Background. Hand hygiene in refugee camp settlements remains an important measure against diarrhoeal infections. Refugee settings are characterised by overcrowding and inadequate access to water and hygiene facilities which favour proliferation of faecal-oral diseases. Handwashing with soap and water is therefore an effective way of preventing such diseases. Despite this knowledge, there is limited information about access to functional handwashing facilities in these settings and associated factors in Uganda. Methods. Quantitative data were collected from 312 refugee households in Rhino Camp Settlement, Northwestern Uganda, using a semistructured interviewer-administered questionnaire. A modified Poisson regression was used to obtain prevalence ratios (PRs) and 95% confidence intervals (CIs) for the determinants of access to a functional handwashing facility among refugee households. All analyses were performed using STATA 14.0 statistical software. Results. Of the 312 households, 123 (39.4%) had access to a handwashing facility, but only 72 (23.1%) of households had handwashing facilities that were functional. Duration of stay in the camp exceeding 3 years (adjusted PR = 2.63; 95% CI (1.73–4.00)) and history of receiving home-based education on hand hygiene (adjusted PR = 9.44; 95% CI (1.40–63.86)) were independent predictors of access to a functional handwashing facility. Conclusion. Access to functional handwashing facilities among the refugee households was low. Our findings highlight the need for more and continued handwashing promotional programs, most especially among newly arrived refugees in the camp.

This article re-examines externalisation – direct migration control by Member States of the EU, within third states, i.e., States which are not members of the EU. The nature and extent of this control is considered. The instruments of externalisation examined are carrier sanctions and immigration liaison officers. State responsibility for these externalised migration controls is assessed. The jurisdiction of the ECtHR is the trigger for Member State responsibility. ECtHR jurisprudence has made it clear that it is the exercise of physical power and control over a person by the State, which is pivotal to deciding jurisdiction. Jurisdiction is engaged where the Court finds that physical power and control to have been ‘effective’. This threshold of ‘effective’ control which has emerged from the Court’s jurisprudence is a demanding hurdle. If State control is found to be ‘effective’, then the State is responsible for the full range of rights contained within the Convention. The question then stands whether or not the ECtHR can keep abreast with these controls which can lead to States evading jurisdiction and thus avoiding fundamental rights responsibilities. One possible interpretation of recent jurisprudence is that the ECtHR is moving toward a broader interpretation of jurisdiction. It is in this context that ‘externalised’ controls have come under renewed scrutiny. A prevailing opinion is that the ECtHR will be able to protect those asylum seekers who encounter externalised control. This article questions any such assumption. The author argues for an alternative reading of the jurisprudence of the ECtHR with regard to jurisdiction. The conclusion reached is that the hurdle of extraterritorial jurisdiction is so demanding that States avoid it despite exercising extensive control over migrants. It is asserted that despite this considerable control, examination by the ECtHR will result in a failure to satisfy the ‘effective’ control threshold. Responsibility can thus be avoided while extraterritorial control is retained. The control level held by the State is still capable of guaranteeing a denial of access to individuals in need of international protection. If jurisdiction is not engaged then this externalised migration control represents a divergence between State control and State responsibility. Taking the threshold for jurisdiction of the ECtHR as a starting point, the author suggests a distinction between externalisation on the one hand and the external dimension on the other. States, oftentimes with facilitation from the Union, pursue one of these two alternatives. Externalisation affords the State stronger and more direct control over the entry of the migrant into the territory of a Member State than the external dimension, where the control is indirect and weaker. This distinction allows for a refined understanding of externalisation and applies it to verifying Member State responsibility for externalised migration control.

Introduction: The major aim of hand washing promotion programs is to persuade people to change their behaviour to reduce high-risk hygiene practices and use. Unfortunately, in a refugee setting, there is a dearth of information about participation in hand washing promotion programs. Objective: To assess barriers and motivators to participation in hand washing promotion programs at household level among refugees in Rhino Camp, Arua district, Uganda. Methods: A crosssectional study was conducted to collect quantitative and qualitative data. A semistructured questionnaire was used to collect data on participation, individual, household factors related to hand washing promotional programs from 312 refugees. Five key informant interviews were conducted to gather data on public policy, institutional and community factors related to participation in the hand washing promotion programs. Qualitative data were analyzed using thematic content analysis. Results: Only 19.6% (61/312) of the refugees had participated in hand washing promotion programs. Significant barriers to participation were; no formal education and staying in the camp for more than 3 years. The significant motivators were; households who had 6 to 10 members and more. Conclusion: Participation in hand washing promotion programs was low among the refugees. There is need for relevant stakeholders to come up with interventions to increase participation among the refugees while taking into consideration the potential barriers and motivators to their participation as identified by this study.