Search Results (52)

Refugee camps have evolved from temporary shelters into permanent, complex urban systems, yet policy models often fail to address their long-term systemic marginality. To bridge this gap, this study conducts a comparative qualitative analysis of three protracted cases in the Middle East: Shatila (Lebanon), Yarmouk (Syria), and Jabalia (Gaza). Using a directed qualitative content analysis, the study evaluates secondary data, spatial reports, and institutional archives across five core System Pillars: Governance Configurations, Legal Regimes, Humanitarian Mediation, Spatial Violence, and Grassroots Agency. Findings show that conditions of urban exception are sustained by a self-reinforcing nexus of these processes. Furthermore, a dual-process model of refugee agency emerges, distinguishing short-term adaptive survival tactics (e.g., informal DIY utility grids) from constitutive practices of urban citizenship that reconfigure institutional aid protocols. In post-conflict contexts, physical destruction is systematically coupled with state-led property legislation to enforce permanent displacement. We conclude that protracted camps must be recognized as dynamic, co-produced urban systems rather than static zones of exception. Effectively breaking cycles of socio-spatial marginalization requires international actors to transition from short-term emergency assistance to rights-based metabolic planning, legal tenure protection, and formalized institutional co-production frameworks. Full article

Access to clean drinking water is one of the main factors influencing public health during humanitarian crises. In the northern districts of the Gaza Strip, long-term warfare and mass migration caused serious damage to the water supply system, cutting off access to drinking water, limiting the availability of fuel and chemicals used for water chlorination, and increasing reliance on intermittent networks and water transportation services. The present study is a descriptive cross-sectional study of water quality and health risks in 11 emergency camps. Water samples were collected from supply points, communal tanks, and household storage containers and analyzed for key physicochemical indicators (pH, turbidity, electrical conductivity/total dissolved solids, residual free chlorine) and microbiological contamination (E. coli and fecal coliforms). Household surveys documented transport and storage practices, perceived service adequacy, and recent gastrointestinal illness. Overall, 35% of samples exceeded WHO microbiological limits; E. coli was detected in 28% of household containers and 24% of distribution tanks. Residual chlorine was <0.5 mg/L in 40% of samples and turbidity exceeded guidance in 18%. Forty-five percent of households reported transferring water using open/uncovered containers, and 42% reported gastrointestinal illness in the previous month, with higher reporting in sites showing microbial contamination. The results suggest that there are significant weaknesses in the source-to-point-of-use system during emergencies. The priority actions we recommend are, restoring residual disinfection; strengthening monitoring at important control points; improving hygienic transport and covered storage; and providing backup fuel and treatment supplies to minimize the risk of waterborne diseases in shelters in North Gaza. Full article

Background/Objectives: Non-communicable diseases (NCDs), including cardiovascular disease and diabetes, present an increasing challenge in humanitarian settings. While healthcare services in refugee camps have traditionally prioritised acute and communicable diseases, the long-term management of chronic conditions remains difficult, particularly among older adults. This study explored healthcare providers’ perspectives on barriers to cardiovascular disease and diabetes care among elderly Rohingya refugees living in Cox’s Bazar, Bangladesh. Methods: A qualitative study was conducted using semi-structured interviews with six physicians working in Rohingya refugee camps in Cox’s Bazar, Bangladesh. Participants were recruited through purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analysed using inductive thematic analysis. Results: Three overarching categories of barriers were identified: service delivery barriers, physical and environmental barriers, and socio-cultural barriers. Healthcare providers described limited diagnostic capacity, restricted medication availability, fragmented continuity of care, transport difficulties, challenging camp terrain, language barriers, low health literacy, and reliance on informal healthcare providers as key challenges affecting long-term management of cardiovascular disease and diabetes. These interconnected barriers were perceived to reduce healthcare access and continuity of care for elderly Rohingya refugees. Conclusions: The findings suggest that humanitarian healthcare systems should strengthen long-term management of non-communicable diseases among ageing refugee populations. Improving diagnostic capacity, ensuring reliable access to essential medicines, enhancing continuity of care, and supporting culturally appropriate health education and outreach services may improve chronic disease management in humanitarian settings. Further research exploring the perspectives of elderly Rohingya refugees is needed to complement healthcare provider perspectives. Full article

Background: The Rohingya refugee crisis is one of the largest humanitarian emergencies of the 21st century, with nearly one million Rohingya residing in overcrowded camps in southern Bangladesh. Women and children face the greatest vulnerabilities, including inadequate access to education and healthcare, which exacerbates their risks and limits opportunities for personal and community development. While international organizations continue to provide aid, resources remain insufficient, particularly in maternal and child healthcare, highlighting the urgent need for sustainable interventions. Objectives: The Hope Foundation for Women and Children in Bangladesh launched a pilot project for the Health Assistant Training (HAT) program to address critical gaps in healthcare and education for the Rohingya community. This nine-month training program equips young Rohingya women with essential knowledge and skills to support maternal health services in both clinical and community settings. Design: We conducted a qualitative evaluation of the HAT Program to explore its acceptance and anticipated benefits for both participants and the community. Methods: The research team used semi-structured interviews, focus groups, and field observations to explore the HAT Program’s impact on young Rohingya women and their community. They analyzed data through thematic analysis, developing a coding framework and identifying key themes to uncover patterns and insights. Results: The results were categorized into four themes: (1) community acceptance of the HAT Program, (2) the HAT Program’s impact on the health assistant trainees, (3) the impact of the HAT Program on the community, and (4) the potential ways to expand the HAT Program. Conclusions: This research underscores the program’s impact on improving healthcare access, enhancing women’s empowerment, and promoting community resilience. By situating this initiative within the broader context of refugee health, education, and capacity-building, this research highlights the HAT program’s potential as a replicable model in Bangladesh and in other humanitarian settings. Full article

Leprosy relief efforts were a key part of the Christian mission of salvation in China. During the Anglo-American Protestant overseas missionary movement in the late 19th and early 20th centuries, many missionaries recorded stories about relief work of Chinese female lepers in Without the Camp: The Journal of The Mission to Lepers in India and the East. First, the missionaries portrayed Chinese female lepers as marginalized figures, symbols of moral suffering and victims in need of salvation, reinforcing their religious mission and humanitarian spirit. Second, through the relief and conversion stories, the missionaries appealed to Anglo-American Christianity to participate in the overseas missionary movement and to fund the leprosy relief cause in China. Finally, the missionaries’ stories of converted Chinese women leprosy victims served as discourses for the spread of the gospel and civilization in China. Full article

This paper examines the sexual and reproductive health (SRH) knowledge, experiences, service access, and unmet needs of Rohingya adolescent refugee girls living in the camps of Cox’s Bazar, Bangladesh. The refugee population in these camps is approximately 1.3 million, with more than half under the age of 18 and girls representing over one quarter of the total. Given the growing proportion of adolescent girls, SRH knowledge and service provision are critical both for the refugee community and for Bangladesh’s broader sustainable development goals. Drawing on direct accounts from adolescent girls and insights from community-based key informants, this research explores levels of SRH awareness, willingness to seek care, encounters with sexual violence, understanding of sexually transmitted diseases, and reproductive health priorities. It also identifies barriers to service delivery faced by healthcare and humanitarian providers. The findings highlight how cultural norms, social constraints, and religious beliefs intersect with structural barriers—including lack of education, financial dependence, gender-based violence, and the need for parental or spousal consent—to restrict access to SRH services. Despite these challenges, some participants reported successfully receiving reproductive health care. This paper calls for coordinated action from the government, humanitarian agencies, and social service organisations to improve both the availability and accessibility of SRH services for adolescent refugee girls. Strategies should include enhanced outreach, culturally responsive engagement, and sustained follow-up care to promote safety, dignity, and well-being within the camps. Full article

Understanding vegetation dynamics and climate variability in the vicinity of Internally Displaced Person (IDP) camps is critical due to the high dependency of displaced populations on local natural resources. This study investigates vegetation cover changes and long-term climate variability around the Sortony IDP camp in Darfur, Sudan, using satellite and climate data spanning 1980 to 2024. High-resolution imagery from PlanetScope and Sentinel–2 Level 2A was used to assess vegetation cover changes from 2015 to 2024, while precipitation, temperature, and drought trends were analyzed over 44 years (1980–2024). Vegetation changes were quantified using the Normalized Difference Vegetation Index (NDVI), and drought conditions were assessed through the Standardized Precipitation Evapotranspiration Index (SPEI) at 6-, 9-, and 12-month timescales. Future precipitation predictions were modeled using the Autoregressive Integrated Moving Average (ARIMA) model. The results revealed a substantial increase in vegetative cover: the dense vegetation class increased by 3.50%, moderate vegetation by 17.33%, and low vegetation by 30.22%. In contrast, sparse and non-vegetated areas declined by 4.55% and 46.51%, respectively. The SPEI analysis indicated a marked reduction in drought frequency and severity after 2015, following a period of prolonged drought from 2000 to 2014. Forecasts suggest continued increases in rainfall through 2034, which may further support vegetation regrowth. These findings underscore the complex interplay between climatic factors and human activity in conflict-affected landscapes. The observed vegetation recovery highlights the region’s potential for ecological resilience, reinforcing the urgent need for sustainable land-use planning and climate-adaptive management strategies in humanitarian and post-conflict settings such as Darfur. Full article

This article presents a comprehensive evaluation of image segmentation methods for monitoring morphological changes in refugee camps, comparing five distinct approaches: ESRI Landviewer clustering, K-means clustering, U-Net segmentation, Meta’s Segment Anything Model (SAM) and ArcGIS segmentation. Using high-resolution satellite imagery from Al-Azraq refugee camp in Jordan (2014–2023) as a case study, this research systematically assesses each method’s performance in detecting and quantifying settlement pattern changes. The evaluation framework incorporates multiple validation metrics, including overall accuracy, the Kappa coefficient, F1-score and computational efficiency. The results demonstrate that ArcGIS’s ISO clustering and classification approach achieves superior performance, with 99% overall accuracy and a Kappa coefficient of 0.95, significantly outperforming the other tested methods. While Meta SAM shows promise in object detection, its performance degrades with aerial imagery, achieving only 75% accuracy in settlement pattern recognition. The study establishes specific parameter optimization guidelines for humanitarian contexts, with spectral detail values of 3.0–7.0 and spatial detail values of 14.0–18.0, yielding optimal results for refugee settlement analysis. These findings provide crucial methodological guidance for monitoring refugee settlement evolution and transition, contributing to more effective humanitarian response planning and settlement management through integrating remote sensing and machine learning technologies. Full article

This study aimed to apply the integrated WASH assessment tool and assess the performance of WASH services in three Internally Displaced Person (IDP) camps in Rakhine State, Myanmar. The tool was applied in a unique non-household setting that is vulnerable to annual storms and storm-induced flooding, while also facing the complexity of political and social constraints. The assessment focused on nine components of the tool: water, sanitation, hygiene, financial, institutional, environmental impacts, technical, social, and climate change. Afterwards, the overall WASH services performance of the three IDP camps was determined. The assessment revealed good performance in water, financial, institutional, and social components across all camps. However, environmental impact, technical, and climate change components showed the need for improvement due to recurrent climate hazards, and their impacts on WASH facilities, such as latrine destruction, saltwater intrusion into handpumps, and increased diarrhea cases. Based on the findings, the study recommends constructing disaster-resilient latrines, reinforcing handpumps with watertight materials, elevating wellheads to prevent contamination, and forming emergency response teams with appropriate training. Overall, Ohn Taw Gyi (South) and Kaung Doke Khar (2) camps had a good level of WASH performance with a 6.38 sum of net scores of components (SAS), and with 6.06 SAS, respectively. Thet Kae Pyin camp had a moderate level of performance with 5.35 SAS. The application of the assessment tool provided valuable data to support evidence-based decision-making. It serves as a useful resource for WASH professionals, humanitarian organizations, and local governments to evaluate service performance and ensure sustainable service provision in their areas. Full article

Background/Objectives: Children that are forcibly displaced are more likely to experience mental health and behavioural challenges than non-displaced populations, including increased risk of anxiety, depression and post-traumatic stress disorder. Building appropriate parenting skills to strengthen the relationships between caregivers and their children in times of war is key to building resilience in children. There is a lack of research on the role of family skill interventions in internally displaced people (IDP). The aim of this study was to assess the potential change in parenting skills, child mental health, and resilience capacity in families living in IDP camps in Kachin State, Myanmar, after taking part in a brief family skill intervention, Strong Families. Methods: An open, multi-site pilot feasibility and acceptability trial was conducted with 100 families. Outcome data were collected prospectively, assessing changes in parenting skills and family adjustment in caregivers, children’s behaviour, and children’s resilience capacities. Families were assessed using three scales, Parenting and Family Adjustment Scales (PAFAS), the Strengths and Difficulties Questionnaire (SDQ), and the Child and Youth Resilience Measure (CYRM-R). Results: Despite being a light intervention, Strong Families produced improvements in the child mental health, parenting practices, and parent and family adjustment skills scales. Improvements were observed in scores particularly for caregivers and children with greater challenges at baseline. Conclusions: The results positively value the importance and feasibility of family skill interventions being integrated into the routine care of IDP families. This advocates for the prioritisation of using such tools for supporting better family functioning and mental health in humanitarian contexts. Full article

Refugee camps are typically designed as temporary sustainable settlements, prioritizing logistics over cultural considerations, which can lead to environments being misaligned with the lived experiences of displaced populations. This study addresses the challenge of traditional humanitarian camp designs that prioritize logistical efficiency over cultural and socio-cultural needs, leading to environments that do not align with the lived experiences of displaced populations. Focusing on the Zaatari Syrian Refugee Camp in Jordan, the research employs a structured questionnaire distributed among 102 households to investigate how refugees have reconfigured the camp’s original grid layout into more cohesive clustered patterns, informed by the principles of defensible space theory. Key findings reveal that refugees actively transform public courtyards into semi-private spaces, driven by cultural imperatives and safety needs. Statistical analyses confirm significant correlations between clustering behaviors and the attributes of defensible space, particularly the zones of influence and boundary demarcation, enhancing community resilience and accessibility. However, the study finds a limited predictive power overall, indicating that while these adaptations are significant, factors such as natural surveillance and territorial behavior do not exhibit strong influences on clustering dynamics. These findings have important implications for humanitarian planning and design. They highlight the necessity for more culturally sensitive and flexible approaches that prioritize refugee agencies and communal identity in camp layouts. This research advocates for a hybrid planning approach that integrates socio-cultural values, promoting resilience and quality of life among refugees. By aligning spatial designs with the social and cultural realities of refugee communities, humanitarian actors can enhance the effectiveness of their interventions, ultimately contributing to more sustainable and inclusive urban environments as part of broader goals related to urban planning and development. Future research is encouraged to explore these practices in diverse refugee contexts, providing further validation of these findings and enhancing the applicability of these design principles in global humanitarian efforts. Full article

This article addresses the development of a human-centered shelter design tailored to meet the specific needs of refugees in the Al-Sahel Region. It focuses on five essential aspects of humanitarian-centered design. The goal is to create a livable unit that accommodates the three distinct phases of an emergency, transitional, and durable situation. We have adopted a non-linear design approach to develop the refugee shelter unit. We engage in discussions with team experts following each data collection phase. The conceptual design of the shelter unit is intended to align with the refugee settlement’s natural growth while maintaining a degree of control over its evolution. We have outlined a spatial configuration for a residential unit designed for three to six individuals and various patio options. Additionally, we have devised plans for an education and healthcare facility, all designed with the same structure to bring a more organized approach to the organic growth of the camp. The design proposal adopts a process-oriented approach, incorporating refugees indirectly in the design and construction of their shelters. While we do not assert that the framework of a ‘refugee camp’ can be sustainable, our goal is to show that its planning, in the absence of alternatives, should adhere to sustainability criteria. Full article

This paper addresses the role that communication and media interventions can play in fostering social cohesion among displaced populations in camp settings through a review of both practical and theoretical notions in this area. The multiple definitions available in the literature on social cohesion do not come to a consensus on what this concept means. Yet, despite this lack of substance, reflecting on social cohesion in contexts of displacement has been a prevalent topic. Horizontal social cohesion, which is critical in protracted situations of encampment, is defined by UNHCR as the bond that ‘hold(s) people together within a community’. While a number of studies have focused on the social connection between host and displaced people, scarce attention has been paid to the dynamics and social fractures among displaced communities themselves. Yet, tensions both within and between groups of displaced people may be equally, if not more important to social cohesion than relationships with other groups. In order to begin to address this gap, a communication-based framework for humanitarian and development work on social cohesion in refugee camps is presented. Ultimately, the aim of this article is to offer a starting point for humanitarian agencies working in refugee camps to articulate the adoption of a communication-driven approach in their social cohesion programming. Full article

Ample scholarship thoroughly documents how modern humanitarian aid enacts legacies of colonialism and processes of Westernization through the imposition of foreign values and promotion of ‘universal’ norms. Extensive research has also explored processes of socio-cultural-moral transformation due to crisis and displacement. This paper extends this work by demonstrating an explicit connection between the two. Drawing on 10 months of ethnographic research that examined how Burundian refugees in Tanzania experience humanitarian social emotional learning (SEL), findings reveal various intersecting lines of crisis in the Nduta refugee camp. This research illuminates how SEL interacts with these lines of crisis to exacerbate intergenerational tensions. The self-centric values promoted through SEL and the pedagogies it employs conflict with the collectivist ethos of the Nduta community, thus breaking the Burundian generational contract of reciprocity, solidarity, and moral responsibility. In this context, SEL operates on conflicting narratives of crisis that clash with generational hopes for the prevention of future crisis in Burundi. These generational fractures are resulting in fears across the Nduta community that the decline of traditional Burundian values and communitarian ethos will not only perpetuate intergenerational experiences of crisis but has also initiated the perceived erasure of their culture and the essence of their humanity. Full article

Violent social and political conflicts have caused several challenges to internally displaced persons (IDPs), especially girls and young women, among which is sexual violence (SV). Despite extensive records on SV in humanitarian contexts, studies to assess the level, examine the disclosure pattern (DP) and evaluate the availability of abortion care in these settings have received inadequate attention. This scoping review sought to synthesise the current African-based research on SV, DP, and abortion and post-abortion care (APAC) in humanitarian contexts. We conducted a systematic search of five databases: MEDLINE, PubMed, Scopus, Embase and Google Scholar, where the articles retrieved met the criteria for inclusion. The review adhered to PRISMA guidelines and the Critical Appraisal Skills Programme (CASP), containing ten questions to help confirm the validity of the research design and the originality of the results in comparison with similar studies. A series of inclusion and exclusion criteria were applied after the search, and 35 eligible articles from ten African countries with evidence of sexual violence, disclosure patterns, and APAC in camp settings were included in the study. Results described situations of SV in humanitarian settings in Africa as “terrible”, “bad”, “an epidemic”, and “severe” as girls were used as sex objects, for profile enhancement and as a weapon of war. We also found that the illegality of APAC in Africa is causing a high occurrence of clandestine abortions in conflict contexts. Disclosing SV among IDPs in Africa did not follow a clear-cut pattern but was generally determined by socio-demographic characteristics. Sexual health is a fundamental right of all, as enshrined in SDG 3, which makes this topic a major public health issue. We therefore conclude that although disclosure may aggravate stigmatisation in some instances due to adverse reactions, it is still crucial to the healing processes. Full article