View Flash version: Anatomy of a refugee camp

Introduction
Every refugee camp is different since every situation is different. In most cases, proper design of a camp isn't possible because refugees have already settled on a site.

In this case, aid agencies look at how to improve the camp, or decide if the population should be moved somewhere else.

Population
The number of people living in a camp depends on the crisis. When the number of refugees is in the hundreds of thousands, aid agencies try to set up a few smaller camps with populations of no more than 20,000 rather than one massive camp. Smaller camps are easier to manage when it comes to fire risks, security problems, the spreading of diseases, etc.

Location
Camps are usually located on the edges of towns or cities in a secure area, away from the border, war zones and landmines. The camp should be set up on sloped terrain that provides natural drainage. It should also be away from breeding sites of insects that can carry disease.

Length of Stay
Camps are only meant to be temporary solutions, giving refugees a place to live until they can safely return home. They are not meant to be permanent residences. However, organizers have learned to plan for the long haul because refugees often end up living in the camps for much longer than expected.

In Albania, refugees from Kosovo lived in camps for only three months, while refugees from Somalia have been living in camps in Kenya since 1991. Palestinian refugees have been living in camps in Lebanon for more than 50 years.

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Gates & Security
In general, security is the responsibility of the host government, which guards camps using its military or local police. In many camps, they work along with the refugees to have some sort of self-policing mechanism. Security is especially a problem in camps that are not closed in by a fence. Because refugees don't have a lot of possessions, security is usually a question of ensuring personal safety to prevent crimes against people, such as the rape of women. Aid agencies also try to maintain camps as civilian institutions. Governments complain that camps are used by rebel soldiers for rest and recreation, and for the smuggling of weapons.

Barbed wire fences
In some cases, host governments insist on enclosing refugee camps with barbed wire fences so the refugees don't mix in with the local population. In Thailand, for example, people are not allowed in or out of the camps without permission of the government.

Other camps are open, allowing refugees to come and go as they please. Camps in Pakistan, for example, look no different from villages except that the residents are Afghan refugees.

Vehicle Entrance
The camp should be accessible by road year round. Within the camp itself, roads must provide access to main facilities so supplies can be delivered to health centres, food storage warehouses, etc. There should also be roads connecting to communal latrines to allow for maintenance. There are usually not roads between shelters, but there are walking paths.

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Reception Centre
When new refugees arrive at the camp, they can rest and get out of the sun at the reception centre while waiting to be registered. Registration is a big priority because keeping track of who is in the camp (how many men, women, children under age five, pregnant women, etc.) is the only way aid workers can assess the needs of the population.

Refugees are given some kind of registration document they use to prove they are a resident of the camp and which serves as their entitlement to get food rations. They also receive their first food package and other relief items, such as blankets, clothing and cooking utensils.

New refugees are given an orientation of the camp (who is in charge, what the rules are, what is expected of them, etc.), in some cases receive an initial medical check, and are assigned one of the shelters. The reception centre is usually located at the entrance of the camp.

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Shelters

Materials
Shelters for refugees are usually made of local materials, such as wood, metal sheets, branches and plastic sheeting. When possible, refugees construct their own shelters with tools and other assistance provided. Shelters usually have stoves for heat and cooking, although often in warm climates cooking facilities are outside.

Space
The minimum shelter space recommended is 3.5 square metres per person in warm climates where cooking is done outside, or 4.5 to 5.5 square metres. In cold climates where indoor kitchen and bathing facilities are needed. In emergencies however, large groups of people are often crammed into much smaller spaces. The minimum distance between shelters should be two metres.

Tents
In emergency situations or if local materials are not available, aid agencies can provide tents. Refugees should be able to stand in all areas of the tent without hitting their heads on the ceiling. Tents should be covered with an outer fly to shade and protect the tent below. Tents last two to three years.

Public Buildings
Schools, warehouses and other public buildings are often converted to shelters.

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Water Point
There should be at least one place to get water for every 200 to 250 refugees. Shelters should be no more than 100 metres from a water point.

The minimum amount of water required in an emergency situation is at least one gallon of water per person per day. This should be increased to five to six gallons per person as soon as possible so people have enough water for cooking, personal hygiene, and washing dishes and clothing.

River
Some camps have their own water source, such as a lake, river or well. If so, the water is treated to make sure it's not contaminated. If there is no water source, water is trucked in.

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Food storage warehouse
Food is usually stored in one large tent that serves as a warehouse. Warehouses should be located near administrative offices for reasons of security, and likely near the entrance of the camp so supply trucks don't have to drive through populated areas.

Food Distribution Point
Food distribution can be done at one location or broken up among several (i.e. dividing a population of 20,000 among four distribution points).

Refugees don't pick up food every day. Instead, they are given rations to last for a week or even as long as a month. The camp is divided so food is handed out to different people on different days, to avoid long line-ups and chaos.

Food Rations
Families receive basic rations that are designed to meet cultural diets. For instance, in some cases rice is handed out, while other times wheat is more appropriate. The minimum recommended daily ration is 2,100 calories per person.

Here is an example of a daily food ration:
(gpp = grams per person)

Rice, wheat or maize
400 (gpp)

Beans, peas or lentils
60 (gpp)

Vegetable oil or butter oil
25 (gpp)

Fortified blended food (i.e. corn soya blend)
100 (gpp)

Sugar
15 (gpp)

Salt
5 (gpp)

Total calories: 2,261
Total protein: 71.2 grams
Total fat: 47.9 grams

Malnutrition
It is considered a serious nutritional emergency when there is a malnutrition rate of more than 15 per cent, or more than 10 per cent with aggravating factors such as an epidemic. But not all camps have cases of malnutrition.

"It depends where you are," says Judith Kumin, the Canadian representative for the United Nations High Commissioner for Refugees. "If you're in a Rafha camp in Saudi Arabia where people have been for 10 years, the material conditions are very good. The problem is that they're just locked up. Everybody has enough to eat and everybody has healthcare, they just don't have a future."

The Role of Women
Aid workers try to give the food to women instead of men. Workers find the food is more likely to get to older people and children that way because women are the ones who cook the food. Men are more likely to sell the rations for money to buy something else.

Kumin says it's better to give refugees food that needs to be cooked rather than MREs (meals ready to eat). She says that during the Bosnian war the U.S. army tried to help refugees by dropping military rations from the sky. For safety, the food was dropped away from the camp. The problem was that the rations were dropped so far away from the camp that, for the most part, only young men ran out to get them. They then proceeded to put the rations in their pockets and keep them for themselves.

Kumin says that if refugees get food that needs to be cooked, they will give it to the women who usually do the cooking, and once cooked the food is better distributed among vulnerable people such as women, children and the elderly.

Feeding Centre
Because human milk is the best and safest source of food for children under two years old, breast-feeding is encouraged. If infants are fed with formula, milk products and/or bottles, they are fed at feeding centres to ensure utensils are sterilized, water is clean and formula is used properly. Mothers who are breast-feeding may also receive additional food at the feeding centres. There is usually one feeding centre per 20,000 people.

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Main Health Centre
Aid agencies provide primary health care, which is co-ordinated at a main or central health centre. In some cases, the health care provided in the camp is better than what the local residents receive, in which case the health services are opened to non-refugees.

Health care includes access to a short list of essential drugs (30 to 40 at most), which are chosen because of their affordability and effectiveness in treating the main diseases the refuges could be afflicted with.

Hospital/Clinic
Some refugee camps have fully operational hospitals or highly developed clinics where doctors can perform complex procedures, such as delivering babies, surgeries or amputations. If refugees have access to a hospital or clinic in the host country, the camp won't build its own. A hospital or clinic usually serves a population of 200,000 (or one hospital per 10 refugee camps).

Health Post
Besides the main health centre, smaller health posts are set up throughout the camp. Each serves 3,000 to 5,000 refugees. Nurses provide treatment for things such as sore throats, fevers, cuts and scrapes. Serious cases are referred to the main health centre.

Cholera Camp
Cholera is a disease people can get by drinking contaminated water or eating contaminated food. It causes diarrhea, severe vomiting and muscle cramps. Without quick treatment, about 50 per cent of people who get cholera will die of dehydration.

An outbreak of cholera hit Rwandan refugees in 1994 in what is now the Democratic Republic of Congo. Of 500,000 to 800,000 refugees, about 10 per cent of the population got sick, with about 1,000 cholera-related deaths per day.

Cholera poses such a significant risk to refugees that it is recommended that a space for a cholera camp is set aside in advance of an outbreak. It should be separated from other health facilities to help contain the disease.

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Latrines
Ideally there should be one latrine per family. If public latrines are used, there should be at least one for every 20 people.

They should be downstream and away from water sources. They should be no more than 50 metres from shelters because if they're too far people won't use them. There should also be space to build new latrines when the old ones become full.

Depending on time constraints, cultural issues and geological factors, one of a number of types of latrines can be built, such as defecation fields, collective trench latrines, or simple pit latrines. Defecation fields are meant to serve as a quick, temporary solution in an emergency because without a designated place, people will defecate wherever they please. When time permits, defection fields are replaced by shallow trench latrines, and these are eventually replaced by simple pit latrines.

Guidelines
Latrines should meet the following criteria:
– contain the waste matter in one place
– don't pollute the water
– accessible to users
– don't attract insects
– provide a minimum degree of privacy
– adapted to serve local habits

Lighting
Latrines should be located in well-lighted areas and close to shelters so women are not in danger when they use the latrines at night. If people don't feel safe walking to the latrines, they may defecate elsewhere, defeating the purpose of creating a more sanitary solution.

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Meeting Place
Meeting places are where leaders among the refugees gather to discuss issues affecting the camp. This usually consists of a tent or structure with a roof so people can get out of the sun. Leaders are elected by the refugees to represent different sections of the camp.

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School
Aid agency Save the Children believes education services should be maintained during emergencies. "It's very important for children to have a sense of normalcy," says Nadine Grant, director of programs for Save the Children in Canada. "By maintaining some sort of schooling, however basic or minimal it is, it actually helps keep a sense of normalcy in the child's life, and it helps in their recovery and it helps to minimize issues of trauma. So we often push for education as a first response in emergencies." There should be one school per sector of the camp (about 5,000 people).

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Market
If the host country allows people to enter and leave the camp as they please, a camp may have a market. In the case of a closed camp, the government may still allow a market day when merchants are allowed in to sell their goods.

Merchants mostly sell food such as fruit and vegetables since fresh produce is rare in camps. They also sell clothing and personal items, such as soap and toothpaste.

It's not accurate to say no refugees have money. Some brought it with them when they fled their homes and some have relatives abroad who send them money.

In general, there is one market in a camp that serves about 20,000 people.

Refugee vendors
Refugees can also sell goods of their own, such as vegetables they've grown or crafts they've made.

Kumin, of UNHCR, says refugees at a camp in northern Thailand sell embroidery to people who come to the camp specifically to buy their goods. Non-governmental organizations not only help the craftswomen obtain the materials they need, but also help to find a market abroad.

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Cemetery
Health facilities keep track of death rates and causes of death, according to the UNHCR. They also monitor sites being used as cemetaries to keep track of how many people are dying.

The most important indicators of the overall status of a refugee population, according to the UNHCR's Handbook for Emergencies, are the mortality rates for the population as a whole and for children under age 5.

The goal is to keep the mortality rate at less than one person per 10,000 per day. More than one person per 10,000 per day is considered a very serious situation, more than two is an emergency and more than five is a major catastrophe.

The main causes of death and disease in emergency situations are measles, diarrhoeas (including cholera), acute respiratory infections, malnutrition and malaria.

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