Surveillance and outbreak reports Infectious diseases among travellers and migrants in Europe, EuroTravNet 2010

To investigate trends in travel-associated morbidity 

with particular emphasis on emerging infections with the potential for introduction into Europe, 

diagnoses of 7,408 returning travellers presenting to 16 EuroTravNet  sites 

n 2010 were compared with 2008 and 2009. 

A significant increase in reported 

Plasmodium falciparum malaria (n=361 (6% of all travel-related morbidity) vs. n=254 (4%) and 260 (5%); p<0.001), 

P. vivax malaria (n=51 (1%) vs. n=31 (0.5%) and 38 (1%); p=0.027) 

and 

dengue fever (n=299 (5%) vs. n=127 (2%) and 127 (2%); p<0.001) was observed.

Giardia lamblia was identified in 16% of patients with acute diarrhoea, with no significant annual variation. 

The proportion of acute diarrhoea due to 

Campylobacter increased from 7% in 2008 to 12% in 2010 (p=0.001). 

We recorded 

121 patients with pulmonary tuberculosis in 2010, 

a threefold increase in the proportionate morbidity from 2008 to 2010. 

In 2010, 60 (0.8%) cases of chronic Chagas disease, 

151 (2%) cases of schistosomiasis and 

112 (2%) cases of cutaneous larva migrans were reported. 

Illness patterns in sentinel travellers, captured by EuroTravnet, 

continue to highlight the potential role of travellers in the emergence of infectious diseases of public health concern in Europe and the relevance of offering medical travel advice and enforcing specific and adequate prophylaxis

http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=2020

UNHCR’s 2012 Annual Consultations with NGOs: Strategic cooperation to better protect refugees

10 July 2012

The UN’s Refugee Agency, UNHCR, held its annual interactive consultations with non-governmental organizations (NGOs) from 3-5 July 2012 at the International Conference Centre in Geneva. 

UNHCR has been holding yearly consultations with NGOs for over 25 years, providing an important forum for NGOs to raise issues, network and exchange views with UNHCR. 
This year, more than 430 NGOs from 86 countries attended the consultations.
During the opening plenary session, Deputy High Commissioner for Refugees T. Alexander Aleinikoff said UNHCR was looking at how the agency and its partners could “become 21st Century organizations” and thus more innovative in assisting refugees.
The consultations took place over three days, and incorporated regional as well as thematic sessions, in addition to numerous, less formal side events. 
Below follows an overview of the main issues discussed during these sessions.

Regional Sessions

Africa Bureau

Bringing together the Director as well as three Deputy Directors of UNHCR’s Africa Bureau, and moderated by the representative of the Sudan Health Association, Justus Lugala, this session aimed to focus on programmes and policies for the protection and the promotion of the rights of refugees in Sub-Sahara Africa.
The session was divided in two parts: one dealt with UNHCR’s programme for 2013 in the region and the impact of the financial crisis on the expected reduced level of funding for the organization. 
The second part was dedicated to the particular refugee situation in Angola, Liberia and Rwanda.

The main challenges that characterize the region and that were brought to the fore during this session include: 

(1) the living conditions in refugee camps, exemplified by high-levels of insecurity and mortality; 
(2) the crucial need to strengthen, in collaboration with partners in the field, a programme to guarantee refugees’ solid and stable participation in society outside the camps; and 
(3) the need for quick solutions to deal with unexpected refugee flows – for example in South-Sudan, to deal with shrinking humanitarian space, and to strengthen ways to empower refugees.

Key recommendations focussed on the financing challenge to plan for 2013, the responsibility of NGOs and UNHCR to lobby governments; and the need to reduce insecurity, especially for women and young girls.

Bureau for Americas: 
Involving legal aid institutions, civil society and those effectively advocating for refugee protection

The American continent is a good example to follow in terms of its legal framework for the protection of asylum seekers and refugees. 
It has not only ratified important international conventions on the protection of the rights of refugees and on human rights, but the region has also seen a strong movement for the adoption of national laws favourable to refugees and asylum seekers. 
Although there is the important commitment from States in the region to protect the rights of refugees and to have legal procedures in place to deal with asylum seekers, the actual implementation of the adopted legislation on these issues remains a key challenge.
The panelists therefore focussed on the challenges that need to be overcome to guarantee legal aid to those requesting asylum and to refugees. 
Some also referred to the Colombian conflict and its impact on the movement of people on the continent. 
According to Juan Carlos Murillo, Senior Legal Officer at UNHCR Costa Rica, it is necessary for UNHCR to strengthen and build its relationship with civil society, national institutions for the protection and promotion of human rights, judicial instances, and the inter-American human rights system.

Bureau for Asia and the Pacific: 
Refugee Protection

Featuring the Director of UNHCR’s Bureau for Asia and the Pacific, Kasidis Rochanakorn, and his two Deputy Directors, Josefa Ojano and Indrinka Ratwatte, as well as Anoop Sukumaran, representative of the Asia Pacific Refugee Rights Network, and moderated by Syed Mazher Hussain of the Confederation of Voluntary Associations, this session played a central role, as the Asia and Pacific region is hosting the largest number of refugees.
Afghanistan, Pakistan and Iran are, for example, among the States that are characterized by a prolonged refugee situation for more than 30 years. 
This session therefore provided an opportunity to UNHCR to discuss how the agency could update its strategies in this region where conflicts are ongoing. It also discussed how civil society and UNHCR can work together to stimulate better practices of hosting refugees; to improve the sharing of responsibilities among States in the region; and to undertake more effective action against new irregular movements of people.
The debate highlighted the importance to end the fragile protection situation of refugees in the region, and for this to happen, UNCHR and NGOs will need to continue their efforts and collaborate to increase protection levels, while taking into account the regional context and establishing new partnerships.

Bureau for Europe: 
Xenophobia and Integration

The Bureau for Europe organized an interactive panel discussion on xenophobia, what is understood by it, how to counter it and how it affects the integration of refugees. 
The moderator of the session, Allan Leas from the European Council on Refugees and Exiles, opened the session by alluding to various Heads of States’ statements that multiculturalism is dead. 
To spark discussion, Leas then posed the thought-provoking question: 
“Are multiculturalism and integration mutually exclusive?”
A principal point of discussion for the panel was the appearance that xenophobia and racism are currently on the rise worldwide. 
Shannon Pfohman from the European Network Against Racism noted that, from a statistical point of view, it is very difficult to confirm that xenophobia is on the rise, because there are no past benchmarks or measurements to compare against. 
Tony Ganzer, from World Radio Switzerland, affirmed that “racism is not on the rise, ignorance is on the rise.” 
An NGO representative put forward the controversial notion that racism is inherent to human beings, making it a moral and not a political issue. 
The NGO representative also noted that the international community should employ social media to instill attitudinal change. 
The idea of racism being naturally inherent was thereafter contested by a number of speakers who chose to adopt a more optimistic view of human nature.
Various specific cases of xenophobia against refugees were discussed, such as the situation of refugees in Greece, and questions were asked regarding best practices. 
Several videos were also shown during the discussion session, the last of which being a compilation of different Heads of States’ iconic speeches about the failure of multiculturalism. 
As a closing remark on this ongoing theme, Shannon Pfohman noted that, “those who say multiculturalism has failed have never had multicultural policies. Canada is the only country who has.”

Bureau for the Middle East and North Africa (MENA)

With the situation in Syria being at the centre of daily headlines, UNHCR’s Bureau for the MENA region explained the particular situation in which the region finds itself, especially since the “Arabic Spring” movement. 
The variety in refugee situations in the region, characterized by a large displacement of people and the high vulnerability of refugees, is the result of both prolonged conflicts, as well as protests against those with political power.
Panelists during this session included representatives from civil society (Humanitarian Forum, Jordan Health Aid Society, Lybian Humanitarian Relief Agency) and the Director of UNHCR’s MENA Bureau, Yacoub El Hillo. T
he main debate was held around the particular situation of urban refugees who constitute the majority of refugees in the region and the massive movement of people that demand a redefinition of humanitarian aid from UNHCR as well as other organisations present in the field. 

Recommendations resulting from the discussion were the following: 
(1) find new sources of financing; 
(2) UNHCR should provide increased support to civil society, especially to women and youth organizations; 
(3) the institutional capacities in the region need to be enhanced; and 
(4) trans-regional dialogue between Africa and the Middle-East needs to be improved in order to better protect refugees.

Thematic Sessions

Refugee Resettlement: Expanding its Reach and Effectiveness through Broader NGO Participation

Estimates from UNHCR on the number of refugees worldwide that need to be resettled are alarming: 800.000 people are concerned – including 172,196 since 2012. 
To deal with this situation, measures should be taken to assist resettlement countries in increasing their capacity to host refugees, as well as to assist these countries with refugees’ effective integration.
This session aimed to share experiences among NGOs and UNHCR and to expand their knowledge on different local and international resettlement activities. 
Special focus was given to the resettlement of the most vulnerable refugee groups, including urban refugees; refugees that are lesbian, gay, bisexual, transgender or intersexual (LGBTI); refugees with disabilities; elderly refugees; and those surviving sexual and gender-based violence (SGBV).
Anoop Sukuharam, Rapporteur of the 2012 Annual Consultations, underlined the need to support the work of NGOs and to enhance their space in resettlement activities by strengthening the links between governments, UNHCR and NGOs for a more effective tripartite collaboration. 
See also the 2012 Annual Tripartite Consultations on Resettlement (ATCR) for more information on this issue.

Climate Change – People on the move

The consultations also touched on the topic of people displaced by climate-related events. 
The panel session on climate change looked at potential ways to address the protection concerns of people displaced by natural disasters and climate change both within and across borders. 
Participants from NGOs and UNHCR representatives expressed their views and concerns on this matter, highlighting the challenges and good practices from the perspective of affected populations and national actors responding on the ground, including the management of the environmental impacts of humanitarian operations.
The panelists for this session included representatives from the Kenya Red Cross Society, the World Wide Fund for Nature (WWF), the Norwegian Refugee Council and the Division of International Protection of UNHCR.

Information Management Symposium: Strengthening Information in Humanitarian Response

Running concurrently with the session on climate change, the Information Management Symposium showcased an exhibit of information tools, methodologies and strategies currently used in the field for refugee situations. 
The International Organization for Migration (IOM), the Office for the Coordination of Humanitarian Affairs (OCHA) and the Agency for Technical Cooperation and Development (ACTED) were among the exhibitors at the symposium. 
Participants were able to freely roam among the information stations, where they could find out about mobile data collection and other technologies used by UNHCR and its partners in the field.

Strategic Litigation, Refugee Legal Representation and Advocacy: 
Pathways to Protection, Durable Solutions and Refugee Rights

Discussing the issue of legal representation, the panellists of this session focussed on the existing variety of legal services offered to asylum seekers, refugees, and stateless persons around the world.
Michael Timmind of Asylum Access Thailand reminded the audience of the importance of legal assistance – for policy makers, asylum procedures and asylum seekers. 
His main concern was that the rights of refugees, such as the right to get assistance or to have access to a fair process, are often not respected. 
He therefore called for the legal defence of refugees and stronger advocacy on this issue.
Martin Jones of the Egyptian Foundation for Refugee Rights and Kaajal Ramjathan-Keogh of Lawyers for Human Rights spoke briefly on the actions undertaken by their respective organizations in Egypt and South Africa. 

Their interventions highlighted some main obstacles to overcome in terms of legal assistance, including:

  the lack of sufficient basic legal education;
the threats faced by lawyers, include violence by police forces;
the difficult access to reach prisoners;
the lack of resources to guarantee a better legal protection of asylum seekers, refugees and stateless persons;
the corruption in asylum seeking procedures;
the need to improve social assistance.

Cornelis Wouters, a UNHCR representative, closed the session by drawing attention to UNHCR’s strategic commitment to promote collaboration among judges, lawyers, States and NGOs. 

These efforts can be divided into three components: 
(1) general support to make information and training available; 
(2) specific partnership support; and
(3) offering a choice in strategic litigation in collaboration with NGOs.

No nationality, no rights? 
Strategies and tools for the protection of stateless persons

Proposed by the NGO Committee on Migration, the Open Society Justice Initiative and Praxis, this session featured a panel discussion on the strategies and tools that need to be adopted to better protect stateless persons, and was followed by three breakout sessions that dealt with: 
(1) the determination of statelessness and grant of status at the national level to stateless persons; 
(2) birth registration, identity documentation and risk of statelessness; and 
(3) protecting stateless persons from arbitrary detention.

The panel composed of civil society representatives focussed on the fact that stateless persons do not have access to the same rights as citizens due to the complexity of their status. 
The serious discrimination that they are facing as a result of ethnicity, religion or gender is both a cause and a consequence of their statelessness.
The panel discussion, as well as the different breakout sessions, called for a Special Rapporteur on the issue of statelessness and for a reform of national discriminatory laws in this regard.

Operational Focus: 
Implementing partnership – A Framework for establishing and maintaining UNHCR partnerships

Since its creation, establishing partnerships with NGOs has not only been vital for the work of UNHCR, but also essential for the protection of refugees. 
Therefore this session aimed to have a dialogue on how to improve these partnerships and the framework of cooperation in order to guarantee an even more effective protection of refugees and to increase the credibility and accountability of the work done by UNHCR and its implementing partners. 
Striving for a common objective, UNHCR put emphasis on the need to promote mechanisms, tools, procedures, etcetera, to better monitor joint projects and review partnerships.

Marginalization and social exclusion of particular refugee populations

While moderated by Volker Turk, Director of UNHCR’s Division for International Protection, the five panellists from civil society discussed the marginalization of refugees that live with HIV/AIDS, have a disability, are LGBTI, or belong to ethnic, religious or linguistic minorities or indigenous peoples.
The session highlighted that the people belonging to these socially excluded groups are not only prosecuted in their countries of origin, but they also to face marginalization or prosecution in the host country or by other refugees. 
These groups thus deserve special attention as they need to overcome even more obstacles than other refugees in seeking asylum, including psychological pressure.
The debate centred on effective ways to work with these marginalized groups and on the means to better integrate them in humanitarian work programmes. 
For example, by enhancing the training of humanitarian staff on this issue.

Redefining protection for children in emergencies

The main recommendation emanating from this session on the protection of children is that of that the detention of minor refugees should be stopped. 
Displaced children, who represent 50% of the populations of concern to UNHCR, face particular vulnerability, especially those that are not accompanied by relatives or guardians. 
An adjusted legal policy framework to guarantee their protection is therefore needed. 
Moderated by Vladimir Hernandez of Community and Family Services International, the three panellists from Plan International, the International Detention Coalition presented new strategies in the protection of children. UNHCR shared a newly developed Framework for the Protection of Children. and called on NGOs to support its effective implementation.

 

Side events

On the sidelines of UNHCR’s Annual Consultations with NGOs, five events were held, bringing together civil society and UNHCR representatives to discuss some of the themes of the aforementioned thematic sessions in more detail. 

The side events focussed on:
(1) Enhancing access to justice for victims and survivors of sexual and gender-based violence;
(2) The impact of protection standards and principles in humanitarian response;
(3) Opportunities and challenges in addressing Protracted Refugee Situations: Colombian, Iraqi, and Somali displacement;
(4) Building and supporting legal aid and legal representation of asylum-seekers, refugees and stateless persons;
(5) Advocating for refugee rights in the MENA region after the Arab Spring: prospects and challenges.

 

Closing session: 

Building strategic, relevant and effective partnerships

The closing session of the 2012 Annual Consultations with NGOs was divided in three parts: a presentation on the conclusions and recommendations of three days of dialogue; a statement by the High Commissioner for Refugees, António Guterres, and a question and answer session for NGOs directed to the High Commissioner.
Besides from underlining the importance of dialogue between UNCHR and NGOs, Mr. Guterres also referred to the importance of communication between civil society organizations and political institutions to enhance the protection of refugees. 

According to the High Commissioner, UNHCR should be fully conscious of how “strategic, relevant and effective partnerships” can enrich decision-making processes. 
Support to local NGOs needs to be increased in order to strengthen refugee protection as well as national democratic institutions, he further noted.

According to the High Commissioner, the main concerns for the protection of refugees remain:
1) The safety of staff, both from the UN as well as its implementing partners (local NGOs)
2) National trends to reduce asylum space and to develop negative national policies and legislation in this regard; and
3) The difficult financial situation. On this point, Mr. Guterres reassured the NGOs in the room by confirming that UNHCR’s commitments towards implementing partners will not be affected by a reduction in funding.

More information is available online.