Authors: Sara Hanafy, Ayah Nayfeh
Increasing conflict and political fragility in Syria has forced the large-scale displacement of millions of Syrians into neighbouring countries like Jordan, Lebanon, and Turkey. Nearly one in every four people in Lebanon is a refugee, many of whom are women and children whose medical needs are not being met . The influx of refugees from Syria over the past five years has moved Lebanon from the 69th largest refugee-hosting country to the third largest.
An estimated one quarter of Syrian refugee children in Lebanon are not receiving the needed care or medications due to issues of affordability . Illnesses such as fever and respiratory problems are treated at a pharmacy rather than from a primary or secondary health care provider as a method to minimize out-of-pocket expenses and consultation fees . Similarly, Syrian refugee women face difficulties with seeking reproductive care, primarily due to cost, but also due to travel distance and fear of mistreatment . Research has shown that Syrian refugee women in Lebanon experience poor health indicators related to reproductive health, pregnancy and delivery complications, and poor birth outcomes , alluding to the fact that poor pregnancy outcomes are an indicator of refugee status, inadequate antenatal care, and insufficient economic means.
There are several reasons for the shortcomings of Syrian refugees in Lebanese host communities, many of which encompass the architecture of the country’s political and health care delivery system. First, the country already hosts a large proportion of the world’s Palestinian refugee population, which comprises nearly 10% of the country’s population. There is also a dearth of up-to-date health information from the State statistical bodies, and information that is available through international financial institutions and private research institutes is influenced through political motives. In order to advance health outcomes, public health policies must be inclusive of the society and should take into account the basic needs of Syrian refugees to ensure that they are being properly met.
It has been proposed that the design and integration of digital platforms would be an asset to improve the welfare of Syrian refugees in Lebanon . The upstream of reliable health data and information to policy makers and stakeholders can allow for tailored planning and implementation of systems that target the needs of vulnerable populations. Digital health technologies, such as mobile phones, have the potential for providing information via text messages to increase health awareness among refugees and to improve home management of illnesses and self-care. However in order for digital platforms to be effective, there are several factors that must be considered, such as the level of literacy both in language and in technology, as well as the attitude towards both formal and informal health advice system.
Recognizing this, the e-Sahha project funded by Canada’s International Development Research Centre (IDRC) was designed to improve the timeliness and reach of health monitoring, and to gather feedback from pregnant women and other users about the perceived and actual quality of care they received. This project is setting the groundwork for a growing number of diabetic or hypertensive refugees to enjoy more accessible and better quality health care on a continuous basis.
There are grand challenges to overcome when providing quality health care to underserved and displaced populations, especially those living in fragile and humanitarian settings. But with creative ways of using technology to reduce health inequities, and with strong relationships with leaders and the community, there is a real potential for positive transformative change.
There is no one-size-fits all system to improve health, but it is crucial that countries like Lebanon continue to work on implementing efforts that are inclusive and that will improve the welfare of Syrian refugees to help reach Agenda 2030 and the sustainable development goals. Primarily, acknowledging the basic social and economic rights of non-citizens should be promoted, and countries should be required to report separately on their citizen and non-citizen populations for all relevant targets. Furthermore, financial compensation to aid those countries with unequal distribution of refugees should be given. This can be achieved with the help of the international community. Joint policies with Europe, North America, and Arab countries on the sharing of refugee burden can be an effective mean of extending a helping hand.
- El-Khatib, Z., Scales, D., Vearey, J., & Forsberg, B. C. (2013). Syrian refugees, between rocky crisis in Syria and hard inaccessibility to healthcare services in Lebanon and Jordan. Conflict and health, 7(1), 18.
- Lyles, E., Hanquart, B., Woodman, M., Doocy, S., & LHAS Study Team. (2016). Health service utilization and access to medicines among Syrian refugee and host community children in Lebanon. Journal of International Humanitarian Action, 1(1), 1-13.
- Masterson, A. R., Usta, J., Gupta, J., & Ettinger, A. S. (2014). Assessment of reproductive health and violence against women among displaced Syrians in Lebanon. BMC women’s health, 14(1), 25.
- Talhouk, R., Mesmar, S., Thieme, A., Balaam, M., Olivier, P., Akik, C., & Ghattas, H. (2016, May). Syrian refugees and digital health in Lebanon: Opportunities for improving antenatal health. In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems(pp. 331-342). ACM