Public Health Implications of the Internally Displaced People Amidst Covid-19
CHAPTER ONE
Objectives of the study
The main objective of the study is to examine the public health implications of the internally displaced people amidst covid-19. The following are the specific objectives of the study:
- Examine the impact Covid-19 on the Social and Family Support of IDP
- Examine the impact Covid-19 on the Mental Health-Related Lifestyle Changes of IDP
CHAPTER TWO
LITERATURE REVIEW
Effect of covid-19 on Internally displaced persons
Internally displaced people are among those likely to be particularly affected by the pandemic, owing to their circumstances (Adamu, 2020). Pursuant to the 2019 Council of Delegates Resolution 7, “Strengthening implementation of the Movement Policy on Internal Displacement”, all components of the Movement, in line with their respective mandates, will seek to ensure a holistic response to COVID-19 that considers the needs and vulnerabilities of internally displaced people:
- Internally displaced people are more at risk of contracting COVID-19 and are more susceptible to complications, owing to cramped living conditions in camps, camp-like settings and urban slums; poor nutritional and health status; limited access to sanitation, health care and reliable information; lack of support networks; and language barriers and other social and cultural obstacles.
- Many internally displaced people will be disproportionately affected by the economic repercussions of lockdown measures, given their already precarious circumstances and heavy dependence on casual labour and/or external support (from host communities, authorities and humanitarian organizations) to meet their basic needs. As such, they will be even more vulnerable to exploitation and abuse, including sexual violence.
- They may be stigmatized and deliberately targeted due to their contact with foreign aid workers (perceived as carriers of the virus) or because they have come from areas with high infection rates. In some cases, the authorities may use the COVID-19 emergency to introduce restrictions targeting internally displaced people, especially those already facing stigma on the basis of their ethnic, religious or political affiliation(s), arbitrarily limiting their rights. Such measures may also entail camps being turned into de facto detention centres.
- Internally displaced people may experience protracted displacement if plans for their voluntary return or resettlement are put on hold due to restrictions on movement and no support is provided for their temporary local integration. Restrictions on movement may undermine people’s ability to flee violence and find refuge elsewhere in their country or their right to seek asylum in other countries (e.g. blanket border closures and push-backs, in violation of the principle of non-refoulement).
- In some countries, COVID-19 may motivate the authorities to speed up processes that are viewed (or presented) as solutions (including camp closures and relocations) but are not truly voluntary, safe and dignified. Furthermore, some internally displaced people may be compelled to return home prematurely, having lost their livelihoods, or to move away from urban centres where the virus is more likely to spread.
- Restrictions on movement, delays in deliveries of goods (relief supplies and/or equipment), the suspension of livelihoods, food aid, cash programmes and vaccination campaigns owing to reduced access and funds, as well as concerns about the safety of staff working in camps may all hamper the ability of humanitarian organizations to help internally displaced people and respond to sudden and slow-onset emergencies, thereby creating the conditions for new or secondary displacements.
CHAPTER THREE
Materials and Methods
Research design
A cross-sectional study was performed from 1st of March to 18th of May, 2020. Only adults (aged ≥18 years) of Nigerian nationality who were able to provide verbal informed consent were recruited in the study using convenience and snowball sampling methods. Additionally, they were required to be living in Abuja, Nigeria throughout the pandemic period including pre-COVID-19 and COVID-19 periods. The pre-COVID-19 and COVID-19 periods were defined as the period from November 2019 until December 2019, and from January 2020 until February 2020, respectively. To ensure that participants were still living in the city, they were asked to provide the name of the city they resided during these periods in the questionnaire. No monetary rewards were given for completing the questionnaire. The study protocol was approved by the Ethics Committee of Abuja Medical University.
Impact of Event Scale (IES)
Participants were asked to complete an online socio-demographic questionnaire (e.g., sex, age and self-reported BMI) via WeChat and phone interviews. Participant personal information including names was anonymized to maintain and protect confidentiality. Additionally, a modified validated Nigerian version of a 15-item IES with a Cronbach’s alpha of 0.84 was used to assess the extent of traumatic stress (excessive panic and anxiety) including trauma-related distressing memories and persistent negative emotions resulting from the pandemic. The response for each question was scored 0 (not at all), 1 (rarely), 3 (sometimes) or 5 (often), with a lower score indicating a less stressful impact. There were two subscales in the questionnaire, namely, the intrusive and avoidance subscales.
A cut-off of the IES ≥26 was used to reflect moderate-to-severe impact.
CHAPTER FOUR
DATA PRESENTATION AND INTERPRETATION
Results
Participant Characteristics
Of the 400 participants who were invited, 263 participants (i.e., 106 males and 157 females) were recruited into the study with a response rate of 65.8% (Table 1). Those who declined the study invitation (n = 137) provided reasons as follows: no time to complete the questionnaire (60.6%), currently not living in Abuja (n = 9.5%), and not interested (n = 29.9%%). The mean BMI of participants was 22.9 kg/m2, indicating normal BMI. The mean age of participants was 37.7 ± 14.0, and 41.4% were aged between 18 and 30 years. More than half of the participants (74.9%) had a higher level of education. Additionally, 60.8% of participants were married at the time of the study. In terms of employment status, 52.5% of participants had a full-time job, 31.6 were students (31.6%), and 16.0% had a part-time job. The majority of participants (95.1%) reported no religion; a minority followed Buddhism (4.2%) and Christianity (0.8%).
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
Conclusion
The Nigeria government and various state governors face the problem of repatriating displaced Almajiri children in the period of COVID-19 pandemic. Then again, after repatriation, there is no evidence that these children will be resettled with their families. At this time, no one should be displaced or unsheltered, given the risk factor and contagious nature associated with COVID-19. As stated earlier, the plan to repatriate these children may not be the best course of action because it will increase the possibility of infecting people with the virus. A possible measure employable by the government is to round up all the Almajiri children in the states where they are and provide temporary camps. Providing a camp by the state governments will support head counting of the children for proper documentation. Providing camps for the Almajiri children, at the states where they currently are, will help the government in controlling the spread of COVID-19 among the children and to the general population. Camping measures mean that there will be a shelter for the children, provision of food and ultimately medical care. Medical care will be available for infected children or suspected cases if they finally tested positive.
The COVID-19 pandemic was associated with mild stressful impact in our sample; since the COVID-19 pandemic is still ongoing, these findings need to be confirmed and investigated in future larger population studies. Our study managed to capture some immediate positive and negative mental health impacts of the COVID-19 pandemic. Our study has also suggested some important future research areas to assess the impact of the COVID-19 pandemic.
Recommendations
The study recommends that the Almajiri children should receive care within the states they currently live in, and not be repatriated. Unresolved displacement of Almajiri children can only be a risk factor for the spread of COVID-19 and public health.
REFERENCES
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