How has Covid 19 impacted access to healthcare?
In October 2021, the UK-based NGO Medical Aid for Palestinians (MAP) submitted a letter to the UN Special Rapporteur on Extreme Poverty and Human Rights, ahead of his visit to Lebanon in November 2021. In a blog article about the submission, MAP quoted a May 2021 interview with “Inas*, a resident of the Ein el Helweh refugee camp:“When we go to a hospital for any problem, they won’t receive us without a negative PCR [COVID-19] test, which costs 75,000 to 180,000 Lebanese Pounds [£35 to £85 GBP]. We don’t have this money, so we decided not to go to the hospital even for essential matters”. MAP further stated that:
”In the submission, MAP highlights how these issues have disproportionately affected people with disabilities; pregnant women, nursing mothers and infants; and young Palestinian refugees. MAP has invited the Special Rapporteur to visit affected Palestinian refugee communities on his visit.
(Source: MAP, “MAP highlights plight of Palestinian refugees in Lebanon to UN Special Rapporteur on Extreme Poverty”, 12 October 2021)
In its annual report for the year 2021, UNRWA’s department of health stated that:
“Palestine refugees in all fields have been affected by COVID-19. By the end of 2021, the accumulated number of cases from Jordan, Lebanon, Palestine and Syria since the beginning of the pandemic totalled 2,315,550, resulting in 29,626 deaths, of which, 147,651 cases and 1,559 deaths were reported among Palestine refugees. The number of confirmed cases increased dramatically in all fields during 2021. As anticipated, the deterioration of the epidemiological situation continued with new variants emerging. In 2021 alone, the confirmed cases reached 1,672,027 and 21,674 deaths, of which, 120,519 cases and 2,063 deaths were reported among Palestine refugees. Many more Palestine refugees continue to suffer from the consequences of lockdown and health measures that were put in place to control infection. The pandemic has exacerbated the existing poverty and vulnerability of Palestine refugees.”
(Source: UNRWA, “UNRWA Department of Health, Annual Report 2021”, 24 May 2022, p. 11)
The same source further reported that:
“As shown in the graph below, Jordan reported 8,819 cases and 928 deaths. Lebanon reported 13,246 cases and 348 deaths, Syria reported 689 cases and three deaths and West Bank reported 23,723 cases and 95 deaths. In Gaza, the largest number of cases among Palestine refugees were recorded, with 74,042 cases and 689 deaths. These numbers include UNRWA staff who are also a part of the refugee community.”
(Source: UNRWA, “UNRWA Department of Health, Annual Report 2021”, 24 May 2022, p. 12)
Table 3: Number of COVID-19 cases reported among Palestinians refugees in 2021
|
UNRWA fields of operations |
Number of cases |
Number of deaths |
|
Jordan |
8,819 |
928 |
|
Lebanon |
13,246 |
348 |
|
Syria |
689 |
3 |
|
Gaza |
74,042 |
689 |
|
WB (including East Jerusalem) |
23,723 |
95 |
|
Total |
120,519 |
2,063 |
UNRWA, in a separate report, also noted that:
“With the ongoing social and economic crisis, Palestine refugees are facing difficulties in covering their most basic health care needs, which were already inaccessible even before the crisis. There are alarming reports on Palestine refugees who are forgoing essential treatments for chronic diseases due to their inaccessibility and lack of health insurance coverage. The Agency’s hospitalization policy covers only a percentage of hospital expenses and an increasing number of Palestine refugees are now unable to cover the remaining cost of care. The reported numbers of COVID-19 related deaths show that the mortality rate for Palestine refugees is three times higher than the rates for Lebanese citizens [...] as a result of the living conditions and cramped camps where social distancing is almost impossible. As of 31 December 2021, 489 Palestine refugees have died as a result of COVID-19.”
(Source: UNRWA, “Palestinian Refugees in Lebanon: Struggling to Survive”, January 2022, p. 12)
The news and information services company Thomson Reuters wrote in February 2021 that:
“Palestinian refugees in Lebanon are three times more likely to die with COVID-19 than the population as a whole, according to U.N. figures that highlight the pandemic’s outsized impact on the community.
[…] Most Palestinians who died after contracting the disease in Lebanon had health conditions such as cardiac or pulmonary issues, which are aggravated by poverty and conditions in the camps, said UNRWA spokeswoman Hoda Samra.
Cramped living conditions and the need to go out to work meant Palestinian refugees were more likely to be exposed to the virus, she added.
«Vulnerable communities tend to have poorer baseline health conditions, hence more co-morbidities and chronic health conditions,» said Joelle Abi Rached, an associate researcher at Sciences Po University in Paris.”
(Source: Thomson Reuters Foundation News “Palestinian refugees in Lebanon three times more likely to die with COVID-19”, 16 February 2021)
The World Food Programme reported in June 2020 about Palestinian refugees’ access to medicine in Lebanon:
“Out of respondents who had to buy medicine in the last month, 56 percent of Lebanese respondents reported facing challenges in accessing medicine, while 71 percent of Palestinians and 73 percent of Syrians reported encountering challenges. With vast majorities not being able to afford medicine.”
(Source: WFP “Assessing the Impact of the Economic and COVID-19 Crises in Lebanon”, June 2020, pp. 17-18)
The New Humanitarian (formerly IRIN News) reported in April 2020 about the impacts of COVID-19 on the refugee population in Lebanon:
“Assaf, a Syrian refugee, underwent treatment for breast cancer last year and is still prescribed medication for that diagnosis, as well as for chronic heart problems and diabetes.
Until recently, a local NGO brought her the medication she needs to stay healthy. But on 15 March Lebanon instituted a nationwide night-time curfew, and various municipalities put in place their own restrictions on the movements of the country’s estimated 1.5 million refugees. Some have also limited the ability of aid workers to enter camps like the one Assaf lives in, even though these informal settlements have so far had no documented cases of COVID-19. As of 20 April, Lebanon had 677 confirmed cases of the virus, and 21 deaths.
Aid groups say they are having a harder time getting non-coronavirus medical care to refugees, and clinics that serve Syrians say they have seen a drop-off in visitors.
[...]Differing regulations
While MSF and Amel are still reaching patients in more remote parts of Lebanon, some – mostly smaller – NGOs that previously provided mobile medical services told TNH they had been being blocked from entering the camps.
This appears to be partly due to new restrictions on refugee movement, like extra curfews, rolled out, according to a recent Human Rights Watch count, by at least 21 municipalities. There are no hard and fast rules for when NGOs can enter the camps or when people can leave them, enforcement varies, and access often seems to depend on location and pre-existing relationships with local authorities.”
(Source: The New Humanitarian, “How COVID-19 is limiting healthcare access for refugees in Lebanon”, 21 April 2020)42
(Lack of) access to anti-Covid19 vaccination