Thinking Aloud: “Health Needs of Populations Displaced by Conflict and Political Upheaval,” Part I

June 28, 2015 by Darius 

Last week, I attended the Middle East Institute’s conference “Cut Off from Care: The Health Crisis of Populations Displaced by Conflict.”  The most informative panel was “Health Needs of Populations Displaced by Conflict and Political Upheaval.”  Over the next two days, I’ll share the panelists’ comments.

Andrew Harper, head of the UN High Commissioner for Refugees’ office in Amman, Jordan, said the often-deliberate destruction of the entire health care infrastructure in Syria means that even if peace were to occur tomorrow, refugees would not be able to return.  Currently, Syrian refugees are putting enormous pressure on the health care systems of Jordan and other refugee host countries.  According to Harper, 8% of Syrian refugees in Jordan have suffered major conflict-related injury.

Harper said providing health care to refugees is easier when the refugees are in organized camps.  However, 85% of Syrian refugees in Jordan are not in camps.  Furthermore, although the Jordanian government offered free primary and secondary medical care to Syrian refugees until late last year, the Jordanian government has amended its policies to require refugees to pay the uninsured Jordanian rate for services.  Medical costs for refugees are still heavily subsidized, but because many refugees are not allowed to work in Jordan, the costs are often out of reach.  Refugees’ access to medical care in Jordan has fallen as a result.  Even more soberingly, Harper said that since the change was made, more Syrians have returned to war zones in Syria because they are unable to afford care in Jordan.

In conclusion, Harper said the entire global humanitarian system is at the breaking point.  Specifically, he said the system for humanitarian assistance is bankrupt.  The UN and other organizations simply cannot keep going back to the same set of donors and host countries for more money.  While discussing the UN response to the unmet needs of refugees, Harper said, “Let’s not kid ourselves.  We don’t have the money.”

Leonard Rubinstein of Johns Hopkins commented on attacks on health workers.  According to Rubinstein, there have been 271 deliberate attacks on 202 medical facilities in Syria, almost all perpetrated by the regime.  He said this statistic is almost certainly underreported.  Rubinstein also said many Syrians don’t go to health care facilities at all because they feel the facilities are too dangerous due to the fact that they are targeted.

However, Rubinstein also pointed out that attacking health care workers is not unique to Syria or even to war zones.  He said that medical personnel have been targeted and criminalized for treating people in Bahrain, Egypt, and Turkey, among others.  Shockingly, the US is not an exception: under US law, providing health care can be considered and prosecuted as material support for terrorism.  As a bare minimum, Rubinstein strongly urged all developed countries to ensure their compliance with international law on the targeting of health workers.


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