The challenges and our response
A small country of more than 6 million people, Lebanon now hosts nearly 1 million Syrian refugees as well as an estimated 250,000 to 400,000 Palestinians. This means that roughly a quarter of the country’s population is made up of refugees—an influx that has left public services severely overstretched and deepened poverty levels in a country already dealing with political and economic turmoil. A bit more than half of Syrians and 10 percent of Lebanese are extremely poor, living on the equivalent of just a few dollars a day. As a result, some 3.3 million people in Lebanon are in need of assistance, a figure that includes both refugee and host communities.
International Medical Corps began operating in Lebanon in 2006 and has played a key role providing relief to people affected by war in the years since. Following the 2011 outbreak of armed conflict in Syria, we have expanded programming to meet the basic health and mental health needs of Syrians who have sought refuge in Lebanon. Today, our activities address the needs of refugees and vulnerable Lebanese residing in greater Tripoli, Akkar, Beirut and Mount Lebanon, Bekaa and the South.
International Medical Corps works to ensure access to quality health services for Syrian refugees, vulnerable Lebanese and people at risk. We do this by supporting a network of about 50 primary healthcare clinics and dispensaries across the country. These clinics focus on prevention and health maintenance, including routine physical examinations, wellness exams for children, malnutrition screening, immunisations, referrals, care and follow-up treatment for those with non-communicable diseases; specialised health services for people with disabilities; and antenatal and postnatal care. International Medical Corps procures essential medications based on the Ministry of Public Health’s drug lists and works closely with supported clinics to dispense and monitor their use.
In addition to providing financial support, International Medical Corps works closely with these clinics to help build capacity, with the goal of improving the quality of services at each facility, maintaining their status as members of the Ministry of Public Health’s PHC Network and preparing them to meet accreditation requirements in the future. Awareness-raising and health education through community health clubs are key components of International Medical Corps’ primary healthcare services, which play a valuable role in limiting the spread of communicable diseases and minimising both primary and secondary healthcare costs. To expand outreach in communities, International Medical Corps identifies volunteers from local areas and provides them with in-depth training and field coaching, enabling them to become Community Health Workers. Training includes a variety of health education topics, including infectious and non-infectious diseases, infant and young child feeding, immunisation, antenatal care and personal hygiene, among others.
Community Health Workers serve as a vital link between the clinics we support and those residing in the surrounding areas. They provide referrals and follow up with refugees and vulnerable Lebanese at home, in informal settlements and collective shelters, and in schools and under-served neighbourhoods. International Medical Corps’ Community Health team also organises health campaigns across the country in coordination with local and international partners, to inform communities through interactive health and hygiene awareness sessions, and distribute hygiene and feminine kits.
Primary Healthcare Services
Awareness-raising and health education are key components of International Medical Corps’ primary healthcare services. These services play a valuable role in limiting the spread of communicable diseases and minimising both primary and secondary healthcare costs. International Medical Corps identifies volunteers from local communities and provides them with in-depth training and field coaching.
Training includes a variety of health education topics, including infectious diseases, non-communicable diseases and other chronic illnesses, infant and young-child feeding nutrition for the life cycle, immunisation, newborn care, antenatal care, personal hygiene and sexually transmitted diseases. The Community Health Workers we train serve as a vital link between PHCCs and those residing in the surrounding areas. They provide referrals and follow up with refugees and vulnerable Lebanese at home, in informal settlements and collective shelters, and in schools and underserved neighbourhoods. The Community Health team also organises health campaigns across the country, in coordination with local and international partners, to sensitise communities following interactive health- and hygiene awareness sessions.
In 2017, International Medical Corps trained and supported 73 Community Health Workers, of which 65 were women. Between September 2016 and August 2017, our Community Health team reached more than 32,000 beneficiaries through awareness sessions and referred more than 16,000 beneficiaries to healthcare services.
Mental Health and Psychosocial Support
Since arriving in Lebanon in 2006, International Medical Corps has played a leading role in delivering comprehensive mental health programming. We have expanded access to services by training primary healthcare providers to detect, refer, diagnose and treat mild to moderate mental disorders, to integrate mental health into primary healthcare. Through the support of primary healthcare centres and community centres, multidisciplinary case management teams comprising case managers, psychotherapists, child psychotherapists and psychiatrists provide continuous support to beneficiaries and refer cases to other services, according to need and free of charge.
As part of our efforts to promote health and well-being among refugees and vulnerable Lebanese, International Medical Corps also offers community-based activities for youth and caregivers, as well as other at-risk people. Psychosocial-support activities, such as community support-group interventions, are designed to raise awareness of a variety of mental health topics and to equip individuals with the resources they need to help themselves and those around them. International Medical Corps also has developed educational booklets on mental health disorders, including depression, postpartum depression, loss and grief, enuresis and psychosomatic disorders.
International Medical Corps coordinates closely with the Ministry of Public Health’s National Mental Health Programme on various activities and services. The National Mental Health Programme provides national-level guidelines and policies for mental health services in Lebanon, while our partnership with the national programme helps integrate mental health into primary healthcare, ensuring access to quality mental health care within the existing healthcare structure.
Gender-Based Violence (GBV)
Women and girls in Lebanon continue to be disproportionately affected by GBV, with early marriage, domestic violence, sexual violence (including rape and physical assault), exploitation and survival sex being its most common forms. GBV goes unreported or is under-reported due to the fear, shame and stigma that beset many survivors.
Recognised as a leader in humanitarian GBV prevention and response programming, International Medical Corps’ interventions span across all regions of Lebanon. We design our programmes to support and empower women and girls who face particular risks after being exposed to conflict. Our priority is to strengthen core services for GBV survivors, particularly case management and psychosocial support services, as well as quality healthcare. To prevent future incidents of GBV, we also work with communities to address protection risks and combat harmful practices. Through our programmes, International Medical Corps contributes to the development of best practices and standards around prevention and treatment of GBV in Lebanon.
We work with local organisations, community-based support workers and healthcare providers to address these risks, and to deliver quality, focused support services for survivors of GBV through community centres and safe spaces for woman and girls. We also work with communities to promote women’s equality and combat beliefs and practices that perpetuate different forms of GBV, particularly through activities that engage men and boys on concepts of gender equality, and help transform behaviours based negative social paradigms into respectful behaviours.
At the national level, International Medical Corps is a member of the GBV Information Management System and the Clinical Management of Rape (CMR) task force. Our programmes are tailored to ensure that interventions are needs-driven, adapted for cultural and security considerations, and responsive to the nature and extent of GBV present in different contexts.
International Medical Corps’ key GBV prevention and response activities include individual GBV case management according to GBV guiding principles; organized safe spaces that enable women and adolescent girls to access information, seek help and establish support networks; psychosocial support through focused and non-focused activities; and stress- and anger-management and masculinity workshops directed toward men.