Vast, dusty and congested. The Dadaab refugee camp, in northeastern Kenya, is a chaotic mess of tents built of plastic and sticks. This year Dadaab is 20 years old and remains the world’s largest refugee camp, originally built by the United Nations High Commissioner of Refugees (UNHCR) for 90,000 people but today accommodating over five times that number.
　　With insufficient medical care, food and water, disease is a constant companion to those who call the camp home - the majority fleeing from somalia, a country embroiled in a deadly mix of conflict, persecution, drought and famine.
　　Somalia remains one of the worst humanitarian crises in the world and has been without a central government since 1991.
　　“The refugee camps in Kenya are overcrowded, have caused huge environmental degradation, have led to growing tensions with host populations and are infiltrated by extremists. This is the reality of the humanitarian and security crisis that Kenya continues to bear,” Kenya’s President Mwai Kibaki told a conference on somalia held in London’s Lancaster House at the end of February this year.
　　That Kenya is at a crossroads due to the lawless, unstable and conflict-ridden somalia is no secret. On one hand, Kenya wants peace in somalia, so that the refugees can return to their home.
　　On the other hand, the Kenya Defence Forces are in somalia pursuing al shabaab militants, so that the country’s transitional Federal Government (tFG) can gain a firm control. The conflict is mainly located in south and central somalia, where the tFG, supported by african Union peacekeepers(aMIsOM), is opposed by Islamist insurgents.
　　However, the tight budget in Kenya and the regional powerplays - Uganda, Ethiopia and Burundi would all want to share the credit for restoring peace in somalia - are obvious constraints to a decisive action in somalia. Kenya yielded to the regional pressure and acquiesced to send its troops to join the peacekeeping force of the african Union Mission in somalia.
　　Back home, Kenya has had to grapple with how it would handle the refugees who are scattered all over the country, given the al shabaab threat.
　　Dadaab unbundled
　　The story of Dadaab is as old as the violent and bloody civil war in somalia. according to the UNHCR, the body that manages the complex, the first camps were put up between October 1991 and June 1992.
　　The Dadaab complex has five camps: Dagahaley, Hagadera, Ifo, Ifo2 East, Ifo2 West, and Kambioos. The UNHCR total people for all those camps as at February was 463,000. The Kenya government figure is 630,000.
　　The variance could be explained because the state is aware that not all refugees are within the camps, and that government had temporarily suspended the registration of new arrivals, which has not stopped the weekly flow of 1,000 refugees from crossing into Kenya, according to the country’s Ministry of Immigration.
　　According to UNHCR spokesman andrej Mahecic, the total somali refugee population in the East africa region is slightly over 1 million. Dadaab already has some 10,000 third-generation refugees born there to refugee parents who themselves were also born in the camp.
　　Mahecic spoke at the recent London meeting that sought to galvanize political and humanitarian support for the restoration of somalia.
　　Citizenship
　　UNHCR figures show that there are 77,000 children under the age of five in the camp. There are also 122,000 aged between five and 17 years of age. Once they turn 18, they will have to grapple with the question of their statehood.
　　In Kenya, one can only become a citizen through birth or registration. Children below the age of eight years, whose parenthood is unknown, are also eligible to be citizens of Kenya. But for the refugees born in the camp, because they have foreign ancestry and are likely to leave once somalia becomes stable, it is difficult to grant them citizenship.
　　Under the laws of somalia, most notably the 1962 somali Citizenship Law, “only the children of somali fathers acquire somali citizenship.”
　　As such, the humanitarian agencies have had few options with regard to raising the children of refugees. Most of them will hold an alien card until peace is restored in somalia. This is similar to those from south sudan, who had to wait out the twodecade conflict in their motherland, before moving back to a brand new south sudan Republic.
　　Health concerns
　　To avoid a “generational freeze” of refugees, the camps have limited schools, mosques, churches, hospitals and even youth programs. There are also markets, where refugees with some money - somalis have a legendary entrepreneurial spirit - or those whose overseas relatives support, sell goods in the camps.
　　“The crisis also presents an opportunity to more actively empower refugees to manage the day-to-day aspects of camp life. This includes the engagement of youth in providing informal education to new arrivals in Kambioos, water committees coordinating and ensuring sufficient water per household, refugee reporters publishing their own newspaper, and women forming groups for livelihood opportunities for mothers,” the UNHCR noted in a dispatch to mark the 20th anniversary of Dadaab.
　　The health of the refugees is also a source of concern for the aid organizations. On a typical day, some 1,800 refugees now get outpatient treatment in hospitals and health posts in the camps. service provision in Kambioos has also improved. However, UNHCR is still seeing new measles cases (11 in the first week of February) and is focusing on vaccinating all new arrivals over 30 years of age.
　　Médecins sans Frontières (MsF) - Doctors Without Borders - in a briefing paper dated February 2012 points out that there are huge health challenges for the refugees.
　　The paper titled “Dadaab: Back to square one” seen by ChinAfrica, points out that the situation in the Dadaab camps are still grave.
　　“Within the camps, the health situation is alarming, with recent outbreaks of measles, acute watery diarrhea and cholera. The situation of the refugees in Dadaab camps is extreme with little hope of improvement in the short term,” the humanitarian body noted in the brief.
　　MsF, whose workers have been abducted by the al shabaab militants, are of the view that the media and political attention has shifted from the “inhuman conditions”at Dadaab camps to the restoration of somalia. That, the body noted, is unacceptable.
　　“While the media and political attention concentrate on the stabilization of the situation in somalia, we cannot ignore the striking needs of thousands of people who live in inhuman conditions. The international community is failing to provide those men, women and children fleeing conflict and drought with more than the bare minimum,” reads the brief obtained by ChinAfrica.
　　“Refugees need protection and care as their lives are becoming more difficult everyday. Their health is at risk of deteriorating rapidly while humanitarian aid agencies are struggling to provide meaningful assistance on an ongoing basis in an increasingly insecure context,” said Dr. Monica Rull, an MsF program manager for Kenya and somalia, quoted on the MsF website.