Refugees and internally displaced persons: refugees (country of origin): 854,849 (South Sudan) (refugees and asylum seekers), 384,049 (Democratic Republic of the Congo) (refugees and asylum seekers), 44,611 (Burundi), 35,924 (Somalia) (refugees and asylum seekers), 16,272 (Rwanda) (refugees and asylum seekers), 13,563 (Eritrea) (refugees and asylum seekers) (2019) IDPs: 32,000 (displaced in northern Uganda because of fighting between government forces and the Lord's Resistance Army; as of 2011, most of the 1.8 million people displaced to IDP camps at the height of the conflict had returned home or resettled, but many had not found durable solutions; intercommunal violence, land disputes, and cattle raids) (2018) Definition: This entry includes those persons residing in a country as refugees or internally displaced persons (IDPs). Each country's refugee entry includes only countries of origin that are the source of refugee populations of 5,000 or more. The definition of a refugee according to a United Nations Convention is "a person who is outside his/her country of nationality or habitual residence; has a well-founded fear of persecution because of his/her race, religion, nationality, membership in a particular social group or political opinion; and is unable or unwilling to avail himself/herself of the protection of that country, or to return there, for fear of persecution." The UN established the Office of the UN High Commissioner for Refugees (UNHCR) in 1950 to handle refugee matters worldwide. Gender Based Violence • Cases of rape, defilement are reported to be frequent in the camps. Perpetrators include fellow IDPs, armed personnel – rebels and government soldiers. • The health facilities lack trained personnel able to provide effective care to gender based violence victims in the areas of psycho social and counseling services. • There is low level of awareness of sexual reproductive health rights issues amongst displaced populations. This may be attributable to the extreme powerlessness the community has been subjected to. Adolescent Sexual and Reproductive Health • Reproductive health services for adolescent services are not provided in exclusive places but in the context of general health services rendered. Main adolescent health needs include access to family planning service, treatment of STIs; information on sexuality and reproductive health and curative services for medical conditions e.g STDs etc. Package of Sexual and Reproductive Services The package of services offered in camp first line health facilities – e.g Unyama, an Emergency Health Unit. Reproductive Health Rights • There is apparent lack of awareness about sexual and RH rights. The observance of law and order is poor especially by the military. Law enforcement is equally very weak. Parents fear reporting cases of sexual rights abuse e.g defilement. Early marriage of teenage girlsis common due to fear of abduction of young girls by rebels. • IDPs live in abject poverty. There are limited sources of income generation - few IGAs projects for the internally displaced persons. The UNDP Human development report identifies the people in northern region as having the lowest human development index (HDI) in the country. • Education facilities, mainly for primary schools, exist in the camps. There is generally lack of sport and recreational activities in the camp settings. Challenges to Health Service Provision in Conflict Settings • Insecurity is a major problem in the camp settings. Thus movement of persons from the camp is prohibited during the early mornings, evening, and at night. This implies no emergency referrals at night. • There is generally high workload in the IDP health facilities. This is attributable to high demand for curative care and lack of qualified personnel working in IDP camp facilities. The ratio of population to trained staff-nurses is high. • The enforcement of laws to punish those who sexually abuse women and children is weak. There is fear in the general population who doesn’t report perpetrators- especially government soldiers.The Global Girl Child Youth Initiatives works with government entities ,civil society , NGOs and development partners address some of the challenges that refugee especially women and children face while at the isolated camp sites.