Refugee Syrian doctors key to healing Lebanon’s over-burdened health system

‘Refugees, healthcare and crises: informal Syrian health workers in Lebanon’, from IIED, is released as the EU and UN jointly chair the second Conference on Supporting the Future of Syria and the region, in Brussels, Belgium (24-25 April). 

The report found that doctors, dentists, psychologists, nurses, medical assistants, technicians and pharmacists are prevented from working, despite a long-standing need for skilled medical staff in the public health system. Making it legal for these displaced healthcare professionals to work in Lebanon would help relieve the over-stretched medical system and move the country closer to achieving the World Health Organization’s priority of achieving universal health care.

Numerous laws and regulations prevent the country benefiting from this influx of health care professionals. This includes Lebanon’s 2014 labour law Decree 197, which prohibits Syrians from being employed in anything other than agriculture, construction or cleaning services. And, anyone wanting to practice as a doctor or pharmacist, needs to have been a citizen for 10 years. 

As a result, Syrian health care professionals in Lebanon are only able to work illegally. Despite their expertise, working in the informal sector they face low-pay, no benefits and no security. Some have lost their jobs and even been arrested.

Diane Archer, senior researcher at IIED, said: “Refugee Syrian doctors are key to healing Lebanon’s over-burdened health system and to providing vital health care to refugees. The government has an opportunity to make the changes that are so urgently needed and introduce limited registration for all Syrian health care professionals who are seeking sanctuary within its borders.”

Adam Coutts, from the Department of Sociology, University of Cambridge, one of the report’s lead authors, said: “The government of Lebanon needs to recognise the value of displaced Syrian doctors and other health care workers. Both to help meet the growing demands on the country’s medical services and for Syria’s future.

"These medical experts are essential to the success of any recovery plans being considered for a post-conflict Syria. The government needs to make sure they can work and have training so their skills are not squandered.” 

Among the action needed, it is vital that the Lebanese government allows Syrian medical workers to be registered so they may at least treat displaced people – a policy that has been successful in Turkey. The pressure on medical services has increased with the arrival of refugees from Syria, who now comprise 25% of Lebanon’s population.

It is also crucial that donors and other agencies fund research to establish how many displaced Syrian health care workers are in Lebanon. This is important for planning early recovery initiatives but also helping Lebanon to make progress towards universal health coverage, which is a current WHO top priority. 

The government also needs to work with local academic institutions to provide courses and support enrolment for those whose studies have been interrupted. WHO and other donor organisations should provide financial support to expand education and training.

This, together with local educational and professional bodies setting up courses, will help make sure skills are maintained and will close the generational gap emerging among Syrian health workers. This is key to making sure their skills are maintained and provides an incentive for them to stay in the region, increasing the likelihood that, when the war ends, they will return to Syria to help rebuild the health care system.