Turkey is hosting 4 million refugees, 3.6 million of which are Syrian refugees under temporary protection and the rest includes other nationals from Afghanistan, Iran, Iraq, and Somalia under international protection and undocumented migrants. With the unexpected health crisis Covid-19, the situation of refugees who are generally under the socio-economic ladder is worsened, leaving many lost their jobs, and having difficulties accessing food and healthcare. Starting from the political crisis on eve of Covid-19 in the Greece-Turkey border to the situation of refugees and their access to basic needs under pandemic conditions are explored through the paper. The paper also touches upon the changing role of NGOs and other civil society organizations from social cohesion to meeting the urgent basic needs of the refugees.
Keywords: Covid-19, refugees, Syrians, socio-economic challenges, healthcare
This paper is based on secondary data analysis. Throughout the paper, academic resources, published reports, surveys conducted in different parts across the country, media resources, news, announcements from the government and its institutions, and briefs in Turkish and English languages have been reviewed and compared.
As the topic is up-to-date, there are limited resources available on academic grounds. Due to the ongoing pandemic, the quantitative data that is implemented in fields is restricted. However, given the several existing sources found, it is observed that the findings are consistent with each other. For the analysis of several funds between Turkey and the European Union, the international organizations’ websites and publications are consulted online.
The national sources such as legal regulations and the official gazette of the Turkish Republic that are available in the Turkish language are interpreted into English by the author herself.
The Legal Status in Turkish Context
Turkey has been hosting approximately 4 million refugees and asylum seekers. Since the outbreak of the civil war in Syria in March 2011, 3.6 million of this number are Syrian nationals residing in various cities across the country. Over 400.000 are conditional refugees and asylum seekers from other nationalities such as Afghanistan, Iran and Somali. (UNHCR, 2021). As being a buffer zone throughout history, the country has been popular for those who are on their way to seek better lives in developed countries. Being among the countries that signed the Geneva Convention on the Refugees 1951 and its Protocol 1967, Turkey, however, retained the geographical limitation clause in which only people who escape from events occurring in Europe may be given the status of refugee excluding non-Europeans. The Convention and its Protocol define the term ‘’refugee’’ and international refugee rights, with ‘’non-refoulement’’ principle preventing refugees to be forced to return their countries they fled from (UNHCR, 2000). As a result, the Convention and its Protocol do not apply to those from the Caucasus, the Middle East, and Africa because of their neighboring states. Specifically, Syrian nationals that has the majority among other refugees in Turkey are simply referred as “guests” and not as refugees or asylum seekers. This caused that not having any legal grounds in the first phase of their entrance to Turkey and restricted them from access to basic needs and rights. Following that, the Law on Foreigners and International Protection (LFIP) adopted by the Grand National Assembly of Turkey in April 2013 determines Syrians’ entry to Turkey and mobility in the country. The second step came in October 2014 and the Temporary Protection Regulation was adopted. With these regulations, the Syrian nationals who came to Turkish borders individually or as mass influx from Syria, as well as the stateless and the refugees were temporarily protected. The emergency and basic needs of refugees and health care who are under ‘’temporary protection’’ have been provided in the same city where they registered.
Having overviewed the overall displaced persons in Turkey, three categories appear; Syrians under temporary protection, non-Syrians under international protection consisting of the ones whose asylum applications’ rejected and who are waiting to be placed in third countries and undocumented migrants who are not registered and difficult the estimate in numbers (Ustubici & Karadag, 2020). There are legal differences among these categories. For example, undocumented migrants are the most disadvantaged category. As they do not have the legal documents, they cannot have access to health services, shelter, and other rights, as well as they cannot have immediate assistance from formal civil society organizations, as it is hard to reach out the data. The refugees under international protection are registered as asylum seeker applicants and as they have no access to residency, they are placed in ‘’satellite cities’ (Asylum in Europe, 2020). On the other hand, the Syrians under temporary protection have somewhat recognition on legal grounds compared to the two other mentioned groups.
Of all Syrians under temporary protection in Turkey, only 2% (60.169) live in camps that are run by the Disaster and Emergency Management Authority (AFAD) and the rest live in cities in Turkey. Once the Syrians are registered by authorities, they are provided an identity card which allows them to access public services, health and education in their registered cities. It is worth to mention here that there are many Syrians living in other cities than their registered ones due to work opportunities. As part of the European Union (EU) -Turkey Joint Action plan, the Regulation on Work Permits of Foreigners under Temporary Protection was introduced (Authorities, 2016). This allowed Syrians under temporary protection to access the labor market and work permit procedures. On the other hand, a small part of them is working in practice. The people permitted to work are mainly active in lower, service, and production sectors such as education, wood, and paper, cement, soil and glass, energy, food, construction, metal, plastic, textile, and leather industries (140journos, 2017).
Covid-19 Outbreak and Greece-Turkey Border
Following the EU-Turkey Joint Action Plan on 18 March 2016, the European Union and Turkey agreed to end the irregular migration from Turkey to the EU borders. According to the agreement, Turkey will take any necessary measures to prevent new sea or land routes for irregular migration from its borders to EU borders, specifically to Greece (European Commission, 2016). Despite this agreement, on 27 February 2020, upon the death of Turkish soldiers in the conflict in Idlib province of Syria, the Turkish government announced that Turkey would no longer stop the irregular migration and asylum seekers to reach the EU border, as there was not enough support received. As a result, thousands of people flooded to Edirne, a border province thinking they would cross the border freely (Bejan, 2020). According to Ustubici and Karadag’s interim report, some refugees under international protection from the detention centers were encouraged to leave and led to the border (Ustubici & Karadag, 2020). This indicates an example of how migrants and refugees are used as some scholars define ‘’political bargaining tools’’ or ‘’political pawns’’. Greek border responded as pushback with tear gas, plastic bullets, left many injured, and allegedly even caused three people’s death with the usage of live ammunition used by Greek forces (Amnesty, 2020).
According to observations from Amnesty International, the asylum-seekers and refugees were lack of shelter was the main problem on the border. There were some families with children sleeping in fields, in makeshift tents, or simply with blankets on the ground. There was no support of shelter by state-led or civil society organizations. Regarding food supplies, along with the Turkish Red Crescent and AFAD, some civil society organizations and associations also were in the field to distribute the supplies (Koprusu, 2020). It is also stated that there were mainly undocumented refugees or the ones their asylum applications rejected and waiting to temporary protection along with small group of Syrians under temporary protection and many mentioned that they would like to cross to border to seek for a legal recognition (Akbal, et al., 2020).
On the eve of this extreme situation, the first Covid-19 case was confirmed in Turkey on March 11. While the pre-covid period was not promising in terms of meeting the basic needs of people, now with the outbreak of Covid-19 the situation is worsened. Ustubici and Karadag define the situation as ‘’Edirne-Covid Nexus’’ with the stuck of 13,000 people in the border while the pandemic was slowly spreading across the country. In the following days, there was a voluntary return to Istanbul. The Turkish government announced that people who would like to return would be transferred through shuttle busses to the Istanbul bus terminal. Later on, the evacuation started by Turkish authorities, transferring people to removal centers or dormitories as a measure of 14 days quarantine. As per the report on Izmir Harmandali Removal Center by Izmir Bar Association, the lawyers received complaints on the conditions of the removal centers by refugees such as overcrowded rooms of up to 15 people, no self-isolation, and lack of hygiene materials, facilities, and personnel. The refugees also stated that their access to a doctor was very limited and their requests for a doctor’s examination were not met (Association, 2020). The Bar Association depicted the situation as a clear violation considering the publishment on 20 March 2020 ‘’Statement of Principles Relating to the Treatment of Persons Deprived of Their Liberty in the Context of the Coronavirus Pandemic’’ by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). CPT reminds the principles such as all the possible actions should be taken to protect the health and safety of the people and special attention is required for detained people (CPT, 2020). Considering the health, hygiene, and accommodation conditions of the removal centers, it should also be underlined that crowded areas pose a serious risk during pandemic. While the The Directorate General of Migration Management (DGMM) of Turkey stated that there was no positive case found in the removal centers or the dormitories in their Twitter account on 31 March, Izmir Bar Association claimed that they were informed that 30 refugees and 1 security guard tested positive (Evrensel, 2020). After the 14 days quarantine, many migrants could not return to their registered cities but randomly left in other cities. Thanks to the assistance of NGOs and local civil society, they were able to return their cities.
Edirne-Covid Nexus reveals that there is a protection gap in humanitarian aid in theory and practice. Moreover, a political crisis that coincides with another health crisis shows how fragile the legal ground of the situation. The refugees are the ones affected most when it comes to extreme situations.
Covid-19 and Refugees in Cities
During the Covid-19 pandemic, the need to access food, health support, work, and shelter of refugees increased. Needless to say, Covid-19 has a major impact on people from every walks of life, yet, as in the other extreme crisis that occurred throughout history, it is realized that refugees and asylum seekers and the ones under the socio-economic ladder are affected the most. The Ministry of Health (MoH) has been announcing overall cases of Covid-19 so far and this data includes the refugees as well, however, there is no separate data only for the refugees. There is a thought that it is an act on purpose to prevent the stigmatization of refugees within the nation.
According to the figures by DGMM, 98% of the refugees under temporary protection live in urban cities mainly Istanbul, Gaziantep, and Hatay due to job opportunities. As Turkey does not provide accommodation to the refugees in cities, they are expected to find a place to stay themselves. Considering the higher rents in the housing markets within the districts where refugees highly resided, sharing a flat among several people, singles or families is very common. This again led to a risk of health issues, preventing self-isolation in the course of the virus.
Access to Healthcare
The Syrians under temporary protection and refugees under international protection can access emergency and primary healthcare services in public hospitals in the cities where they are registered; however, according to national gazette in 24 December 2019, a one-year duration enacted for the refugees under international protection. Therefore, anyone except the ones need special treatments who are under international protection and above 18 years old may access to health services free of charge only one year. Syrians under temporary protection are also required to pay the premiums unlike before since 1 January 2020 (Gazette, 2019). Undocumented refugees have to pay the service fee in public hospitals. Later on, the government announced that no one is denied to emergency services (Karakas, 2020). Yet, the registration of undocumented migrants appears as a problem; although, there is a ‘’stateless’’ status in the system of hospitals, not all the systems have this option and in the end, it depends on the decision of the service provider whether admitting the person or not. To support the government and provide health services to people under temporary protection, the SIHHAT project funded by European Union established 177 Migrant Health Centers (MHC) in 29 cities where refugees highly reside (SIHHAT, 2021). In the centers, Arabic-speaking medical staff has been recruited. MHCs help to share the burden on the public hospitals and allow refugees to be examined in their language, which also prevented any mistreatment that might be caused due to language barriers. In case the symptoms of the patients are severe then they are referred to public hospitals. It is also crucial to mention primary healthcare is given to anyone irrespective of their legal status in MHCs.
Nonetheless, due to various reasons such as language barriers, information pollution, and fear of deportation and stigmatization, people often avoid visiting public hospitals. Due to fear of deportation, undocumented migrants do not prefer to seek help from public hospitals unless they have severe symptoms. There is also fear of stigmatization within the community they live in with the nationals. Therefore, the chances of spreading disease in their environment increase. As per language barriers, although Arabic staff is hired in hospitals, the availability is limited. The NGOs or civil society organizations used to provide face-to-face translation services before the Covid-19. Because of restrictions, their operations are mostly suspended, and now they can only assist with telecommunication services. Furthermore, although MoH and the DGMM published several brochures in several languages and announced guidance on the official website and social media accounts, there is still a lack of information on the services given by the authorities among refugees. The report by HASUDER indicates that the measure has not fully reached its goals due to language barriers. For instance, only basic information on an individual measure in Covid-19 is available in different languages. However, they do not know about the implementation of free emergency services in hospitals. Besides, there was a delay in official decisions and this resulted in a lack of trust in information, there are full of different interpretations in the circulation of information (HASUDER, 2020).
Another problem is access to hygiene materials. On 3 April, the government enforced the use of facemasks in public spaces and regulated the distribution of the masks through pharmacies via sending text messages according to the identity number. The refugees and especially the undocumented experienced difficulties and mostly rejected by pharmacies as they did not have the identity (Karakas, 2020).
The refugees who are under international protection live in ‘’satellite cities’’. 2% of Syrians living in temporary accommodation centers receive healthcare, education, and financial support assistance from DGMM. Most of the refugees live in crowded areas; they share common facilities kitchen, baths. This creates concerns during the pandemic in terms of health issues and makes physical distancing challenging. Another problem is access to hygiene materials. On 3 April, the government enforced the use of facemasks in public spaces and regulated the distribution of the masks through pharmacies via sending text messages according to the identity number. The refugees and especially the undocumented experienced difficulties and mostly rejected by pharmacies as they did not have the identity (IFRC, 2020).
Access to Work and Food
One of the other challenges the refugees are experiencing because of Covid-19 is financial problems and purchasing power. The income of Syrian families living in Turkey is generally low and irregular. According to researches, while 18% of the refugees were defined as unemployed before Covid-19, this figure increased 88% during the pandemic. Only %8,21 has a regular job. The survey conducted by Association for Solidarity with Asylum Seekers and Migrants with 1162 refugees and migrants from mainly from Syria (approximately 900) and other nationalities; Afghans, Iraqi and Somali over 48 cities in Turkey, reveals again that half of the participants confirm that they sustain their living from daily works and assistances (SGDD-ASAM, 2020). There is a high rate of job loss due to business shut down, or for the ones who are still working there is a cut off in payments due to halt in business in different sectors during the pandemic. It is known that many refugees who lost their jobs cannot even receive their salaries or there is a delay in the payments. As the refugees mainly work in informal jobs without any security, they cannot claim their rights upon job losses or cannot receive cash allowance from the government. Correspondingly, they are having difficulties in purchasing needs such as buying food and sanitary products. Paying rent is another problem that refugees are facing considering the landowners’ taking advantage of the situation with high rent prices in the housing market. There is also the expectation of an increase in shelter needs by some scholars due to the housing market.
Under the humanitarian program of the EU, the Emergency Social Safety Net (ESSN) provide cash aid to refugee families, 120 TL (about €13) per family member based on vulnerability criteria such as families with several children, elderly or disabled persons (Commisson, 2020). 90 % of the cash aid receivers are under temporary protection and the rest are non-Syrians under international protection. However, undocumented migrants do not have access to aid. Another aspect is that vulnerability criteria included elderly, disabled, and family with several children. In the pandemic period due to job losses, the number of refugees in need increased and almost everyone becomes who needs aid. Some refugees in Gaziantep and Izmir provinces who participated in the survey conducted by Karaman and Vesek claimed that Syrians help each other within their community. They borrow money from other Syrian acquaintances or they get food from the Syrian-run groceries through debts (Karaman & Vesek, 2021).
Activities of NGOs and Civil Society Organizations
Before the pandemic, especially within the border of Greece and Turkey, and during the pandemic, both local and international non-governmental organizations and civil society organizations assisted the refugees to meet unexpected and basic needs such as food and hygiene kits. It is realized that there has been a switch in the role of organizations and the activities of humanitarian from social cohesion activities into providing the urgent needs. While they were focusing on integration activities and workshops in the pre-Covid-19 period, currently, they are allocating their budgets to distributing the kits to people in need. Due to limited budgets, they are only able to assist those under vulnerability criteria. Civil society organizations played a vital role to fill in the gap as well (Ustubici & Karadag, 2020).
Because of curfew and other preventive restrictions announced by MoH, the activities of the organizations have been suspended on the ground. They are not able to provide face-to-face services such as consultations, translation assistance, gathering data, etc. anymore. The refugees cannot simply walk into the institutions either. Most of them have switched to online support and working remotely or stop their activities. Some of the foundations have provided market-shopping cards, an example is Sevgi ve Kardeslik Vakfi that provided food, cleaning, and hygiene supplies as well as grocery cards to over 5000 households in Istanbul and Hatay cities between June and October 2020 (SEVKAR, 2020). Here it is vital to mention the collaboration between the local organizations and municipalities plays an important role for the NGOs and organizations to reach out to the undocumented refugees and other larger populations.
Turkey is a country that is hosting the highest Syrian refugees and other refugees from other nationalities. As pointed out in the legal status in the Turkish context chapter, there are different legal statuses given to refugees. This prevents their access to basic needs in different ways although their need is common. Although Syrians under temporary protection have legal recognition and access to the basic needs in their registered cities, the refugees under international protection and their needs are sidelined and undocumented migrants are excluded from access to healthcare services. The paper finds out that the impact of Covid-19 on the refugee community in Turkey is mainly on reaching out to their basic needs. Along with pandemic, the difficult living conditions of refugees and migrants increased. The events in the Greece-Turkey border show how the border crisis coupled with an unexpected health crisis. Considering the 14 days quarantine of refugees on the border after the evacuation highlights that the disadvantaged people should be focused more to ensure a comprehensive Covid-19 response and an inclusive approach will leave no one behind.
There are several obstacles preventing refugees and undocumented migrants to access healthcare services such as lack of documents, lack of information, language barriers, and fear of deportation. The MHCs established to assist next to public hospitals also run in lower capacity during the pandemic. Firstly, regarding language barriers, cooperation with NGOs and other organizations to continue the translation services will be helpful to eliminate misunderstanding and mistreatment. To prevent lack of information and information pollution, there should be effective communication provided to the public through media and published leaflets in several languages.
The pandemic also requires collaboration among the municipalities and NGOs and other civil society organizations. As studies and projects show that, data sharing is very vital in terms of reaching out to wider disadvantaged groups.
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