Moawad Paul, Andres Lauren
Bartlett School of Planning, UCL Faculty of the Built Environment, University College London, Central House, 14 Upper Woburn Place, London WC1h 0NN, United Kingdom.
J Migr Health. 2020 Dec 5;1-2:100011. doi: 10.1016/j.jmh.2020.100011. eCollection 2020.
This paper is exploring and critically accessing the nature and mechanisms of preparedness and response plans to COVID-19 in Syrian ITSs in Lebanon along with their immediate health impacts on refugees and their abilities to survive. Little is known to date about how such plans have been set up and how they have immediately impacted refugees, particularly those in countries affected by severe economic and political turbulences along with fragile health systems. This qualitative study has been conducted during the pandemic and hence is providing important and novel insights into a time-limited research window during which not only refugees' mobility was restricted but also research capabilities severely constrained. We are focusing on the relationships between refugees, health and the COVID-19 pandemic and unwrapping how very strict and control-led preventive mechanisms have emerged as a consequence of already stretched and problematic health and socio-economic systems. We are also demonstrating how the multi-level strategy and local responses have led to significant challenges to local municipalities, local NGOs and international aid agencies in order to reduce transmission risks in very unhealthy settings as they try to address wider needs. This paper concludes that the impact of the constraining preventive measures implemented to date means that refugee communities will suffer consequences for months and years to come, with their ability to survive being threatened and an expected long-term health impact for a population already at high risk of NCDs. We argue that more research will be needed into deconstructing further refugees' reactions to encampment mechanisms and mobility restrictions, particularly if survival becomes even more problematic; similarly relationships and tensions with local municipalities, as well as measures and support provided by local and international NGOs, will deserve attention. A key question remains about the likely scenario if cases start to spread widely in ITSs and, hence, what will happen to both refugees and host communities in a country with a health system on the edge of collapse.
本文正在探索并批判性地评估黎巴嫩境内叙利亚临时避难场所针对新冠疫情的防范与应对计划的性质和机制，以及这些计划对难民的直接健康影响和他们的生存能力。迄今为止，对于此类计划是如何制定的，以及它们如何立即影响难民，尤其是那些身处受严重经济和政治动荡以及脆弱卫生系统影响国家的难民，人们知之甚少。这项定性研究是在疫情期间进行的，因此为一个时间有限的研究窗口提供了重要且新颖的见解，在此期间，不仅难民的行动受到限制，研究能力也受到严重制约。我们关注难民、健康与新冠疫情之间的关系，并揭示由于本就捉襟见肘且问题重重的卫生和社会经济系统，如何出现了极为严格且以管控为主的预防机制。我们还展示了多层次战略和地方应对措施如何给当地市政当局、地方非政府组织和国际援助机构带来重大挑战，以便在他们试图满足更广泛需求时，在非常不健康的环境中降低传播风险。本文得出结论，迄今为止实施的限制性预防措施的影响意味着难民社区在未来数月乃至数年都将承受后果，他们的生存能力受到威胁，而且对于一个已经面临非传染性疾病高风险的人群，预计会产生长期健康影响。我们认为，需要开展更多研究，以进一步剖析难民对营地机制和行动限制的反应，特别是如果生存变得更加困难的情况下；同样，与当地市政当局的关系和紧张状况，以及地方和国际非政府组织提供的措施和支持，都值得关注。一个关键问题仍然存在：如果病例在临时避难场所开始广泛传播，可能会出现什么情况，进而，在一个卫生系统濒临崩溃的国家，难民和收容社区将会怎样。
