Flower, BCR; MacDonald, K; Dobbin, J; (2020) SARS-CoV-2 and displaced persons in Afghanistan: A blind spot in epidemic preparedness. Journal of Global Health , 10 (2) , Article 020308. 10.7189/jogh.10.020308.

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Abstract

Displaced populations living in overcrowded settlements present an emerging and severe COVID-19 public health risk in conflict-affected countries across the globe. In Afghanistan, the scale of the risk is sobering: over 8 million people have been displaced since 2012, including 4.2 million internally displaced people (IDPs) and 4 million returnees from Iran and Pakistan [1]. Many live in overcrowded urban settlements that lack basic water, sanitation and hygiene (WASH) services, where the virus and associated lockdowns can wreak human, social and economic havoc. In addition, forty years of protracted conflict have left the country with a fragile health infrastructure – there are less than 2000 isolation beds nationwide – that may exacerbate the human toll of the disease [2]. The spread of the virus is of immediate concern because of the country’s porous border with global hotspot Iran: since January 223 157 Afghans have returned, many fleeing the COVID-19 outbreak and settling in crowded urban settlements, presenting severe transmission risks [3]. In this context, this article assesses COVID-19 risk in urban IDP and returnee settlements by examining a displaced community in the eastern Afghan city of Jalalabad. In doing so, it provides insights into the causes of vulnerability and potential mitigating measures.

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