Back to Contents In its annual report for the year 2021, UNRWA’s department of health wrote about an increase of hepatitis A among the population of Palestinian refugees in the countries where the organisation works: “Other Communicable Diseases Viral Hepatitis The Agency-wide incidence of suspected cases of viral hepatitis (mainly hepatitis A) increased from that in 2020; the reported cases from Gaza were at 262 versus 53 cases in 2020, same for Syria at 362 versus 184. At the same time, Lebanon reported 60 cases in 2021. Jordan and West Bank reported 20 and 9 cases, respectively. Agency-wide incidence went up from 10.73 in 2020 to 23.07 per 100,000 in 2021. Such increase is most probably related to poor hygienic conditions inside some camps as well personal related issues, more adherence to cleanliness and personal hygiene measures are required.” (Source: UNRWA, “UNRWA Department of Health, Annual Report 2021”, 24 May 2022, p. 24) Non-communicable diseases UNRWA Annual Operational Report 2021, published in 2022, reported that: “The prevalence of NCDs among Palestine refugees is increasing, with diabetes mellitus (DM), hypertension, cardiovascular and chronic respiratory diseases being the primary cause of death across all UNRWA fields of operation. In 2021, the overall number of NCD patients under care at Agency health centres increased to 291,333- from 283,584 in 2020 - with these conditions being aggravated by an ageing population and sedentary and unhealthy lifestyles. Palestine refugees, particularly the estimated 48,000 PRS in Jordan and Lebanon, remained especially vulnerable to NCDs as those who have fled violence with limited resources endure conditions of prolonged displacement and deepening poverty, and thus struggle to pursue healthy lifestyles.” (Source: UNRWA, “Annual Operational Report 2021” 27 October 2022, p. 34) Mental health and psychosocial-related disorders among stateless Palestinians 6.6. Are stateless Palestinians particularly affected by mental health disorders? Walaa Kayyal, a researcher living as a Palestinian in Lebanon who was interviewed for this report in October 2022 indicated that: “UNRWA has been working very recently on mental health, so usually the UNRWA clinics, when they started they were focusing on chronic diseases, communicable diseases, providing awareness, providing dental services, et cetera. Because mental health was and still is a taboo in Lebanon, you cannot say «I’m seeing a psychologist to help me do one, two, three.» People would answer «Oh what, are you crazy?» ... But then many Lebanese organizations started saying, «No, people should talk, mental health is not a taboo,»... So within all of this time when the awareness on the importance of mental health started to rise, UNRWA started to include mental health services inside their clinics, where there is a psychologist who comes maybe two days per week in order to see patients…. But I don’t have solid information about this. This is what I know from a project that I worked on with UNRWA but I wouldn’t say that there is a clear structure in place. Also, the Lebanese Ministry of Public Health has a mental health department, they say that their services are open for all nationalities, not only for Lebanese. A lot of the NGOs also have a hotline where you can call, but then you should be calling from your [phone] credits.” (Source: Walaa Kayyal, interview record, 31 October 2022) 6. Access to health care 68