The Impact of Gender Identity on Access to Healthcare Services for Refugees in Lebanon’s Northern Regions
Awarded the Center for Human Rights and Humanitarian Studies Seed Grant Award from Brown University; in partnership with the Center for Immigrant, Refugee and Global Health at the City University of New York.
Lebanon’s healthcare system’s structure and modes of operation cast a blind eye upon refugees’ specific challenges and needs. It not only remains highly privatized but also involves a number of exclusionary practices across private and public sectors. This reality, coupled with political agendas, partisan politics, clientelism and an overall lack of transparency at the level of public administration, gives private health providers substantial amounts of subjective influence – and more importantly, the authority to be exclusionary. In light of the aforementioned, private healthcare facilities, UN agencies, international humanitarian organizations and local NGOs continue to shape refugees’ access to healthcare and health-related services along with (tele)mental health support. While becoming increasingly difficult amid limited access to resources, efforts to enhance the provision of healthcare services to Syrian refugees in Lebanon have mainly been a collaboration between the Lebanese Ministry of Public Health (MoPH), the UN Refugee Agency (UNHCR) and local and international humanitarian organizations. Despite the fact that there are more than two hundred primary healthcare facilities in Lebanon where refugees are able to receive subsidized treatment, medication and vaccinations, access to these facilities remains challenging amid fears over crossing checkpoints, issues with residency paperwork and concerns over deportation or detention. The research aims to explore how gender identity has impacted access to healthcare services for the Syrian refugee community since 2019 with a specific focus on women and members of the LGBTIQ+ community. More specifically, the research will explore how the country’s ongoing economic and financial crisis has impacted the health sector and the provision of health services to the refugee community in general, particularly in increasingly vulnerable regions in North Lebanon. The study focuses on the regions of Tripoli and Akkar – a selection rooted in the demographic compositions of these regions as two of the most refugee-dense in Lebanon, as well as their social and political significance.
Twice the Threat: Gender Identity, Refugee Status and Freedom of Movement in Lebanon
Awarded the Williams Institute LGBT Small Grant Award from the University of California, Los Angeles; in partnership with MOSAIC MENA.
Over the past decade, more than 1.5 million Syrian refugees have fled to Lebanon at an unprecedented rate. With a total population approaching four million people, Lebanon presently hosts the highest number of refugees per capita in the world. Lebanon’s social, political, economic and legal landscapes cast a blind eye upon refugees’ intersectional challenges – particularly those from the LGBTIQ+ community. LGBTQI+ refugees in Lebanon continue to endure extreme forms of violence, discrimination, stigmatization and isolation in the “safe” places they seek. In June 2022, Lebanon’s Minister of Interior gave “urgent” instructions to security forces to stop gatherings of the LGBTQI+ community, following what he referred to as “pressure from religious institutions.” Through key informant interviews and focus group discussions, MOSAIC and the Institute for Migration Studies (IMS) at the Lebanese American University will examine the different ways that the Ministry of Interior’s latest decision against the community, coupled with its already long-standing restrictions on the mobility/movement of the country’s refugee community, has added contributed to further insecurity within the LGBTIQ+ refugee community.
Growing Up Uprooted: Experiences of Marginalization and Agency in Shaping the Identity of Palestinian Youth in Lebanon
Palestinian refugees in Lebanon face numerous structural restrictions that are all-encompassing, impacting the political, economic, social and humanitarian spheres of their lives. The systematic restrictions imposed on Palestinians are one of the main causes of the social exclusion and marginalization Palestinians suffer from. Moreover, most Palestinians in Lebanon live in dire conditions, in overcrowded, marginalized and economically depressed camps; the image that resides in the Lebanese collective consciousness is a negative one. Evidence points to the fact that prejudice, discrimination and social exclusion have a negative effect on the social functioning of individuals, which can result in lowered self-esteem and an inadequate, general sense of personal identity, especially in adolescents and emerging adults. Thus, this research aims to explore how Palestinian adolescents and emerging adults living in Lebanon develop their sense of self and self-identity in the context of social exclusion, discrimination and marginalization. The study also aims to explore coping mechanisms used by Palestinians to survive social exclusion, stigma, marginalization and negative stereotypes. To achieve this, the research will focus on the Mar Elias and Burj Al Barajneh camps.
Evaluating a Peer Support Group Program for Refugees and Host Populations Living with Diabetes and/or Hypertension in Lebanon: A Mixed-Method Implementation Research Study
In partnership with The London School of Hygiene and Tropical Medicine
The main aim of this research project is to evaluate the implementation and impact of the peer support group (PSG) strategy for people living with diabetes and/or hypertension in a humanitarian setting in Lebanon. The project aims to build a more coherent system of Noncommunicable Disease (NCD) prevention, care and support for Syrian refugees and Lebanese host communities, focusing on capacity-building at the health center and community level. The project has three main pillars: 1) community-level prevention; 2) access to healthcare; and 3) advocacy, research and partner engagement. The project will employ two complementary implementation modalities for scale-up: a comprehensive and integrated model of prevention, screening, treatment and care in four Lebanese Red Cross (LRC) primary healthcare centers (PHCs) targeting Baalbek, Qob Elias, Jal El Dib, and Tripoli, in addition to a lighter model, scaling up community-based NCD approaches through awareness and sensitization, including psychosocial support in additional eight locations where LRCs mobile medical units and social workers are active. The comprehensive and integrated model will also include peer-support groups for diabetes and hypertension patients in the selected centers. Youth-focused approaches for promoting healthy lifestyles and NCD awareness will be included as components in both models, targeted in six locations.
Democracy and Human Rights: Syrian Refugee Youth in Lebanon 2021
In partnership with the Friedrich-Ebert-Stiftung
Based on a survey carried out among Syrian refugees in Lebanon aged between the ages of 16 and 30, this study found that the priorities of Syrian refugee youth in the country were largely rooted in their socio-economic standing and that of their households. This ultimately serves as a push factor inﬂuencing their desire to leave the country and defend their rights. It also found that the compounded crises in Lebanon (economic, political, humanitarian and health) have profoundly impacted the identity, self-expression and psychosocial well-being of Syrian youth, as well as their ability to express themselves. In the current climate in Lebanon, questions surrounding refugee youth’s livelihoods, health and well-being have centered on the ongoing decline of the country’s economy, the worsening living conditions, as well as questions around migration, human rights and freedoms — particularly for the country’s young people. The crises have relegated young people’s voices, needs and priorities to the back seat, with essentially no government policies fostering or reinforcing their economic and political participation. Local NGOs, international humanitarian organizations and academic institutions have stepped up to ﬁll this void. Essentially, there are no safe civic spaces for young people to voice their views, express themselves freely or integrate into a healthy society. Excluding Syrian refugees from national and formal systems increases their vulnerability, reduces their quality of life and limits their future plans. This study, therefore, demonstrates how national policies of exclusion, coupled with the Lebanese government’s strategic indifference towards the refugee communities it hosts, generate new forms of vulnerability and imbalances of power — namely between refugees and landlords, employers and local authorities who exploit refugees for their own gains. This study also highlights that the well-being of the refugee community depends strongly on their empowerment and their inclusion in legal structures/ service provision.
The Gender Dimensions of Sexual Violence Against Migrant Domestic Workers in Post-2019 Lebanon
In partnership with Egna Legna Besidet
In December 2020, the Lebanese Parliament passed the landmark Law 205 against sexual harassment which could see perpetrators spend up to four years in prison and pay fines up to fifty times the minimum wage. The law additionally affords protection to both the victims and any witnesses who testify against the accused. While the law was applauded as a step forward for sexual harassment victims, it excludes an important faction of the community — migrant domestic workers. The law falls short of international standards by addressing sexual harassment solely as a crime and neglecting to complement this law with labor law reforms, monitoring and civil remedies. This research focuses on the various forms of sexual violence either protected or enabled under the Kafala system. It aims to depict the incessant violations this type of system has produced. Qualitative interviews were conducted with 913 migrant domestic workers in Lebanon. A variety of multifaceted, mixed design methods were used to collect information during the write-up of this report, all of which are participatory, inclusive and target group sensitive where needed. These methods ensured that the findings were derived from a collective contribution from a wide range of target groups, triangulated and validated and that gender considerations were integrated into the data collection and analysis methods. Primarily, these methods included: (1) Desk/Policy Review and (2) In-Depth Key Informant Interviews. Whilst asked about whether or not they had survived at least one incident of sexual harassment during their employment or stay in Lebanon, 68% of respondents informed the study that they had. According to respondents, various forms of sexual harassment included: (1) inappropriate staring or leering in a sexual manner; (2) sexually suggestive comments/jokes/name-calling; (3) intrusive questions about your sex life/physical appearance that were offensive; (4) someone showing his/her private parts/half or fully-naked body offensively; (5) unwelcome touching, hugging, kissing or other inappropriate physical contact; (6) sexually explicit calls or messages; (7) repeated or inappropriate invitations to dates; (8) sexually explicit pictures, posters or other material; (9) actual or attempted rape or sexual assault; (10) video/photo taking of survivors of a sexual nature; (11) requests or pressure for sex or other sexual acts; and/or (12) other forms of sexual harassment. 56.2% of the sample (513 women) insisted that they had experienced at least one of the aforementioned forms of sexual assault, while 11.7% (107 women) confirmed that they had experienced sexual assault, but weren’t willing to describe their experiences in detail. The variety in nationality and race across the sample presented important findings pertaining to ill-treatment, fetishization and violence each group of women faced. In addition to an overall sense of racism experienced by black MDWs, hierarchy within the MDWs’ community presents itself in various forms at the early stages of recruitment at the agency. Undocumented MDWs are left powerless in terms of reporting sexual abuse and therefore, are at the mercy of the aggressor. Navigating the country’s legal, cultural and social landscapes without documentation or a legal residency permit has become increasingly difficult in recent years, as this has laid the foundation for exploitation and abuse in the areas of: (1) paying less than what MDWs deserve; (2) taking advantage of their legal standing to make them work longer hours; (3) threatening to report them to the authorities if they object; and (4) sexual harassment in all forms.
Read the full study here.
Refugee Decision Making in First Country of Asylum
In collaboration with the Raoul Wallenberg Institute of Human Rights and Humanitarian Law, Lund University
The research project aims to develop a model for understanding refugee decision-making and consequently protection that allows for nuanced and quantifiable predictors of protection gaps, identification of vulnerable groups and predictors for secondary movement from Lebanon.