Damaria Chimpaye’s eyes light up when her children appear in the distance. 

At 41, she has given birth nine times, lost her home and husband, and does not know where three of her children are. She is from the Democratic Republic of Congo, but has for almost two years been living in Uganda.

The East African country is home to 1.6 million refugees, the largest number relative to population in Africa, and the third in the world. Its 3.6 per cent ratio is more than double the European Union’s.

These refugees mainly come from neighbouring South Sudan and the Democratic Republic of Congo, which are marred by violence. Eighty-one per cent of them are women and children, who often fled after their villages were attacked and their husbands and fathers killed. 

This is the case for Damaria.

After escaping she lived two years as an internally displaced person in other Congolese villages. Another armed attack prompted her to move eastwards, with a small child in her arms and five others around her, until she reached the border with Uganda.

Now Damaria lives in the Nakivale refugee camp, one of the largest and oldest on the continent: a 185-square-kilometre area housing 185,000 people in southwestern Uganda. She misses her village, and her mother who chose to stay behind but she will never go back there.

The Ugandan exception

Uganda has one of the most unique refugee policies in Africa, and perhaps the world. It lets in virtually everyone, granting immediate protection to those from war-torn regions under a system known as prima facie.

“They are recognised as refugees at access points along the borders and then transferred to settlements such as the one in Nakivale,” Claire Birungi Agaba of the Norwegian Refugee Council, one of the organisations involved in welcoming refugees, told Euronews last week during a trip to the country.

Its policy is considered very progressive, despite the country’s poor results in democracy indicators: it scores 4.55 out of 10 in the latest Democracy Index compiled by Our World in Data and only 13 out of 100 when it comes to respect of minorities, according to the last LGBT Equality Index.

To maintain this policy, the Ugandan government – which spends 40% of its annual budget repaying interest on its debt – relies on humanitarian aid from international partners, who provide material support and finance infrastructure in the country’s 14 refugee settlements.

The many humanitarian organisations – financed mainly by the EU, US and UN – replace the national authorities in providing food, education and medical care. Schools and hospitals, built in the remote rural areas where the settlements are located, are then also used by the local population.

In the settlements, the neediest receive a house, others a small sum to buy the materials needed to build it. Each refugee is entitled to a small plot of land to cultivate and to support in money and food, which, however, depends on the funds available: in 2020, 100% of the food needs were covered, the UNHCR said, this is no longer the case.

For example, people in Nakivale are divided into three categories. The most vulnerable receive 24,000 Ugandan shillings a month (€5.6), the least vulnerable 12,000, and those considered able to manage without, get nothing.

Every six months, needs are reassessed: most try to fit into the first category, for example, by presenting themselves as single parents instead of as families.

Hunger in refugee camps

As an alternative to cash support, there is food support: three kilos of rice and half a kilo of beans per person per month. But that is barely enough for a fortnight, Damaria told Euronews. The small plot of land she cultivates gives her two harvests of about 10 kilos of beans each per year.

It is impossible to feed an extended family: in addition to her six biological children, there are two others under her roof, aged 17 and 18, whom Damaria has agreed to raise as part of a voluntary fostering project in the Nakivale camp.

To put lunch and dinner together, she and her two eldest daughters work a day job in other fields. The little food the family eats is always half-cooked: the maize leaves used to make the cooking fire burn too quickly.

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The malnutrition rate in Nakivale is 2.6 per cent, a threshold described as ”acceptable” by Justin Okello of the Nakivale Health Centre III, the main clinic in the area.

But at times the level rises dangerously, especially among children below five. “The result is that these children are much more likely to get infections and die from these infections, which in their sufficiently nourished peers would be easily treatable, sometimes without even using medicine,” Okello added.

Growth in those who survive is nevertheless impacted. The rate of stunted growth in children is 40 per cent: that is, four out of ten children are shorter and weigh less than they should for their age, with consequences for their physical and mental development.

“The first thousand days of a child’s life are a crucial time. Anything that goes wrong during this time risks having lifelong consequences: an ill-treated child can easily become a boy who is unable to finish school and get a job”.

In Nakivale, a special programme called ‘Nutricash’ allocates 48,000 shillings per month (€11) to women who are pregnant or have children under two precisely to combat child malnutrition. But as Dr Okello explained, this money is used by the mothers to feed the whole family, thus losing its purpose.

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Besides hunger, disease, school drop-outs and lack of prospects are the plagues that afflict minors, who account for 57% of the total number of refugees, according to national statistics.

A model at risk

The numerical growth of refugee settlements is challenging the resilience of the Ugandan model. Eight out of fourteen exceed 100,000 inhabitants. In Nakivale, for example, there are new arrivals every week.

In the last two years alone, 225,000 refugees have arrived in Uganda. The last migration crisis coincided with the civil war that broke out in Sudan in 2023 and more than a quarter of the refugees registered in 2024 came from this country.

Then there is the high birth rate in the refugee camps, which contributes to making them more and more crowded: in Nakivale 400 children are born every week. 

Against a backdrop of growing needs, humanitarian aid is decreasing.

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“In 2018, around $170 (€155) per year was spent on each refugee, today, only $85 (€77),” says Bruno Rotival, Head of Uganda at ECHO, the European Commission’s humanitarian aid department.

The EU allocated €27.5 million for 2024, down slightly from €30.5 million the previous year. “All operations around the world suffer from a funding gap. More acute crises situations receive more funds, while Uganda, being a more stabilised country, perhaps suffers a little more in the provision of humanitarian aid.”

Uganda, Rotival said, was identified by the EU as a country in which to begin the transition from a system based on humanitarian aid to one based on development cooperation.

The war in Ukraine has complicated plans, with a 20% cut in the EU’s overall humanitarian budget.

“But we are confident that we will be able to maintain all our support,” Rotival added.

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