In Dagahaley, where MSF runs a mental health clinic as part of its 100-bed hospital, the number of attempted suicides is rising, and psychosocial consultations have jumped by more than 50 per cent from last year, from 505 to 766, over the same time period until September. In the last two months, five people have reportedly attempted suicide in the camp, two with fatal results.
MSF teams provide medical treatment for patients with various mental illnesses, including depression, schizophrenia, personality and anxiety disorders.
Many refugees in Dadaab were already frustrated with the lack of progress in finding durable solutions. Now they are faced with the new challenges related to the COVID-19 pandemic, as the meagre humanitarian assistance they depend on has been further reduced amid donor concerns of widening funding gaps. The World Food Programme has been forced to cut food rations by 40 per cent and many other agencies have drastically reduced their presence, severely disrupting access to basic services.
These cuts in food rations, along with a lack of gainful employment and ever-present uncertainty about the future, have created a new mental health crisis.
The number of refugees being resettled from Kenya had already slowed to a trickle even before COVID-19; now it has almost completely stopped. Returning voluntarily to Somalia, where insecurity is widespread and the health system is deeply stretched, seems even less of an alternative for most camp residents. As of August this year, UNHCR had reported no returns from Kenya to Somalia. The promise of local integration for refugees has also gradually dissipated as initiatives to extend state services to refugees remain stalled.
In August, Haret Abdirahman’s 24-year-old son took his own life in Dagahaley camp, after struggling with a lack of future prospects.
“Despite finishing his high school education, he kept talking about how life was difficult for him in the camp without a job. He would often say that he wished he could take his own life, but I never thought he would actually do it,” says Abdirahman.
No durable solutions in sight
“COVID-19 has ended what little chance refugees had of escaping the degrading circumstances in the camps, compounding the mental distress for many who had nothing left but hope to cling to,” says MSF project coordinator for Dadaab, Jeroen Matthys. “We are seeing a groundswell of desperation in the camp.”
The after-effects of COVID-19 will likely deal a severe blow across societies and poor and marginalised Kenyans will not be spared. But refugees, even those with access to some form of humanitarian assistance, remain extremely vulnerable, and the slightest shock risks upending their lives completely.
“As the Kenyan government draws up COVID-19 recovery plans, integrating refugees’ needs would represent a resounding acknowledgement of its commitment to seek a permanent solution for the forgotten refugees of Dadaab,” says Dana Krause, MSF Head of Mission. “For donors, there has never been a more apt moment to demonstrate international solidarity with refugees, and they must fully share responsibility with the Kenyan government, not only through financial commitments, but also through restoring resettlement and complementary pathways for refugees.”
MSF in Dagahaley
MSF has been providing healthcare to refugees in Dadaab for most of the camp complex’s existence. MSF's health services are open to host communities and are a crucial lifeline for unregistered refugees who are denied access to basic services in the camps. MSF’s current programmes are focused in Dagahaley, where it provides comprehensive primary and secondary healthcare to refugees and host communities. The medical services include sexual and reproductive healthcare, medical and psychological assistance to survivors of sexual violence, mental health care and palliative care.