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Africa’s largest city, Lagos, home for more than 20 million people is as a quiet as never before.  As with many other cities in the world, Nigeria’s economic capital, on the 31th of March entered a two-week lockdown to prevent the spread of the coronavirus. As everywhere across the Globe this will be challenging for local businesses and the broader economy. However, the main concern is that hundreds of thousands of people living in informal housing in Lagos, and having to rely on everyday small earnings, will not be able to make ends meet. Amongst one of the most vulnerable groups living in such areas are internally displaced people who fled from the eastern part of the country due to the Boko Haram insurgency.

This situation where internally displaced people in Lagos will find themselves in is just one of the examples which tells about the challenges displaced population are facing in a COVID-19 crisis. As the UNHCR, the UN Refugee Agency stated, ‘80 per cent of the world’s refugee population and nearly all the internally displaced people live in low to middle-income countries, many of which have weaker health, water and sanitation systems and need urgent support.’Whilst we must be aware of the impact and implications of COVID-19, it is vital that we also continue to pay attention to wider ongoing social and political issues.

Displacement in Nigeria

Photo: some houses of the community of IDPs in Ibeju Lekki district of Lagos, by Samuel Ojima Adejoh

Despite populist discourse about the refugee ‘crisis’ in the West, in fact most of the displaced population are internally displaced within their own country – 41.3 million, compared with the number of refugees – 25.9 million. Around 40 per cent of the number of internally displaced people (IDPs) are in Africa where nearly 17 million people had to flee their home because of wars, violence, and climate change. The Boko Haram insurgency caused mass population displacement, resulting in 2.2 million officially registered internally displaced people (IDPs) by December 2018 with most lacking food and adequate health assistance and shelter. However, this data only covers those who live in refugee camps, and thus there is little known on the number, or stressors in the everyday lives, of IDPs living in urban areas.

Displacement and health

As The UCL-Lancet commission on Migration and Health pointed out, ‘the migration and health are inextricably linked’, and the health needs of refugees and internally displaced people are unmet. While there is emerging research on the issue in refugee camps little is known about the mental health issues migrants experience in cities in Global South, such as the everyday pressures they face, the problems experienced in accessing health care, and the nature and suitability of support from Non-Governmental Organisations (NGOs), the State and wider community groups.

Before the COVID-19 pandemic, we explored everyday experiences of the displaced population in Lagos, Nigeria. We identified the huge impact of adverse living conditions and lack of resources on their well-being. Temporary accommodation is often lacking in safe cooking facilities, toilets, and anti-mosquitos nets. The situation is exacerbated because of the lack of affordable and safe electricity. Also, the safety and everyday life of females in Nigeria’s largest city is impacted because they perceive it is dangerous to go outside their living accommodation in the informal settlements.

There are several camps of IDPs in Nigeria, but many of the displaced people we interviewed mentioned that there are serious concerns relating to camp life. First of all, they said that they wanted their children to have a sense of belonging to a family and to home (even temporal) and live a ‘normal’ life; secondly, some reported safety concerns associated with camps; and finally life in a city provides opportunities to work. Difficulty in accessing these elements of everyday life will only be exacerbated by a COVID-19 lockdown. When most of the international aid resources geared towards refugees are used to support those who live camps, we argue that a more nuanced approach is required, including greater attention to the wishes of the displaced who dare to live independently.

Environmental health conditions 

Living and working conditions are increasingly recognised as important determinants of mental and physical health for refugees and IDPs in camp situations. Nevertheless whilst Crea et al found that in South and Eastern Africa urban dwelling refugees reported higher health and environmental satisfaction than their camp dwelling counterparts, other data remains patchy, even before the current pandemic. For example, recent research by Lehne et al in refugee camps showed that as many as 7 million displaced people across the world have access to electricity for less than 4 h a day, but there is no information about the access to electricity for non-camp refugees and IDPs.

Our research focused on IDPs from the Chibok region currently living in informal urban settlements in Lagos State’s Ibeju Lekki region revealed that urban-based IDPs face many challenges in accessing shelter, food, employment, formal education for their children and affordable health care. Furthermore, they do not receive the same level of support that is provided by the State and NGOs to IDPs living in camps.

These issues are exacerbated by the barriers IDPs face in obtaining energy, clean water and adequate shelter and sanitation, combining to make their living conditions injurious to health. For example, a lack of electricity forces cooking to be undertaken on open fires which increases air pollution, which, in turn, leads to respiratory diseases amongst vulnerable groups. In addition, the use of naked flames in overcrowded and poorly constructed shelters increases the risk of fire. This disproportionality impacts upon women and children as a lack of employment opportunities, the loss of social networks to provide child care and the difficulties IDPs face in obtaining school places for their children, coupled with a lack of safety on the streets, means that they spend the majority of their time at home. Furthermore, our research revealed that often IDPs move on a regular basis in search of accessible energy sources (this may prove impossible in context of lockdown, raising a number of possible issues). This increases their vulnerability as it ruptures any social networks they have developed and provides further barriers to children’s education.

The ability to be with a family, to work, and the most importantly, not to have guards and fences around, and being able to cope with new conditions of life – this is what leads many refugees and IDPs to live beyond the camps, because it is a human right to live independently whether a person is a refugee or not. Our pilot research highlights the importance of developing an integrated approach consolidating the efforts of the communities, NGOs, public health, and international organisations to address the health and well-being issues of IDPs in cities.

Acknowledgments: this work has been supported by the Academy of Medical Sciences GCRF networking grant, project ‘Mental Health and Well-Being of forced displaced persons in African cities.’

About the authors: Irina Kuznetsova, (@irinakuzn) is a University Fellow in the School of Geography, Earth and Environmental Sciences, at the University of Birmingham, UK. Samuel Ojima Adejoh, is a Senior Lecturer in the Department of Social Work, at the University of Lagos, Nigeria. Surindar Dhesi, (@Surin75) is a Lecturer in the School of Geography, Earth and Environmental Sciences, at the University of Birmingham, UK.