Despite Kenya’s generosity in hosting Somali refugees, their presence has recently beenseen as problematic by the Kenyan authorities. In the wake of the 2011 Kenyan army offensive against Al-Shabaab in Somalia, Kenyan authorities began proposing the repatriation of Somali refugees. A Tripartite Agreement signed on 10 November 2013 by Kenya, Somalia and UNHCR outlines the practical and legal procedures for the voluntary return of hundreds of thousands of refugees to Somalia.
Médecins Sans Frontières (MSF) was present in the Kenyan camps between 1991, when they were established, and 2003. Since 2009, MSF has again been working in Dagahaley camp. In 2013 it conducted a survey in its health facilities to highlight the living conditions and health issues experienced by refugees, as well as their views regarding possible repatriation to Somalia.
The overall result was to show the extremely poor living conditions experienced by refugees, and especially by those who settled in the camp after 2011, when the violence and the nutritional impact of the drought in Somalia created huge increases in the numbers of Somali refugees. These living conditions appeared to be worse than the ones experienced by the refugees who arrived between 2007 and 2010, when growing insecurity (stemming from confrontation between Al-Shabaab and Ethiopian and Somali troops) and burgeoning drought conditions in Somalia triggered new waves of displacement. They also appeared to be worse than the conditions of those who arrived before 2006, when the camps were more or less stabilised.
Living conditions and health status
Although Dagahaley (Dadaab) was initially planned to hold 30,000 people, they currently host 100,776 people and the consequences of overcrowding in terms of shelter, water, sanitation and living conditions are naturally problematic.
The survey showed that the later refugees arrived in Dagahaley, the more likely it was that their housing unit would not offer adequate protection against the rain. The reasons for this difference are likely to be rooted in the diverse settling processes of Dagahaley refugees. Late arrivals are more frequently settled in housing units built with scavenged material rather than shelters made of UNHCR-provided raw material, with the latter offering more protection against rain than the former.
A higher percentage of those who arrived after 2011 also lacked access to water and latrines, probably because most post-2011 arrivals settled on the edges of the land granted to UNHCR. These areas lacked (and still lack) essential infrastructure such as latrines and boreholes. Similarly, access to water is also uneven across the camp, with later arrivals similarly disadvantaged, meaning that the same groups were likely to have not only poor shelter but also poor access to water and sanitation.
In addition, the proportion of respondents asserting that they had enough food was lower among those who arrived after 2011 compared to those who arrived before 2006 and between 2007 and 2010. Finally, self-declared health status appears to be significantly related to the time of arrival in Dagahaley, since the percentage of interviewees reporting themselves to be in ‘average’ or ‘bad’ health was higher among those who arrived in 2011 than among the pre-2010 arrivals. This perception is consistent with the aggregated medical data reported by both MSF teams in the field and survey respondents. But how does this reality affect the intentions of the refugees to return?
Intention to return
Overall, there is a negative correlation between the extremely poor conditions and the intention to return; counter-intuitively, experiencing bad living conditions appears to weaken, rather than reinforce, the intention to leave the camp and return to Somalia. Only 20% of respondents declared they were ready to go back to Somalia under present conditions in Somalia. The intention to return related to a number of factors and it appeared more frequently among refugees experiencing better living conditions in terms of security and access to water and latrines than among those worse off.
Among those feeling safe, 21% were willing to return, while only 14% of those not feeling safe were. Similarly, 21% of those with access to latrines and 20% of those with access to water were willing to return, and only 8% of those without access to latrines and 13% of those without access to water were willing to return.
Looked at from the point of view of the refugees, the correlation between better living conditions and the willingness to return appears rational. Dagahaley inhabitants weakened by lack of access to essential services such as food, water and health care are likely not to have the material and inner resources allowing them to return to Somalia. On the other hand, refugees who are ‘well-off’ in terms of assistance may at least consider travelling home.
This consideration is naturally only one among several that residents in the camp will be taking into account but nevertheless these figures invite one main conclusion: that the worse off the refugees are, the less likely they are to repatriate voluntarily.
Caroline Abu Sa’Da firstname.lastname@example.org is Head of the Research Unit in Médecins Sans Frontières Switzerland. Sergio Bianchi email@example.com is Researcher in Médecins Sans Frontières Switzerland www.msf-ureph.ch/en
The assessment upon which this article is based is available upon request from the authors.
In the first two weeks of August 2013, 1,009 adult patients and patients’ carers were interviewed.
The Chi-Square test with a confidence interval of 95% was used to verify the existence of statistically significant relationships.