Back to Contents 6. Access to health care 6.1. Do stateless Palestinians have access to any existing Lebanese public healthcare system/healthcare insurance? In a UN new brief, Dr Akihiro Seita noted that UNRWA was the only solution for Palestinian refugees needing primary hospital care. “In Lebanon, where there are around 480,000 refugees registered with UNRWA, its medical director Dr Akihiro Seita, said that the agency was the “only solution” for primary and lifesaving hospital care for these displaced people.” (Source: UN News, “News in Brief 24 May 2022”, 24 May 2022) In a paper published in the Global Journal of Health in March 2022, it was noted that Palestinian refugees in Lebanon are ineligible for the State’s healthcare services. “Lebanon currently also has approximately half a million Palestine refugees who are registered with the UNRWA. Close to half of these reside in camps with complicated health problems emerging from the deteriorating living conditions, low wages, high poverty and deprivation. Palestinian refugees in Lebanon are ineligible for the State’s health care services. They can only access health care through private sectors, which have high fees, or by international organizations such as UNRWA. UNRWA operates 28 primary health care facilities, providing both preventive and curative care. The UNRWA formed an agreement with Palestine Red Crescent Society (PRCS) to provide equity for Palestinian refugees in accessing secondary health care services. The UNRWA also works on decreasing the financial burden borne by the refugees by providing services such as family planning, preconception care, antenatal and postnatal follow-up, infant care, school health, oral health, outpatient consultations, diagnostics, laboratory services, vaccination, among others. In other words, UNRWA is playing the role of the Ministry of Health to provide Palestine refugees with essential health care services.” (Source: Shadi Saleh, Sarah Ibrahim, Jasmin Lilian Diab, Mona Osman, “Integrating refugees into national health systems amid political and economic constraints in the EMR: Approaches from Lebanon and Jordan”, 12 March 2022, Volume 12, Journal of Global Health) 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 [...].” (Source: US Department of State (USDOS) “2021 Country Reports on Human Rights Practices: Lebanon”, Section 2. Respect for Civil Liberties, March 2022, p. 29) 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) 6. Access to health care 57