Aden Warsama from Djibouti is all too familiar with the suffering endured by migrants passing through East Africa. ‘I have seen people collapse and die at the side of the road simply because they had diarrhoea or were dehydrated. But no one’s life should end like that,’ he says with visible emotion. As a doctor, it is important to him that he can now contribute to protecting migrants across the Horn of Africa.
The 31-year-old works for the hospital in Obock, a small port town in northern Djibouti and the location of one of the country’s refugee camps. The Bab el-Mandeb Strait on the Red Sea is a key transit route, for example for refugees from Yemen who have made the crossing to escape the civil war at home, and for Ethiopians seeking work on the Arabian Peninsula. Many put their trust in unscrupulous people smugglers, to whom a human life is worthless.
Defenceless along a dirt road
Aden Warsama looks after vulnerable migrants – children, women and men. He is a member of a mobile health team that patrols the coastal roads in specially equipped ambulances, providing care for people in need. Many have entered the country illegally and are too scared to approach the authorities for help. ‘When we spot them, we start by giving them water and asking if they need medical assistance,’ he explains.
The mobile health teams have been operating in all five regions of Djibouti since late 2017, driving up and down the dust roads and assisting stranded and vulnerable migrants. Each day, more than 300 migrants arrive in Djibouti, a small country with a population of just one million. That adds up to more than 100,000 arrivals a year, equivalent to ten percent of the population. Although many of the migrants are simply passing through, the challenges facing Djibouti are immense.
Avoiding conflicts with local communities
As diverse as the conditions in the various countries may be, they have one feature in common: they cannot deal with the challenges posed by the mass migration movements of the 21st century unaided, at least not in a way that safeguards the basic human rights of refugees and migrants and avoids conflicts, as far as possible, between the new arrivals and local communities. Together with various other European countries and the EU, Germany is therefore taking on a share of this responsibility.
It is a similar situation in Sudan: this East African state is also a destination and transit country for migrants, mainly from Eritrea, Ethiopia and neighbouring South Sudan. Many only stay in Sudan for a few days or weeks; others become permanent residents, some as registered refugees, others undocumented. Some opt to keep their illegal status because of Sudan’s policy of housing migrants in camps, where people often feel unsafe, live in fear of violence and exploitation, and have few opportunities to earn a living.
Life on the move is harsh and it is the weakest refugees – many of them children – who suffer most. Some of them are travelling with their parents but others have been abandoned in camps or are making their own way towards a new life in a place of safety. According to UNICEF, in 2016, 44 million children worldwide were living in forced displacement, either internally or outside their home country, many of them in East Africa.
In March 2018, the fate of these children was addressed at a regional conference which took place in Djibouti and was attended by more than 170 international and national experts. Organised by the Better Migration Management (BMM) programme with the support of child rights advocacy organisation Save the Children International (SCI), the conference provided a platform for experts and government representatives to seek ways to improve the protection afforded to child migrants. As Steve Morgan from SCI explains, this is an important issue: ‘In Africa, two child migrants in every three fall into the hands of human traffickers.’
Safe spaces for minors and capacity building for social workers, justice officers, and border officials to better identify and refer children to protection services are among the key demands made by the experts. Border officials are often the first to spot unaccompanied minors, whether children or teenagers, so the provision of training for these officials is one of the practical improvements that can be made in migration management.
First-aid training for border officials
The first-aid training being offered to border officials in Sudan is another example. ‘They are the people who have to provide first aid in an emergency,’ says Sami Hadi Adam, who is responsible for the work of the Red Crescent relief agency in Sudan’s Northern state. To date, with support from the German development agency GIZ, he has organised courses for more than 100 border officials working for the customs and immigration authorities and for staff from the assistance points for migrants. ‘The people arriving at the border are often in poor shape,’ he says. ‘Many are severely dehydrated after their journey across the desert. Some have broken bones or have been bitten by snakes or scorpions.’ As he explains, officials previously lacked the training needed to deal with this type of emergency, but with more courses coming up, that is about to change.
Stringent criteria are applied to select the candidates for training, as the programme in Sudan is not without its controversies. The International Criminal Court (ICC) has issued an arrest warrant for the country’s President Omar Hassan Ahmad al-Bashir on charges including genocide and war crimes. Sudan is still ranked below almost every other country on human rights and political freedoms.
Supporting prosecutors and investigators
‘Our work is certainly not about supporting the Sudanese leadership and the country’s elite or fulfilling all their demands,’ stresses BMM Programme Manager Sabine Wenz. Rather, the long-term goal, she says, is to establish a coordinated migration policy in the programme countries and to support institutions such as the prosecution and law enforcement services that take action against human trafficking. In addition, direct assistance and awareness-raising for migrants are intended to help the most vulnerable and stabilise society as a whole in the participating countries.
In order to improve migration conditions, the programme team works directly with the national ministries and also with civil society groups. Sudan is no exception: the regional coordinator and seven staff members in Khartoum carry out intensive checks on partner organisations, which includes finding out exactly who is behind them. Absolute transparency regarding the beneficiaries and purpose of the support is essential. ‘We keep a very close eye on these matters,’ Sabine Wenz says.
Clear rules for partner selection
The same applies to the EU-BMZ steering committee, which scrutinises the programme activities. All the participants apply the ‘Do No Harm’ principle, developed by American academic Mary B. Anderson as a set of rules for international aid, especially in conflict settings. For example, the rules prohibit cooperation with individuals or groups that may be implicated in human rights abuses.
Despite the challenging environment, Sabine Wenz believes that engaging is the right approach. It is, she says, the only way to establish contacts with a view to building sustainable civil society capacities, genuinely improving conditions for refugees and migrants and uncovering the smuggling networks.
But it all takes time and patience. The process of setting up a health centre in Djibouti was completed much more quickly. Improvements in health care are already one of the visible changes here. Obock is not only the base for Aden Warsama’s mobile health team; a small clinic opened at the migrant centre here in March 2018. It is already doing much to ease the burden on the hospital in Obock and is thus benefiting the local community. That’s as it should be, says Aden Warsama: ‘Universal access to health care is a basic human right.’