Refugee Health

In Paul Collier's excellent book "Exodus: How Migration Is Changing Our World”, he considers the impacts on migrants, those left behind, and the indigenous population of the host country. Although we have just defined a difference between migrants and refugees, it might be helpful to consider this classification of the impact.

Impact on those left behind:

While migration can have a positive effect on those left behind, for example through remittances sent to family members, there is little literature on whether this applies to refugees - at least until they become migrants.  Regarding migrants at least and according to the Economist, Nigeria, for instance, got $24.3bn in 2018 from its citizens working abroad, a 24% increase over 2016 and about eight times more than it receives in development aid. That is also more than ten times what Nigeria got in foreign investment in 2018. Senegalese working in Spain send back as much as half of their earnings (helping remittances make up 9% of Senegal’s national income). Not only are such flows far larger than aid, they are also often better spent. There may be negative effects as well, as the elderly, the very young, and the disabled, may be left behind without support from the family member who has left.

Impact on the refugees themselves:

There are some effects that apply to all refugees, others that differ according to their experience prior to and during their journey, and the place where they have sought refuge.

The paper by  UNHCR, summarises the essential needs of refugees: Providing for Essential Needs, as shown in the table below:

The International Federation of Red Cross and Red Crescent Societies has a very informative web site, which includes a section on Migration focusing on issues of relevance to refugees.

Effect on the host country

A paper in the Forced Migration Review by Roger Zetter Are refugees an economic burden or benefit? gives an excellent review and states:

"The notion of the 'refugee burden' has become firmly rooted in the policy vocabulary of governments and humanitarian actors. Understandably, governments emphasise the negative impacts and costs but these, although undeniable and well documented, are only part of the picture....

Thirty years ago ICARA 1 (International Conference on Assistance to Refugees in Africa, 1981) and ICARA 2 (1984) highlighted the 'burden' that refugees place on their hosts: imposing additional costs on already hard-pressed public and social welfare budgets, arresting economic growth, distorting markets, causing environmental degradation and putting political strains on already fragile and conflict-affected countries. On the other hand, refugees also bring economic benefits and development potential - for example, new skills and, above all, expanding consumption of food and commodities such as building materials, which stimulates growth of the host economy. At the same time, the host community may benefit from assistance programmes such as infrastructure and welfare services provided by agencies responding to refugees' needs."

The large influx of refugees due to the Syrian crisis, produced a special set of problems. At the end of 2015, a report in the Bulletin of WHO, said "An estimated 700 000 refugees and migrants arrived in the Europe Union this year and, according to the European Commission, more than three million more may arrive by the end of 2016....Countries already squeezed by the financial crisis are struggling to respond to the health needs of large numbers of refugees and migrants." The report outlines how these countries might prepare themselves to respond.

There is debate in the literature about the impact on the host country.

Economic impact of refugees finds that "the economic impacts of refugees on host-country economies within a 10-km radius of three Congolese refugee camps in Rwanda reveal that cash aid to refugees creates significant positive income spillovers to host-country businesses and households. An additional adult refugee receiving cash aid increases annual real income in the local economy by $205 to $253, significantly more than the $120–$126 in aid each refugee receives. Trade between the local economy and the rest of Rwanda increases by $49 to $55. The impacts are lower for in-kind food aid, a finding relevant to development aid generally."

On the other hand, The Economic Effect of Refugee Crises on Neighbouring Host Countries: Empirical Evidence from Pakistan finds that "Afghan refugees have a strong negative impact on economic growth in Pakistan. The effect holds in both the short run and the long run, suggesting that the influx of refugees lowers real economic activity in the country. Ultimately, the study implies that hosting refugees can never be a boon to Pakistan's economy."

In Asylum seeking: seeing the positive - by Manuel Carballo, International Centre for Migration, Health and Development, we hear that "Much could be gained by if governments would recognize the potentially positive impact of quickly integrating asylum seekers in the community. The global number of asylum seekers is small and the world has already defined their rights.  People fleeing persecution and threats to their lives deserve better, and we should never lose sight of the fact that although some people are clearly more at risk than others, we are ultimately all at risk of becoming asylum seekers.”

Country focus. You can see the UNHCR country focus reports and search for a country of your interest - this link is to the UNHCR Global Reports - Africa. You can also search Refworld country reports here.

We also provide a link to Refugees, migrants and health care in South Africa, explained.

Finally: We need to point out that these few references provide only a snapshot of a very complex situation.