I'm going to hazard a guess. If I mention Somalia, you'll think of warlords and pirates. Because that's what the media headlines have highlighted. What's garnered less attention, however, is the impact that the Somali crisis is having on the wider region of East Africa and neighboring Kenya in particular.
Kenya is now home to more than 320,000 refugees. These individuals have fled conflict or persecution in around a dozen different countries, but it's safe to say that the overwhelming majority are from war-torn Somalia next-door.
What’s life really like in a refugee camp? Well, Kenya is a good place to find out – it currently plays host to at least 320,000 refugees, from Kakuma camp in the drought-prone northwest to the massively overcrowded Dadaab camp in the east. Men, women and children all try to go about their daily lives, coping with cramped living conditions, water shortages and the grinding drudgery of having your independence taken away. (Zoriah/www.zoriah.com)
Somali women walk with their empty containers to collect water in the dry conditions of Hagadera, Dadaab. The area is now home to around a quarter of a million Somalis who have fled ongoing fighting at home between the government and Islamic insurgents. The camp population is more than double the expected number and essential resources such as water are in tight supply, despite new boreholes dug by aid agencies. The area simply can’t cope with so many people. On average, a refugee in Hagadera gets around 16 liters a day. (To put that into context, imagine having the capacity of eight plastic fizzy drink bottles for drinking, cooking and washing.) (www.markmuinde.com)
Dadaab’s population also increases by 500 to 700 babies a month. Here, a mother and newborn baby rest in the maternity ward of the International Rescue Committee’s hospital in Hagadera, Dadaab. Refugees and local Kenyan-Somalis can use the hospital and its dedicated ante-natal services, but many Somali women are reluctant to have caesarians due to cultural beliefs. This is placing some mothers and babies in danger, as both become exhausted and weak during difficult births.
Many of the new refugees turn up fairly dehydrated and malnourished – for example, in Dadaab many have walked more than 80km under a hot sun. Young children are particularly at risk, so they receive special nutritious food to help them regain the vital vitamins and minerals they may have lost. Some of this food comes in small foil packs, meaning mothers can open them and give them to their children straight away. In Kakuma, an area frequently hit by drought and poor harvests, local mothers can also receive help for their children. (Nancy Farese)
Refugees who have been in camps like Kakuma for years, build themselves relatively sturdy homes out of mud bricks, supported by wooden poles. The roofs – as in this photo – are often ingeniously made out of giant tin cans that once contained the likes of cooking oil. The cans are pummeled flat and made into ‘tiles’. (Nancy Farese)
Newly arrived refugees have to make a shelter from whatever they can find. Once registered, they will receive wooden poles and plastic sheeting to make a more weatherproof structure. (Nancy Farese)
With hundreds of refugees using food or healthcare services every day, keeping track of everyone is an essential but time consuming process. Especially when everything is written down by hand! (Nancy Farese)
And with so many languages spoken – Kakuma is home to refugees from more than eleven countries – doctors and nurses often work alongside a translator to ensure a patient’s needs are fully understood. (Nancy Farese)
Measures by IRC nurses to keep young children healthy are not always appreciated by their young patients!
When tens of thousands of people all live in very close proximity – and with limited water supply and toilets – there’s a much higher risk of infectious diseases such as cholera or tuberculosis spreading quickly. Health organizations therefore try and raise awareness about these diseases, how to prevent them and where to go for potentially life-saving treatment. The IRC recently conducted a polio mass immunization campaign for 13,173 children in Kakuma camp, as well as 5,683 children in Turkana. (Nancy Farese)
Dadaab camp in eastern Kenya alone currently houses more than a quarter of a million refugees. Virtually all are Somali. Even though the official Kenyan-Somali border is closed, more than 60,000 Somalis crossed into Kenya last year and the influx has continued apace in 2009.
The refugees are fleeing vicious fighting between the government and Islamic insurgents, severe food shortages and recurrent drought that has decimated livestock. In Dadaab, they find relative safety and humanitarian aid, but they also find overcrowding, water shortages and increased exposure to contagious diseases such as cholera and measles.
Dadaab's camps were built for an initial population of 90,000. They now house almost three times that number. In Hagadera camp, Dadaab, the hospital and four health clinics operated by the International Rescue Committee (IRC) have been working hard to contain a recent outbreak of cholera - a highly contagious disease that can kill in a matter of hours.
"To date, the number of cases in Hagadera has been small - just 26 - and we have managed to contain the outbreak, but resources in the camps remain massively overstretched and provide ideal conditions for diseases like cholera to keep coming back," says Dr Vincent Kahi, the IRC's health coordinator in Kenya. "All agencies in Dadaab are doing their best, but the sheer number of people in such a small space and in an area with water scarcity is a recipe for future problems."
Drawn-out discussions between the Government of Kenya and the United Nations High Commissioner for Refugees (UNHCR) have yet to find a solution. There's talk of a fourth site in Dadaab being opened to ease the overcrowding, as well as moving tens of thousands of refugees west to Kakuma - a camp formerly established for Sudan's Lost Boys in the early 1990s. But this latter option would be massively expensive and would take a mammoth coordination effort as it's a three-day trip over some pretty atrocious roads from east to west.
So while the talks continue, so does life in Kenya's camps. Aid agencies in Kakuma have been working with the Ministry of Health and the UN to vaccinate children against polio, after the potentially-paralyzing disease reared its head again in the region after decades of dormancy. In Dadaab, a similar campaign to vaccinate children against measles is ongoing.
The UN has estimated that it will need around US$91 million this year to improve conditions for existing refugees in Dadaab and provide aid to new arrivals. It's a daunting task ahead and one that won't get any easier until an agreed solution to Dadaab's dreadful congestion is found.
Check out the International Rescue Committee here.