On his mobile phone, Dr Youssouf Moussa Mohamed looked anxious before speeding off across Djibouti's desert to locate migrants in distress.

“One challenge is that the desert is so big. Often you get to a place responding to a distress call, and the migrants have moved,’’ says Dr Youssouf, who leads the medical patrol unit attached to the country's only Migration Response Centre (MRC) in the coastal region of Obock.

The centre, run by the International Organization for Migration (IOM), is the busiest among several operated by IOM in the Horn of Africa, testimony to the significance of Djibouti as a transit location for migrants.

Four hours from the capital, Obock is the departure point for predominantly Ethiopian migrants seeking to cross the Gulf of Aden on their way to Yemen, en route to the Gulf states, especially the Kingdom of Saudi Arabia, where they hope to find work. Accurate numbers are unknown but annual estimates are in the thousands.

Obock has a population of about 20,000. According to IOM’s Displacement Tracking Matrix (DTM), 32 per cent of Djibouti’s 13,539 movements monitored in October 2021 were through the Obock region.

It is a place that has adjusted to hosting migrants, but it also helps that most of IOM’s staff members in the city are from the local community.

The region is characterized by extreme temperatures, and in summer, from June to September, temperatures can hit 46 degrees Celsius, with high humidity.

This migration route, commonly referred to as the “Eastern Route”, has two variations, both taking migrants through Yemen. The majority of migrants access the sea through Bosaso in Somalia, from where they cross the Gulf of Aden. Others travel to Obock and find boats that take them to Yemen.

However, with movement restrictions enforced by states to control the spread of COVID-19, many migrants are returning, via the route. With few options to return home, migrants along this route often contact smugglers for the sea crossing back to Djibouti and Somalia without any guarantee of safe arrival. Smugglers use small, unseaworthy and overcrowded boats that can easily capsize. Occasionally, some smugglers throw migrants overboard to reduce the weight.

“If you don’t have mobile patrols, you risk having many dead migrants, especially in the summer,” says Marie Hudault, coordinator of the EU-IOM Joint Initiative in Obock.

When Dr Youssouf arrived at the MRC in 2018, he had intended to stay only a few months, but that plan changed after he attended to a migrant lying on the side of the road. “Local people have their own families, but migrants don’t have anyone. They count on you to do your best,” he says. “That is what motivated me to continue.”

Dr Youssouf is the MRC’s only doctor and the head of the mobile medical unit that was established a year ago with an ambulance, a nurse and a nurse's assistant. To date the unit has assisted more than 9,700 migrants with food and water while over 2,000 have received medical support.

The unit operates in a part of Obock frequented by migrants returning from Yemen. Two 5,000-litre water tanks mark the route and are positioned strategically with solar panels and taps. The clean water – replenished regularly – is meant as a lifesaver for migrants, while the light on each tank helps migrants find their bearings.

The idea emerged from the high number of migrants who would get lost soon after being dropped off on the coast under the cover of darkness in a bare landscape with few defining features. IOM is also installing directions in the main Ethiopian languages, says Hudault. “There are many roads (that confuse migrants) and worse if there is a storm.”

Waiting at one of the tanks for the migrants, Dr Youssouf sees 53 arrive on two trucks. They jump out and head for the water tank – quenching their thirst and then washing faces and feet. High-energy biscuits are handed out to the weary travellers.

Among them is a young man from Kismayo in Somalia who tells Dr Youssouf that he took this route because it was cheaper to get to Djibouti from Yemen than the more direct way through Bosaso. The youngest within the group is a 14-year-old boy who says he spent seven months in Yemen in difficult conditions, unable to find work.

The migrants are escorted to the MRC, where those in need of assistance are provided with further support including shelter, medical assessment and psychosocial assistance, as well as information on return and reintegration support.

The MRC, which handles about 400 migrants monthly, has an observation room for 10 people who can be referred to the local hospital for further treatment or for X-ray and lab facilities.

Dr Youssouf says skin infections and diarrhea are common among migrants but many of those newly arrived from Yemen are traumatized by conflict and some have gunshot wounds.

Since May 2020, close to 16,000 migrants have returned through Obock, according to the DTM data. Hudault explains that increased cooperation between IOM and the Ethiopian embassy facilitates the process of voluntary return of vulnerable migrants seeking support

Funding for IOM’s work in Obock is provided by the European Union through three projects: “Durable Solutions for Host Populations, Refugees and Migrants in Djibouti”, the “European Civil Protection and Humanitarian Aid Operations (ECHO)”, and the "EU-IOM Joint Initiative for Migrant Protection and Reintegration in the Horn of Africa"

Story by Wilson Johwa, Regional Communications Officer, Nairobi, Tel: +254 701 838 029, Email: wjohwa@iom.int