the gates, however, created new protection challenges as people living in these sites are dependent for their survival on UN staff and humanitarians trucking in food and water. Surveillance effects at borders: Use of security surveillance resources to enable the crossing of borders have also affected vulnerabilities. The border between North-West Syria and Turkey has been closed to Syrians seeking refuge in Turkey since 2016. However, exceptions have typically been made for patients with critical conditions like cancer to seek medical care.66 In March 2020, lockdown measures implemented by the Turkish government mean that crossing the border is no longer an option for Syrian patients, which threatens transnational health seeking practices that have developed over time.67 This measure is particularly affecting people recently displaced by the military campaign on Idlib by Russia and the Syrian government. Here, health facilities have been bombed, but the violence and politics of the conflict means that Damascus is also not available as a safe space, leaving most patients in North-West Syria stranded without access to specialised healthcare. In most countries of East Africa, screening and quarantine measures were implemented early on in the epidemic to enable migration and control potential transmission from international travellers as well as large numbers of lorry drivers bringing in essential goods. The same sorts of provisions have not always been made available to forcibly displaced people. Partial or complete border closures affect asylum-seekers in all countries of the Horn of Africa and Great Lakes Region with refugee registration processes typically only available to asylum-seekers already in the country.14 In Uganda, some refugee reception centres have instead been converted into COVID-19 quarantine facilities to serve refugee and host area populations.40 Migration at informal border crossing points has nevertheless continued both by people who are already registered in camps and those who intend to. Elsewhere, border lockdowns have reinvigorated the smuggling of people and cash as a source of military-security income.68 Without registration, asylum-seekers do not have access to services provided by UNHCR and its implementing partners including food and healthcare. They can also not register for telephone sim cards to communicate and receive mobile money transfers. Moreover, border closures prevent the sorts of ‘self-reliant’ transnational economic activities that people claiming refugee assistance are not supposed to engage in. While in early June, the Ugandan government lifted most lockdown restrictions on movement to enable commerce in the centre of the country, including the capital, they remain in place in rural border districts where most refugee settlements are located.14 Surveillance of strangers: In refugee settlements in Uganda, there is an understanding of why people who have crossed borders during the lockdown need to ‘hide’ in the community, but there is also fear that those migrants may facilitate the transmission of COVID-19. Groups of refugee youths are now patrolling informal crossing points at rivers and in forests in Adjumani at night when Ugandan border authorities are not active, and settlement residents are reportedly highly attuned to the entry of strangers into the settlements. Such an improvised ‘surveillance’ system, which primarily aims to identify (and punish) outsiders who pose a risk of disease transmission –rather than to identify symptomatic cases as in public health strategies– has emerged during many other epidemics on the continent, including during the West African Ebola crisis. 69 KEY CONSIDERATIONS: COVID-19 AND FORCED DISPLACEMENT IN THE MIDDLE EAST AND EAST AFRICA Contact: a.wilkinson@ids.ac.uk 13