BEIRUT: Funding for Doctors Without Borders (Medecins Sans Frontieres) has been secured for next year, according to an MSF program manager, however the organization faces limitations in adequately meeting needs of the Syrian refugees it has been serving for the past four years.
“We have been confronted with hard choices in terms of which services to provide and what areas to provide them. There’s been a need to prioritize,” Dr. Gustavo Fernandez, who manages MSF support across countries hosting Syrian refugees, said, adding that the amount of international support is insufficient to meet refugee needs, given the magnitude of the crisis.
Since the start of the refugee influx in spring 2011, international organizations and the U.N. have struggled to keep up with the health needs of Syrian refugees.
As the years have passed, an increasing number of refugees have settled across Lebanon, living in precarious conditions and in desperate need of basic health care.
Meanwhile a stressed Lebanese health infrastructure is ill-equipped to meet their needs.
Funded through private donors, MSF has been responding to the refugee influx since the first waves came to Lebanon. Since then, they have expanded and adapted their response to meet the growing demand, as the protracted conflict has demanded a longer-term vision.
According the latest figures from the MSF office in Beirut, more than 400,000 needy Lebanese and Syrians have been treated by the organization since the beginning of the influx.
“The magnitude of crisis is enormous. International support needs to be reinstated and upscaled for plans in the mid-to-long-term range,” Fernandez said. Based in Geneva, Switzerland, he has assessed and implemented projects in Lebanon and other host countries.
In an interview with The Daily Star, he spoke about the health situation among Syrian refugees and the host population in Lebanon.
“The number of people arriving to Lebanon has been huge. There was no way under current circumstances, with underfunding ... to cover the volume of the crisis,” he said.
MSF coordinates with the Health Ministry in each of its health facilities, offering support alongside local governmental authorities.
The organization supports clinics and hospitals in the Bekaa Valley, north Lebanon and Sidon and has increased the number of services it offers to both Syrian refugees and the host population.
Lebanon has more Syrian refugees than any other host country in proportion to its population. Since refugees first arrived in 2011, the number of refugees has swelled to a total of 1.1 million registered with the UNHCR.
The Lebanese government estimates that between 300,000 and 500,000 unregistered Syrian refugees also reside in the country.
The U.N., as well as international aid organizations such as MSF, has struggled to respond to the increased needs of refugees in Lebanon. While expanding activities, they have faced limitations due to scarce resources.
As shortages of medical services struck, clinics have been swamped with many more patients than they can handle.
According to a July 2014 UNHCR report documenting the situation of refugee health needs in Lebanon, humanitarian organizations were “facing a 41 percent funding gap.” The report estimated that around 900,000 Syrian refugees and needy Lebanese might “not receive support for basic curative and preventive treatment.”
Syrians are concentrated in the most vulnerable areas of the country, such as the Bekaa valley, north Lebanon and the south, where many Lebanese also lack access to basic health services and are economically insecure.
MSF Clinics in Tripoli’s Jabal Mohsen and Bab al-Tabbaneh neighborhoods primarily address the needs of low-income Lebanese, while their Bekaa valley-based clinics overwhelmingly serve Syrian refugees.
According to figures from MSF in Lebanon, Syrians represent 68 percent of those treated by the organization, followed by 28 percent Lebanese and 4 percent Palestinian.
Social and environmental factors play a huge role in determining health outcomes for the displaced. Syrians continue to face inadequate access to food, water and shelter, making them vulnerable to ill-health.
“After four years, there is still a huge amount of people living in unfinished buildings,” Fernandez said, “in winter months, when there is no heat and not enough blankets, the refugees are more vulnerable to upper respiratory tract infections.”
He also cited access to clean water as a pressing concern.
MSF clinics are confronted daily with a high demand for health services including preventive care, maternal health, family planning needs and treatment for communicable diseases.
Fernandez stressed that demand has risen for chronic disease treatments and reproductive health care. MSF has identified major gaps in access to these services throughout their areas of operation in Lebanon.
Rates of hypertension and diabetes have risen among the country’s refugee population, while Fernandez explained that those with chronic diseases often stop looking for necessary routine treatment once they know it is too expensive
In some areas as many as three out of 10 patients don’t have access to treatment at all, “either because they can’t afford it or because they have stopped asking. It has changed their health seeking behavior,” he said.
Reproductive health has fared no better. Fernandez said that pregnant women don’t visit the doctor routinely, with their pre-natal medical needs “not monitored enough throughout pregnancy.”
Looking forward, Fernandez believes that long-term planning must occur in order to help the Lebanese government and international organizations meet the needs of the continued high numbers of Syrian refugees.
“Our strategy is to remain committed, to address those needs of the population we serve,” he said.
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