Story of Jamy Story of Bibinoz Jamy is originally from Sierra Leone, now based in Gambia in West Africa with his wife and four children. He has been living in Gambia for more than 20 years. He is a medical practitioner working in a private clinic, and through his profession he faces the challenges of COVID–19 daily when meeting his patients. When Jamy is watching the news, he also becomes aware that all over the world medical care workers are dying from the virus, and that causes fear. Since he is more ex‑ posed to people who could potentially be infected by COVID–19, Jamy is afraid of a higher risk of trans‑ mission. Jamy explains how the limited access to quick tests for COVID–19 makes the situation stressful for medical professionals like himself: “You don’t have the facility where you can test yourself regularly. We have rapid test for malaria. We have rapid test for HIV now, here in Africa, within a few minutes you can have the result. So, this is quite contrasting when it comes to COVID–19. Because it is something new, so we don’t have the facility. So, these are some of the challenges that we have.” Bibinoz, a woman in her fifties, was unem‑ ployed and left Tajikistan for the Russian Federation before the COVID–19 pandem‑ ic. She supports six children. She is a single mother and a clinical laboratory physician by profession. But it is very difficult to get a job in her speciality in the Russian Federation. Her two eldest sons graduated from school and received higher education in Du‑ shanbe, but their diplomas are not recognized in the Russian Federation. They have to study and get their diplomas again. Bibinoz received a temporary resi‑ dence permit and applied for citizenship. She pur‑ chased a plot of land to build a house, through selling her house in Tajikistan. She works as a nanny and does everything to ensure that her children receive a proper education. They had been ill with COVID–19 but had access to medical care when needed. Fortu‑ nately, her efforts to maintain hygiene in the apart‑ ment were not in vain. She and her eldest son do not use public transport. They avoid public places and try to shop early in the morning and at night or on Sun‑ day afternoons. Seeking health care The lower the educational level, the less likely refugees and migrants were to seek health care when they or a family member had symptoms (Fig. 5). The primary reasons for not seeking medical care were fi‑ nancial, fear of deportation, lack of availability of health care or no entitlement (Fig. 6). Such reasons may not necessar‑ ily be specific for COVID‑19 but may reflect more the day to day challenges faced by refugees and migrants to seek care. Residence status was also found to be a factor that impact‑ ed willingness to seek medical care for themselves or for their family members or friends even when they developed COVID-symptoms (Fig. 7). One out of six migrants (290 (18.6%)) without any documentation would not seek medi‑ cal care for COVID-symptoms; this was much less common among respondents having citizenship or permanent doc‑ uments in the country in which they lived (363 (5.9%) and 228 (4.1%), respectively). 12 | Self-reported health status, and seeking health care Story of Sanjib Sanjib, in his thirties, is a migrant originally from Bangladesh who had been living in a Gulf State for the last seven years. His rea‑ son for moving was to get a job to provide for his family. When COVID–19 emerged, his living condi‑ tions became extremely challenging. He had been living in an apartment with people who shared the same story as Sanjib. They were all in Kuwait with temporary documents and were trying to make a living. The crowded apartment made it difficult for Sanjib to follow the restrictions regarding physical distancing, and he also relied on public transporta‑ tion to get to his job. These conditions made it hard for Sanjib to avoid transmission. Even though he tried to cover his mouth and nose, he was still more exposed because of the frequent interaction with many different people. Sanjib has been infected with COVID–19 and fears the consequences it might bring. He worries about his ability to main‑ tain his job and to secure his financial situation.