Report A den Warsama from Djibouti is all too familiar with the suffering endured by mi- grants passing through East Africa. ‘I have seen people collapse and die at the side of the road sim- ply because they had diarrhoea or were de- hydrated. But no one’s life should end like that,’ he says with visible emotion. As a doctor, it is important to him that he can now contribute to protecting migrants across the Horn of Africa. The 31-year-old works for the hospital in Obock, a small port town in northern Djibouti and the location of one of the country’s refugee camps. The Bab el-Man- deb Strait on the Red Sea is a key transit route, for example for refugees from Yemen who have made the crossing to escape the civil war at home, and for Ethiopians seek- ing work on the Arabian Peninsula. Many put their trust in unscrupulous people smugglers, to whom a human life is worth- less. Defenceless along a dirt road Aden Warsama looks after vulnerable mi- grants – children, women and men. He is a member of a mobile health team that pa- trols the coastal roads in specially equipped ambulances, providing care for people in need. Many have entered the country ille- gally and are too scared to approach the authorities for help. ‘When we spot them, we start by giving them water and asking if they need medical assistance,’ he explains. The mobile health teams have been operating in all five regions of Djibouti since late 2017, driving up and down the dust roads and assisting stranded and vul- nerable migrants. Each day, more than 300 migrants arrive in Djibouti, a small coun- try with a population of just one million. That adds up to more than 100,000 arriv- als a year, equivalent to 10 per cent of the population. Although many of the mi- grants are simply passing through, the challenges facing Djibouti are immense. The health teams out on patrol on Djibouti’s desert roads were organised by its Health Ministry and the International Organization for Migration (IOM), a United Nations agency. This primary care for migrants is provided as part of a com- prehensive programme that aims to ensure that migration in the Horn of Africa takes place in a humane and orderly fashion. This extensive Better Migration Man- agement (BMM) programme is coordinat- ed by the Deutsche Gesellschaft für Inter- nationale Zusammenarbeit (GIZ) GmbH on behalf of the European Union (EU) and five of its member states, including Ger- many. GIZ is working with a number of other well-known organisations in this context, including the British Council, the UK’s international organisation for cultur- al relations and educational opportunities, and the French development agency Ex- pertise France. According to the United Nations, more than nine million people in and around the Horn of Africa are currently displaced. Some are fleeing war or hunger in their home regions. Some have been persecuted and are seeking political asy- EU EMERGENCy tRUst FUND FOR AFRiCA The EU Emergency Trust Fund for Africa is a foreign, security, stability and develop- ment policy initiative established in 2015. It focuses on three regions: the Sahel, the Horn of Africa and North Africa. The re- sources currently allocated to the Fund amount to EUR 3.3 billion. Its target bene- ficiaries include refugees, migrants, return- ees and communities that are hosting refugees and migrants despite living in poverty themselves. Through the Fund, the EU, Germany and other European countries are working together to alleviate suffering in these regions and establish more effec- tive structures for legal migration. www.ec.europa.eu/trustfundforafrica lum. Some are on the move because they have no economic prospects at home, or because their lives have been blighted by the impacts of climate change. These mixed migration flows are imprinting themselves on this easternmost region of Africa. Only a tiny proportion of the migrants and refu- gees set out to reach Europe; most remain within the region. However, in the Horn of Africa – one of the world’s poorest re- gions – protection for migrants is often inadequate and livelihoods are precarious, not only for refugees and migrants but for locals as well. Avoiding conflicts with local communities As diverse as the conditions in the various countries may be, they have one feature in common: they cannot deal with the chal- lenges posed by the mass migration move- ments of the 21st century unaided, at least not in a way that safeguards the basic hu- man rights of refugees and migrants and avoids conflicts, as far as possible, between the new arrivals and local communities. Together with various other European countries and the EU, Germany is there- fore taking on a share of this responsibility. It is a similar situation in Sudan: this East African state is also a destination and transit country for migrants, mainly from Eritrea, Ethiopia and neighbouring South Sudan. Many only stay in Sudan for a few days or weeks; others become permanent residents, some as registered refugees, oth- ers undocumented. Some opt to keep their illegal status because of Sudan’s policy of housing migrants in camps, where people often feel unsafe, live in fear of violence and exploitation, and have few opportuni- ties to earn a living. Life on the move is harsh and it is the weakest refugees – many of them chil- dren – who suffer most. Some of them are travelling with their parents but others have been abandoned in camps or are making their own way towards a new life in a place of safety. According to UNICEF, in 2016, 44 million children worldwide were living in forced displacement, either ) T H G I R M O T T O B , 8 1 E G A P ( A P D / R E T S R O F A I O I G / E C N A I L L A E R U T C I P , ) E L D D I M , 8 1 E G A P ( N E T R A G K R A M / O T O H P N U : S O T O H P akzente 2/18 19