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Refugees in Lebanon receive wider, cheaper access to hospital services

Making a Difference, 28 January 2011

© UNHCR/A.Yungrova
Iraqi refugee children draw in a community centre in Beirut. The new agreement is good news for their health care.

BEIRUT, Lebanon, January 28 (UNHCR) A landmark cooperation agreement, supported by UNHCR and Lebanon's Health Ministry, will allow refugees to receive medical treatment at four state-run hospitals around Lebanon at affordable prices.

The cooperation agreement was signed last week in Beirut by representatives of the four hospitals and some of UNHCR's local implementing partners. It follows similar recent agreements with five private health facilities across Lebanon.

Before the agreement, Iraqi refugees in Lebanon only had access to basic health services at reasonable rates, but access to emergency services was often denied and hospital treatment was beyond the means of most refugees and much more expensive than that charged for Lebanese citizens.

The latest agreement has been welcomed by Iraqi refugees, UNHCR and the government. "The state cannot see a person die and turn its face away. We have taken up our responsibilities as a state," Health Minister Mohammad Khalifeh said at the signing ceremony.

"Today we can say that not only does Lebanon stand apart from many nations in its appreciation and commitment to good health for its citizens, but that it extends this consideration to refugees," added Ninette Kelley, UNHCR's representative in Lebanon.

With quality medical care becoming more accessible and affordable for registered refugees, their health will improve, as will the health of the communities in which they live.

Among the first to benefit from the new arrangement was 20-year-old Hussein, who had been mutilated by militants in Baghdad before fleeing to Lebanon last year. One foot had been partially amputated and the toes on the other chopped off, while his legs were badly burned.

Hussein urgently needed surgery costing US$8,000 to save his legs, but he could not afford it. He approached UNHCR for help in applying for asylum and also sought the agency's help for immediate medical care.

"I had no money for the surgery. I had to borrow money from friends to live. So I approached UNHCR and they helped me," he said, sitting on his hospital bed. Under the cooperation agreement, the surgery cost half the price Hussein would have had to pay as a private patient. UNHCR and one of its partners shared the costs.

But for some refugees, like 28-year-old Wajiha, the agreement has come too late. The pregnant mother of three, who fled from Iraq 11 years ago with her family, went into labour prematurely and needed urgent medical care.

Wajiha had trouble getting admission to the hospitals she went to in Beirut last year because they required that refugees pay the full fees in advance or show proof of payment from UNHCR or its partners.

"I was rejected by two hospitals even though I presented my UNHCR refugee card. Finally I found one that admitted me," she recalled. "I had the baby immediately after I was admitted. The baby and I were not well and a week later my child died."

She mused that if the agreement with the hospitals had been in force, "maybe I wouldn't have lost the baby." With the new arrangement, the more than 9,000 mostly Iraqi registered refugees in Lebanon will feel more reassured about gaining access to crucial health care without having to worry about the cost.

By Wafa Amr and Ziad Ayad in Beirut, Lebanon

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A Face in a Million: the Struggle of Syria's Refugees in Lebanon

They are everywhere in Lebanon - 1 million Syrian refugees, in a land of 4.8 million people. There are no refugee camps in Lebanon. Instead, most rent apartments and others live in makeshift shelters and in garages, factories and prisons. Three years after the Syria crisis began, Lebanon has become the country with the highest concentration per capita of refugees in the world. It's struggling to keep pace with the influx. Rents have spiked, accommodation is scarce; food prices are rising. Meanwhile, a generation could be lost. Half of Syria's refugees are children; most don't go to school. Instead many of them work to help their families survive. Some marry early, others must beg to make a bit of money. Yet they share the same dream of getting an education.

In the northern city of Tripoli, many of the Syrians live in Al Tanak district, dubbed "Tin City." Long home to poor locals, it is now a surreal suburb - garbage piled to one side, a Ferris wheel on the other. The inhabitants share their dwellings with rats. "They're as big as cats," said one. "They're not scared of us, we're scared of them."

Award-winning photojournalist Lynsey Addario visited Tin City and other areas of Lebanon with UNHCR to show the faces and suffering of Syrians to the world. Addario, in publications such as The New York Times and National Geographic, has highlighted the victims of conflict and rights abuse around the world, particularly women.

A Face in a Million: the Struggle of Syria's Refugees in Lebanon

Forced to grow up too soon in Lebanon: Mahmoud

Mahmoud,15, hasn't been to school in 3 years. In his native Syria, his parents were afraid to send him because of the civil war. They ended up fleeing a year ago when, in the early morning hours, a bomb fell on a nearby house. The family, still groggy from being jolted awake, grabbed what they could and fled to Lebanon. Their home and the local school have since been destroyed.

In Lebanon, Mahmoud's father is unable to find work and now the family can barely afford rent.

A month ago, Mahmoud started working for tips cleaning fish at a small shop next to his home. He makes about $60 USD a month. With this money he helps pay rent on his family's tiny underground room, shared between his parents and eight brothers and sisters. Mahmoud is proud to help his family but with the fish shop located in the same subterranean structure as his home, he barely goes out into the sunshine.

Children like Mahmoud, some as young as seven, often work long hours for little pay, and in some cases in dangerous conditions. These children forfeit their future by missing out on an education and the carefree years of childhood. Many are also traumatized by what they witnessed back in Syria.

UNHCR and its partners together with local governments are providing financial assistance to help vulnerable Syrian refugee families cover expenses like rent and medical care, which means there is less need to pull children out of school and put them to work. UN agencies and their partners have also established case management and referral systems in Jordan and Lebanon to identify children at risk and refer them to the appropriate services.

Forced to grow up too soon in Lebanon: Mahmoud

Lebanese Town Opens its Doors to Newly Arrived Syrian Refugees

Fresh fighting in Syria has driven thousands of refugees across the border into eastern Lebanon's Bekaa Valley over the past week. An estimated 6,000 people were forced from their homes by the fighting around Qarah and the Qalamoun region of western Syria. The desperate civilians crossed the mountains and made their way to the town of Arsal in Lebanon. Most of the refugees were already internally displaced in Syria, some as many as half a dozen times, before finally being forced out of the country. Some 80 per cent of the new arrivals were originally from the Syrian city of Homs. The refugees are arriving in a desolate and impoverished part of Lebanon that has seen its peacetime population grow by 50 per cent since the Syria crisis began in March 2011. Harsh early winter conditions are making matters worse. UNHCR and its partners have found temporary shelter in Arsal for the new arrivals in a wedding hall and a mosque. They are handing out blankets, food packages as well as kitchen and hygiene sets. A new transit site is also being built until better shelter can be found elsewhere in the country. The following images were taken in Arsal by Marc Hofer.

Lebanese Town Opens its Doors to Newly Arrived Syrian Refugees

Lebanon: Rush to ArsalPlay video

Lebanon: Rush to Arsal

The bombardment of the Syrian city of Yabroud has driven thousands of refugees across the mountains into the Lebanese town of Arsal. UNHCR and its partners, including Lebanese NGOs, are working to find shelter for the newly arrived.
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Lebanon: Out in the ColdPlay video

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Syrian refugees living in makeshift shelters exposed to the cold are helped by UNHCR.