Opinion: Ensuring access to equitable health services, especially during protracted crises

A view of the Shatila refugee camp in Beirut, Lebanon. Photo by: Trocaire / CC BY

Haifa Hospital, located in a southern suburb of Beirut, Lebanon is operated by the Palestine Red Crescent Society. It is modest in size, with 40 beds, 30 doctors, and 44 nurses who provide primary and secondary health services to an average of 300 inpatients each month and approximately 100 outpatients a day. The patients are mostly Palestinian refugees who fled Palestine after the 1948 Nakba — the Palestinian exodus — and settled in Lebanon. In addition, Haifa Hospital provides its services to Syrian and Palestinian refugees who have fled the conflict in Syria.

There are more than 450,000 Palestinian refugees registered and 35,000 non-registered in Lebanon — half are living in the country’s 12 refugee camps. Like refugees all over the world, they uprooted their families and fled their homes in search of safety, security, and a better life in another country. The economic, personal, and emotional costs for these refugees are tremendous, and upon arrival to the camps they often find themselves unemployed, living in crowded spaces in poverty, with little or no access to basic services.

The cost of displacement

Displacement can have a detrimental impact on people’s health. Children on the move often miss out on their vaccination schedules, and people with existing chronic conditions face interruptions to their care. There is also an increased potential for infectious diseases to spread in displaced populations.

“Refugees, migrants and internally displaced persons have fundamental rights to life, development, the highest achievable standards of health, and access to health services.”

— Dr. Younis Al Khatib, president, Palestine Red Crescent Society

Refugees, migrants and internally displaced persons have the same fundamental rights to life, development, the highest achievable standards of health, and access to health services as anyone else. The Palestine Red Crescent has not forgotten these people. We apply universal health coverage at our own small scale, in a country that is not our own.

How to apply UHC on a small scale

We provide patients with access to safe, effective, and affordable medicines and vaccines, while protecting them from financial risk. We invest in the health of the most vulnerable now, to reduce the number of people who need assistance in the future. Children who have been immunized will grow up healthier, live longer, and contribute to a country’s economy in order to sustain their needs and those of their loved ones.

Through partnership and collaboration with our host communities, donors, and our broader Red Cross and Red Crescent movement network, we have been able to serve the health needs of people who are otherwise forgotten.  

Q&A: How can we provide UHC amid disaster?

When disaster strikes or conflict rages, the challenge of providing health care gets ever harder and more complex. Speaking to Devex, Elhadj As Sy, secretary general of the International Federation of Red Cross and Red Crescent Societies, explains that when it comes to universal health coverage, it’s important to talk about those living in fragile settings, and to ask how health care can still be delivered in the most difficult circumstances.

Haifa Hospital, as with other Palestine Red Crescent facilities and services, was initiated by doctors and nurses who were themselves refugees suffering from the lack of basic services in their surroundings. They all built this hospital and started providing health care to other refugees. In fact, the Palestine Red Crescent itself was built by refugees who took the initiative to develop a network of care and support, which culminated in the creation of their Red Crescent National Society in the diaspora.

With support from international partners, the Palestine Red Crescent has been operating Haifa Hospital in Lebanon since 1985. Located in the narrow roads of the Bourj el-Barajneh refugee camp, the hospital has an emergency room and surgical, pediatrics, obstetrics, gynecology, and intensive care units. Originally it was set up to serve up to 10,000 Palestinian refugees settled in the camp. However, today the camp has grown to over 20,000 people.

Haifa Hospital treats anyone in need, whether refugees or local Lebanese people living near the camp who cannot afford the cost of private health care. The doctors focus on the patients’ symptoms and never ask their nationality. Medical services are pro bono for those who cannot afford to pay.

For the people living in and around the camps, the Palestine Red Crescent Society remains the only health service provider that is affordable and accessible. Tens of thousands of vulnerable people have sought medical care at the hospital because we make equity our driving force. We have partners that share the same values and provide us with life-saving support in the form of medicine, equipment, training for doctors and nurses, and in paying the bills on behalf of patients who cannot afford the costs. The Palestine Red Crescent has been able to deliver equitable community health care services to the most vulnerable because of our committed volunteers who are delivering immunizations, promoting health services, and tackling many noncommunicable diseases in communities where there may be hostility, discrimination, and stigmatization.

Our volunteers are part of the refugee communities and well placed to help households have access to health services, referral, and follow up within their own communities. They assist communities in identifying local solutions to critical health problems in complex settings, contributing to local and community resilience. Such approaches strengthen the refugee communities’ resilience and give them hope.

However, the demand for health services today exceeds our capacity to provide care for the increasing number of refugees and local communities who settle in camps. To continue our work, we depend on stronger partnerships that bring together government, private sector, communities, and humanitarian actors. These partnerships must translate into investments that strengthen the local capacity in our hospital-training, our volunteers staff, improving hospital equipment, infrastructure, and covering more patients’ costs.

Protracted crises are as devastating as sudden emergencies. It is important that we have the resources and capacity to continue to provide health and care to the forgotten populations in these crises. For the Red Crescent, UHC means extending services and support to the most isolated, and most vulnerable.

How do we ensure that people worldwide get the care they need without the risk of being pushed further into poverty? Devex explores the path to universal health coverage. Join us as we ask what it will take to achieve UHC for all by visiting our Healthy Horizons site and tagging #HealthyHorizons, #Health4All and @Devex.

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