How to Help Refugees and Host Countries Combat COVID-19


May 18, 2020

A worker rides on a vehicle transporting food supplies distributed by United Nations Relief and Works Agency to the homes of Palestinian refugees as a precaution against the spread of COVID-19, in Gaza City, March 31, 2020, photo by Mohammed Salem/Reuters

Workers transport food supplies to the homes of Palestinian refugees during the spread of COVID-19, in Gaza City, March 31, 2020

Photo by Mohammed Salem/Reuters

By Shelly Culbertson and Gary Edson

This commentary originally appeared on The National Interest on May 16, 2020.

At a time when the pandemic is forcing people to stay at home and practice social-distancing, that is not possible for one of the most vulnerable populations—the world's seventy-one million refugees, internally displaced persons, and asylum seekers (PDF). Having escaped conflict and persecution, they now risk illness and death from the coronavirus. That risk is heightened by a policy regime that focuses largely on refugees in camps, not the almost two-thirds that live in urban areas. But the crisis could provide an opportunity to reform a broken system for the benefit of refugees and host countries alike.

The word refugee has become synonymous with images of Syrians, Afghanis, Sudanese, Central Americans, and other groups huddled in makeshift camps that have become way stations between the homes they left behind and the safe havens they hope one day to find. Supported by the UN system and international nongovernmental organizations, these camps pose a heightened risk for the coronavirus, with a density of living conditions and lack of water and sanitation that makes social distancing and adequate hygiene impossible.

But the 61 percent (PDF) of refugees who live in urban areas are also at risk, precisely because their situation is so fundamentally different from those in the camps. While these refugees receive some limited assistance from UN agencies and other multilaterals, they largely rely on work to pay their rent, buy food, and support their families. Indeed, a RAND survey of Syrian refugees in Turkey, Jordan, and Lebanon found that 65 to 85 percent relied on income from work as their main source of support. Refugees often work on the lowest rungs of the employment ladder, informally, below minimum wage, and without access to a social safety net if they lose their jobs.

Social-distancing measures during the coronavirus pandemic mean that many of these refugees can no longer work. This has put them in a dire situation because of food insecurity and the need to pay for rent and other expenses. Worse, when they cannot work, they resort to negative coping mechanisms, including reducing the quantity or quality of food, forgoing health care, selling personal goods, relying on child labor for additional family income, or having daughters enter into early marriage.

Refugees in urban areas also depend on local public and private health care providers, to whom they often have limited access. For example, the over one million Syrian refugees in Lebanon's urban areas often cannot afford the fees to access Lebanon's mainly private health care system. The majority of the 1.6 million Venezuelans in Colombia lack regular immigration status and therefore have access only to emergency medical care. If refugees in urban areas do not have access to testing, treatment, and, ultimately, a vaccine during the coronavirus pandemic, then they could become vectors for transmission, posing risks to themselves and their host nations.…

The remainder of this commentary is available at

Shelly Culbertson is a senior policy researcher focusing on refugees at the nonprofit, nonpartisan RAND Corporation. She is the author of The Fires of Spring: A Post-Arab Spring Journey Through the Turbulent New Middle East. Gary Edson served as deputy national security adviser and deputy national economic adviser to President George W. Bush.