Back to Contents UNRWA noted that even those Palestine refugees in Lebanon who work and contribute to the National Social Security Fund are excluded from the sickness fund. “PRL who have the right to work, are required to contribute to the Lebanese National Social Security Fund (NSFF) but are “still excluded from family allowance and the sickness and maternity fund” (Source: UNRWA: “Protection brief Palestine refugees living in Lebanon Updated in September 2020”, p. 1) The same source also discussed the bigger picture: “[...] In the last quarter of 2021, Lebanon was fluctuating between the third and fourth COVID-19 community transmission phase, according to WHO daily briefs. By October 2021, 76,000 Palestine refugees had received both doses of the COVID-19 vaccination. UNRWA will continue to support national vaccination efforts, through raising awareness of the importance of vaccination across the Agency’s staff and Palestine refugees. Through this EA the Agency will also continue to cover the cost of PCR tests for 10,000 PRL and PRS, in addition to providing medications and hospitalization costs for approximately 1,000 refugees requiring COVID-19 treatment. UNRWA will maintain COVID-19 prevention and control through multiple interventions aimed at vulnerable refugees and Agency staff, including: (i) awareness raising on good hygiene practices; (ii) the use of appropriate disinfectants; and (iii) the provision of PPE to all health staff. Based on the situation in 2021, there will be a need to hire 112 additional health staff in 2022 to cover the work of staff who are absent due to contracting COVID-19 or who need to self-isolate or quarantine.” (Source: UNRWA, “Syria, Jordan and Lebanon Emergency Appeal 2022”, January 2022, p. 36) The World Food Programme reported in June 2020 about the majority of Palestinian refugees in Lebanon without access to health insurance: “Impact on healthcare Public and private health care in Lebanon vary significantly as public health practitioners have always been underpaid compared to those providing private health care. Private hospitals account for 82 percent of Lebanon’s health care capacity [Human Rights Watch 2019], which is unaffordable and inaccessible to many. Since mid-2019, medical equipment importers, for both public and private hospitals in Lebanon, began facing difficulties in bringing medical supplies into the country due to the shortage of US dollars, which was exacerbated further in November due to the unofficial devaluation of the Lebanese pound. This has become more alarming with the emergence of the global pandemic. Around 95 percent of Palestinian refugees do not have health insurance in Lebanon which means they are heavily reliant on the UN Relief and Works Agency for Palestinian refugees (UNRWA) and other sources to cover hospital fees. As a result, most are completely dependent on Palestinian Red Crescent Society (PRCS) hospitals for medical care.” (Source: WFP “Assessing the Impact of the Economic and COVID-19 Crises in Lebanon”, June 2020, p. 17) In the internationally recognised book they published in 2020, legal scholars Dr. Francesca Albanese [currently Special Rapporteur on the situation of human rights in the Palestinian Territory] and Professor Lex Takkenberg wrote: “As foreigners, Palestinian refugees do not have access to Lebanese public health services and rely mainly on UNRWA for health services, in addition to assistance from charities. Through UNRWA, they can access primary health care, although not all medical services and treatments are possible through UNRWA clinics; UNRWA financially assists refugees with partial cost coverage for treatment in secondary and tertiary health care in UNRWA-contracted hospitals. UNRWA’s frequent funding shortages hamper its capacity to meet refugees’ demands.” (Source: “Francesca P. Albanese and Lex Takkenberg/Oxford University Press, Palestinian Refugees in International Law”, May 2020, Chapter 3.3.3, Legal Status and Treatment, p. 276) 6. Access to health care 62