Palais des Nations - 28 June, 2018
Geneva International Centre for Justice (GICJ) with International Organisation for the Elimination of All Forms of Racial Discrimination (EAFORD), and International-Lawyers.Org organised and participated in a side-event at the Thirty-Eighth Regular Session of the Human Rights Council. The event took place from 14h30 to 16h00 on 28th June, 2018 in Room XXVI at the Palais des Nations.
Kelsi Kriitmaa: Migrant Health Assitance Programme Coordinator at the International Organization for Migration
Dr. Melanie Samson: Senior Manager in the Capacity Building team at the Union for International Cancer Control (UICC).
Nour Hamada: Pharmacist and Researcher in international pblic health, focusing on access to medecines in humanitarian crisis.
Ahmed Quraishi; Policy analyst, researcher and writer. He is currently associated with an independent, Islamabad-based think tank projectpakistan21.org
Since the outbreak of the civil war in Syria in March 2011, over 11 million Syrians have fled their homes. The majority have sought refuge in neighbouring countries such as Turkey, Lebanon and Jordan. Over one million refugees have settled in Lebanon, making it the country with the highest per capita concentration of refugees in the world. This influx of refugees has aggravated political, economic, and security challenges and has placed a considerable burden on the Lebanese health system. As far as health is concerned, UNHCR and other relief agencies have sought to form their own delivery channels and their own mechanism to finance coverage, operating in parallel to the existing health system. This has led to fragmentation and poor coordination of the health system response to the refugee crisis. Due to irregular funding sources, some Syrian refugees died prematurely of cancer before receiving any course of medical intervention. Addressing the many challenges associated with cancer as a public health issue in this context requires complicated and expensive health care.
The purpose of the event initiated by the Geneva International Centre for Justice was to tackle some of the issues faced by refugees and more precisely it focused on the current situation and health challenges of Syrian refugees in Lebanon. Indeed, Lebanon is one of the top host countries with about 1 million Syrian refugees and according to our speakers, a large number of them are faced with health issues and are unable to access medical care and this for various reasons such as the legal status that might not be in norm or because they cannot afford to pay for the medical attention or because of the unavailability of medical facilities.
There is no doubt today for the international community that the right to health for everyone is of utmost importance since it crucially impacts the development of all countries and is actually part of the 2030 Agenda for Sustainable Development “Goal 3: Good health and well-being”. However migration is across all goals, universal health coverage will not and cannot be achieved without ensuring health to refugees and as well put by Kelsi Kriitmaa: “we do not want to stigmatize migration in itself”. Plus, refugees are people who have been “forced to flee” considering that usually these people fear for their lives and have been victims of violence, war, organized crimes and thus it does not automatically mean that refugees are the ones spreading diseases as some like to think but are rather caught up in dangerous situations especially when it comes to illegal migrants. According to Kelsi Kriitmaa, these illegal migrants face several challenges and hinders such as congestion on boats, lack of access to services, exposure to traumatic events, lack of water and sanitation, malnutrition, cholera, abuses etc.
For these reasons, the international Organization for Migration, the WHO and the OHCR published a document exposing the main four challenges faced by refugees with health problems. First, the access to health facilities, second the access to equitable distribution of health facilities (goods and services), third the availability of essential drugs and lastly the participation of affected population.
Unfortunately, “The right of access to health facilities, goods and services in a non-discriminatory basis” is systematically violated and as well researched and demonstrated by Nour Hamada. Her focus during two years in Lebanon was on Syrian refugees affected by cancer. According to her, there are four main challenges for these people. First, the unwillingness of the Lebanese government to provide refugees with a legal status which prevents them from easily circulating around the country out of fear of getting arrested and be sent to jail or to the country of origin. It also means that even when feeling sick, they would still tend to abstain from going to the doctor hence end up finding out they have a cancer at the last stage and some other times it is too late to cure it. The second challenge focuses on the financial hardship which is interlinked with the first one. Considering that without a legal status, they do not have access to the marketplace and all refugees are fully dependent on international aid. It becomes extremely difficult to find a job and even when they manage to get one, they are poorly paid which explain why 58 percent of Syrian refugees in Lebanon live in extreme poverty -less than US$ 3 per day per person-. Accordingly, the living conditions are worsening by the day considering the Lebanese government’s decision to cut funds stating “the Lebanese government does not have the budget to treat non-Lebanese people”. More than that, they live in informal settlements of private lands-wood and plastic tents with no lights and no heat.
Consequently to these conditions, it has become even harder for Syrian refugees to access health care services and goods which is technically surprising considering the several refugee crises of the past decades, one could imagine that in 2018, there would be a better international response since it is by nature a global issue, policy makers play a considerable role in figuring out the reasons behind countries’ failure to effectively respond to these issues.
Dr. Melanie Samson as part of The Global Cancer Control Agenda & UICC’s Treatment for All Campaign which focuses on three areas of focus – Convening, Advocacy and capacity building in order to fight cancer. According to Dr. Melanie Samson, Cancer is one of top ten causes of mortality in low- and middle-income countries. UICC’s “Estimated that most common cancer type is breast cancer – diagnosed at an advanced stage – in Lebanon: estimates that effect of refugees on breast cancer incidence +37.6%” which is an alarming figure that pushed the UICC to develop a plan of action known as the “Treatment for All” plan which purpose is to act upon reducing these numbers and is based on the following pillars: improve cancer data collection for public usage, “access to early detection and diagnosis, timely and accurate treatment, supportive and palliative care”.