Lebanon Report

Syrian refugees put strain on health care

A report issued by the World Health Organisation last year outlines the ongoing pressure on the healthcare system caused by in an influx of refugees fleeing the Syrian civil war. Middle East Health reports.

Lebanon has experienced an unprecedented influx of refugees due to the conflict in neighbouring Syria. This is putting a severe strain on the host communities and authorities. The Government of Lebanon estimates that 1.2 million Lebanese nationals are directly or indirectly affected by the crisis.

The UNHCR estimated late last year that at the beginning of 2015, there would be 1.3 million registered Syrian refugees in Lebanon – around 20% of the total population inside the country.

The UNHCR says “an effective display of international solidarity and support is vital for Lebanon, which has received the highest number of Syrian refugees in the world. Failing this, the country’s capacity to respond and withstand the Syria crisis will be severely tested”.

Syrian refugees are, for the most part, sheltered among the poorest communities of Lebanon, sharing scarce resources with many Lebanese who live below the poverty line (85% of registered refugees are living in 182 locations in which 67% of the host population is living below the poverty line according to preliminary UNICEF data).

This situation is causing increasing tensions. The availability of cheap Syrian refugee labour is, for example, reducing wages and opportunities for many Lebanese workers, while many of the social services on offer cannot cope with the ever increasing demand.

This is particularly true in the health sector where tensions arise due to an overburdening of services resulting in less access to basic care for vulnerable Lebanese. A perception that Syrian refugees get preferential treatment, perhaps due to humanitarian assistance directly targeting them, is adding to the friction. Host communities also fear infectious disease outbreaks due to increasing numbers of refugees living in unsanitary informal settlements, as well as to regular rumours of disease outbreaks. This contributes to a vicious cycle of increasing prejudices and stigmatization.

The UNHCR notes that there are tens of thousands of stateless people in Lebanon. Syrian refugees born in Lebanon are particularly at risk. A 2014 survey of 5,779 Syrian newborns found that 72% do not possess an official birth certificate, raising concerns over the recognition of their nationality by the Syrian authorities.

The scale of the refugee influx is unprecedented. Government, UN agencies, communities and nongovernmental organizations are struggling to respond adequately.

Instrument for Stability

In an effort to provide some relief, the European Union responded by mobilizing its Instrument for Stability (IfS) to provide humanitarian assistance through WHO Lebanon. IfS is specifically suited to promoting conflict reduction in crisis or pre-crisis situations. IfS actions are used to reassure the host population with visible support and thus reduce tension while bridging humanitarian aid with development cooperation by strengthening existing governmental primary health infrastructure and systems. It serves to reassure the Lebanese population while re-enforcing government public service institutions, such as helping improve delivery of basic services to the citizens, in this case providing for the health needs of its most vulnerable population. It does so by:

• Reinforcing the capacity of the Ministry of Public Health in terms of communicable diseases monitoring, early warning and response.

• Reinforcing the capacity of the Ministry to deliver quality primary health care and maternal and child health care.

• Reinforcing the capacity of the Ministry in sustaining the provision of chronic medications.

The theory of change which underpins this project is that by increasing the availability and quality of health services, particularly in areas which have traditionally not enjoyed a high level of state-provided services and are currently experiencing the impact of the Syrian refugee crisis, competition between host and refugee communities will be reduced.

 Date of upload: 21st Jul 2015


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