An estimated 1.2 million Syrian refugees, Palestinian refugees from Syria, and Lebanese returnees have sought refuge in Lebanon since the Syrian conflict began in 2011. Lebanon, a tiny country with a population of only four million, is struggling to cope.
With few employment opportunities and dwindling financial resources, the refugees and returnees are largely reliant on humanitarian assistance for survival. As no official refugee camps have been established in response to the Syrian conflict, a very large number of people live in informal settlements, collective shelters, farms, garages, unfinished buildings and old schools, with inadequate access to shelter, food and water. Overcrowding and exposure to extreme weather conditions have a negative impact on their health.
The lack of healthcare is one of the main problems. Thousands of people who had previously received regular medical treatment in Syria for chronic diseases such as hypertension, asthma and diabetes have had to interrupt their treatment – sometimes with severe consequences – because they cannot access or afford it. Many women receive no monitoring during their pregnancies and specialised care is completely out of reach for most people.
Médecins Sans Frontières (MSF) continues to respond with free medical care for people in need, regardless of nationality and refugee registration status.
Many people who have crossed into Lebanon have stayed close to the border, in areas such as in Bekaa Valley, where there is insufficient healthcare infrastructure to meet the current needs. MSF provides basic and reproductive healthcare, treatment for chronic diseases, counselling, and health promotion activities to Syrian refugees and vulnerable Lebanese. Teams work at clinics in the towns of Baalbek and Majdal Anjar (West Bekaa), Aarsal (North Bekaa), and in Hermel. Across the Bekaa valley, 113,000 consultations were carried out during the year.
MSF continues to work in Shatila camp in southern Beirut, a Palestinian refugee settlement dating back to 1949, where more recent Palestinian refugees from Syria and Syrian refugees are also living. The focus is on unregistered refugees who are not eligible for official assistance and registered refugees with medical needs falling outside the UN Refugee Agency’s eligibility criteria. Basic healthcare for children under 15, treatment for chronic diseases and mental health support services are available. A referral system is in place for patients requiring specialist medical intervention, such as caesarean sections for women with high-risk pregnancies and birth complications.
In the coastal city of Tripoli in northern Lebanon a team works in Dar al Zahraa hospital in the Abou Samra neighbourhood. Medical services, including treatment for acute and chronic illnesses, reproductive healthcare, counselling and routine vaccinations, are provided to vulnerable Lebanese and Syrian refugees, regardless of their status. Similar services have been offered in Abdie since April. MSF also offers reproductive healthcare, counselling and care for acute diseases in Jabal Mohsen and Bab el Tabbaneh dispensaries.
A small team based in southern Lebanon offers basic healthcare to refugees. MSF supports three health centres, with activities focused on children under 15, chronic diseases, mental healthcare and reproductive and maternal health services. There is also a referral system for patients in need of specialist healthcare. In 2014, MSF extended its healthcare programme from Ein-el-Hilweh camp to assist the Palestinian refugee community, Syrian refugees and vulnerable residents across the Sidon area. More than 4,800 mental health consultations were conducted; nearly double the number that took place in 2013.
No. staff in 2014: 284 | Expenditure: €15.6 million | Year MSF first worked in the country: 1976 | msf.org/lebanon
Samar Ismail – MSF counsellor, Shatila camp, Beirut
Many of the people I see come from parts of Syria that have been bombed. Some have lost children or other family members ... The first thing I try to do is understand what happened to them and where the negative feelings are coming from. We work on stress management, after we understand the problems. Most people have difficulty understanding why people have treated them the way they have.