Clinic set-up in refugee settlement

Update on the Refugee Crisis in Lebanon

The conflict in Syria has been raging for over nine years and in this time more than five million refugees have fled into neighbouring countries. Lebanon currently hosts around one million Syrian refugees, including 34,000 Palestinian refugees from Syria. All these refugees live in the most deplorable social, economic and environmental conditions. Some live within already overcrowded and under-resourced Palestinian refugee camps, but most live in tents or disused/unfinished buildings with no basic amenities. Women and children are always the most vulnerable members of displaced communities and comprise over 70% of the refugee population. During 2020 the impact of the country’s worst economic crisis in history, with local currency devalued by over 80%, the devastating Beirut blast and COVID-19 pandemic, resulted in a rapid and frightening escalation in the level of need within refugee and host communities; rising unemployment and poverty levels, rising levels of food insecurity and malnutrition (particularly affecting young children and pregnant/breastfeeding women), and an exponential rise in mental health disorders. Linked to these changes are extremely worrying increases in reports of sexual/gender-based violence (SGBV) and child safeguarding violations (neglect, physical, emotional and sexual abuse/exploitation).

The international humanitarian response never met the unprecedented level of need and the growing political/economic crisis in Lebanon over the past year is worsening an already appalling situation. Governmental mental health programmes have been suspended since March 2020 and the United Nations (UN) humanitarian budget has been cut drastically. The need for our services grows ever greater as other sources of support for this hugely disadvantaged population diminish and disappear.

IDEALS’ Support for Syrian Refugees in Lebanon

Phase One

Together with our local partner, Blue Mission, we supported a mobile medical unit providing essential primary health care services for over 15,000 vulnerable people in the south of Lebanon for the 16 months up until July 2018. The vast majority of our beneficiaries were Syrian refugees, but Palestinian refugees (from Lebanon and Syria) and disadvantaged Lebanese patients were also supported. They couldn’t afford to pay for health care, and the quality of care in these deprived communities is generally very poor anyway. Over this period we successfully provided:

  • Essential medical care - a total of 14,800 consultations, including:
    • Management of all acute illnesses
    • Vital reproductive health services for women; ante and post-natal care and family planning
    • Growth monitoring and general health promotion for young children
    • Support for the routine vaccination of young children, prioritising measles and polio
    • Referral of those patients needing specialist or emergency care to the nearest clinic or hospital
  • Regular health/hygiene awareness raising sessions; a total of 8,600 attendees

These services undoubtedly saved lives and improved the quality of many more.

Health education for a patient with diabetes

Phase Two

But in mid-2018, following a national needs assessment led by the Lebanese government and UN agencies, it was recommended that humanitarian resources be diverted away from mobile medical units to static health centres. Subsequently we decided to address other essential health needs identified in this robust assessment process:

  • Major gaps in ante and post-natal care were worsening and contributing to rising maternal and newborn morbidity/mortality.
  • Mental health indicators for adolescents (specifically 13-17yr olds, both Lebanese and Syrian) were shocking, with virtually no services addressing the need:
    • 14.2% had seriously considered attempting suicide in the preceding 12 months
    • 16.6% had been bullied on one or more days in the preceding 30 days
    • 18.9% had drunk alcohol on one or more days in the preceding 30 days (alarming within highly conservative communities)

So, again in partnership with Blue Mission (who have considerable experience of working with host and displaced communities in the region), we began delivering the following combination of services for the same 15,000 beneficiaries at the beginning of August 2018:

  • A midwife/gynaecologist led sexual and reproductive health service, incorporating:
    • o Ante and post-natal care, including the identification and referral of high-risk pregnancies;
    • o A full family planning service;
    • o Newborn health surveillance/promotion; and
    • o Sexually transmitted infection advice/counselling.
  • A pyramid of mental health and psycho-social service interventions, particularly targeting women, children and adolescents:
    • o Community/school level engagement activities, including play and arts/drama sessions;
    • o Cognitive behavioural and arts/drama-based therapy for those with identifiable mental health problems; and
    • o SGBV/child safeguarding awareness raising and case management.

In the 20 months from August 2018 to April 2020, 10,000 patients benefited from medical/midwifery/gynaecological consultations and treatment, 3,500 beneficiaries attended health education sessions (including SGBV and child safeguarding awareness raising), 13,000 children and adults participated in psychosocial support sessions (playgroups, art sessions, signposting to other services and “problem” discussions) and 470 women, children and adolescents completed courses of therapy; cognitive behavioural or arts/drama-based therapy.

The number of beneficiaries accessing services and the number referred to our team by other agencies (including the UN, Medecins Sans Frontieres and Norwegian Refugee Council) increased every month during this time, as services provided elsewhere disappeared and the needs grew ever greater.

Medical assessment of a child with a sore throat

Current Project; Phase Three

After a gap caused by lack of funds we restarted our partnership with Blue Mission at the beginning of January 2021, providing the same 15,000 beneficiaries with the following package of essential services, all delivered free of charge:

  • Essential primary health care services, targeting women, children and adolescents; assessing and treating acute and chronic health conditions and referring to regional primary health care centres/hospitals for further investigation/treatment as needed.
  • Regular health/hygiene awareness raising sessions, with an initial focus on COVID-19 prevention and response. This will complement and augment a parallel COVID-19 awareness raising initiative, delivered by Blue Mission and funded by the UN Children’s Fund (UNICEF).
  • A midwife/gynaecologist led sexual and reproductive health service, incorporating:
    • Ante and post-natal care, including the identification and referral of high-risk pregnancies;
    • A full family planning service;
    • Newborn health surveillance/promotion;
    • Sexually transmitted infection advice/counselling; and
    • Management of COVID-19 concerns in pregnant/breastfeeding women.
  • Essential mental health and psycho-social service interventions, particularly targeting women, children and adolescents:
    • Cognitive behavioural and arts/drama-based therapy for those with identifiable mental health problems; and
    • SGBV/child safeguarding awareness raising and case management.

Expected Results

The project’s expected results mirror those for the health sector in the Lebanon Crisis Response Plan 2017-21:

  1. Improved access to comprehensive primary health care, including:
    1. Chronic disease medication provided free of charge at primary health care level.
    2. Acute disease medication, medical supplies and reproductive health commodities provided free of charge at primary health care level.
    3. Routine vaccination for children under five provided free of charge at primary health care level; polio and measles campaigns will be supported by our project.
  2. Improved outbreak and infectious disease control.
  3. Improved adolescent and youth health.
  4. Meaningful child safeguarding and SGBV interventions provided at community and primary health care levels.

Funding Required

The project costs £7,500 per month. We desperately want to continue these hugely valuable services for at least another 12 months at a total cost of £90,000.


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Conditions in a tented settlement in Tyre