Resilient public health in the context of large-scale, drought-related migration in East Africa

Abstract

GREEN, AIR, LMIC: PECHAKUCHA COMES TO ISEE! Johan Friso Foyer, Floor 1, August 27, 2019, 10:30 AM - 12:00 PM Background/Aim: Millions of people are at risk of famine in East Africa, due to droughts and environmental degradation. Driven by climate change and political instability, people are forced to migrate in order to survive. This places a severe burden on public health systems. Our project aimed at identifying knowledge status and needs regarding climatic and environmental changes, their impacts on migration and, subsequently, public health in Ethiopia, Somalia and Kenya. Methods: In 2018, we synthesised documentary evidence from international and national sources, and conducted interviews with 39 stakeholders from the three countries, recruited by eight in-country colleagues, and representing different organisations and academic fields. Preliminary findings were discussed and validated at a stakeholder workshop in Nairobi. The three final country reports included recommendations for building climate-resilient health services in East Africa. Results: In East Africa, droughts and floods are becoming more prolonged and widespread. Climate change, overpopulation and land degradation threaten the livelihoods of farmers and pastoralists, and lead to large-scale displacement. Refugee camps in Kenya and Ethiopia accommodate up to several hundred thousand cross-border migrants, while several million internally displaced people (IDPs) settle informally in urban areas, particularly in Somalia. Knowledge gaps exist in particular regarding the health status and needs of IDPs, while there is better coverage for cross-border migrants. Migrants’ mental health needs are reportedly enormous, but these are poorly understood and scarcely addressed. There is also an ongoing urgency to engage affected communities in needs assessments, and to conduct high quality evaluations of health interventions targeting IDPs and cross-border migrants who have been displaced long-term by droughts. Conclusions: IDPs, pastoralists and ethnic minorities appear to be the most vulnerable groups. Cross-border and cross-sectoral collaboration is necessary to build resilient public health systems to serve migrants displaced by droughts and floods in East Africa.