Interview: How Lebanon’s economic collapse is compounding pandemic woes for Palestinian refugees

On top of the global COVID-19 pandemic that has impacted lives and livelihoods the world over, Lebanon is also experiencing its worst economic crisis in decades. The value of its local currency – the Lebanese Pound – has collapsed, and more than half of the country’s six million inhabitants are now living in poverty and struggling to afford basic essentials such as food and medicines.

We spoke to Wafa Dakwar, Medical Aid for Palestinians (MAP)’s Senior Programme Officer in Lebanon, to learn about how these overlapping crises are impacting the Palestinian refugee communities we serve.

The situation in Lebanon has been described as the “worst economic crisis since the Civil War.” Can you briefly describe to us the economic crisis and its impact on people’s lives?

“The financial and economic crisis in Lebanon has affected every vital sector in the country and every aspect of people’s lives. In a short time, the local currency has lost more than 85% of its value and inflation reached an all-time high. COVID-19 lockdown measures, the massive Beirut blast in August 2020, and political tensions have exacerbated the situation and pushed the economy to almost complete collapse. Poverty rates doubled, with more than half of the population now living below the poverty line and 23% of people in extreme poverty. The economic recession caused thousands of businesses to close and tens of thousands to lose their jobs.

Food prices have quadrupled since 2019, making access to food a major concern for many vulnerable families. According to the American University of Beirut’s Crisis Observatory, families living on the minimum wage will no longer be able to afford a standard Iftar meal this Ramadan. Seeing people queuing for food rations and fights breaking out in local supermarkets over subsidised products almost daily is a shocking reminder of how deep the crisis is and how difficult it is to have a dignified life under these circumstances.

"Seeing fights breaking out in local supermarkets over subsidised products is a shocking reminder of how deep the crisis is."

The crisis has also had a profound psychological effect on people, causing a rise in demand for mental health services. Increasing gender-based violence, and violence in general ‒ including armed robbery, murder, and theft ‒ has been documented as well. But while the need for support and protection services has increased, COVID-19 restrictions have placed additional barriers to access.

Overall, people have a grim outlook on the situation especially in the absence of the political will or a serious plan for economic reform.”

This economic crisis is also happening in the context of the COVID-19 pandemic too. Has it impacted health and access to healthcare in the country?

“When COVID-19 arrived in Lebanon, the healthcare system was not prepared for a crisis of such a scale. Hospitals are suffering severe shortages to medicines and equipment due to hyperinflation and the lack of foreign currency reserves needed to procure and import these items. Many health professionals have emigrated, causing hospitals to lose valuable human resources. Hospitals report significant delays in the government’s payment of their dues, which has constrained their operational capacity and preparedness.

More than half a million COVID-19 cases have been recorded to date, and for long periods of the last year hospital beds have been at full occupancy. During peaks, healthcare access has been limited to essential services, emergency cases, and life-saving treatments. For instance, the daily attendance rate at UNRWA’s health centers, where Palestinian refugees usually seek primary healthcare, dropped by up to 65% in the months that followed outbreak.”

Palestinian refugees have long been among the most marginalised and impoverished groups in Lebanon. What has been the impact of this crisis on them?

“Before the drastic deterioration of the economic conditions in Lebanon, 65% of Palestinian refugees were already living in poverty, compared to 28% of Lebanese people. As the crisis has disproportionately affected marginalised groups, these dire conditions have only worsened, sending unemployment and food insecurity rates soaring. The Lebanese government excludes Palestinian refugees from assistance programmes and UNRWA lacks the financial resources to expand their relief programme to sufficiently respond to the growing needs, so Palestinian refugees have been left exposed and struggling to secure their basic survival needs.

Stories of hardship are everywhere. In my last visit to a Palestinian camp, one mother told me that for the next four months she must make monthly payments for a single bottle of cooking oil she bought.

Another mother told me that her daughter, who was at her second year of university studying engineering, had to drop out as they were no longer able to pay her symbolic tuition fees (less than $100) because the husband has been out of work for almost a year. The daughter was the only family member to make it to university.”

With goods such as food and medicines now much more expensive, how are poorer refugees coping?

“With the significant increase in prices in Lebanon, refugees are only able to buy the most essential items. More and more people are resorting to reducing the number of meals they eat per day, reducing portion sizes, and choosing inexpensive and sometimes less nutritious foods. These coping mechanisms could lead to malnutrition in the long term. Many refugees are selling whatever assets they have, borrowing money from relatives and friends, or spending less on education. Many have also reduced expenditure on health, foregoing diagnostic tests or not buying prescribed medicines.

"Mothers often report feeling sad about being unable to give their children a normal childhood"

A study by World Food Program found out that one in five Palestinian refugees have already exhausted their coping capacity. Mothers often report feeling sad about being unable to give their children a normal childhood with toys, new clothes, or things they themselves had when they were young.

Under these circumstances, refugees, and in particular youth, are highly vulnerable to being recruited to serve the agendas of political factions in return for small amounts of money.”

How have MAP and our partners been responding to the crisis on the ground? What additional support have you been able to provide to families?

“MAP’s programmes in Lebanon have been extremely important in this dreadful context. During the cold winter months, we provided food parcels, blankets  and fuel for heating to vulnerable refugee families living at high altitudes, and we have provided winter clothes kits for children and food parcels to pregnant women and new mothers for the month of Ramadan. This assistance was highly needed and helped alleviate some of the worst suffering as reported by the communities.

Despite the additional pressures from Lebanon’s overlapping crises, MAP also continues to provide reproductive health consultations and home visits for pregnant women and new mothers and their babies, which is particularly important now given the restricted access to the mainstream health services.

Our COVID-19 emergency response has included providing personal protective equipment (PPE) and essential medical supplies to frontline health workers at Palestine Red Crescent Society hospitals. MAP and local partners have adapted our group psychosocial support programmes for youth, parents, and children to provide remote activities during these very stressful times. Innovative remote and blended modalities have also been deployed to ensure continued support for adults and children with disabilities during the pandemic.

We have also helped establish hotlines to provide round-the-clock support to individuals in distress and survivors of gender-based violence.”

Thank you Wafa for your time, and for all that you and MAP’s Lebanon team are doing to support vulnerable Palestinian communities at this difficult time.
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