Migrants in the eastern route often face status-based discrimination and stigmatization as potential COVID-19 carriers. This results in reduced or denial of access to essential services such as primary health care, food, or shelter assistance at various points throughout their journey, with limited support from local communities. In the MRP-targeted countries (Djibouti, Ethiopia, Somalia, and Yemen), IOM will provide basic services to vulnerable migrants, including stranded migrants, accompanied and unaccompanied children, GBV survivors, and victims of trafficking, along the Eastern Route and returnees from the Kingdom of Saudi Arabia. IOM will work closely with Migration Response Centres (MRC), Migrant Response Points (MRP), mobile health clinics and host communities in providing services to migrants including:

• Assisting the target population with food and/or nutrition assistance, and non-food items.
• Providing the target population in Ethiopia and Yemen with multi-purpose cash assistance.

The pandemic prompted governments in the Horn of Africa and the Gulf states to impose stringent border closures, increase movement restrictions and tighten security along known migratory routes. This had a significant impact on migrants and communities in the region with regards to their mobility, as some of them are now stranded in transit countries without being able to continue their journey or return to their country of origin. In order to enable migrants stranded in vulnerable situations in Yemen, Djibouti and Somalia to reach their communities of origin safely, IOM will undertake activities including:

• Assisting vulnerable and stranded migrants with medical assistance, treatment, referrals to specialized care for the migrants needing this type of assistance, medical escorts for migrants with chronic illnesses as well as awareness raising on Infection Prevention Control of COVID-19 and other infectious diseases at all stages of the journey. The movements will be done by road and air transport depending on the country of departure.
• Post arrival assistance, including food, temporary accommodation, post-arrival health screening and assistance, onward transportation assistance (OTA), NFIs, medical support (in-house and through referrals), MHPSS, and advocacy with governments on the issuance/replacement of identity documents.

Many migrants suffer from mild to severe psychosocial trauma as they experienced physical abuse, sleep deprivation, illegal detention, forced labour and theft. Improved access to Psychological First Aid and Mental Health and Psychosocial Support (MHPSS) services could be a relevant factor of resilience and recovery for vulnerable migrants who show negative psychological reactions including disorientation, sense of instability, lack of trust, isolation, anger and aggressive behaviours. In 2021, IOM will provide MHPSS to strengthen the protection environment for migrants and affected communities. All the MHPSS activities will be in line with the IOM Manual on Community-Based Mental Health and Psychosocial Support in Emergencies and Displacement. Key activities will include:

• Training officials/actors on MHPSS.
• Assisting people with MHPSS and life skills training.
• Conducting training of trainers (ToTs) for migrants on peer counselling and information sharing.

The pandemic has resulted in disruptions in key health services for the treatment of other communicable and non-communicable diseases, such as tuberculosis, HIV, malaria, as well as preventative services such as routine immunizations and reproductive health for women. In addition, measures imposed by countries led to a large number of migrants requiring referral to COVID-19 testing and treatment facilities, as well as support with quarantine measures. Given the already overstretched national health systems, the required resources significantly exceeded the existing capacity in the affected countries and risked draining resources further. Therefore, IOM will provide life-saving primary health services, and supports the strengthening of referrals to specialized health services. Key activities under this activity area will include:

• Providing vulnerable migrants with medical screening, emergency health support, and referrals for primary and secondary healthcare, including specialist clinics or services such as cardiology, physiotherapy, vaccination, Hepatitis, HIV/AIDS, non-communicable diseases, etc.
• Supporting the government and other relevant stakeholders with COVID-19 related assistance, including capacity building and implementation of Risk Communication and Community Engagement (RCCE), Infection Prevention and Control (IPC), support for isolation/quarantine, procurement of equipment, etc.

Access to water, basic sanitation and improved hygiene conditions in households, community kitchens, border crossings, collective and individual shelter solutions, and health centers are amongst the most crucial needs of migrants as well as of the affected host communities in targeted countries; and these needs have become further exacerbated as a result of the dramatic impact of the COVID-19 pandemic. IOM will respond to immediate and medium-term water, sanitation and hygiene needs of migrants and host communities to save lives and uphold their dignity. The intervention is planned at both the household and institutional levels as people will be assisted with WASH items, services and infrastructure, and all activities will follow country guidelines on COVID-19 preventive measures, such as physical distancing. Specifically, the action will seek to:

• Provide access to/increase quantity and quality of safe water.
• Implement/improve/rehabilitate sanitation services (e.g. excreta management, solid waste management).
• Establish and strengthen Operation and Maintenance (O&M) activities for the sustainability of the services.
• Support hygiene promotion through awareness campaigns and distribution of hygiene kits inclusive of Menstrual Hygiene Management (MHM) items.

Access to shelter for migrants has become more critical since the onset of the COVID-19 pandemic. Some temporary shelters and Migrant Response Centres were forced to close their doors to new entries during the pandemic to ensure sufficient space for physical distancing, while others suspended operations entirely due to the lack of Infection Prevention and Control (IPC) measures in place. Those shelters that remained open reduced their capacity significantly. Adding to these challenges, movements across the region are expected to continue in 2021, putting increased pressure on limited capacity in shelters solutions. In 2021, IOM’s focus will be:

• Providing shelter assistance to migrants in transit and destination countries. This includes shelter kits or alternative solutions such as referrals to temporary partner-run shelters.
• Establishing, strengthening and managing Migrant Response Centres in targeted countries.
• Distributing of Non-Food Items (NFIs) to stranded migrants as well as the most vulnerable populations in host communities. NFIs will be context-based, based on the needs of the stranded migrants, as well as the context in which the stranded migrants find themselves.

The Displacement Tracking Matrix (DTM) monitors migrant movements and is used to capture, process and disseminate information regularly and systematically to provide a better understanding of these movements and evolving needs of mobility flows in places of transit or destination. These activities will include:

• Developing and disseminating flow monitoring reports and needs assessments.
• Integrating mobility data with health surveillance efforts to inform programming and responses to public health emergencies.
• Providing data to inform protection advocacy and programming at country and regional levels, and cross analyze data with other migrant service provision (such as MRC registration and service data) to identify possible stranded caseloads, migration protection needs, vulnerabilities and design referral pathways at the local level.

IOM will enhance the effectiveness and coordination of humanitarian assistance, protection, sustainable and development-oriented solutions through the collection, provision, and dissemination of evidence-based information on mobility movements and needs. Key activities include:

• Strengthening coordination with regional and sub-regional mechanisms on policy coherence and evidence-based programmes in support of migrants and sending and host communities.
• Strengthening engagement with government and partners through existing coordination mechanisms and ensure that protection issues related to migrants are discussed and addressed.
• Supporting regional or bilateral government dialogue initiatives in support of research studies as well as policy or advocacy documents.