UNHCR report says Syrian influx strains host country health services

GENEVA, April 26 (UNHCR) - A UN refugee agency report released on Friday warns that the Syria refugee crisis is increasingly straining health services in surrounding countries, while refugees are facing increasing difficulties in accessing the quality treatment they need - particularly those with chronic and other costly health conditions.

The report, which covers the first three months of 2013 in Iraq, Jordan and Lebanon, shows that refugees need treatment for a wide range of both common and conflict-related conditions, UNHCR spokesman Adrian Edwards told journalists in Geneva.

"These include injuries, psychological illnesses and communicable diseases - e.g., respiratory illnesses, diarrhoea, skin and eye conditions - often found in other refugee settings worldwide plus other costlier and longer term chronic diseases such as diabetes, hypertension and cardiovascular illnesses as well as expensive referral care that is more commonly diagnosed and treated in middle income countries," he explained.

With more than 1 million Syrian refugees in these three countries, and above 1.4 million around the region, there are two major problems facing the health system. First, with low funding for the refugee crisis, the challenge of providing access to quality health care for Syrian refugees is growing - particularly for people living outside of camps. Secondly, the increasing numbers of people needing medical help is straining existing health services in each of the affected countries.

"Both issues are a matter of serious concern to UNHCR," Edwards stressed, adding: "We continue, with our partners, to provide medical care for refugees in the camps in Jordan and Iraq. But for those refugees who live outside of camps, often in urban settings, the situation is more difficult."

In Jordan and Iraq, health care costs for refugees are covered by governments, UNHCR and many other organizations, but providing expensive referral care - such as renal dialysis, orthopaedic surgery and cancer treatment - is becoming much more difficult. In Lebanon, which has a largely privatized health care system and cost sharing is the norm, resource shortages mean UNHCR and partner agencies are faced with having to reduce support for both primary and more costly referral health care.

In terms of the overall health situation of Syrian refugees, the UNHCR report shows a mixed picture. Syrian refugees are not reported to be suffering from high rates of mortality and acute malnutrition. Mortality at the Za'atri camp in Jordan, for example, is reported at 0.1 per 1,000 people per month, while global acute malnutrition in children below five years is less than 5.8 per cent - neither rate being outside norms seen in the region. This is in contrast to many other humanitarian situations in other parts of the world.

However, preventative services, chronic disease treatment and expensive referral care are not sufficiently provided at a cost that refugees, despite the support provided by the governments and humanitarian agencies, can afford.

Edwards said that among people undergoing consultation for mental health illness, generalized anxiety disorders and post-traumatic stress disorder were found at Jordan's Za'atri camp in 21.6 per cent and 8.5 per cent of patients, respectively. "In Lebanon some 400 mental health consultations are conducted every week. Disease outbreaks have been limited thus far and the surveillance systems have been capturing them; these include limited transmission of measles, hepatitis A and leishmaniasis," he added.

The report was primarily based on information from established refugee camps except for data from Lebanon and showed, among other issues, that further work is needed to improve data collection - particularly for out-of-camp situations. UNHCR and its partners have alread

y begun working to address this issue.

As of last night 1,401,435 Syrians had registered as refugees in the region or were pending registration. This corresponds to 30 per cent more than the total envisaged under the current Regional Refugee Response Plan by end June 2013 - for which around 55 per cent of funding has so far been received. An updated plan is due to be presented to donors in late May. UNHCR continues to roll out additional capacity as funding comes in.

The report can be seen at http://data.unhcr.org/syrianrefugees/regional.php