Impact of refugee crisis on Lebanon’s public health sector

BEIRUT: The 1.5 million refugee influx into Lebanon has resulted in heavy strain on the Lebanese health care infrastructure and has excluded massive numbers of refugees from access to basic health services.

Unlike other host countries, Lebanon has forbidden official camps. Consequently, refugees are spread throughout the country, at times with restrictions on movement, and in substandard living conditions that predispose them to illness. Moreover, hundreds of thousands of unregistered refugees are excluded from assistance for health services.

The health sector in Lebanon is dominated by private hospitals and clinics, and many services are financially out of reach for low-income Lebanese and refugee populations. Over the past several years, some refugees have returned to Syria to obtain treatment at lower cost.

Public health specialists and policymakers alike have cited the lack of coordination between aid organizations and the Lebanese government as a major hurdle to efficient health care delivery.

From the start of the unrest, Lebanon’s hard-pressed public health services were unprepared to accommodate a large refugee presence, particularly amid the country’s weak economic situation. A 2007 survey of household living conditions found that approximately 50 percent of Lebanese lack health insurance.

According to research on Syrian refugee access to health services in Lebanon, compiled by AUB’s Knowledge to Policy Center, the refugee crisis had caused Lebanese to avoid the country’s primary health centers and public hospitals, “due to overcrowding, increased waiting time and perceived decreased quality of care.”

At present, refugees face overwhelming economic barriers in paying for primary health services. If registered with the UNHCR, they must still cover 25 percent of health care costs, while UNHCR covers the remaining 75 percent.

International aid organizations have provided assistance, and vastly expanded their activities as refugee numbers have swelled. Many address both the needs of vulnerable Lebanese and Syrian refugees. Despite their efforts, health demands remain difficult to address due to the uptick in refugees streaming across the border occurring in tandem with dwindling funds for relief efforts.

Throughout 2013 and 2014, multiple reports cited gaps in U.N. funding for basic needs, among them, food and health care. A July 2014 UNHCR regional response plan for Lebanon found that only 44 percent of the year’s necessary public health funding had been received.