60 district staff on Case management, Surveillance, IPC and Laboratory handling and sample collection.

Mother MUAC screening approach was introduced where the parent/caretaker of the children below five years in each household was trained on how to measure child nutrition using MUAC and do referral for management of acute malnutrition. 8,567 caretakers were trained and received MUAC tapes. IMAM training in COVID 19 context, expansion of the programme distribution days and increase distribution cycle from monthly to two months distribution cycle.


United Republic of Tanzania - DRC & other refugees and asylum seekers in Kigoma - Protection and mixed solutions

Access to comprehensive Primary Health Care (PHC) and medical referral care services was freely availed to all people of concern. Crude and Under Five Mortality rate remained better than SPHERE minimal standards. CMR and U5MR were 0.23/1000/month (standard: <0.75/1000), and 0.66/1000/month (standard: <1.5/1000/month) respectively. Compared to 2019, there was a slight increase of the mortality indicators amongst the Congolese refugees in Nyarugusu camp. Lower Respiratory Tract Infection is the leading cause of Mortality followed by Neonatal deaths and Malaria. Infectious diseases are the top ten causes of morbidities. Sub-optimal living conditions, challenging WASH conditions, infectious disease burden and limited access to health care could be among the causes of the above described morbidity and mortality pattern.

UNHCR health, shelter and WASH sectors along with partners presented some of the interventions to ensure people of concern are secured during the COVID-19 pandemic. UNHCR along with partners installed handwashing facilities in all health facilities, rearranged isolation room at each health facility as well as conducted temperature screening of all POCS entering the camps and in health facilities. Partners at health facilities increased the number of clinic days and proposed specific timetable with specific date and time for each village, and ensured sitting arrangements at the out-patient department adhered to social distancing guidelines. UNHCR in coordination with shelter sector installed two RHUs at Congolese refugee zone for screening at the entrance of the health facility. A total of 160,774 consultations were made with a facility utilization rate of 2.04%. The average consultation/clinician/day in Congolese population is 23, which is within the SPHERE standards of less than 50 consultation per clinician per day. The proportion of consultations for Tanzanian nationals was 8.5%. A total of 4,967 Congolese refugee patients were provided with in-patient care at Nyarugusu camp health facilities during the same period.

The above health service provision was achieved through five health facilities which were maintained and functional including one main hospital, one primary health centre with 24 hr-Inpatient/Outpatient department (OPD) and maternity services along with three health post providing OPD services supported by UNHCR through its partner. Camp health facilities availed health promotion,

outpatient consultations, routine immunization, in-ward-patients care, minor surgical procedures, medical referrals, reproductive healthcare (BEmONC and CEmONC), HIV/AIDS prevention and treatment, mental health, communicable and non-communicable disease management and nutrition assistance.

Nevertheless, access to health services remains a challenge especially for newly arriving asylum-seekers who walk long distances to seek services. Capacity building was done on COVID -19, drug supply and pharmacy management system and new IRHIS to improve the quality of data and reporting at all health facilities in Nyarugusu camp. Essential drugs and medical supplies were availed continuously for health services of people of concern by UNHCR, in collaboration with other sister UN agencies and other partner organizations. Despite the remaining challenges regarding drug management and availability of stocks, the drug supply management, especially the warehouse and pharmacy drug management, has slightly improved if compared to 2019. Essential medicines and medical supplies were availed continuously for health service delivery to people of concern by UNHCR, other sister UN agencies, and operational partners. The parameters of drug management have been improved and stock supplies of essential medicines significantly maintained from 2019. The inventory verification exercise was conducted twice by MFT and routine monitoring done by public health team.


Venezuela

Venezuela - Refugees and asylum seekers in Venezuela - UNHCR global management

The overall objective of the Shelter and Infrastructure Strategy for 2020 was to contribute to the rehabilitation and construction of community spaces, health-care centres and schools to improve the living conditions and resilience of vulnerable populations. There was a particular emphasis on people at risk of displacement, ensuring that they receive trainings and assistance to improve their housing conditions.

Throughout 2020, UNHCR coordinated with other humanitarian actors, trained 906 people on temporary shelter management, on the best techniques for safe constructions and on how to deploy, assemble and maintain the refugee housing units (RHUs). Apart from the organization of trainings, UNHCR rehabilitated 58 different spaces such as temporary accommodation shelters, healthcare centres, schools, common spaces for the communities and shelter facilities for children, women and elderly. 77,826 people benefited from these rehabilitations.

UNHCR also engaged in the construction or rehabilitation of 28 structures, benefiting more than 160,000 people. All the targets for the impact indicators under this objective were exceeded thanks to all the new projects implemented under the COVID-19 response. This objective and all related actions were developed in line with SDG 11.


Venezuela - Refugees and asylum seekers in Venezuela - UNHCR global management

Based on field needs assessments, UNHCR focused on the distribution of key items other than food among people at heightened need and other affected populations such as people on the move. Items provided included buckets, jerry cans, mosquito nets, kitchen utensils, sleeping bags, solar lamps, mats, bunk beds, foam mattresses, bedsheets, laundry soap, alcohol dispensers, hands-free liquid soap dispensers, repellent, hammocks, body towels, ponchos, shampoo, toilet paper and wheelchairs.

Given the pandemic, many items distributed were those to help prevent the transmission of COVID-19 among target populations and included hygiene kits, cleaning products, soap, masks, gloves and hand sanitizer gel. In prioritized communities and temporary accommodation centres (including PASI), UNHCR distributed masks, gloves, hand sanitizer, toilet soap, laundry soap, spray deodorant, toothpaste, toothbrushes, sanitary pads, condoms, insect repellent and, in certain cases, water purification tablets. Both UNHCR and partner staff carefully abided by biosecurity measures.

UNHCR also distributed food kits, through its implementing partners, to most vulnerable persons, while avoiding overlap with the Government’s own social food programme (Comité Local de Abastecimiento y Producción - CLAP).


Venezuela - Refugees and asylum seekers in Venezuela - UNHCR global management

Amidst the pandemic, UNHCR enhanced its health response ensuring the provision of personal protective equipment (PPE) for communities, beneficiaries, and health facilities, and delivering water tanks for local health facilities. Additionally, the Office rehabilitated communal and local health facilities, provided mobile and permanent hand-washing equipment for community spaces, health facilities, state buildings, and other strategic places.

UNHCR reached 3,854 direct beneficiaries (2,307 women and 1,547 men): 2,132 people received health equipment, 1,585 people received individual assistance, and 137 people received trainings and other type of health-related support. In addition, UNHCR executed a prevention campaign on sanitation, delivering 17 water tanks to health facilities and communal spaces. Though not a direct health intervention, this and the rest of activities carried out by UNHCR and partners responded to a more preventive strategy towards achieving a better response to COVID-19.


Yemen

Yemen - Internally displaced - Emergency response

Throughout 2020, peaceful coexistence with local communities was promoted by UNHCR and its implementing partners. With COVID-19 awareness-raising, cash for work projects, hygiene kit distribution and cash grants, UNHCR brought IDPs and host communities together as part of its plans to promote peaceful coexistence.

Restriction of movements due to COVID-19 affected livelihoods and increased socioeconomic vulnerabilities. Lack of income sources also contributed to increased domestic violence due to financial stress and social pressures. UNHCR implemented quick impact projects (QIPs), such as the production of face masks and sanitizers as cash for work projects for displaced and host communities, and this had a positive impact on social cohesion.

Through its partners, UNHCR trained 137 IDPs and host community members to produce 131,793 face masks. UNHCR provided the sewing machines and raw materials for making the reusable face masks. The masks and sanitizers were distributed to front line workers, most vulnerable IDPs and host communities. Beneficiaries used the sewing machines for other income generation activities where 3,222 IDPs and host community households benefited from the QIPs.

UNHCR promoted COVID-19 awareness through outreach volunteers, new hotlines, and social media posts to improve communication with communities. Awareness-raising sessions on COVID-19 were conducted by UNHCR’s partners, targeting 13,905 IDPs. Additionally, 30,377 posters and brochures were distributed as part of COVID-19 awareness-raising. UNHCR provided a one-off cash assistance payment to 38,020 households in Yemen to mitigate their loss of livelihoods and enable them to respond to COVID-19 preventive measures.


Yemen - Internally displaced - Emergency response

UNHCR and implementing partners covered 382 of 1,594 IDP sites for site coordination and site management. The CCCM Cluster ensured coverage of the IDP hosting sites with the highest population in 8 Governorates: Aden, Lahj, Al Dhale, Taizz, Marib, Hajjah, Al Jawf and Al Hudaydah, and aimed to expand its coverage in 2021 if funding allows.

Fifteen community centres have been built, of which five will be managed by the Executive Unit to serve as service points for humanitarian partners in the area.

The cluster organized a CCCM pre-Training of Trainers, intended to prepare participants for holding training sessions for/with frontline workers and field staff in IDP hosting sites, including community focal points. Elements of remote training were also included in the modules to adapt to the COVID-19 context. The CCCM team also held a training for the Supreme Council for Management and Coordination of Humanitarian Affairs (SCMCHA) on camp administration, coordination, and supervision.

In 2020, the cluster increased its information capacity as partners were able to collect and update multisectoral data for 74% of IDPs in 892 sites across Yemen. In partnership with REACH, the cluster analysed and shared this site-level information in the CCCM site report dashboard. The partnership with REACH and the findings from the site report informed CCCM’s planning, mainly in the following:

  • Site monitoring: methodology development (2020);
  • Communicable disease vulnerability score (April 2020);
  • 2021 Humanitarian Needs Overview (December 2020);
  • Marib and Yemen IDP Location and Flood Susceptibility mapping and analysis (August 2020);
  • Information management (IM) system review (November 2020-January 2021).

The cluster established the referral and escalation system (RES) to track and follow up on sectoral gaps that could not be resolved at the site. Since its activation, 406 gaps were escalated in the RES, 177 of which were resolved. Moreover, the cluster also established the eviction tracker, where partners report active eviction threats. The tool allows the activation of the Eviction Taskforce that identifies solutions to these threats with the authorities, landowners, and stakeholders. In 2020, 111 active eviction threats were reported in the tracker. Throughout 2020, the cluster IM team and REACH provided six training sessions to partners and refresher training sessions to partners on the above tools.

CCCM played a key role in CCCM response in camps by providing timely guidance to partners and coordinating with other clusters; particularly Protection, Shelter, WASH, and Health to ensure complementarity of efforts in good use of limited resources. The tri-cluster maximized results and impact through concentrating the following activities in IDP hosting sites:

  • Analysis and prioritization targeting with regards to WASH and health assistance;
  • Awareness-raising and gap-filling distributions;
  • Community mobilization, participation, and community alert systems;
  • Referrals and coordination (RES);
  • Scale up of infrastructure works (including Cash for Work); and
  • Organizing distribution of emergency assistance as required in all sectors.

Yemen - Refugees and asylum-seekers - Emergency response

In Yemen, displaced communities have been disproportionately affected by COVID-19. Refugees and IDPs were among the first to suffer from COVID-19’s socioeconomic consequences such as (a) limited economic activities, (b) greater restrictions of movement limiting opportunities to find livelihoods, (c) discrimination due to their status as “on the move”, and (d) limited purchasing power to cater for their basic survival needs such as food, hygiene items and medical treatment.

In response to the rising needs, UNHCR provided four months’ unrestricted cash assistance to refugee families in response to emerging vulnerabilities as part of the protective measures implemented by the Yemeni authorities in response to COVID-19. A total of 20,951 refugee families received unrestricted cash under the COVID emergency response. Refugees living in cold zones also received cash for winter to mitigate their risks of contracting COVID-19 and flu during the season.


Yemen - Refugees and asylum-seekers - Emergency response

UNHCR’s efforts to mitigate COVID-19 risks included improving sanitation and hygiene measures in the supported primary health centres (PHCs), capacity-building and training of the health partner personnel and community health workers (CHWs), who provided 10,220 awareness-raising sessions on COVID-19 and distributed information, education and communication materials to 21,433 refugees and asylum-seekers and 8,041 Yemenis.

UNHCR provided personal protective equipment to all partners, and particularly the medical staff in the supported PHCs, ensuring a safe and conducive working environment and continuity of service delivery to refugees, asylum-seekers and host communities. In addition, UNHCR’s health partners provided two months’ worth of medicines to refugees and asylum-seekers with non-communicable diseases and mental disorders, and four months’ worth to those with HIV, which helped to avert overcrowding and further mitigated the risk of spreading COVID-19. Furthermore, UNHCR and its health partners expanded the hotline services by adding two lines for uninterrupted access to phone counselling.

In response to COVID-19, UNHCR donated equipment to two public referral hospitals and national laboratories in Sana’a, and supported four public hospitals in Aden, Lahj and Taizz by providing temporary accommodation for their medical staff.

Community health workers conducted awareness-raising campaigns, distributed IEC materials to 81,057 refugees and host communities in Kharaz camp, Basateen and Mukalla. UNHCR distributed hygiene kits to 8,149 refugee and host community families in Kharaz, Basateen and Al Mukalla, and 1,800 handwashing basins to IDPs in 17 sites in Aden, Lahj, Abyan and Al Hudaydah.

In coordination with the Ministry of Public Health and Population and WHO, UNHCR’s infection prevention efforts targeted refugees and host communities in Kharaz camp, Basateen and Al Mukalla. Community health units established and equipped in Kharaz camp and Basateen for treating mild and moderate cases received 517 individuals (279 refugees and 235 Yemenis) and the ambulance service transported severe cases to public hospitals.

UNHCR’s aforementioned interventions increased the capacity of the public health facilities to respond to COVID-19 cases and reduced the risk of COVID-19 infection among refugees, asylum-seekers, IDPs and host communities.


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