The New York Declaration for Refugees and Migrants, adopted by the United Nations GEneral Assembly in September 2016, stresses that root causes should be addressed “through the prevention and peaceful resolution of conflict, greater coordination of humanitarian, development and peace-building efforts, the promotion of the rule of law at the national and international levels and the protection of human rights”. The international community has thus recognized “a shared responsibility to manage large movements of refugees and migrants in humane, sensitive, compassionate and people-centered manner”.
UN Document A/71/L.1. (paragraph 11)
Refugees & Migrants and Ethical Responsibility for their Health Care:
- It is more than simple generosity, simple charity.
- It aims to build spaces of normalcy in the midst of what is abnormal.
- More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings.
Nobel Lecture by James Orbinski, Médecins Sans Frontières, Oslo, December 10, 1999
Since the start of the Syrian conflict in 2011, Lebanon has been host to incoming refugees. The UNHCR estimates 1,050,877 Syrians are now in Lebanon, amounting to 25% of the Lebanese population. Refugees are concentrated in the North and Bekaa regions, host communities that are already poor, underserved and vulnerable.[1]
The Issue
The large and constant influx of Syrian refugees into Lebanon has greatly strained the Lebanese healthcare system and economy. Many local and international NGOs, humanitarian organizations and governmental agencies are involved in providing humanitarian assistance and health services to Syrian refugees. Yet, there remain existing structures that limit refugee access to essential health care services, including poor coordination between them. The result is a rise in communicable diseases, increased risk of epidemics, suboptimal control of chronic diseases, and other health related matters.[2]
How can the Lebanese MOPH and other stakeholder organizations secure better access to essential and urgent healthcare needs of Syrian refugees?
Current Health Situation of Syrian Refugees in Lebanon
Access to Healthcare by Syrian Refugees in Lebanon
Roles and Responsibilities of the Lebanese Ministry of Public Health (MoPH)
Conclusion
It is important to promote access to Essential Health Care Services for Syrian Refugees in Lebanon and to recognize the severe shortage in financing and unmet promises by the international community. An immediate action and far greater support from the international community is needed to address the needs of refugees in Lebanon.
Recommendations for the MOPH and international aid agencies:
- Develop an essential package of healthcare services for Syrian refugees and Lebanese people.
- Develop a mechanism at the level of the government to raise funds to finance the delivery of the essential package.
- Expand the number of primary healthcare centers, and hospitals that are within the humanitarian sector.
- Developing refugee health information system through:
- Identifying priority data needs and requirements;
- Developing guidelines for data collection, and data use;
- Establishing a mechanism for data monitoring, data sharing between all stakeholders including the private sector.
- Invest in building capacities of local infrastructure and local government (municipalities) to handle crisis situations.
- Explore mechanisms to increase transparency in the work including resource allocation of NGOs and other agencies in delivering health interventions.
- Invest in decentralizing decision making capacity at the level of the government departments to match interventions and aid to the needs of the local community.
- Identify research priorities on refugee health.
- Strengthen the stewardship function of governmental departments and having a lead organization that is capable to play a major role by coordinating and establishing effective partnerships with local and international agencies.
About the Author:
Michel Daher, MD, FACS
Professor of Surgery, Univ of Balamand
Secretary General, Lebanese National Ethics Committee
Vice-Chair, National Committee for Palliative Care
Saint George Hospital-UMC, Beirut- Lebanon
mndaher@inco.com.lb
Photo Credit: One-month-old baby boy, Walid, is comforted by his mother after a check-up provided by UK aid at a Save the Children clinic in Lebanon’s Bekaa Valley. Walid’s mum was worried about him but the diagnosis was just that’s he suffering from colic, which will hopefully get better by itself in time. The UK is supporting Save the Children to provide access to primary healthcare for thousands of Syrian refugee children in Lebanon, as well as ensuring that hundreds of pregnant Syrian women have access to anti-natal care. To find out more about how the UK is responding to the humanitarian crisis in Syria and its neighbouring countries, please see:www.gov.uk/government/news/syria-the-latest-updates-on-uk… Picture: Russell Watkins/Department for International Development
[1] (UNHCR, 2014 – WB&UN, 2013; UNHCR. 2015. Syria Regional Refugee Response http://data.unhcr.org/syrianrefugees/regional.php)
[2] (Refaat & Mohanna, 2013)
Humanitarian Health Ethics 