MSF Crash's directors of studies, Rony Brauman and Michaël Neuman talk about MSF's refugee camp experience.

On 6 May 2016, the Government of Kenya announced its intention to close the Dadaab refugee camps due to "financial, environmental and security" concerns raised by the presence of Somali refugees on Kenyan soil. The initial target date of 30 November was put back six months by the Kenyan authorities, for whom insecurity and the 2016 elections underway in Somalia constitute "a delicate situation" that demands more time.

In a press release on 13 October 2016, Médecins Sans Frontières called for other alternatives to be considered. Can we talk about what those might be?

Rony Brauman (RB): There's no doubt that breaking Dadaab down into a number of smaller, more manageable camps would be preferable, from a human perspective, to sending the refugees back to Somalia. So would resettling and integrating part of the refugee population locally or in a third country. But these are very theoretical solutions.

Although MSF has spoken out about the closure of the Dadaab camps, the organisation no longer allows its own international staff to work there due to - understandable - security fears. So MSF's position is very tenuous: while rightly setting out all the arguments against sending the refugees back to Somalia, the fact that the organisation itself cannot work in the complex "normally" is disregarded. Dadaab is a collection of camps which have existed for 25 years and which are home today to nearly 260,000 people. For the Kenyan government, it represents a very real problem in terms of image, security and politics. Given the situation on the other side of the border in Somalia, however, it is impossible to organise the refugees' return in good conditions.

MSF is, faced with this impasse, trying to maintain a precarious status quo, hoping that something will give either from the Kenyan or from the Somali side. Building smaller camps would mean greater dispersion and would therefore require more resources (more health centres, more vehicles, more water distribution points, etc.). In the current global refugee crisis, demands for these resources are prolific, widespread and substantial, making this alternative seem fairly unrealistic and more of a chimerical plea in the absence of more practical solutions.

Michaël Neuman (MN): MSF is in an extremely awkward situation. Since it began working in the Dadaab camps, the organisation has regularly criticised the living conditions and lack of aid there. Today, it is speaking out against these conditions while also condemning the Kenyan government's decision to close the camps. The alternatives proposed by MSF remain nebulous, and it seems their delineation is complex.

The problem for the Kenyan authorities is the very presence of so many Somalis on Kenyan soil. It seems that for these authorities, the only solution is the refugees' departure, either back to Somalia or to another country. We know very well that only a small number of Somali refugees are resettled in Europe or the United States for example. And mass repatriation is not an option. Somalia is still characterised by a very high level of political violence and extremely limited access to healthcare and basic services. It is important to remember that MSF hasn't worked in Somalia for more than three years both as a consequence of the organisation's own experiences in the country and the extremely precarious security conditions there.

It seems to me that until the situation in Somalia improves considerably, the only solution is both to resettle more people in third countries, increasing pressure on Western governments to accelerate the processes - although convincing them in the current climate is unlikely to be easy - while significantly improving the living conditions at Dadaab and accepting that these people, who have been living in "temporary permanence" for 25 years, will, in the long term, need to be settled definitively.

Do you believe that aid organisations contribute to the perpetuation of refugee camps?

MN: It's not the NGOs that are at war in Somalia. It's important to keep in mind that the main factor keeping the Somali refugees in Kenya is the continuing conflict in Somalia. It's difficult to imagine today how Somalia could welcome these people in good conditions, particularly given how difficult it is for aid organisations to work there.

With regards to the perpetuation of refugee camps, a certain number of Palestinian camps, in Syria, in Lebanon, in the Occupied Palestinian Territories, have evolved into cities. The city-camp boundaries are almost indiscernible. It's about government policy and not the assistance offered by NGOs, whose role is to help people live in acceptable conditions until they are offered a long-term solution.

Of course, the camp is a practical configuration for delivering assistance. That is clearly documented, acknowledged and recognised. When a population is scattered throughout a city or a host community, the work of aid organisations becomes more complicated. It is, however, far more effective for developing autonomy and limiting the erosion of personal freedoms. The alternatives to the refugee camp should be considered when the population is displaced initially, rather than after 25 years of semi-permanent settlement, as is the case in Dadaab.

In 2013, the Governments of Kenya and Somalia, and the United Nations High Commissioner for Refugees (UNHCR), signed a tripartite agreement to encourage the voluntary return of Somali refugees to their home country."According to the UNHCR, 24,000 people have already decided", Dadaab to Somalia: Pushed Back Into Peril, MSF, October 2016.

Since the Kenyan authorities announced their intention to close Dadaab, the UNHCR has accepted to help facilitate the \"voluntary returns\". According to an MSF report published in October 2016 however, 86% of refugees interviewed declared that they did not want to return to Somalia, which seems to contest the voluntary nature of these returns. What do you think of the UNHCR's participation in the camp evacuation policy?

MN: What we have observed is that the refugees themselves have not spontaneously and massively shown a desire to return to Somalia. Whether or not the term voluntary is appropriate should be assessed from the individual refugee's perspective: is he or she convinced, or not, in the end by the arguments put forward by the campaign surrounding this operation? Despite a lack of conviction, does he or she feel forced to return to Somalia? Some people are taking advantage of the financial incentive "Returning refugees receive $200 per person from UNHCR when they depart from Dadaab and then another $200 per person upon arrival in Kismayo. Additionally, refugee returnees receive $200 per household per month for the subsequent six months, as well as $15 per month for food." Mark Yarnell, Refugees International, Field Report, 4 November 2016. offered to them when they decide to return, but, it does appear, in fact, that most of the returns are not voluntary.

The UNHCR's decision to participate in these forced repatriations clearly raises questions. Perhaps it is a pragmatic decision in an attempt to lessen the demographic pressure in the camps in case the Kenyan government should do what it has said, and close the camp completely. There would be fewer Somali refugees to manage in far worse conditions. Perhaps they see this as the lesser of two evils. If this was the rationale behind the UNHCR decision, the lesser of two evils would still result in an erosion of the refugee's right to protection, and particularly to their right to protection against refoulement (if we consider these to be forced repatriations, if other options such as resettlement in third countries are not being considered.)

This hypothesis, which remains unverified, does raise problems in terms of its global impact on how refugee populations are treated. We're talking a lot about Dadaab, but let's not forget that Pakistan and Iran have been sending hundreds of thousands of Afghan refugees back to Afghanistan, also in conditions that worry a certain number of press agencies and organisations.

Have there been situations similar to Dadaab in the past that we can learn from?

RB: There have been bigger camps in the past - I'm thinking particularly about those on the Cambodia-Thailand and Malawi-Mozambique borders - and there have been operations to send refugees back to their country of origin, particularly the Rohingya people. But each situation is unique and I can't see what lessons can be learned for Dadaab. Most often, refugees have decided of their own accord to return home when they consider the situation to be favourable. The two mass return operations organised by the UNHCR were for the Salvadorans from Honduras and the Khmers from Thailand.

Were those voluntary returns?

RB: That depended on the populations. For the Khmers in Thailand, I was there and I heard some people accept the decision under the pressure and others declare that they would come back. Most people had arrived in 1980, which was 12 years earlier. It's not as long as in Dadaab, but long enough for a whole generation to have grown up in these border camps, for young children to have become teenagers in conditions that were completely different to those in their home country. In the camps they had access to health centres, to entertainment, they went to school. Basically, they had access to the resources available in a relatively developed city, established artificially in the camps. So the idea of moving back to a country many considered to be "frozen", partly by the reign of the Khmer Rouge and partly by ten years of communism, wasn't particularly attractive. The Salvadorans in Honduras returned after an agreement had been signed with the guerrilla forces.

Different situations vary considerably. The refugee camps in Kenya are not the same as those in Jordan or as those in Cambodia and Thailand were back in their day. The organisation and the rules in place differ and the degree of isolation from the host country varies. The stagnation and isolation can be absolutely suffocating. And, despite all this, for some the camp is the only living environment that offers a little material security.

For many, Somalia has lost its sense of materiality. It's no longer a tangible place, just a vague idea. Today you can be an adult Somali refugee at Dadaab and know nothing about your home country other than what you've heard from your parents or neighbour. Returning just doesn't mean anything: you can't return to a place you've never been to, it's a migration.

MSF has developed operational expertise in refugee camps. Can we talk about that experience?

RB: MSF began working in refugee camps periodically in 1976. As the organisation did not have enough resources to work alone, it supplied medical teams to organisations already working on the ground. The idea that we could work directly in the camps ourselves then slowly gained momentum.

The aim was to provide medical treatment and sanitation to people who had been uprooted and were dependent on international aid. It seemed entirely justified and timely, in a context where providing medical care under ordinary circumstances was perceived rather negatively, like some kind of missionary charity, as opposed to development assistance, which attempted to tackle health problems at their root. In conflict zones, on the other hand, medical care was considered necessary. In refugee camps, in other words in the immediate vicinity of the war zone, an arena for humanitarian medicine emerged that corresponded to the desire to work in emergency situations. Our collective intuition was telling us that the refugee phenomenon was only going to escalate, with the growing numbers of tensions and conflicts across the world that marked the end of the 1970s and the beginning of the 1980s. So the camps represented a new field for us to work in, particularly because the more traditional areas of international aid were generally unreceptive to the kind of medical care MSF was proposing. Over the years, MSF developed expertise and acquired the organisational resources required to respond to the needs in refugee camps.

All our expertise in terms of vaccination, epidemiology and so on was developed in the camps. In the 1980s, we were working in refugee camps in the five crisis zones in the world: Central America (Honduras, Salvador, Nicaragua), Southern Africa (Angola, Malawi, Mozambique, Zimbabwe, Zambia), the Horn of Africa (the Somali-Ethiopia conflict), Central Asia (Afghanistan - five million refugees between Iran and Afghanistan) and South-East Asia (Vietnam, Laos, Cambodia).

MSF acquired more than just practical expertise working in the camps: it developed an organisational culture in the broader sense. We developed professional sectors, lines of work organised by speciality, an organisational logic, a priority framework. It goes far beyond a simple geographical limitation of our activities, it is more about an action culture. On this subject, read the article by Bertrand Taithe, "The Cradle of the New Humanitarian System? International Work and European Volunteers at the Cambodian Border Camps, 1979-1993", Contemporary European History, Volume 25, Special Issue 02, May 2016, pp 335-358.

Can we learn anything from MSF's experience in Calais and in Grande-Synthe?

RB: The situation in Calais is too specific. It is a camp that is home to 4,000 to 6,000 people in which we would not have worked had it been anywhere other than in France. It is important then to keep in perspective the lessons that could be learned in terms of MSF's operational strategy and our capacities to work in refugee camps.

MN: It is interesting to talk about Calais again, but as a starting point for discussions on the value of a refugee camp, on what a refugee camp produces. I say that bearing in mind all the very critical visions of refugee camps that have emerged over the last few years - and rightly so. The UNHCR for example initiated its alternatives to refugee camps policy in 2013 and researchers working on refugee camps have voiced criticisms, particularly of the camp as a supranational object to manage "undesirable" populations and on the invisibility of certain populations. So there is a critical view of the way in which camps can limit freedoms, and entrench people in a protracted refugee situation. Dadaab in fact is a good illustration of this.

These views however seem to disregard the fact that the camp is also a place where new ideas are born, a cradle for political activity and contestation.On this subject, read the article by Steven Robins, "Humanitarian aid beyond "bare survival": Social movement responses to xenophobic violence in South Africa", published online by the American Anthropological Association, 6 November 1999

Initially, it can be a place where people gather of their own free will. People get together in camps, like we are seeing in France, because they feel better when they are together, more protected by the community, more able to find ways to survive. Before people gathered in the "New Jungle" in Calais in March 2015, squats proliferated and dominated the countryside.

And in the end, the tables turned in Calais. The authorities decided to gather people together on the outskirts of the town to remove them from the urban fabric, to make them invisible, but the opposite happened. The refugees brought themselves directly into the limelight in a movement that was joined by volunteers, activists and others. So the refugees acquired a new type of visibility, because of their numbers but also because of their unusual situation, their coming together and establishing a semi-permanent community, the very strong links they created with many people and the development of social, economic and political activities that brought to life something that is not a UNHCR camp, that is not a city, but that is some kind of hybrid entity. And it is far from perfect. There has been a lot of violence in the camp, violence that it would be fair to say was partly sustained or caused by the authorities and the pressure they put on people, and particularly the police presence. It was also partly related to "endogenous" causes (power struggles, struggles between communities, prostitution, etc.) as the camp is, by definition, a group of vulnerable people that have come together.

There is clearly ambivalence over the definition of a camp, which cannot simply stop at a measure to ensure the safety of a population living in precarious conditions, to make them disappear and secure the geographical area. Social links, political links are recreated. The camp can be a place where people unite around their political cause; it can be a birthplace for internal mobilisations and, in the case of Calais, in ways that had rarely been seen before, particularly in terms of the transformation of the living environment.

The camp can be described as a kind of urbanism. Could Calais have been maintained? A certain number of observers of the Jungle had attempted to transform the camp into the embryo of a new city. But I remember many people being concerned about the site on which people were gathering in March 2015 as it was a former industrial zone, a waste disposal area and not at all suitable for as a place for people to live.

Others were considering similar ideas for Grande-Synthe, near Dunkirk, which is a camp that MSF created with the city's mayor, Damien Carême. There is clearly also a chance, a desire to see the camp become part of the city, albeit peripheral. There again, the camp's location between a road and a railway does not make it particularly attractive as a potential residential district. But the idea of joining the camps to the city, the migrants to the population, is compelling. The interesting thing about Calais and Grande-Synthe is that they came into being with very little involvement from the government: Thanks to the initiatives of local officials in Grande-Synthe, while Calais "Jungle" emerged as a community that was self-managed by the refugees themselves and by those who came to assist them.

And so the vitality of the solidarity that unfolded, through a network of community-based organisations that has existed for many years, and particularly the solidarity networks, the oldest of which were created in the early 2000s, was actually a result of the government's inaction, of its entirely passive attitude.

If such networks do not already exist, and if the government desires a high level of control, this type of movement is less likely to emerge. In Greece for example, there are both government-run camps that are managed by the military (in which interactions between the Greek population and refugees remains fairly limited, and their dependence on aid is high) and a certain number of very rich initiatives like City Plaza in Athens, which is an abandoned hotel occupied by collectives of Greek citizens who have opened the doors to hundreds of refugees. Since April, the hotel has been self-managed collectively as a cooperative, in good conditions, with very limited government intervention (the authorities decided not to outlaw the initiative and to refrain from getting involved, which is itself a form of intervention.)

With these types of stimulating, creative initiatives, there seems to be a greater chance of integration, and far richer interaction between the population and the refugees.