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Preface

 

Palestinian camps and gatherings are suffering from multi-source and complicated health problems resulting first from deteriorating living conditions, low wages, high poverty and increasing deprivation in camps and among Palestinian refugees in general, and caused as well by unhealthy housing environment in camps. 

 

The Problem 

 

The general health situation of the Palestinian refugees in Lebanon is facing various problems mainly revolving around the following:

  • Situations relating to primary health care, especially the health conditions of children and mothers;
  • The health protection systems represented by the health insurance;
  • The additional health care costs, despite the services offered by UNRWA, the Red Crescent and other health care institutions;
  • The quality of nutrition and the chronic nutrition practices;
  • The service providers, who are facing pressure in terms of budget, which negatively affects the quality and quantity of the services offered to the refugees;
  • Healthy environment, whether in terms of housing conditions or the general services, especially the health facilities such as water, water services and sanitation.
 
In order to face the health challenges that are burdening the lives of refugees, it is crucial to determine a starting point to confront these problems, so as to alleviate their negative impacts on different levels. In this regard, it is relevant to discuss the issue of the general environment in camps, in all its aspects and prevailing living conditions, as a central issue that should be of interest to the various initiatives required to face the health challenges pressuring the lives of refugees. The nutrition issues intersect at this point with the provision of material living conditions, such as water, shelter, basic services, infrastructure and sanitation, as well as improving the health services, developing the centers, enhancing the quality and efficiency of such services and developing the insurance system, which altogether constitute the interlaced and required interventions in the aspired health and social policies. 

Health Care Providers

 

UNRWA

UNRWA is witnessing a decrease of funding by the donor countries in light of the growing Palestinian refugee demands on its services generally, and on its health services more specifically. While the attempts to compensate for this deficit persisted, UNRWA launched some initiatives towards developing its health services through devising new health policies that compensate for certain shortcomings witnessed in the previous experience, and that can cover the increasing demand on health services along with new health services that were not available in the required extent and diversity.

 

Since 2011, “UNRWA began a reform process based on a Family Health Team approach and the development of electronic medical records (e-Health). The aim was to modernize the agency’s primary health care services, making them more person-centered and more efficient. The Family Health Team approach is considered a model for providing primary health care focused on the patient and the family in a comprehensive and continuous manner. Not only does it emphasize on quality curative care, but it is also centered on health education and health promotion interventions at the household level. Moreover, it covers the entire health chain, from protection, prevention, treatment, management of diseases to psychosocial welfare. In addition, the e-Health System approach aims at improving the efficiency of the health care services, and decreasing the number of medical mistakes, as well as facilitating the decision-making process in an urgent and credible manner, based upon the needs.”

 

UNRWA has been suffering a budget pressure caused by the demand on health care services, which pushed the latter to adopt many procedures that resulted in massive waves of protests in Palestinian camps. Following the formation of two technical committees composed of the agency’s doctors and factions, a moderate compromise was reached, whereby patients entering the hospitals of the Red Crescent were exempted from the 10 per cent. In addition, it was agreed that the agency covers 90 per cent of the hospitalization bill in the Lebanese governmental and private hospitals, while an amount of 10 per cent is to be paid by the patient, provided that the agency increases its contributions in favor of the third class patients …noting that most of what was agreed upon is in line with the agency’s capacities on one side, and the series of circumstances surrounding the Palestinian refugees on the other side. 

 

                                                  Palestinian Red Crescent Society (PRCS)

 

Since its establishment in Jordan in 1967 and its transfer of activities to Lebanon, the Palestinian Red Crescent Society engaged in the required health, relief, social and humanitarian missions. It established a good number of hospitals and health centers, and carried out its duties considering that, according to the Palestinian National Committee, it was the official Palestinian health institution.. Although its services declined after the PLO’s departure from Beirut in 1982, along with the exacerbation of its financial hardship, and despite the creation of a Ministry of Health by the Palestinian Authority, the official mandate of the association remained as is, meaning that it is still responsible for providing relief services, blood transfusion, emergency services and health services.

The decline of the Red Crescent’s performance is coupled with the latter’s loss of its status of  health refuge and haven for Palestine refugees, and with the increase of the hardships and problems that burdened the Red Crescent, deeply affecting the services provided by its health centers. The coverage of the required specialties decreased and the quality of the services provided dropped; thus, the Red Crescent has become unable to meet the growing demand of Palestinians on these services. In fact, many of these centers have become mere clinics that provide emergency and relief services, and hence lack the funds required for the expenses of the patients, as well as lack many modern medical equipment and ambulances.

 

                                                     The Private Sector and the Civil Institutions

 

In light of the decrease of services provided by UNRWA’s health centers and the Red Crescent in terms of covering the required specialties and ensuring appropriate medical staff, Palestinians are now resorting to other health institutions and centers. While these new centers may not be very large, they have however assumed a signification place for the refugees. With the health services provided by UNRWA’s centers and institutions and the Red Crescent Society, and those provided by the private sector albeit at a high cost, it becomes evident that a set of humanitarian and health services are provided by civil institutions that seek to provide as much services as possible, depending on individual initiatives, or on the support of international and regional parties. 

 
 
 
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