Note: Poverty is defined as the percent of the population living with less than $2 a day (World Development Indicators database). The annual number of refugees in each country is given by the Center for Systematic Peace (http://www.systemicpeace.org/).

# **4.2. Lessons from Case Studies in Kenya, Tanzania, and Uganda**

Given the limits of cross‐country comparisons, we present below three short case studies on the impact of protracted refugee situations on hosting communities. These case studies were not chosen based on a systematic review but they are sufficiently close to each other to allow for comparative learning. These case studies are also those emerging from a growing literature on the quantitative assessment of the impact of refugees on hosting communities (Mabiso et al. 2014).

# **Case Study #1: The protracted refugee situations in Tanzania**

Tanzania has been known as a refugee‐hosting country for long due to its peaceful history and its location surrounded by conflict‐affected countries (Burundi, Rwanda, Uganda, Mozambique). The first president of Tanzania, Julius Nyerere, welcomed most of refugees as a sign of pan‐African solidarity in the post‐independence periods from many African nations. For example, in 1972, refugees fled from Burundi and were directed towards, what is called now, the “old settlements”. The Tanzanian policy with respect to refugees radically changed in the 1990s when more than one million refugees from Burundi (1993), Rwanda (1994) and the Democratic Republic of Congo (1997‐1998) moved to Western Tanzania, i.e. in the regions of Kagera and Kigoma. As documented by Rutinwa (2002), regulation moved from an “open‐door” policy promoting local integration to a “no more refugees” policy promoting repatriation in the country of origin. In addition to the lack of mobility outside of refugee camps, that shift in policy translated into more restrictions on the integration of refugees into their hosting communities and the declared intention to favor repatriation. The most obvious consequence of that policy change is the forced return of about 600,000 refugees to Rwanda in 1996. The number of refugees from Burundi strongly decreased in 2000 to reach a number of about 70,000 refugees in 2004.

Reviewing the literature and based on fieldwork semi‐structured interviews, Maystadt and Verwimp (2014) summarize the main reported impacts through the labor and good markets, the health sector, the change in infrastructure (mainly road networks) as well as the reported environmental degradation and security concerns. The most often heralded concern about refugees is the spread of disease. Consequently, Baez (2011) studied the impact of the Rwandese refugees on children’s height. He finds adverse impacts over one year after the refugee inflows on children’s height, together with the incidence of infectious diseases and under‐five mortality. Mabiso et al. (2014) extend this analysis to several years after refugees repatriated. They do not find evidence of long‐lasting impacts. This result hypothesizes the existence of catch‐up processes among children within puberty. The health consequences seem to be rather short‐lived at the times of the refugee presence. The limited impact on health outcomes is also in line with qualitative evidence reporting health services to have improved following the refugee inflows in Tanzania (Maystadt and Verwimp 2014).

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