Access limited by prohibitive costs and insecurity As the crisis in Syria intensifies daily, the humanitarian needs – both in Syria and in surrounding countries – are increasing significantly. Many people have been killed and wounded and tens of thousands have fled their homes, leaving behind everything they own. Medical and humanitarian assistance within Syria is limited, and aid from international organizations – including Médecins Sans Frontières (MSF) – has been severely restricted. In neighbouring countries such as Lebanon, Jordan and Iraq, MSF has strengthened its response to the refugees who are flowing across the Syrian borders.

“In Lebanon, the Syrian refugees we are assisting are not in a position financially to afford medical treatment,” says Fabio Forgione, MSF’s head of mission in Lebanon. “Although aid was quickly deployed at the start of the crisis, and many organizations are still present, it needs to be maintained. Free access to healthcare and humanitarian assistance must be reinforced for Syrian refugees."

On July 20 and 21, there was a new surge of refugees as thousands of Syrians entered Lebanon. MSF teams were dispatched to the areas along the border and to the Bekaa Valley, where many refugees are settling.


Lebanon 2012 © Nagham Awada/MSF
An MSF nurse administers a vaccine to a Syrian boy at the Aarsal Public School in Bekaa, Lebanon. As the crisis in Syria intensifies and new waves of refugees arrive in neighbouring countries, they are finding it difficult to access humanitarian aid, mainly due to insecurity and financial constraints.  A survey on the living conditions and health of Syrian refugees, carried out by MSF in June 2012, indicates that many are living in overcrowded conditions, fearful for their safety, suffering psychological distress and unable to afford medical care.

Some 889 families were interviewed in Tripoli and Wadi Khaled, in north Lebanon, and in the Bekaa Valley, in east Lebanon. Most were from Syria’s Homs governorate and had fled Syria because of insecurity and a lack of access to medical care. Nearly half of those interviewed had lost at least one family member to the violence in Homs in the past six months. Most arrived in Lebanon with very little, having left behind their extended families, houses, assets and businesses.

Living conditions for many refugees in Lebanon are tough. MSF estimates that more than a thousand people are living in overcrowded shelters in Wadi Khaled and the Bekaa Valley. With the Syrian border just a few kilometres away, many continue to fear for their safety. In the city of Tripoli, meanwhile, rents are high and many families are sharing crowded apartments.

The vast majority of refugees have experienced traumatic events, and many are suffering psychological distress. MSF psychologists and psychiatrists carried out almost 800 consultations from April to June. Some patients described being tortured in Syria. Due to the current internal political instability in Lebanon and the security situation there, a significant number of Syrian refugees do not consider Lebanon to be a safe place of refuge.

Meanwhile, the 5,800 general healthcare consultations conducted in MSF clinics from April to June highlight the fact that many Syrian refugees are unable to access treatment for chronic diseases – such as diabetes, asthma, hypertension and cardiovascular diseases – either because it is too expensive, or because it is not available. A quarter of the patients were suffering from a chronic disease requiring treatment, yet 19 per cent of patients were not receiving the treatment they need.
Four out of ten people interviewed said they were unable to access a hospital in Lebanon, either due to prohibitive costs or due to insecurity.

MSF reiterates its call for authorization to work in Syria. The organization stands ready to mobilize its medical and surgical teams, and is determined to operate independently, providing care to anyone requiring it. MSF continues to support a network of Syrian doctors and field hospitals in Homs, Daraa, Hama, Damascus and Idlib, delivering supplies and medicines from neighbouring countries.

In Jordan, Lebanon and Iraq, all of which share borders with Syria, MSF has been providing medical care, mainly to Palestinian, Syrian and Iraqi refugees. MSF teams in these countries are prepared to deal with needs arising from the conflict in Syria. In Lebanon, MSF has pre-positioned emergency medical stocks and relief items for 10,000 people in case a possible decline of the situation in Syria triggers a massive influx of refugees.