June 20th is World Refugee Day. The United Nations explains that, “Refugees are among the most vulnerable people in the world. The 1951 Refugee Convention and its 1967 Protocol help protect them.” This protection includes the right to public relief and assistance, and in that context the UN High Commission for Refugees aims to provide refugees with “clinics, schools and water wells for shelter inhabitants and gives them access to health care and psychosocial support during their exile.” Major physical health problems and symptoms of internally displaced persons in Sub-Saharan Africa included were fever/malaria among 85% of children and 48% of adults.
Many of today’s refugees are located in malaria endemic areas of the world, and movement from familiar areas to uncertainly increases refugees’ exposure to malaria. As the Roll Back Malaria Partnership noted, “exposure to malaria is significantly increased when moving from low- to high- transmission areas, because they have no acquired immunity and frequently little knowledge of malaria prevention or treatment.”
Efforts to prevent malaria among refugees who came from South Sudan in in Northern Uganda is crucial as they experience malaria as one of their major health problems. This led to the provision of intermittent preventive treatment for malaria (IPTc) in two refugee camps among children aged 6 months to 14 years through help from Médecins Sans Frontières.
In Australia guidelines for assessing needs for services for refugees include an emphasis on person-centred care and risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections.” Based on country of origin “refugees and asylum seekers to Australia and includes country-specific recommendations for screening for malaria, schistosomiasis and hepatitis C.” This includes use of malaria Rapid Diagnostic tests.
Efforts to reach refugee populations with insecticide treated bednets can be a challenge. Studies in a displaced persons camp in the Democratic Republic of the Congo found that there was lower access to nets by camp dwelling children than those in nearby settled villages. Considering the high burden of malaria in the area the authors recommended increased attention to net distribution for these internal refugees.
World Refugee Day is a time for people in malaria national control/elimination programs to take note of the refugee and displaced populations within their boundaries and step up efforts to protect everyone.