Humanitarian Response for Refugees and Migrants Transiting Through Project Name: (BiH)

Region & Sector: Bosnia and Herzegovina, Western Balkans; Emergency Response

“If they deport me to Serbia, I will kill myself. From there, there is no way out.” - , May 2018, a refugee from Syria 1.0 Situation Assessment1 For the first time since World War II, Europe is experiencing a massive movement of refugees and migrants, women, girls, men and boys of all ages, fleeing armed conflicts, mass killings, persecution, pervasive sexual and gender-based violence (SGBV) and extreme hardships. All refugees are entitled to protection under the 1951 Refugee Convention, its subsequent Protocol, and other international instruments. Many experienced displacement and hardship in transit countries such as Bosnia and Herzegovina (hereafter, BiH), and embark on dangerous travels. Lack of information, uncertainty about immigration status, potential hostility, changing policies, undignified and protracted detention all add additional stress. Forced migration erodes pre-migration protective supports – like those provided by extended family – and may challenge cultural, religious and gender identities. Forced migration requires multiple adaptations in short periods of time. People - especially but not only - children, become more vulnerable to abuse and neglect. Pre-existing social and mental health problems can be exacerbated. Importantly, the way people are received and how protection and assistance is provided may induce or aggravate problems, for example by undermining human dignity, discouraging mutual support and creating dependency. An acute sense of urgency among the people on the move may prompt them to take extreme medical and psychosocial risks and their fast-paced mobility through several countries, leaves only very little time for service provision.

From January to November 2015, Europe witnessed 950,4692 refugee and migrant arrivals through the Mediterranean. Europe has to face the consequences of war and conflicts in other parts of the world, and has a duty to act, not only in terms of addressing the situation of refugees and asylum seekers reaching European countries, but also to promote real peace and security for all. In in particular, in BiH, issues of migration, border securitization, and Islamophobia have been quietly playing out in their own way in recent years, also against the backdrop of the crises in Syria.

Even though the closure of the so-called Balkan route significantly reduced the risk of exceptional numbers of refugees and migrants arriving there is still a slow but continuous movement of people crossing the borders into Western Europe, largely with the help of illegal people smugglers. Due to Nationality profiling and the complete closing of borders refugees are now taking much more difficult and treacherous routes, with many being difficult to identify as they are hiding in forests and travelling in very small groups making them difficult to detect. Human rights abuses are increasing, as is the illegal trade in people smugglers. The medical and protection needs of refugees are escalating.

The number of refugees and migrants arriving to BiH increased noticably during late 2017. Between 1 January and the 31 March 2018 authorities registered 1,314 new arrivals. Over the same period, 741 attestations of intention to seek asylum were issued by the Service for Foreigners’ Affairs (SFA). Nineteen percent of these arrivals had registered an asylum claim by the end of March. As of 31 March, 253 people had lodged their asylum claim in BiH. Of these, 30 percent were from the Syrian Arab Republic, 19 percent were from Pakistan, 11 percent were from Afghanistan, 9 percent were from Libya, and 8 percent were from Palestine.

1 As of the 20th of May 2018. 2 UNHCR, Weekly Report, 2015.

80% reached BiH via Serbia, while 20% travelled through Albania and Montenegro. Refugees and migrants report that the journey through Montenegro is easy without major obstacles. Among those coming via Montenegro, the majority (40%) were single males from Syria. Families with children are finding it much easier to cross the border into BiH than single males, who often get pushed back 2-3 times on average before they manage to cross the border successfully.

A number of key congregational points within BiH are developing.

In May 2018, the number of irregular (i.e. at non-official border crossing points) border crossings into BiH has significantly increased, amounting to approximately 450 entries per week. This is largely due to the out flows of refugees and migrants from Serbia, most of whom entered the territory of BiH via Mokra Gora, following roads and rail tracks3 leading to the Višegrad area. A smaller number of migrants enter BiH via the - line. Further short-stay accumulations of refugees and migrants are visible at entrance points in urban areas along the eastern border, from , Višegrad, Goražde (arrivals via and Čajniče), Foča to .

According to the statements of cantonal authorities, in recent months, no coordination or joint approach for the identification and registration of new arrivals has been established. As a result, local authorities often allow newly arrived refugees and migrants to pass through their jurisdiction without registering them. Local police believe that smugglers change their routes depending on how strongly protected certain border areas are, which is why they believe that the border between BiH and Montenegro is better protected today than it was in March, when the numbers of those arriving from Montenegro were significantly higher than those coming from Serbia4.

Between May 15th and May 18th up to 350 refugees and migrants, in more than 60 tents, slept rough in Sarajevo city center (a park near City Hall), of those counted 40% (140) were women and around 14% (50) children under the age of 165. During the same period around 1,000 refugees and migrants resided in and around Sarajevo. These include at the asylum facility in Delijaš outside Sarajevo where between 120 and 150 are sheltered. UNHCR- sponsored hotels/hostels which currently accommodates up to 400 beneficiaries; accommodation provided by volunteers and locals, where around 120 people are sheltered, and an unknown number of those sleeping in squats around Sarajevo, which is not below 100.

At the same time, there is an ongoing accumulation of refugees and migrants at various potential exit points along the Western border with Croatia. This accumulation is particularly visible in Velika Kladuša and Bihać.

Urban areas primarily serve as transit areas in which refugees and migrants spend on average 24 hours6, except in Velika Kladuša, which serves both as a transit area and a place of prolonged stay.

This report does not engage with longer term humanitarian needs such as education and other integration efforts as the current situation is relatively new, dynamic and tied to a number of unpredictable factors both within and without BiH. As such, the situation could evolve in a number of different ways.

National and regional media, with memories of increased refugee and migrant arrivals in the neighbouring countries in 2015-2016, have taken keen interest.

3 No refugees or migrants reported crossing the Drina river in boats or on rafts. 4 according to the data provided by the Service for Foreigner’s Affairs in Gorazde, around 90% of those registered during that period entered BiH via Montenegro. 5 Refugee Aid Serbia, Migration related context in Bosnia and Herzegovina Follow up Assessment, p.3. 6 Refugee Aid Serbia reported an average stay of 7 days.

2.0 Legislative Framework7 regarding the movement and stay of foreigners in BiH8 All refugees and migrants who enter or attempt to enter the territory of BiH in an irregular manner are first referred by the Border Police to the organizational unit of the Ministry of Foreign Affairs - Service for Foreigners Affairs (SFA) with territorial jurisdiction, i.e. the regional Terrain Centre (TC)9, for international protection needs screening. Prior to the significant increase in numbers, individuals who did not express an intention to apply for asylum or a fear of returning to their country of origin at the stage of contact with the SFA were referred to the Immigration Centre, where the majority were then returned - through the readmission processes - to Montenegro or Serbia. The SFA shall issue ex officio - or based upon the proposal of another organisational unit of the MoS or other law enforcement body - a decision on expulsion. In limited cases, the SFA may issue an order for voluntary leave from the BiH territory instead of pronouncing the expulsion measure.

Individuals who express an intention to seek asylum are issued an attestation of the expressed intention to seek asylum by the SFA and are referred to the Asylum Centre if in need of accommodation10. Asylum seekers may also choose to reside in private accommodation, in which case they must register their address with the SFA or police station. The attestation provides a 14-day window11, during which individuals must formally submit their asylum application and undergo registration with the Sector for Asylum (SA) of the MoS.

Registration of the application for asylum can currently be carried out at the Asylum Centre in Delijaš or, if a person is staying in a private accommodation whose address has been recorded with the SFA or police station, at the premises of UNHCR’s Information Centre in the UNITIC Building in Sarajevo. Registered asylum seekers are given an asylum seeker card. Asylum seekers are entitled to the right to reside in the country until a final decision on the asylum claim is made and have access to a number of services, as described further below. If an asylum seeker is in possession of a travel document, it will be temporarily confiscated by the Ministry of Security, pending a final decision on the asylum application.

The SA will then conduct an interview with the applicant and decide on the asylum application within six months, and exceptionally within 18 months, from the moment the application was filled. In particular cases, the MoS may reject the application in an accelerated procedure (within 30 days)12.

During the asylum procedure, a person has a right to: • Residence in BiH; • Information on the procedure, rights, and obligations linked to the status; • Accommodation in the centre for asylum-seekers or at a registered private address if the person can provide themselves with accommodation13;

7 Please note that the description of asylum procedures is not intended to be comprehensive but rather an overview to clarify the context of the proposed humanitarian response. This is a summary from the MIRA Report by the UNCT in BiH, May 2018. 8 Law on Foreigners available at: http://sps.gov.ba/dokumenti/zakoni/Law%20on%20Aliens.pdf. Published in the Official Gazette of BiH no. 88/15 It should be noted that temporary residence on humanitarian grounds is regulated by Article 58 of the Law on Foreigners and granted only in a limited number of cases (victims of trafficking, stateless persons, minor unaccompanied child, if abandoned or a victim of organized crime, or left without parental care, or CoM could approve temporary residence on humanitarian grounds for other justified reasons, or if an alien’s stay is need for cooperation in criminal procedure/or he/she is a victim of organized crime). 9 Currently, there are 16 SFA Terrain Centres in Sarajevo, , , Tuzla, , Brčko, , East Sarajevo, Bihać, , Trebinje, Bijeljina, , Ljubuški, Orašje and Goražde. 10 Article 34 of the Law on Asylum foresees that exceptionally, in situations of increased numbers of asylum applications, asylum-seekers in need of accommodation may be received and accommodated in private homes, apartments, hotels or other premises adapted for this purpose. The Law also prescribes that in case of persons who expressed the intention to seek asylum who are in need of accommodation, organizational unit of the Service for Foreigners’ Affairs informs the Ministry of Security which ensures reception and accommodation. 11 Article 32 of the Law on Asylum foresees a period of 8 days and in case of large number of intents to apply for asylum, 14 days. Currently, authorities are issuing 14 days. 12 Special grounds for use of the accelerated procedure are included in art. 45 of the Law on Asylum and include, among others, submission of incomplete, contradictory or misleading information, concealed identity documents or having entered in the country irregularly without reporting to the competent authorities in due time. 13 Article 10 of the Law on Asylum prescribes that foreigners who expressed an intention to seek asylum, asylum seekers, refugees, and persons under subsidiary or temporary protection enjoy freedom of movement in BiH and free choice of the place of stay, which may be partially or fully restricted only under the conditions prescribed by law.

• Primary health care; • Access to primary and secondary education; • Free legal aid; • Follow the procedure in a language they understand; • Psycho-social support; • Access the labour market if a decision on the asylum application is not made within nine months, and the burden of failure to make a decision cannot be placed on the applicant; • Contact a representative of UNHCR.

In practice, until the moment of registration with the SA or SFA, asylum seekers are not guaranteed access to most of the above-enumerated rights or those guaranteed by international or regional instruments that BiH is a party to, unless provided by UNHCR and its implementing partners, IOM, civil society, the local red cross, volunteers or other international organizations or if individuals are hosted at the Asylum or Immigration Centres.

Foreigners who are placed in the Immigration Centre, detention, prison or institution for accommodation of victims of trafficking can express an intention to seek asylum to the SFA through the management of the institution in which they are placed.

Migrants staying outside the Immigration Centre are not guaranteed access to most of the above- enumerated rights or those guaranteed by international or regional instruments that BiH is a party to, unless provided by IOM, civil society, local Red Cross, volunteers or other international organizations.

4.0 BiH Government Strategy The Council of Ministers of Bosnia and Herzegovina adopted a set of urgent measures and plan of action in response to the increased presence of refugees and migrants.

According to the Ministry of Human Rights and Refugees, strengthening the capacities of the border police remains in focus, as well as increased cooperation with neighboring countries.

The provision of appropriate accommodation for all refugees and migrants sleeping rough in various areas in BiH is a key priority. Besides the recently opened center in Salakovac near Mostar, BiH authorities are considering several other locations for increasing reception capacities in order to accommodate the number of new arrivals. Locations include the village of Hadžići outside Sarajevo and Klokotnica near Doboj-Istok. Some of these facilities have not been used in over two decades, so significant investment will be needed before they can become suitable facilities for accommodating refugees and migrants. Authorities are also considering the provision of containers and tent-based camps.

At the UNHCR partners coordination meeting, it was mentioned that, high costs of renovating and adapting unused facilities for the reception of migrants raise concerns about cost effectiveness of such actions and leave the option of providing vouchers and accommodation in hotels and hostels as one possible long-term solution. The Ministry of Human Rights and Refugees and UNHCR agreed on continuing to use a dual system of accommodation: continue to sponsor accommodation in hostels and hotels as well as in governmental facilities.

A network of partner organizations will be created to support the government in responding to the current refugee and migrant situation.

On March 27 and 28, UNHCR in collaboration with partner organisations conducted a multi-cluster/sector initial rapid assessment (MIRA) which will contribute to the development of the Government’s national migration response.

Beneath Bosnian officials’ attempts to project an air of readiness are signs of looming disarray suggesting that the country may tolerate only 5,000 refugees and migrants on its territory before closing its borders altogether.

5.0 Mapping of Services

5.1 Accommodation Currently there are three types of accommodation provided in BiH; reception facilities in Delijaš14 39 km from Sarajevo and Salakovac, the Immigration Centre in Lukavica, commercial, and private accommodation, and in squats around the city.

Accommodation is provided by the state, UNHCR and IOM, independent volunteer groups and local community. BiH has neither reception nor transit centres at the border entry and exit points/areas.

Persons who have filed a request for asylum have the right to be accommodated at the Asylum Center in Delijaš. It currently provides shelter for 115 people and has the capacity to host up to 154 persons. IOM together with UNHCR report that the Centre is at capacity. In March only 58 people of 437 in need of accommodation were able to be accommodated in the Asylum Centre15. Despite the efforts of camp management to separately accommodate families, they often share rooms with “single men”, which causes security concerns, resulting in families leaving the center16. The recent MIRA by UNCT however, makes mention of a space within the AC to accommodate vulnerable categories such as women and children. The Asylum Centre does not have access to internet or regular transportation to Sarajevo which makes organising onward movement for refugees difficult causing refugees and migrants to refuse accommodation or leave the centre.

The Salakovac Reception Center, 14.6 km from Mostar, has the capacity to host 296. On May 18th, 269 refugees and migrants sleeping rough in the park opposite City Hall in downtown Sarajevo were relocated to the reception facility. 18 were unaccompanied and/or separated children. There is concern as a larger number of minors were identified during the previous three days which could indicate that a significant number remain in Sarajevo, hidden due to fear, and thus outside the existing protection system. The ICRC is providing food within the facility. Freedom of movement is respected however, access to rights and services is challenging with the nearest bus station 8 kms from the centre. There is no official assistance with transportation.

The centrepiece of BiH’s migration control regime is the Immigration Centre located in a wooded area behind a football stadium on the outskirts of East Sarajevo in the neighbourhood of Lukavica17. The Immigration Centre is a closed facility and persons held there are kept in a state of detention. It is unknown how many persons of concern are accommodated in the facility.

Most asylum-seekers currently resort to alternative accommodation solutions, such as private houses, hostels, hotels and mosques, provided by international organisations, volunteers, religious institutions, or by private individuals. The number of refugees and migrants staying in a shelter called “House of All” in the municipality of Ilidža varies between 90 and 100. This accommodation, run by volunteers, is designated for families and vulnerable persons of concern mainly those with expired registration documents. Government representatives confirm the “House of All” will continue to serve as viable shelter. An Egyptian landlord has provided two private houses located in the village of Semizovac, around 20 km from Sarajevo. Water and electricity are available. One house is accommodating 35 people coming from different countries of origin (Afghanistan, Pakistan and Sri Lanka), while in the other house 25 Arabic-speakers, mainly originating from North African countries, are residing. Current separation between the ethnicities residing in the two houses is a consequence of previous

14 Accommodating 115 person of concern, capacity of 154. 15 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 24. 16 Coordination meeting at UNHCR Headquarters in Sarajevo, March 30th. 17 The statistics regarding the numbers of refugees and migrants being accommodated at Lukavica is not publically disclosed. The capacity of the centre is 100.

disputes and conflicts between Arabs and non-Arabs.

UNHCR and IOM18 currently provide temporary accommodation to registered vulnerable refugees and migrants in 10 rented hostels/hotels19 in Sarajevo20. UNHCR stated that this number represents their full capacity and that they are unable to provide shelter for further incoming families and vulnerable persons. In general, refugees and migrants reported that conditions in the hostels are good and the staff are supportive and polite.

The Government will require support to expand the accommodation capacity for refugees and asylum seekers in BiH over the coming months. Furthermore, the summer tourist season is fast approaching which may increase the likelihood that hostels may be hesitant to accommodate refugees and migrants.

In addition to a lack of government provided accommodation for asylum-seekers, challenges in registering as an asylum-seeker, especially in cases where the initial attestation has expired, prevent vulnerable asylum-seekers from even accessing accommodation provided by UNHCR.

It is estimated that between 450-500 persons currently reside in Bihać, divided between two locations21 an abandoned structure near the Una river and the main city park, hosting approximately 90 persons; the other is an unfinished dormitory south of the city center, hosting around 250-30022. The dormitory structure does not allow for the separation of single men and women and children, which is concerning given incidence of fighting in the evenings. International and local organisations are present at the dormitory. The Red Cross distributes 350-400 food portions per day. Showers and toilets are available. There are frequent water outages. Tents and blankets are available to newly arrived refugees and migrants. The joint IOM-UNHCR mission will be established in Bihać on June 1st. There is no support provided to those residing near the Una river.

In Velika Kladuša, near the border with Croatia, it is estimated that there are between three hundred and twenty and three hundred and fifty persons of concern including Arabic speaking women and children, residing in different locations of the city. Fifty persons of concern were counted in the city park and one hundred persons in the neighbourhood of Trnovi where a makeshift camp has been set up on the eastern side of the city. Within the camp electricity (produced by gasoline-powered generator), toilets and showers are being provided by the municipality. There is no infrastructure. Food is being distributed several times a day by local citizens. The situation is peaceful with no reported occurrences of physical conflicts or tensions.

There are no official figures for refugees and migrants sleeping rough on the streets or in public places such as on the University Campus in Sarajevo. Beneficiaries on average spend seven days sleeping rough in the park before travelling to the border with Croatia. The location of the majority of informal squats and the number of refugees and migrants residing in them remains unknown, to date there has not been a coordinated effort to map them.

The UNHCR office, located in Sarajevo city center, is a gathering spot for newly arrived persons and those trying to obtain either the registration documents or accommodation.

A very small proportion of refugees and migrants can fund their own accommodation however this should not be seen as a sustainable solution.

In the context of this emerging crisis both accommodation and funding is limited and will not be able to cope with increasing numbers of new arrivals.

18 Since January 2018 IOM has provided shelter for 113 vulnerable individuals primarily in hostels until an alternative accommodation could be found. 19 While necessary, using private hotels and hostels for accommodation is not in compliance with the asylum law in BiH which prevents persons staying there to obtain the status of asylum seeker. 20 Between 1 January and 31 March of this year, 538 asylum-seekers who could not be accommodated in the Asylum Centre have been provided with accommodation by UNHCR and their partners. 21 This could be due to the ethnic make up of the population as those residing in the informal settlements fear theft and physical confrontations with different ethnic groups residing at the dormitory. 22 The facility is accommodating 10 families with young children.

5.2 Food Security Sixty-seven percent of refugees and migrants interviewed by UNHCR and IOM report accessing one meal per day. Currently, the amount and quality of food that one person is able to access is directly correlated to the location of the person. Those living in state facilities and accommodation provided and or supported by volunteers are receiving three meals per day. While refugees and migrants residing in hostels are receiving only one dry meal per day provided by UNHCR with distributions being carried out by their partner organisation Bosnia and Herzegovina Women’s Initiative (BHWI). The food security mechanisms outside Sarajevo rely almost exclusively on local volunteers23. Groups of “single males” who are forced to spend several days on the streets of Sarajevo due to the lack of available accommodation, are usually receiving one meal a day from volunteers. In Velika Kladuša, food is provided by local citizens.

5.3 Non-Food Items (NFI’s) NFI’s are being distributed at the Asylum Centre to a large extent, while the remaining needs are being met by UNHCR, IOM Mobile Teams and volunteers.

Non-food items (hereafter, NFIs), such as tents, blankets and clothing are being provided mainly by informal volunteer groups and local citizens who sporadically visit places where refugees and migrant congregate. A smaller number of NFI’s are distributed by different local and international volunteer groups. Distributions take place in an information uncoordinated manner typically carried out immediately after food distributions, which often results in increased tensions among queueing beneficiaries.

According to the MIRA, 82% of refugees and migrants expressed a need for clothing and shoes. 48% expressed a need for a sleeping bag24.

Due to the lack of an established position for the collection and distribution of NFI’s located away from both food distribution points and places of informal residence, it is still not possible to conduct an efficient and coordinated NFI distribution targeted at the most vulnerable. It is unknown if the local population have established a collection point for donations.

There is a need for a range of humanitarian assistance in other areas where people are transiting or congregating including NFI distribution points. In Goražde there are many cases of people arriving exhausted from the journey needing clothing and footwear. Further, due to the tightly closed border with Croatia, frequent attempts to cross and terrain characteristics, leave returning migrants in urgent need for humanitarian assistance, including NFIs.

5.4 Health Care and Water, Sanitation and Hygiene (WASH) The vast majority of refugees and migrants are arriving to Sarajevo in a state of sever physical exhaustion after travelling for a long period of time, through extremely harsh terrain. This makes them susceptible to a range of illnesses due to a generally lowered immune system. Common injuries include: blisters, bone fractures, ligament damage, rash/allergies, psychosomatic diseases, flu, body pains, vision problems, kidney problems. There were also a few reported cases of hepatitis C, carcinoma and epilepsy. Records also mention weight loss and insomnia due to stress as well as food and sleep deprivation. Further, a number of cases where pre-existing medical conditions have been aggravated by the difficulties of the journey and lack of adequate medication (diabetes, hypertension, epilepsy) have been recorded25. It should be noted that there is a measles epidemic in Serbia, with reported cases of measles in and Montenegro. The vaccination status of both adults and children refugees and migrants is unknown, while babies and children are at particular risk.

The MIRA conducted by UNHCR notes that access to health and mental health care, including sexual and

23 The Red Cross of the City of Trebinje, supported by IOM, distributed 273 meals during February and March of 2018. 24 Primarily in Western Bosnia. 25 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 27.

reproductive health services, is a major concern26. Current Bosnian legislation ensures access to primary health care for all asylum seekers. In practice, this is applicable only to persons accommodated in asylum centres27 while those who are sleeping rough have no opportunity to access medical examination, diagnosis or therapy. Especially concerning is the position of the government as conveyed by the Ministry of Security, that those with expired registration documents are no longer under international protection, thereby preventing them from access to primary health care services.

Those still sleeping in Sarajevo have no reliable access to toilets or showers. None of the migrants interviewed had any opportunities to take a shower during their stay in Sarajevo (extended for a period of up to two weeks), which in several cases resulted in serious skin conditions. Other beneficiaries reported that they occasionally visit one of the local mosques to use the toilets, however, this service is not available at all times.

There is no regular, well-established presence of medical aid workers in the city centre. This leaves the most vulnerable people, especially those suffering from chronic diseases, at risk. Both NGOs and volunteers periodically identify persons suffering from chronic conditions and pregnant women in need of frequent and intensive medical attention. Occasional visits by the MSF mobile teams have recorded an increasing need for various specialised medical services, including psychological counselling.

There is no organised referral system for accessing secondary and tertiary health care facilities and other specialised services including from the Asylum centres. Irregular migrants in the Immigration Centre may have access to secondary health care or pregnancy care with the recommendation of the Centre’s doctor28.

The system of referrals and scope of jurisdiction of medical centres is still being established and currently dependent on negotiation between the actors in the field and the health care institution in BiH on a case-by-case basis. Those in need of medical assistance are being transported to hospitals and private clinics by volunteers who occasionally cover the cost of treatment.

Hospitals in have been receiving all referrals however it is rumoured that they may begin insisting that migrants and refugees have proof of legal status in the country. It is reported that the state primary health centres are willing to take migrants in need of medical assistance free of charge; however, several migrants reported illnesses and health problems which are not covered under state provided services. Beneficiaries who are suffering from chronic illnesses find it difficult to maintain the required frequent contact with medical personnel after their initial consultation.

Compounding this issue, the MIRA assessment shows that the majority of interviewed persons are not aware of their rights in terms of health care and medical assistance, proving deficiencies in health vulnerability assessments leading to restricted access to the services and information vital to the health and wellbeing of refugees and migrants.

The IOM has engaged a doctor to provide healthcare for refugees and migrants referred to their mobile teams by the border police.

5.5 Mental Health and Psycho-Social Services Many refugees and migrants have experienced traumatizing events, whether in their countries of origin or during their travel. For diverse reasons, many feel in relatively better security conditions in BiH which allows them to release psychological tensions. According to experts, this context encourages the resurgence of past traumas and fears which may lead to increased need for psychosocial assistance. UN Agencies and civil society have collected

26 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 27. 27 Timely health care is currently available to residents at the Asylum Centre in Delijaš from a medical facility in the municipality of Trnovo. This accounts for 12% of the total refugee and migrant population in BiH. Healthcare is provided in the Immigration Centre in East Sarajevo, statistics regarding the number of persons of concern accommodated there is not available. 28 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 27.

evidence of a number of refugees and migrants with symptoms of psychological problems and mental health conditions29. This has been confirmed by observations by Médecins Sans Frontières during the conduct of the MIRA assessment. For example, since January, UNHCR’s partner BHWI have identified 114 people with symptoms of psychological problems and diagnosed seven people with a mental disorder. The following symptoms prevail: anxiety disorder, depression, psychosomatic symptoms, difficulties in adjustment, behavioural disorders, and post-traumatic disorders. Additionally, sixty-seven people were identified with symptoms of psychoactive substance and medications abuse (benzodiazepines, alcohol, marijuana/hashish, pregabalin, analgesic, cocaine, sedatives, etc.) and four people were diagnosed with mental and behavioural disorders due to such abuses.

Of particular concern, is the need for psychosocial assistance within the groups of refugees and migrants in Western BiH. Frequent unsuccessful border crossing attempts, diminishing group resources, and a lack of outside assistance may prompt deteriorations in people’s psychosocial condition.

Psychological first aid has been provided by Government, civil society and international actors, such as UNHCR partner the BHWI30, the UNHCR Information Centre, within the Asylum Centre, the Immigration Centre, and during field visits. Similarly, IOM Mobile Teams include one psychologist per team31. Psychologists provide initial psychological first aid and psychosocial assistance to vulnerable refugees and migrants during transit, as well as in the Immigration Centre, upon request of the SFA or other actors in the field. In some cases professional psychiatric assistance and administration of adequate medical therapy may be required. Providing systematic assistance is particularly challenging in the current context where refugees and migrants move onwards very quickly.

Due to the absence of reliable and sustainable systems of provision of basic services, provision of specialised services such as mental health and psychosocial support remains one of the main challenges for the actors in the field.

5.6 Protection Access to asylum procedures has been problematic, especially at the stage of formal asylum application and registration. Asylum-seekers are usually able to obtain attestations of expressed intention to seek asylum upon their entry to BiH or relatively soon thereafter32. However, it has proven more challenging for people to access asylum application and registration procedures, which give right to an asylum-seeker card, which is valid for a longer period: over the same period, only 30 percent of those who were issued an attestation managed to then lodge the asylum claim.

Challenges surround the registration of Asylum-seekers who reside in accommodation other than the Asylum Centre as the registration of stay must be guaranteed by the property owner. Advocacy efforts made by the IOM and UNHCR have relaxed the financial implications to the property owner to try to encourage more registrations. Evidence from the field shows that a number of refugees and migrants in BiH change “status”, sometimes on multiple occasions. Some express intention to seek asylum, but, once they become aware of the criteria for international and humanitarian protection or are faced with the challenges of the BiH asylum system and the lack of assistance available in the country, they decide to proceed further to reach EU countries. Cases of the opposite have also been observed, whereby individuals and families, strained by repeated push-backs at the border, finally opt to file a request for asylum in BiH.

Irregular migrants who did not or could not express intention to claim asylum are detained in the closed Immigration Centre. Some subsequently express intention to seek asylum but are not released automatically thereafter. As such, some asylum-seekers are detained in the Immigration Centre.

29 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 27. 30 By the close of March 2018, BHWI had 415 instances of psychosocial assistance to asylum-seekers. 31 Between 1 January and 31 March, IOM psychologists provided psychosocial counselling and assistance in 174 instances. 32 Based on the figures regarding the number of attestation of issuance of asylum claim, 70% of new arrivals are able to access this process.

Protection related services are offered by UNHCR, on the territory of Sarajevo, and IOM across BiH through the presence of its two mobile teams.

Volunteers support the registration of newly arrived beneficiaries by escorting them to the Police station to gain access to asylum procedures. Refugees and migrants staying in UNHCR-funded shelter and those sleeping in squats or other types of accommodation in Sarajevo report not having been informed about their rights or procedures related to their asylum claims.

Refugees and migrants residing outside the Asylum Centres report that they have not had any contact with protection teams and those who continue to sleep rough in the city centre feel even more vulnerable as a consequence of the fragmentation of the community into much smaller groups. Families with children constitute a significant proportion of those remaining in the Sarajevo city centre, the protection situation remains critical as the locations and conditions of their residences remain unknown.

During the wars in ex-Yugoslavia, mine fields were scattered throughout the territory of BiH. By September 2013 land mines and unexploded munitions remained scattered in 28,699 locations in BiH. To prevent devastating accidents our team will show refugee and migrants what to look for and to encourage safe behaviour around mine affected areas. The MIRA Report has recommended that data of the locations and risks of mine suspected areas should be shared widely and in multiple languages with refugees and migrants. This should be facilitated in partnership with BiH Mine Action Centre (BHMAC)33 and the Red Cross. Where needed along the route, marking of mine suspected areas must be in place, especially in potential border crossing areas. We are currently reaching out to the Halo Trust to assist in supporting this component of the project.

Unaccompanied and Separated Children (UASC) According to UNHCR representatives, unaccompanied and separated children are at extreme risk of sleeping rough, as no legal guardians have been appointed to them to this date. Without a legal guardian it is impossible to formally regulate the status of minors in BiH and therefore obtain accommodation, as by law no one is allowed to provide any kind of services to minors without the presence and consent of the legally-appointed guardian. The Centre for Social Work does not have a mandate in migration related issues, including those involving unaccompanied minors and potential victims of gender-based violence34. There is great need for support from the Centre for Social Work in Velika Kladuša.

Although there is a clearly stated openness towards the establishment of cooperation and coordination between the different actors in the field, no reliable system of referrals and protection monitoring are currently in place. This is primarily due to current actor’s capacity being insufficient to meet the emerging and increasing needs and the passive response of the state institutions but also due to difficulties in the provision of shelter as the majority of refugees and migrants are residing in small groups, scattered throughout urban areas.

5.7 Legal Aid Free legal information and legal counselling is being provided to asylum-seekers by UNHCR partner organisation Vaša Prava (VP)35 Monday to Friday from the UNHCR Information Centre, at the offices of Vaša Prava, as well as at the Asylum and Immigration Centres (where individuals are referred to VP by the SFA). Their presence has been noted at the “House of All” shelter by the Refugee Aid Serbia team.

Legal information and legal counselling is also provided by IOM and other assistance actors that come into contact with asylum-seekers, and whom refer cases seeking asylum to the UNHCR Information Centre and VP. Demonstrating a real demand, in the first three months of 2018, 640 people were provided with free legal aid by VP (in and outside the information centre) and 521 came to UNHCR’s information centre.

33 http://www.bhmac.org/?page_id=747&lang=en 34 Coordination meeting at UNHCR headquarters in Sarajevo on the 30th of March 2018. 35 Vaša Prava provided legal counselling to 417 persons in March 2018.

The involvement of the Free Legal Aid office of the BiH Ministry of Justice in migration related issues remains unclear.

Consistent legal assistance is currently not being provided. The capacities of the one NGO providing free legal aid will not be able to manage the growing number of registrations, as well as support required given the majority of registered refugees and migrants are losing legal residence 14 days after their arrival. Numerous requests have been made to the Government of BiH to find a way to regulate the residences of refugees and migrants with expired registration documents however the Government continues to conform with the narrow framework of the asylum procedures.

6.0 Gender and Social Inclusion Issues Approximately forty percent of the refugees and migrants sleeping rough in Sarajevo were women and girls, none reported traveling alone. Only a small number of children – and therefore families – were relocated to the reception centre in Salakovac. Among the more than one hundred people sleeping rough in Sarajevo city centre, only one woman was seen during the assessment. It remains unclear where women and children found shelter. Safety of all women and girls sleeping rough in Sarajevo, Bihać, Velika Kladuša and other parts of BiH remains a major concern. Currently, the reproductive, mental and physical health of women and girls cannot be properly addressed, as access to medical care and psycho-social support varies between the different locations and cities. A rapid assessment should be facilitated in partnership with UNWOMEN to ensure that all humanitarian actors can respond to and be sensitive to the special needs of women and girl children.

7.0 Push-backs A large number of refugees and migrants have reported being pushed back from the border with Croatia in the West of the country. Hence, newly arrived refugees and migrants take care to register as soon as possible before moving towards the border areas, hoping that having an official document issued in BiH would compel the Croatian border police to refrain from transferring them to Serbian territory. During the assessment conducted by Refugee Aid Serbia cases of pushbacks to Serbia were noted for those with BiH registration documentation as well as those who entered BiH via Montenegro, having never transited through Serbia.

Rough treatment of refugees and migrants by Croatian border police is common. Reports of theft, damage to property and physical assault against children have been made. Despite the harsh measures carried out by the border police, the success of irregular border crossing is much higher than elsewhere along the Balkan route, with 20-30% of the attempts being successful.

8.0 Projections Based on the position taken by all organizations involved in migration-related issues in BiH, but also statements provided by refugees and migrants, it is certain that the number of persons of concern in BiH will not decline, but will continue to gradually increase. This can be further confirmed by interviews conducted with migrants in Serbia. Although the number of recorded arrivals has not yet reached humanitarian crisis levels, the current trend calls for increased support, engagement, and coordination from a range of actors, as well as increased funding36. It should be noted that capacities to respond are already being tested and strained. A prime example of this is the available accommodation, with the Asylum Centre’s, managed by the Ministry of Security (MoS), now regularly at or close to capacity and limited sustainable alternatives exist without large investments made to infrastructure repairs.

Additionally, structural problems that already undermine the immigration and asylum systems would be further exacerbated should the current arrivals trend continue. These include obstacles to accessing the asylum procedure and health care for people accommodated outside of the Asylum and Immigration Centre’s, challenges with the identification and referral of unaccompanied and separated children (UASC), no official and sustainable support

36 United Nations Bosnia and Herzegovina, Refugee and Migrants Situation in Bosnia and Herzegovina. The Multi-cluster/sector Initial Rapid Assessment (MIRA) Report, p. 31.

– such as the provision of food - for refugees and migrants outside of Sarajevo, and the presence of land mines.

The Government has predicted a cost of thirty one euros per beneficiary per day.

9.0 Proposed Response: This rapid assessment and literature review provides a common understanding of the situation at hand and its likely evolution. These findings provide evidence allowing humanitarian actors such as Ethnovision to inform and strengthen the design of our protection response by identifying strategic humanitarian priorities, and to monitor the situation as it progresses. Hence, this response must be understood in relation to the context and volume of new arrivals. Migration has always existed but the phenomenon has dramatically accelerated in recent years. These migratory flows prompted by multiple factors, globalisation, wars and economic crises, plus the added consequences of climate disruption will shape the world of tomorrow and have a considerable impact on migrant populations. Ethnovision will be there to support this movement and must anticipate the needs of all migrant populations, whether going South/North or South/South and whatever the reason triggering their migration. As an organisation Ethnovision is well placed to respond to the complex needs of refugees and migrants on the move. Our organisation places our beneficiary at the center of all that we do through the engagement of ethnographic techniques and other anthropological methodologies. The European refugee crisis has been particularly challenging to respond to. It can be unpredictable with changing routes, changing countries and a change of border management practices and deterrent measures. Our work over the past three years has been successful due to its responsive and flexible nature but also as our team is able to conceptualise the specific issues affecting the refugee and migrant population such as language, culture, gender dimensions and barriers to accessing services. The proposed response builds upon three years of expertise in the refugee crisis providing comprehensive primary health care, the provision of reliable and respected culturally sensitive protection information, and escorting and referral services.

Since August 2015 Ethnovision has been working with civil society actors and the Government of the Republic of Serbia to support the refugee and migrant population in transit by implementing both static and mobile medical and protection responses for refugees within and outside the government run asylum centers. Since January 2016 we have provided medical and protection services on trains, on streets, in the jungles on the border with Hungary and Croatia, daily medical consultations at the barracks in Belgrade37, as well as providing a medical clinic within the Adaševci Trransit Centre and the Obrenovac Reception Centre. We provide direct access to primary and mental healthcare through cultural mediation to enable refugees and migrants to receive protection servies and be made aware of their medical and legal rights in the Republic of Serbia. A major source of stress for people on the move is the lack of information. Provision of up to date factual information about where and how assistance can be obtained, can greatly reduce distress in a constantly changing situation. Such information38 will be provided through our mobile teams and, where relevant, by making referrals to organisations specializing in protection work. From January 2016 – January 2017 Ethnovision mobilised five mobile outreach medical and protection teams working on Belgrade streets 24 hours a day, 7 days a week, providing emergency medical triage and primary healthcare, protection and basic legal information, distributed NFI's, and provided escorting and referrals to secondary and tertiary care facilities by our Arabic, Farsi and Pashtu speaking cultural mediators and translators.

In the Republic of Serbia Etnovision was also involved in the establishment of an appropriate and efficient referral system between primary and secondary healthcare systems to ensure, amongst other things, support and follow- up of the most vulnerable individuals. We seek to support local stakeholders such as civil society and local authorities through training on questions of mental health and sexual violence, so that they can provide quality medical assistance to refugees in Serbia.

A mapping of available services and resources in BiH is currently required and will be facilitated immediately along with the initiation of a coordination meeting between all health actors. Ethnovision has expertise in

37 Prior to it’s demolition. 38 Information will be provided about services, support and legal rights and obligations.

coordinating sector cluster meetings having initiatied the health sector coordination meetings during the refugee response in Serbia.

It is proposed that two mobile medical and protection teams will be mobilised, one will be located in Sarajevo and a second near the Western border with Croatia will immediately be established. Each team will comprise of one doctor, technician/driver and a translator/cultural mediator. Protection staff and at times a lawyer with specialisation in refugee and asylum issues will accompany the outreaches to ensure the timely and accurate provision of information concerning refugee health and social rights in BiH. Mine risk awareness education and information will be developed and distributed to transiting refugees and migrants in partnership with key civil society and Government actors.

The mobile teams will ensure immediate emergency first aid and triage where appropriate, to ensure the patient is stabilised, before ensuring referrals to secondary or tertiary state provided care are made. A referral system that ensures access to primary health care for all registered asylum-seekers outside of the Asylum Centre will be established; it will be necessary to assign the provision of health care-related referral documents to a state paid GP in the cities/towns on the main route of migrations.

Mobile medical outreach and protection teams in the field will be provided in two shifts per day, seven days a week while also responding to calls for help on the Hotline number. We will provide escorting of patients to secondary and tertiary care services for Government run asylum facilities, and other civil society organisations working in Sarajevo. The majority of health issues to be treated by our mobile medical and protection outreach units will be fatigue, wounds, injuries, hypothermia, upper and lower respiratory tract infections, bronchitis, common colds, pneumonia, fever, diarrhea, constipation, gastrointestinal tract infections, urinary tract infections, hair lice and skin rashes including body lice and scabies. Other common afflictions are bodily traumas, headaches and muscle aches. Chronic diseases mentioned: stomach ulcers, hypertension, epilepsy, and arthritis. Our teams are able to carry the necessaryequipment and medications to treat these conditions, by two medical bags.

A small fund of auxillary medical items39 will be set up to ensure that all humanitarian civil society actors are able to cover the cost of medical services such as repairs to prosthetics, eyeglasses and prescription medication for chronic conditions that need to be bought from the pharmacy.

Dignity kits help women and girls maintain their dignity during humanitarian crises. Preserving dignity is essential to maintaining self-esteem and confidence, which is important to cope in stressful and potentially overwhelming humanitarian situations. Supporting women’s self-esteem and confidence also assists them in providing care and protection to their children. NFI’s namely travelling kits for children40, hygiene41 and dignity42 kits will be procured in line with SPHERE standards as needs are identified. Ongoing procurement will occur to avoid wastage. The contents of each dignity kits will last for at least one month. To avoid distribution problems and crowd management issues all hygiene and dignity kits will be available to patients being seen by our mobile teams.

All hospital inpatients will receive daily visitation by our mobile team to check on their medical progress, and to ensure that their personal and medical needs are being met43.

The teams will remain on standby to treat cases of scabies and body lice. Although challenges should be anticipated due to the lack of water and sanitation facilities in the field. Bottled water will be available from the

39 Approximately USD$5000. 40 Small travelling kits for children will comprise of a small toy, notebook and coloring blocks which will be available to encourage play and to pass the time while waiting for medical care within state institutions. 41 Hygiene Kits for men will include underwear, T shirts, socks x 4, soap and a razor. Kits for children and babies will include nappies, nappy rash cream, bottles and baby formula, enough for one serving – which must be administered. 42 Dignity kits contain hygiene and sanitary items, as well as other items explicitly tailored towards the local needs of women and girls of reproductive age. Each dignity kit will include a t shirt, underwear, sanitary pads, hand soap, tooth brush, tooth paste, comb/hairbrush, shampoo, hand cream, nail clippers, tweezers, a small hand mirror, towel, washing powder/laundry soap, flashlight, whistle. 43 All inpatients will receive a hospital pack its contents being: underwear x 4, socks x 4, pajamas, shampoo, soap, toothbrush and toothpaste.

mobile medical vehicles at all times.

Gender and Social Inclusion Our teams, who are well experienced in the identification of extremely vulnerable individulas, will undertake screenings44 of all persons of concern sleeping rough and cannot reach medical facilities. This is especially important from the perspective of pregnant female migrants. Even during short stays, people who are much more at risk than others should be identified and offered referral to protection and social services. This can, in certain cases, be lifesaving. People who may be particularly vulnerable include children who travel alone, older people, people with disabilities, pregnant women, victims of torture, victims of trafficking, survivors of sexual and gender- based violence (SGBV) and persons with diverse sexual orientation and gender identity. We will focus on identifying and providing emergency triage and other services to these individuals.

Ethnovision is reaching out to UNWOMEN to garner interest in supporting a Gender Needs Assessment addressing Refugees and Migrants in Bosnia and Herzegovina.

10.0 Partnerships Ethnovision has a formal partnership with the Ministry of Health at the central level sharing recommendations, guidelines and trainings. At the field level Ethnovision partners with the local Primary Health Center collaborating daily with Government health workers and directors.

It will be necessary for our mobile teams to collect and share information with the UN and other relevant agencies in a timely manner. This will be facilitated through weekly field reports. Epidemiological surveillance reports will be submitted to the Institute of Public Health weekly.

44 Including for communicable diseases.