Long Term Refugee Camps
Original Editor - Patrick Le Folcalvez & Pasala Maneewong
In the context of a refugee camp, a temporary artificial structure by definition, development projects are in theory not possible. Swinging between emergency and post-emergency, the objective must be an appropriate response to basic and specific needs of vulnerable populations. However, in many cases some camps last for years or even decades e.g., Kenya and Thailand, making more advanced actions possible and needed, including setting up rehabilitation and training activities.
Because they are long-term, lasting beyond the initial crisis situation mobilizing the international community, the activities to be developed in long-term camps are even more dependent on institutional donors. It therefore becomes necessary to think about a certain level of sustainability: ability to maintain quality services over time via capacity-building including skills transfer and community mobilisation, but not the involvement of institutional decision-makers or financial viability.
Unlike in the short-term camps, where essential rehabilitation services are directly provided by a pool of specialised volunteers or staff, the services in the long-term camps cannot rely purely on international specialised human resources. Therefore, once this input in short term stage have been given to the target camps, the agencies should consider and reassess the situation of the camps with stakeholders and explore if any potential that the camps to be implemented in the long term. The collaboration between agencies, camp residents and host communities should always keep in mind long-term perspectives.
In such a long-term perspective, the intervention relies on the existing facilities inside the camp and in the host country. As many services as possible should be provided by the refugees themselves, by implementing a community-based approach involving:
- Mapping of the available resources in terms of Health, Psychosocial or Rehabilitation Services in the camps and in the host communities.
- Identification or development of Referral Pathways
- Building Rehabilitation Skills of the Refugee Community
- Identification of volunteers
- Selection of volunteers according to their motivation and commitment, their skills, their links with the target community (some camps include various communities, sometimes using different languages), their personal experience in the disability field, their comprehension level, their stability in the camp, their charisma, etc.
- Basic training of the selected volunteers: Disability issues, Person-centered Approach, Value of rehabilitation services.
- On the job coaching & mentoring of the volunteers, based on their beneficiaries’ needs and the evaluation of their skills.
On a minimum basis, the volunteers should be able to :
- Identify persons at risk of developing a disability
- Identify persons in need of rehabilitation services
- Identify signs of violence or abuse
- Provide basic rehabilitation services, including home adaptations, active exercises, assistive devices
- Refer the person in need of specialized support or services
- Monitor the beneficiaries’ progresses, and report
The community-based approach requires a physical base or bases, according to the population and the geographical surface of the camp, where individuals requiring rehabilitation services can receive advice, orientations and referrals, basic services, technical aids or peer-to-peer exchanges.
These focal points are also the place where the volunteers can gather to exchange experiences, cases studies, and to receive trainings. For example in in Humanity and Inclusion Supported Camps these are ‘Disability Focal Points’.
According to the needs and the available human resources and equipment, these focal points may also host certified rehabilitation workers, such as physiotherapists, occupational therapists or orthopaedic technician.
Note: As much as possible, the development of rehabilitation services should consider including the surrounding host communities, when services are hardly available for them too. In the long-term camps, it often happens that the services are of higher quality and more accessible for the refugees than for the host communities, creating frustrations, rejection of the refugees, and even violence.
As much as possible, the capacity building of the volunteers should rely on recognised academic or service institutes that will provide trainers, training material, coaching & mentoring of the volunteers, certification engaging the recognition of the acquired skills for the volunteers future career either inside camps, when settling back to homeland, or in the host country, and possibly financial support.
In the specific context of refugee camps, the trainers should be carefully selected, considering in priority :
- Their training skills and experience: understanding of training cycle, understanding of adult learning process
- Their intercultural behavior
- Their creativity, to overcome the lack of equipment by adapting locally available resources (for instance home-made assistive devices)
The formalization of the trainings is a must, in order to:
- Promote the new skills and prevent volunteers turnover
- Improve the level of quality of services close to the standard level as much as possible although this context was many limitation
- Encourage the volunteers to invest in a career supporting persons with disabilities
- Facilitate a professional reconversion in host country, third country, or resettlement.
Standard Basic Training on Disability and Rehabilitation are available from various National or International Agencies, providing certificates of either ‘Rehabilitation Agent’ or ‘Rehabilitation Volunteer’ or ‘Physiotherapy Assistant’. In practice, most of these trainings combine physiotherapy, occupational therapy and social skills that can complete in an efficient way, in the communities, center-based treatments.
Following the standard basic training, more and more specialized trainings can be progressively envisaged, considering the:
- Beneficiaries’ needs, in accordance with the “staircase strategy’ (see below)
- Volunteers motivation and results
- Available training resources. As much as possible, local training resources (host country or surrounding countries) will be privileged, as facilitating their adequacy to the context, and the long-term technical coaching and follow-up.
When starting rehabilitation activities in a refugee camp, there is no way of knowing how long the camp is going to exist, or whether funding sources will be stable and uniform. A “Staircase Strategy” is therefore needed, represented by a series of activities that, though time-limited, fit into a medium/long-term plan, including a response to new needs. The steps are climbed progressively and in order, according to the:
- Recommendations from an evaluation or diagnosis at the end of each step
- Needs observed or expressed by the beneficiaries. Prioritisation of impairments may have to be established, considering the ratio impact/investment
- Financial and training resources
Each activity must be self-contained including exit strategies, while preserving/reinforcing the gains from the preceding steps.
- This document presents the physical and functional rehabilitation-specific challenges, principles and recommendations for Handicap International. Above all, it sets out the overall framework within which the theoretical underpinnings of the Rehabilitation Services Unit are applied; the primary objective is to ensure consistency between the association’s mandate and the implementation, in its programmes, of projects falling within the unit’s scope of activities. The secondary objective is to formalise the selection and/or identification of external guidelines for adaptation for internal use.
- This document is a supplement to the above “Physical and functional rehabilitation” policy paper; by itself it is not sufficient. As its title indicates, it focuses solely on physical and functional rehabilitation services inside long-standing refugee camps.