While Uganda remains the largest refugee hosting country in Africa, the refugee population figure reduced following a verification exercise conducted in 2018 and due to the lower than anticipated refugee influx from Democratic Republic of the Congo (DRC), South Sudan and Burundi.
Sixty per cent of the 1,223,033 refugees in Uganda are children who bear the brunt of the displacement and remain at risk of abuse, neglect, violence and exploitation.
A total of 29,541 children were immunized against measles by the Ministry of Health (MoH) with support from UNICEF and the Global Alliance for Vaccines and Immunization (GAVI).
Over 11,829 children affected by displacement were enrolled in Early Childhood Development learning in Adjumani, Arua and Yumbe refugee hosting districts.
About 106 district education actors were trained on Ebola Virus Disease (EVD) prevention and control in Kabale and Rukungiri districts focusing on basic Ebola epidemiology, mode of transmission, signs and symptoms and impact of the disease on child protection.
Situation Overview and Humanitarian needs
According to UNHCR and Office of the Prime Minister (OPM), Uganda is host to 1,223,033 refugees as of 28 February 2019. Of these, 95 per cent live in settlements in 11 of Uganda’s 128 districts, and five per cent live in Kampala. Sixty per cent of the refugee population are children. Most of the refugees are from South Sudan (801,055), the DRC (326,383) and Burundi (36,256). In February, a total of 9,751 new refugee arrivals crossed over, including (4,658) from DRC, (4,635) from South Sudan and (458) from Burundi, which represents an overall increase of 73 per cent from January when 5,900 arrived.
Uganda’s Refugee Response Plan (RRP) 2019-2020 is being revised and it is anticipated the exercise will be completed by mid-March. Compared to the initial projections (June 2018), RRP partners need to plan for 422,000 refugees less in 2019 and 431,000 refugees less in 2020. The refugee population figure in Uganda has reduced following a verification exercise conducted in 2018 and the lower than anticipated refugee influx from Democratic Republic of Congo (DRC), South Sudan and Burundi.
A recent survey was completed by Ground Truth Solutions (GTS) and the Organisation for Economic Co-operation and Development (OECD) on refugees and humanitarian staff in Uganda to understand how people affected by crises and humanitarian field staff perceive the impact of the Grand Bargain commitments. Among the key findings are that despite a modest improvement since 2017, most refugees (53 per cent) do not consider that aid covers their most important needs. Food, healthcare and education were identified by refugees as their primary unmet needs. This compares with 78 per cent of humanitarian staff, who believe that humanitarian aid and services adequately meet the needs and priorities of affected people. Provision of adequate education gives hope for the future (42 per cent), followed by security and peace (38 per cent) and adequate shelter and food (14 per cent). On the fairness of aid provision, refugees have mixed views, with 38 per cent saying that it does not go to those who need it most.
Orphans, people with disabilities, older persons and single mothers are perceived as the population groups most left out of aid programmes. Meanwhile, 92 per cent of staff consider that humanitarian programming adequately targets the most vulnerable population groups. The majority (56 per cent) of refugees surveyed do not see themselves as becoming more self-reliant. Respondents seem better informed about available services than in 2017, with almost half (46 per cent) saying they have the information they need. Yet, 43 per cent do not feel their views are considered in decision-making. A lack of beneficiary consultation, actions based on previous feedback given to aid providers, and a general opinion that there is inadequate respect for refugees and their rights are highlighted as obstacles to encouraging effective and meaningful refugee participation. In contrast, some 82 per cent of staff say they take refugees’ views into account when they make programme changes. Refugees remain positive about their ability to report abuse and mistreatment. Seventy per cent say they know how to make a complaint
Ebola Preparedness and Response: At the end of the reporting period, Uganda remained EVD free. However, the risk of EVD importation remains very high. Contacts with Ebola cases travelling into Uganda have increased during the first quarter of 2019, with reports of people travelling to the DRC for burials of relatives and returning to Uganda without reporting their status. Community based surveillance for EVD cross-border activities between DRC and Uganda continues, including coordinated contact tracing.
A knowledge, attitude, practices and behaviour (KAPB) survey on EVD was conducted by the Uganda Red Cross Society (URCS) who assessed risk perceptions and beliefs of people living in the high-risk communities of Bundibugyo, Ntoroko, Kabarole, Bunyangabu, Kasese, Kanungu and Kisoro districts in Western and South Western Uganda. The majority of respondents (88.6 per cent) had heard about EVD. Community volunteers (77.6 per cent), as well as radio spot messages, announcements, talk shows, disc-jockey mentions (76 per cent) constitute the main sources of information. Many respondents (85.3 per cent) also expressed fear of contracting EVD. A sizeable number of respondents indicated that EVD is can be treated by local herbalists (58 per cent). Only 48 per cent of respondents believe that the DRC Ebola outbreak could be imported into Uganda. The survey reported high-levels of potential stigma and discriminatory attitudes towards Ebola. The EVD risk communication messaging and engagement by multiple agencies continues to be revised to place more emphasis on propagating correct information on the misconceived views related to EVD transmission, prevention and treatment methods.
Cholera: As of 5 February, 53 cumulative cases of cholera had been listed with three community deaths (CFR = 5.7 percent) since the disease was reported on 4 January in Kampala District. As of 20 February, Kampala had completed 14 days without any new cholera cases; a WHO requirement to declare an end to the outbreak.
Measles: Uganda continues to experience measles outbreaks. As of 28 February, a total of 139 suspected measles cases from 38 districts (nine are refugee hosting districts) were investigated by the Expanded Programme for Immunization (EPI) laboratory, of which 33 samples from 12 districts were confirmed positive for measles specific immunoglobulin. Further analyses confirmed 23 cases were children under five years. Frequent stock-outs of measles vaccines at the district and health facility levels, compounded with irregular outreach activities, are the underlying factors contributing to the measles outbreak. The basic causes are related to chronic underfunding of traditional vaccines, and stagnated funding to primary health care in the context of the rapid population growth.