The spread of Covid-19 has been driven by inequality, in particular, the shortfalls in housing and living conditions that typically afflict marginalized groups, including minorities and indigenous peoples.

Overcrowding and the absence of basic services, such as clean water and sanitation, have proven to be key factors in the spread of the virus in informal settlements, camps and other contexts.

Even before the pandemic, these environments were exacting a heavy toll on health outcomes for minorities and indigenous peoples, contributing to lower life expectancy and above-average infection rates for communicable diseases such as tuberculosis.

Better housing and service provision is therefore critical, not only to protect these groups from COVID-19 but also to boost resilience to other public health threats in future.

Upon his appointment as the Global Goodwill Ambassador for UNHCR (the UN Refugee Agency) in March 2021, Alphonso Davies, a young star at Bayern Munich Football Club and former child refugee, told reporters he wanted to use his platform to show how urgently refugees need support to survive and to thrive.

Alphonso’s message comes as no surprise. Born in Ghana’s Buduburam refugee camp, at the age of five he relocated to Canada under a resettlement programme and developed into the football superstar that he is today.

He recalled how his own parents had struggled to find food and water during their stay in the Buduburam refugee camp.

But for the many thousands of child refugees like Alphonso who were not lucky enough to be accepted into a refugee resettlement programme, life in the camp is a constant challenge.

It is crowded with traumatized people with limited access to food, health care and basic sanitation, and living conditions were already hazardous even before the pandemic.

For many undocumented residents, there is also a constant threat of deportation. Limited opportunities to earn an income have also forced large numbers into sex work and other areas of exploitation.

While the advent of COVID-19 and resultant lockdowns caught everyone unprepared, the impacts of the deteriorating situation have been magnified for those fending for themselves in Buduburam.

Life for Liberian residents in the camp has long been precarious, particularly since Ghana withdrew recognition of their refugee status a decade ago, and with it the humanitarian aid they relied on.

The only alternative to voluntarily repatriating back home to Liberia was to remain in Ghana under the vaguely defined status of a migrant, a path many chose over the insecurity of return – yet it has often left them in limbo, with few protections or certainties, ever since.

Because most worked in the informal sector, when COVID-19 struck large numbers of refugees and migrants lost their only sources of income as work possibilities vanished due to lockdowns and other restrictions.

At the same time, like many other countries, Ghana adopted a range of policies that appeared to prioritize citizens over non-citizens, whose plight was often overlooked.

In this context, former Liberian refugees, who were now only protected under restrictive rights to work, fell through the cracks, as the government enforced strict immigration laws and restricted freedom of movement, resulting in crackdowns on migrants and widespread loss of livelihoods.

This has occurred in a broader context of fear and uncertainty for non-citizens in general amidst reported threats of deportation, closure of border points and restricted freedom of movement.

As a result, some have been forced to flee from isolation centres and hesitated to seek health care and other social services.

Psychological needs are yet another area of concern for Ghana’s refugee populations. Frequently contending with the impacts of previous trauma, refugees and asylum seekers are often among those at greatest risk of mental health impacts of the pandemic, given the distinct challenges they face.

This is reflected in the situation of refugee and migrant populations more broadly, as demonstrated by a global World Health Organization study that assessed the impact of Covid-19 on these groups in different countries and found elevated levels of depression, fear, anxiety and isolation.

In most cases, there is little support to alleviate this burden. Although some refugees are being offered counselling, because of stigma, inattention to mental health issues and the refocusing of resources towards Covid-19 containment in many low-income countries, the full mental health impacts of the pandemic on Ghana’s refugee populations is impossible to gauge.

Recognizing the severe lack of personal protective equipment among refugee communities, in October 2020, UNHCR Ghana partnered with Abrantie, a Ghanaian fashion designer, to launch an initiative, ‘Masks for Refugees by Refugees’, which trains refugees to produce their own masks.

The project, which commissioned 40 refugee tailors and seamstresses, was expected to produce about 35,000 masks to be distributed to refugees and members of host communities in Ghana, while creating livelihood opportunities for refugees – making a clear statement that, though often forgotten and excluded, refugee communities can rebuild, fend for themselves and even benefit host communities, if only given the chance.

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NB: This article is from the Minority and Indigenous Trend report for 2020. This report primarily focuses on minority and indigenous communities and their experiences during COVID-19. But we also turn our gaze inward briefly. In seeking to come to terms with the loss and the trauma inflicted by the pandemic, it is incumbent on us all to extract the painful lessons emerging from this experience to be better prepared for similar crises in future.