379 20 Health and wellbeing in refugee camps Sarah Meyer, Cyril Bennouna and Lindsay Stark INTRODUCTION There are more people displaced by conflict and persecution today than at any other time in recorded history, and the numbers continue to grow rapidly. At the end of 2014, the United Nations High Commissioner for Refugees (UNHCR) estimated there were 59.5 million forced migrants 1 worldwide, up from 37.5 million just a decade earlier (UNHCR 2014). About a third (19.5 million) of individuals displaced by conflict and persecution cross a border and receive refugee status, a legal designation with special protections afforded under international law (UN General Assembly 1951). The remaining two-thirds (38.2 million) are internally displaced persons (IDPs) who remain within the borders and under legal regimes of their home countries, or asylum-seekers (1.8 million) whose refugee status has not been determined by the receiving government or the UNHCR. There are three ‘durable solutions’ to resolve a refugee situation and thereby reduce the global total of refugees. First, refugees can be repat- riated voluntarily to their home countries once the conflict or fear of persecution has subsided. This option, which is largely favored by host countries, is complicated given the increasing trend of conflicts to be prolonged and cyclical (Long 2014). The second solution, local integra- tion, takes place when refugees become full legal, economic and cultural members of the host country. Local integration is rare, as many host countries do not want to take permanent responsibility for refugees, who may be considered threatening either to the country’s security or economy (Hovel 2014). In 2014, for example, only 27 countries reported granting citizenship to refugees (de jure integration), covering a total of just 32,100 individuals (UNHCR 2014). De facto integration, whereby refugees settle in the host community informally, and outside of the law, is likely more common, especially in places where refugees and host communities share common ethnic, religious or linguistic identities; but altogether this phenomenon has not been well-documented (Hovel 2014). The third durable solution is resettlement from the first country of Felicity Thomas - 9781784714772 Downloaded from Elgar Online at 07/31/2018 11:00:06AM via Hungarian Academy of Sciences