Katie Ogwang
Senior Community Based Protection Officer,
UNHCR Regional Bureau for East, Horn of Africa and the Great Lakes
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In the East and Horn of Africa and Great Lakes (EHAGL) region, violent conflicts, political instability, the impact of climate change, and other disruptions have displaced millions of people. Of the 5.4 million registered refugees and asylum seekers in the region, a small but significant segment of the refugee population — approximately 200,000 people, or 8 percent of the total — are classified as “elderly,” meaning they are 60 years old or older.
Stories shared with UNHCR by older adults in refugee camps in Gambella, Ethiopia are a stark reminder of the compounded difficulties they endure, and the challenges that exacerbate their vulnerabilities and needs. Their experiences underscore the urgent need for targeted interventions, to ensure the unique plight of older refugees does not go unnoticed amidst the broader humanitarian crises affecting displaced populations.
Challenges Faced by Older Refugees
For 60-and-older refugees in the EHAGL region, their advanced age compounds the numerous challenges of displacement and overall scarcity of resources in refugee camps and settlements.
Health and Mobility Issues: Access to health care is a critical concern for refugees over age 60. In Gambella’s Pinyudo camps, budget cuts have led to the discontinuation of essential medical services such as optometric support and prosthetic limb services. Gatluak Nhial Deng, a 62-year-old resident of Pinyudo 2 camp, lamented, “Some medical services have stopped due to budget cuts. These are very essential and critical services that elderly people need.” This lack of access to basic health care significantly impairs their quality of life, especially as many older refugees suffer from chronic conditions such as arthritis, hypertension, and diabetes, which require consistent medical attention.
Additionally, the shrinking funding situation has led to the reduction in the number of incentive workers, who provide care for unaccompanied older adults, further exacerbating health challenges. These community workers often play a crucial role in assisting older adult refugees with daily activities, including accessing food and medical services. Their absence leaves many older refugees struggling to manage on their own, increasing their risk of accidents and further health complications.
Nutritional Deficiencies: Food insecurity and a lack of food for safety net targeting to vulnerable and older persons is another pressing issue. With ongoing food ration cuts, refugees over 60 face severe nutritional deficiencies, which are particularly concerning given their health conditions. Malnutrition can exacerbate existing health issues and lead to new ones, such as weakened immune systems and decreased muscle strength, making older refugees more susceptible to infections and falls.
Tut Puok Gach, a 70-year-old refugee in Ethiopia living with a partial physical disability, shared his reliance on a small home garden to supplement his diet amidst a 40 percent reduction to the food assistance he receives. “Due to diminishing food supplies, I rely on my small garden to support our nutrition,” he said. Not all older refugees have the physical ability or resources to grow their own food, however, leaving many dependent on insufficient rations provided in the camps. Without immediate intervention, the health and well-being of older refugees will continue to deteriorate.
Isolation and Protection Risks: Older refugees often experience social isolation, compounded by mobility issues and the fear of further displacement. The displacement to unfamiliar and often hostile surroundings as well as the loss of social networks and support further alienates them, often leading to feelings of loneliness, depression, and anxiety.
60-year-old Nyabuony Puot Dar, who has also been displaced thrice in her life, expressed anxiety about the possibility of being displaced again, saying, “The recent rise in insecurity has worried me a lot. I can’t imagine being displaced again. I don’t know where I could go.” The prospect of another displacement is particularly terrifying for older refugees, many of whom have already been displaced multiple times. This constant state of uncertainty and fear can severely impact their mental and physical health.
Limited Tailored Assistance: Assistance provided in refugee camps too often fails to meet the specific needs of people 60 and older. Financial strains caused by dwindling funding lead to the de-prioritization of targeted support, leaving older refugees marginalized and under-served despite their increased vulnerabilities. Chol Pur Reath, 63, heads the Elderly People’s Association in Ngunyyiel camp. She highlighted the gap in key services, stating, “The most difficult part of being an elderly refugee in this camp is the limited nutritional support and the food cuts.”
She also noted the challenges in mobility and the lack of specialized services for refugees over 60, particularly those living with disabilities. Many camps do not provide adequate mobility aids, such as wheelchairs or walking aids, making it difficult for older refugees to move around the camp and access essential services. The lack of these and other tailored assistance programs leaves older refugees without the necessary support to live dignified and independent lives.
Proposed Solutions
Addressing the needs of older refugees in the East and Horn of Africa and Great Lakes (EHAGL) region requires a multi-faceted approach that takes into consideration their unique needs and vulnerabilities. UNHCR is committed to enhancing the support provided to older refugees through targeted and sustainable solutions. As one example, in Somalia, older adults are prioritized among the most vulnerable refugees and benefit from a monthly protection cash assistance programme to meet their basic food and medical needs.
Enhanced Health Care Services: There is a need to restore and expand health care services tailored to the needs of older refugees. This includes the provision of essential medical supplies, mobility aids, and chronic disease management. Health insurance schemes specifically designed for refugees age 60 and older could also be introduced to ensure sustained access to health care services. Moreover, partnerships with local health care providers and international NGOs could be strengthened to deliver specialized care for older refugees, ensuring that they receive the attention and treatment they require.
It will also be important to prioritize mental health services. Older refugees who have experienced trauma, loss, separation and displacement need access to support and services to help them cope with emotional and psychological challenges. In Ngunyyiel camp, UNHCR’s operational partner HelpAge International provides recreational activities such as storytelling and singing to engage older adults in social interaction and support emotional well-being.
Nutritional Support Programs: Targeted nutritional support programs should be implemented to address the specific dietary needs of refugees over 60. This could involve the distribution of food supplements, fortified foods, and the provision of gardening tools and seeds to encourage self-sustained food production in camps. In addition, establishing communal kitchens or meal programs that provide nutritionally balanced meals specifically for older adults could help address the dietary gaps that many of them face.
Social Support and Protection Mechanisms: To combat isolation and protection risks, community-based social support networks should be strengthened. These networks can provide regular check-ins, companionship, and assistance with daily activities. Organizing social events, support groups, and recreational activities specifically for older refugees can help reduce feelings of loneliness and foster a sense of community.
Moreover, training and support for caregivers, who often are family members, are essential to ensure that they can provide adequate care.
Tailored Assistance Programs: Humanitarian organizations must develop and implement assistance programs specifically tailored to the needs of people over 60. This includes not only the provision of necessities like mosquito nets and other non-food items, but also the establishment of dedicated spaces within camps where older individuals can receive specialized care and support. For example, in Gambella, Ethiopia, creating “elder-friendly” zones in camps that are easily accessible, safe, and equipped with the necessary facilities for elderly care has significantly improved their living conditions.
Conclusion
The stories of older adult refugees from the Gambella camps in Ethiopia paint a vivid picture of the challenges they face daily. From health and mobility issues to food insecurity and social isolation, these challenges are compounded by a lack of targeted assistance.
With the right interventions — enhanced health care services, targeted nutritional support, strengthened social networks, and tailored assistance programs — these challenges can be mitigated. The aging of the global population and the potential for greater numbers of refugees in the years ahead make it imperative that the international community recognizes and addresses the unique needs of older refugees. We can — and must — ensure that they are not left behind in the humanitarian response.