Wellbeing in refugee camps: life inside a bottle

Refugee camps may be an easy way to offer support to people in an emergency but they should not be the long-term solution. New research led by IIED shows that refugees in East Africa who live in cities experience better wellbeing and more economic opportunities

Boel McAteer's picture
Insight by 
Boel McAteer
Researcher in IIED’s Human Settlements research group
06 December 2022
Houses can be seen inside a sealed, glass bottle on its side.

Life in Kenya’s Dadaab camp is described by one woman as "suffocating. It’s like living in a bottle enclosed from all ends and recycling the same oxygen” (Photo: Cem F. Gökçimen)

In many countries, host governments require refugees to live in camps rather than cities. For governments and humanitarian actors, camps are an easy way to offer temporary support to refugees during an emergency, making sure that everyone fleeing can quickly be given food, water, and shelter.

But sometimes emergencies continue for a long time and refugees remain in camps for years and even decades, which makes refugee support difficult and expensive to maintain.

According to new GCRF-funded research led by IIED, refugees in Kenya and Ethiopia living in cities have better levels of wellbeing as well as more available economic opportunities. Leaving camps can be difficult – even illegal without the right documentation – and this limitation of people’s movement can lead to despair. A 45-year-old woman living in Kenya’s Dadaab camp since 1992 told us: “[The camp] is suffocating. It’s like living in a bottle enclosed from all ends and recycling the same oxygen.”

Ethiopia and Kenya, two of the countries included in our research project, have a long history of hosting refugees in camps. These countries also have policies that actively prevent refugees from moving to urban areas.

Comparing levels of wellbeing

Our research set out to examine and compare the wellbeing of refugees in cities and camps. We surveyed over 1,000 refugees in each country, including Dadaab (camp) and Nairobi (city) in Kenya, and Aysaita (camp) Semera Logia (town) and Addis Ababa (city) in Ethiopia. We also conducted qualitative interviews with refugees in each location. The project looked at five areas of wellbeing: 

  • Bodily – access to food, shelter, health care, water, sanitation and hygiene
  • Economic – access to paid labour, education, financial services, levels of debt
  • Political – rights, recognition, documentation, community representation
  • Social – networks, connections, leisure activities and spaces, and
  • Psychosocial – mental health, hope, aspirations, feeling at home.

In both countries, we found that refugees living in camps in Kenya and Ethiopia have considerably lower levels of overall wellbeing compared to those who have managed to make it out of the camp and into the city. The scores for bodily and economic wellbeing were particularly low.

Diminishing food provision

Kenya is home to some of the largest refugee camps in the world. Almost 235, 000 people are registered in the Dadaab complex, which opened in 1991 in response to the conflict in Somalia. It is made up of three camps: Hagadera, Dagahaley and Ifo.

The issues around bodily wellbeing often stem from declining food provision. According to our survey, 60% of respondents based in Dadaab did not have enough food at some point in the previous seven days. Refugees who had lived in Dadaab since the 1990s reported a reduction in provision of food.

The fall in food provision is the same for Aysaita camp in Ethiopia’s Afar region. Aysaita opened in 2007 and is currently home to around 23,000 refugees, predominantly from Eritrea. Refugees reported that food has been so far reduced it is no longer possible to live on what is provided. Almost 80% of survey respondents also described the quality of healthcare as low.

Hemmed in

People living in Dadaab are not allowed to leave the camp complex without a permit, obtained only with a specific reason, such as a medical need, that cannot be addressed within the camp, meaning some residents have not left the camp in 30 years. An 85-year-old man from Somalia who arrived in 1992 compared it to life in prison.

Within the camp, there are services like schools, health centres and markets, where refugees work, but most camp residents are not able to cover their expenses through work. A majority of our respondents said that their incomes are always or mostly unstable and unpredictable from one month to the next.

A supportive community

Despite the very harsh living conditions in camps, refugees can feel more at home in them than in cities. Many camp-based refugees described their neighbourhoods and communities as a big family sharing joys and difficulties.

A 60-year-old woman shared the support and sense of community in Aysaita: “These are my people. We share happiness and sadness. We help each other during mourning. It is our culture. Everyone provides what he has. Those who have goats give goats, those who have money give 50 birr, 100 birr, or more based on their ability. Others collect firewood, prepare food… We stayed with those who lost their relatives for weeks. The same for marriage, we celebrate religious and cultural events here together. We are one family in this camp.”

Women come together in informal support groups where they listen to each other’s worries and offer whatever support they can. Men are more likely to build their sense of community through formal structures, such as peace and mediation committees, or organised responses to issues such as droughts.

In the city refugees are more likely to feel isolated, which points towards a lack of inclusion between refugees and host communities. In other words, refugees may need to sacrifice the sense of belonging found in camps as they seek a better life outside.

A world without camps – the best of both?

Refugees creating a positive sense of community inside camps does not mean camps are positive environments. Our research showed that, overall, these are places of struggle, dependency and a feeling of being stuck – trapped inside that bottle.

Where is the value, or long-term vision, in governments and international funders continuing to keep refugees in camps when there is not enough money to provide for the most basic needs?

Rather than continuing to fuel the aid-dependent economy within refugee camps, where efforts to improve access to food and work are failing, international actors could work with city authorities and refugee communities to improve service access and build integration in cities.