Back to Contents In its series of country reports for 2021, the US Department of State wrote about Lebanon: “Palestinian refugees typically could not access public-health and education services [...].” […] “Palestinian refugees who fled Syria for the country since 2011 received limited basic support from UNRWA, including food aid, cash assistance, and winter assistance, such as cash to purchase fuel for heating. Authorities permitted children of PRS to enroll in UNRWA schools and access UNRWA health clinics.” (Source: US Department of State (USDOS) “2021 Country Reports on Human Rights Practices: Lebanon”, Section 2. Respect for Civil Liberties, March 2022, p. 29) UNRWA has also noted what they have done to curb the effects of COVID-19: “Finally, the impact of COVID-19 has been keenly felt among Palestine refugees. By 31 October, 15,443 Palestine refugees had been infected with the virus, with 1,819 requiring hospitalization and 443 losing their lives. Amongst UNRWA staff, there have been 888 positive cases and five deaths. Vaccine hesitancy is high among Palestine refugees, with 45,831 having received one dose and 35,309 two doses of the vaccine, either at a Lebanese hospital or UNRWA facility. In order to address emerging needs across the Palestine refugee population, the 2022 EA focuses on ensuring regular cash assistance for vulnerable groups amongst PRS and PRL. Under this appeal, UNRWA is expanding support towards vulnerable PRL families who have been disproportionately affected by the crises impacting Lebanon. The Agency will provide 162,301 PRL, PRS and other eligible populations21 with emergency cash assistance to support them meet their most basic needs. Other essential services such as health, education and protection will also continue, adjusted to the COVID-19 context to ensure the safety of staff and beneficiaries. Under this appeal, UNRWA will ensure the continuity of learning for 39,129 Palestine refugee students; will continue to provide primary, secondary and tertiary health care to PRS, as well as additional secondary and tertiary care to 6,210 of the most vulnerable PRL affected by the crisis; and will ensure that Palestine refugees with protection concerns are supported, including with referral pathways.” (Source: UNRWA, “Syria, Jordan and Lebanon Emergency Appeal 2022”, January 2022, p. 16) In a public letter to the UNHCR published by UNRWA in June 2021, the relief agency stated that: “Palestine refugees have limited access to public services in Lebanon [UNHCR 2016]. As such most Palestine refugees rely entirely on UNRWA for health care unless they can afford private health insurance. For Palestine refugees registered with UNRWA in Lebanon, UNRWA health services comprise primary health care that includes preventive interventions and general medical consultations, in addition to the coverage of 90 per cent of the costs of secondary hospital admissions and 60 per cent for tertiary admissions in selected hospitals. However, due to the significant costs of hospitalization in Lebanon for Palestine refugees without private health insurance, the sum not covered by UNRWA is still considered high, particularly for those with complex and/or chronic needs. Currently, for example, with limited exceptions [50 per cent of the cost for selected medication for cancer cases, 80 per cent for multiple sclerosis, and 95 per cent for thalassemia cases]. UNRWA is also not able to provide medications for chronic conditions. As a consequence, UNRWA is not able to provide comprehensive medical support to persons with disabilities with chronic medical needs. The additional costs will be prohibitive for many Palestine refugee families.” (Source : UNRWA, “Letter from UNRWA to UNHCR in the case of NB and AB v. SSHD before the Court of Justice of the European Union (Case C-349/20).”, 21 June 2021, p. 5) Human Rights Watch reported in an article about Lebanon’s vaccination campaign in April 2021 that: “Many [Palestinians] have very little trust in the Lebanese government, which has systematically discriminated against them and barred them from getting government social services, including health care. They can get health care only through the private sector, which charges prohibitively high fees, or through international organizations like UNRWA.” (Source: Human Rights Watch, “Lebanon: Refugees, Migrants Left Behind in Vaccine Rollout Ensure Greater Information Access”, 6 April 2021) 6. Access to health care 61