The Lancet’s special issue on Violent Conflict and Health (featured in the last three posts in this blog) includes required reading for refugee professionals examining trends in health-care needs among conflict-affected populations. The article, “Health-care needs of people affected by conflict: Future trend and changing frameworks,” is a collaborative effort between researchers at the UN High Commissioner for Refugees, the London School of Hygiene and Tropical Medicine, and the International Rescue Commission.
Recent trends include an increase in internally-displaced persons and a decrease in refugees — essentially due to an increase in intrastate conflicts. The concept of refugees fleeing across borders to escape wars between armies is old hat. Much more likely now is the armed conflict that happens within regions of countries, leading primarily to internal displacement. The best example of this is in a nation not often thought of in the refugee cannon. Currently, this country in home to the largest displaced population in the world… Give up? Colombia.
Two trends cited by the paper are worth thinking about a little bit: (1) the urbanization of refugees and (2) higher baseline development index of refugees’ countries of origin.
The urbanization of refugees refers to those people who flee their country and settle in cities rather than in refugee camps. You can think of Somalis in Nairobi (Kenya) and Zimbabweans in Johannesburg (South Africa). Here’s a chart from the article showing the trend in the growth of urban refugees, 1996-2008. The aqua bar at the bottom is the number of refugees in camps, the next bar (is that khaki?) is the urban population, and the olive bar is the number in rural areas.
Where Refugees Live
Note the jump in the middle bar between 2005 and 2006 on to 2007. What major refugee crisis was coming to head these years? Well, the second largest refugee population in the world (1.9 million last I checked) was from Iraq, and many many many of those are in Damascus, Syria, and Amman, Jordan. So, the urbanization of refugees is certainly a trend in terms of numbers, but this chart doesn’t really tell us much beyond the fact that the Iraq War resulted in a large urban refugee population in neighboring countries. As Iraqis return home (as many have been doing for a year or so now) we shall see whether the urbanization trend is as strong as this article contends.
My guess is that urbanization of refugees is increasing, but that if you removed Iraqi refugees from these data, urbanization would be increasing at a lot slower rate than it appears here (perhaps at the rate urbanization is increasing in general). In any case increasing urbanization of refugees means that aid groups need to shift their strategies for needs assessment and service delivery; a group of refugees that is living dispersed throughout a city is much harder to find and help than a group living enclosed within the well-defined confines of a camp.
Contrast this with the trend examining the increasing baseline development index of refugee “sending countries” (i.e., the socioeconomic status of places where refugees flee has been increasing over time). Here the authors used the “human development index,” or HDI, presented in the chart below. The blue bar indicates refugees from “low human development” countries, the khaki from “medium and high development” countries.
HDI of Refugee Sending Countries
Here too we should think about how Iraq fits into this trend, as Iraq was a relatively well-developed country until recently. Note the general annual decrease of the blue bars from 1993 to 2008; here it looks like there was a trend before the emergence of the Iraqi refugee crisis, and so these data seem to present a more reliable trend than urbanization.
Note here that the HDI is a measure of countries, not people. This matters becasue it’s often the poorest who become refugees. For instance, Sudan has a moderate HDI (lots of oil, decent roads in the north), so the destitute farming refugees from Darfur or the rural cattle herders from the South would be evidence of this trend. It’s not the case that refugees are getting richer, only that the nations they flee from are richer. Indeed, there may be evidence in there somewhere for the hypothesis that an increasing income gap between richer and poorer is an important predictor in modern refugee-producing conflicts.