From the field: Syrian refugees in Lebanon risk their lives for medical treatment

This is the first in a new series of dispatches about Amnesty International’s work on the ground, researching human rights crises around the world. For the latest updates on Syrian refugees in Lebanon, follow @CharCamille and @KDhala on Twitter. 

Syria’s enormous refugee crisis has been consistently described as the worst humanitarian crisis in a generation.

A recent announcement by the UN High Commissioner for Refugees gives a sense of the scale of the suffering – as of late February, more than 2.5 million people had fled across Syria’s borders to escape the conflict. This is more than a hundred-fold increase on the number of refugees two years ago. 

“LATEST: Syrian refugees 24.02.14 = 2,501,392 24.02.13 = 756,157 24.02.12 = 20,437 #Syria#childrenofsyria

— Andrew Harper (@And_Harper) February 24, 2014

@Refugees: Syrians will soon replace Afghans as the world’s largest refugee population – HC Guterres 2the @UN today

— Andrew Harper (@And_Harper) February 26, 2014

Half of those refugees are children. 

At the time of the UN announcement, researchers Charlotte Phillips and Khairunissa Dhala from Amnesty International’s Refugee and Migrants Rights team were visiting areas which host Syrian refugees including informal settlements in Lebanon. This country of 4.3 million people that shares a long land border with Syria has received almost 1 million refugees since the uprising began. An additional 50,000 are registered every month. 

In Beirut researching #SyrianRefugees. Over 50,000 refugees registered by #UNHCR in #Lebanon every month

— Khairunissa Dhala (@KDhala) February 24, 2014

Strain on resources

The total number of Syrian refugees in the country is expected to reach 1.5 million by the end of the year, putting immense additional strain on resources that are already tight.

Lebanon has already received 62% of the 1.5 million refugees predicted to arrive by end of 2014 #SyrianRefugees

— Charlotte Phillips (@CharCamille) February 24, 2014

To give just one example of how the crisis is stretching capacity in Lebanon, in Rafik Hariri hospital in Beirut, the health system is finding it difficult to keep up with the influx. More than half of the babies delivered there last year were to Syrian parents.

At Rafik Harir hospital. Health system strained by big number of Syrian refugees. Of 2852 babies delivered 2013, 1997 were Syrian. #beirut

— Charlotte Phillips (@CharCamille) February 24, 2014

Beirut’s Shatila refugee camp – set up for Palestinians in 1949 – houses hundreds of new refugees from Syria. They are considered among the poorest in the capital. There and elsewhere, the high costs of medical care mean that the UNHCR won’t cover treatment for chronic diseases, including cancer.

Refugees from #Syria in Chatila inc Palestinians that fled Syria are considered some of the poorest in Beirut

— Khairunissa Dhala (@KDhala) March 4, 2014

Treatment for chronic disease inc cancer are not covered 4 refugees by #UNHCR due to the high costs in #Lebanon

— Khairunissa Dhala (@KDhala) March 4, 2014

A #Syria‘n man shows AI his medical reports. He has cancer & can’t afford treatment in Leb.

— Khairunissa Dhala (@KDhala) March 4, 2014

also intvwed 27 year old #Syria ‘n mother of 2 in Shatila. She has lymphoma cancer, but no treatment since arriving in Leb due to high cost.

— Charlotte Phillips (@CharCamille) March 4, 2014

Malnourishment – a ticking time bomb

The team visited eastern Lebanon’s Bekaa Valley, the area of Lebanon with one of the highest concentration of Syrian refugees – nearly 300,000. Many of the makeshift refugee camps there – referred to as “informal tented settlements” – lack adequate access to even the most basic necessities, such safe water, hygiene and sanitation. 

moody skies in bekaa valley, #Lebanon. view from a mobile clinic at an ‘informal tented settlement’

— Charlotte Phillips (@CharCamille) February 27, 2014

a woman boils water outside her tent at an informal tented settlement, bekaa.

— Charlotte Phillips (@CharCamille) February 28, 2014

Litter fills open streams in an ‘informal tented settlement’ in Bekaa. 500 #SyrianRefugees there

— Khairunissa Dhala (@KDhala) February 28, 2014

In addition to the strained resources and dire conditions, thousands of refugee children under 5 years of age are facing malnourishment in the camps. 

High energy biscuits in Bekaa Valley. UN says over 2000 #SyrianRefugees under 5yrs are malnourished there

— Khairunissa Dhala (@KDhala) February 26, 2014

UNICEF has called it a “silent, emerging threat” that has left children at risk of dying and in urgent need of immediate treatment to survive. In 2013, the rates of malnutrition were double what they were just a year earlier.

UNICEF say malnutrition is a silent emerging threat in lebanon. Severe acute malnutrition doubled in 2013 vs in 2012

— Charlotte Phillips (@CharCamille) February 26, 2014

primary health care centre in Bekaa, east Lebanon, where refugee children are weighed and measured for malnutrition

— Charlotte Phillips (@CharCamille) February 26, 2014

Perilous trips back to Syria

Meanwhile, since many refugees with medical issues are strapped for cash they are simply unable to afford the high cost of treatment in Lebanon. Doctors told Amnesty International that many were repeatedly making the perilous trip back into Syria to receive care.

doctors tell AI that #SyrianRefugees are forced to go back to Syria for medical treatment because cost of treatment in Lebanon is too high

— Charlotte Phillips (@CharCamille) February 27, 2014

#SyrianRefugee shows pills. She needs kidney dialysis but too costly in Leb so goes to Syria 2x a week for treatment.

— Charlotte Phillips (@CharCamille) February 28, 2014

10yr old boy AI spoke to in Bekaa with typhoid and blood disorder has been 2 Syria 3x since Jan for treatment.

— Khairunissa Dhala (@KDhala) February 28, 2014

His father will cont taking him to Syria and risk their lives as long as healthcare is unaffordable in #Lebanon

— Khairunissa Dhala (@KDhala) February 28, 2014

Some may have to go even farther afield to get the care they need. In Tripoli, in northern Lebanon, the team met a 12-year-old Syrian boy who suffers from infection and other complications after not receiving initial treatment for burns on his legs. His family is waiting to see if he can be sent to Europe to be treated. 

in tripoli, intvwd 12yr old syria ‘n boy wth burns on legs. Not initially treated, led to complications and infections

— Charlotte Phillips (@CharCamille) March 5, 2014

now he is waiting to see if he can get medical care in Europe #SyrianRefugees

— Charlotte Phillips (@CharCamille) March 5, 2014

What needs to be done?

The UN says it needs to resettle some 30,000 Syrians in 2014. 

#resettle syrian refugees and invest in the future. The UN needs to resettle at least 30,000 Syrians in 2014

— Charlotte Phillips (@CharCamille) February 25, 2014

But with the total number of refugees from Syria in Lebanon due to skyrocket to 1.5 million by the end of the year, what will happen to the huge number who are still living in squalid conditions in the informal settlements in Bekaa Valley and elsewhere?