War In Nagorno-Karabakh Highlights The Vulnerability Of Displaced Populations To Covid-19

Conflict, war and the resultant displacement of populations increase risk for infectious disease transmission. Forced migration, loss of safe shelter, loss of livelihood and interrupted access to clean water, electricity and healthcare all lead to increases in epidemic risk. Refugees and displaced people are uniquely vulnerable to COVID-19. The chaos of war and its aftermath override the population health education messages to wear a mask, socially distance and wash hands frequently.\n\nRisk of COVID-19 transmission is heightened for people living in densely populated community spaces and overcrowded shelters, particularly for those with inadequate access to clean running water, soap and appropriate sanitation and hygiene facilities. Such circumstances make it challenging to physically distance and maintain proper hand hygiene. Overwhelmed healthcare systems and fragile capacities for social services further contributes to group-specific vulnerabilities of refugees and displaced people. World Health Organization (WHO) and the United Nations High Commissioner for Refugees (UNHCR) have recognised the disproportionate impact of the pandemic on these communities and the need to protect them.1 2 We, the Public Health Working Group for Armenia, echo the call previously made by Kluge et al 3 for an inclusive approach in guiding the global response to the COVID-19 pandemic, emphasising the principle of leaving no one behind. We are particularly concerned about the postconflict setting in the Nagorno-Karabakh Region and the recently displaced Armenian population who have relocated to the Republic of Armenia.\n\nIn November 2020, the governments of Azerbaijan, Russia and Armenia signed a ceasefire agreement which brought an end to a 6-week long war between Azerbaijan and Armenia over the disputed Nagorno-Karabakh region, an enclave historically populated by indigenous ethnic Armenians (online supplemental file 1). A recent re-escalation of the decades-long conflict, despite the United Nations Secretary General’s call for a global ceasefire during the pandemic4 …