Lebanon: nothing left to lose

Tired. Dejected. Patient. These are the expressions on the faces of Palestinians living in Lebanon that greet questions about their life now, some 18 months after the historic signing of the Declaration of Principles by the State of Israel and the Palestine Liberation Organisation. The expressions are not difficult to read nor to understand: politically and financially, the Palestinians in Lebanon find themselves left out of the peace picture.

Palestinians have been living in Lebanon for generations now. They first came, mostly from northern Israel, in 1948 and today an estimated 350,000 Palestinians make up 12.5 per cent of Lebanon’s population. At least half of them live in refugee camps which are characteristically overcrowded, war-torn and very poor. Unlike Palestinians in Jordan, Syria or Egypt, they enjoy no civil rights and, to a greater extent than elsewhere, their presence in Lebanon threatens the extremely delicate balance of power in the country.

Oslo, the dream thief

If the Palestinians in Lebanon are not proponents of this peace agreement, it doesn’t mean they are not proponents of peace. “We were not included in these agreements,” says Abou Hani who has lived in the Chatila refugee camp in Beirut since 1950. “It’s difficult to be enthusiastic about something that excluded you, but to say that we are not in favour of the peace process doesn’t mean we are extremists. It doesn’t mean we don’t want peace. We do want peace, but it should be a just peace. How should we feel? Before the Oslo agreement, at least we could dream of returning one day to our homes. The agreement stole our dreams.”

That also holds true for Palestinians in Jordan, Syria and the rest of the world. In fact, the Oslo and Cairo agreements do not treat the matter of Palestinian refugees at all, but leave it for what is called “permanent status agreements” originally scheduled to begin three years into the so-called transitional period which began when Israeli troops left the Gaza Strip and Jericho. Considering that approximately two-thirds of the total Palestinian population live outside the occupied and the autonomous territories, this omission is significant.

The bilateral nature of the peace negotiations does not bode well for a quick resolution of the Palestinian refugee problem in Lebanon: with Israel and Lebanon still officially at war with one another, there is little hope of an agreement between them in the near future.

Compounding the political disappointments of the Palestinians in Lebanon is their current financial crisis. Like Palestinians everywhere, the practical consequence of the Gulf War was a drying up of the cash flow to and from the PLO. In addition, the Gulf War cut off an important income source for Palestinians living in Lebanon whose family members were working in the Gulf states and sending part of their earnings home. An estimated 95 per cent of Palestinians living in Lebanon are unemployed.

Palestinians in Lebanon enjoy few, if any, civil and political rights. In 1991, a committee was formed to study the issue of civil rights for Palestinians, but its work was quickly suspended. Among other reasons, it was discontinued so as not to pre-empt the outcome of the peace process — an ironic twist for those who hoped peace would improve their everyday life.

Against the odds

In this political and financial climate, the Palestine Red Crescent Society in Lebanon (PRCS/L) is struggling to exist and to meet the needs of both Palestinians and Lebanese who have no other means of obtaining health care.

Living conditions for many Palestinians in Lebanon are unhealthy. Overcrowding, inadequate sanitation facilities and a general lack of basic infrastructure threaten large numbers. According to the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), up to 300,000 Palestinians are not receiving adequate medical care.

UNRWA is responsible for providing health care to those Palestinians registered as refugees, but many Palestinians do not fall into this category. Some estimates put the figure of unregistered refugees as high as 150,000. In addition, UNRWA concentrates on the provision of primary health care, leaving a gap that is being filled by PRCS/L in the area of specialised treatment and hospital care that also extends to Lebanese. Some 40 per cent of the people treated by PRCS/L are poor Lebanese.

In Lebanon, the PRCS is a child of war. As a result, it has a solid reputation for emergency care and it runs 15 health care facilities scattered throughout the country. Its staff numbers about 900. But peace and its problems have meant a near collapse of PRCS activities here.

“Our resources are completely depleted,” Dr Mohammed Osman, head of the PRCS in Lebanon, explains. “We used to receive funding from the PLO, but that stopped in 1993. People here are not able to pay for the true cost of services and we’ve lost staff because we are not always able to meet salary requirements. Our salaries are below the minimum wage which is US$ 150 a month here. If it wasn’t for the help we recently received through the Federation, we would not be functioning at all.”

Preventing tragedy

In June 1994, the Federation requested 1.2 million Swiss francs to strengthen three PRCS/L health centres: Al Hamshary hospital in Saida, Chatila polyclinic and A’kka diagnostic centre in Beirut. The support includes the provision of medical supplies, equipment and running costs, as well as selected renovations. In addition, the Federation and PRCS/L are in the process of rationalising PRCS services so that they better reflect peacetime conditions.

“Some of our health centres will close and others will be strengthened and specialised so we can use our resources more efficiently,” Dr Osman explains.

The Federation’s request for assistance has been met in part by National Societies in Canada, Germany, Japan, Norway, the UK and the USA. The aid has been received with extreme gratitude. “It is because of those National Societies that we are standing on our feet today,” Dr Osman says.

Zacharias Backer, head of the Federation’s delegation in Beirut, stresses that the need for assistance is short term but critical. “The PRCS in Lebanon is in a unique position to fill a well-defined need that no other organisation can,” Backer says. “By co-operating with UNRWA, the PRCS can provide the hospital care so badly needed by Palestinians and Lebanese alike. But, if they don’t have some help in the next two years to put them back on their feet, 350,000 Palestinians will certainly develop into a permanent humanitarian problem.”