Likewise, alternative arrangements should be made to maintain asylum activities if reception centres
are repurposed for the COVID-19 response.
◼
Ensuring border controls balance needs to control COVID-19 transmission and protect peoples’ right to
asylum so that entry is safe for everyone.91 People fleeing war in an epidemic still need protection,
regardless of real or perceived fears of COVID-19. For undocumented refugees, every effort should also
be made to enable temporary amnesties to access health services without putting refugees at risk of
being arrested or deported. These measures will require cross-sectoral and multi-level responses to
protect the lives and futures of forcibly displaced persons.
Use research to tailor responses: COVID-19 responses should incorporate social science research and
vulnerability assessments to adapt interventions and ensure they reflect the diverse realities and political
contexts of displacement. Research in previous epidemics has highlighted the critical importance of
understanding local social responses to the epidemic, consulting people affected by interventions to find the
best ways of adapting them, identifying response priorities including non-medical needs, and engaging
representatives who are trusted by communities in decision-making.90,92-94 Research can also be used to
identify local groups and individuals best placed to overcome political tensions driving armed conflict, liaise
with international aid groups and provide local insight to the vulnerabilities that standard approaches are
not addressing.85 Special care should be taken in a remote programming approach to monitor power
relations and intervention effects on frontline workers.95-96
Adopt a whole-of-society approach to COVID-19: The WHO emphasizes a whole of society approach to
control COVID-19.83 In settings of forced displacement, this means that:
◼
Multiple sectors and stakeholders should be involved in the response, including the various and
legitimate forms of local authorities (such as elected representatives, hereditary chiefs, religious and
civil society organisations) which govern displaced populations and enable coping and participation in
social life. Bypassing or discrediting them could otherwise have damaging effects in post-pandemic
times. Initiatives which value the skills and context-specific knowledge of displaced healthcare providers
to engage with patients who are similarly displaced can potentially be powerful in an epidemic like
COVID-19, where trust and localisation are key to successfully implementing any public health measure.
◼
Perspectives from different forms and waves of displacement should be welcomed. Partnerships
encouraged with diaspora and local groups involved in humanitarian response in ways that the
comparative advantages of these actors are complemented and built on for the benefit of all.97 Involving
diaspora and refugee-led groups may be especially important to improve support to displaced people
not living in formal settlements, though care should be taken to understand who certain groups
represent, whose voices may remain marginalised within these structures and how strategies can be
adapted to reflect the diversity of forcibly displaced people within and across borders.98-99
◼
Coordination between different types of actors should be supported. While not always possible in
conflict settings where IDPs flee government persecution, coordination between governments and civil
KEY CONSIDERATIONS: COVID-19 AND FORCED DISPLACEMENT IN THE MIDDLE EAST AND EAST AFRICA
Contact: a.wilkinson@ids.ac.uk
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