Pain Relief

In June 2012, Lebanon had about 25,000 Syrian refugees. Today, that figure has multiplied by a factor of more than 30. The numbers, however, don’t tell the whole story: Lebanon was already a haven for Palestinian refugees, and it is grappling with longstanding sectarian tensions and the consequences of a government collapse this spring. It hasn’t opened new camps to accommodate the Syrians pouring over the border, and, in the absence of sufficient funding and upgrades to support the population influx, Lebanon’s infrastructure is under extreme pressure. Resentment among local communities toward Syrian newcomers is also reportedly mounting.

The crisis has been described as "out of control." One of the key people seeking to bring some order to the situation, by working with the Lebanese government, a dozen U.N. agencies, and over 80 NGOs to track refugees and provide them with aid, is Ninette Kelley, the representative to Lebanon for the U.N. High Commissioner for Refugees (UNHCR). Foreign Policy sat down with Kelley this week while she was in Washington. She discussed the challenges of assisting a wildly dispersed population living in garages, sheds, and empty buildings; her frustration that international journalists seem more interested in covering Jordan’s Zaatari camp than other aspects of the refugee crisis; and why Lebanon feels like it’s been abandoned by the world.

Below is an edited transcript of the conversation.

FP: Today, how many Syrian refugees does UNHCR estimate are in Lebanon?

NK: Over 800,000…. We’re registering between 11,000 and 15,000 every single week. It’s a lot of people in a tiny country.

FP: The government has opted against opening new refugee camps. So where are most of the refugees?

NK: They’re all over the country. When they first started to arrive, they settled in the north, and they gradually spread…. There are some 300,000 in the Bekaa [Valley], which is a large area in the east. There are around the same number, or slightly less, in the north, and around 90,000 in the south and in the Beirut area…. There is not a single area in Lebanon that is not touched by the Syrian refugee presence, and, in some communities, there are more refugees than there are Lebanese.

FP: What challenges has the government not opening camps presented to UNHCR?

NK: Certainly with the crisis, it was better to have people in communities rather than in camps. Camps are very easy to put up but very difficult to take down. People don’t like being in camps…. It’s much easier to distribute aid [in camps], but it comes with other risks. 

Around December of last year, we said, "This is not sustainable over the long term, and you [the government] need to think of a mix of shelter solutions, including some settlements, some camp-like settlements with up to 10,000 persons." We mapped areas in the country where that could be done, but the government still has not given its permission. That’s very difficult because it means we don’t have adequate shelter for people, and they are living in terrible circumstances.

FP: You’re describing what sound like compromise solutions, where there are not camps, exactly, but concentrations of people that make it easier to deliver aid.

NK: What we’re saying is you need a mixture of shelter options. You need cash-for-rent so people can rent apartments. You need to finish unfinished buildings so people can reside there….  But, for those people who still have not found adequate shelter, you need a place for them to go. We call it a transit center, but, in fact, it’s a camp of manageable size, so it doesn’t threaten any local communities, where we can put the necessary infrastructure in quickly and make sure that people are safe and secure.

FP: The government has also placed restrictions on the sort of shelters that can be constructed. What are the restrictions, and what is the rationale behind them?

NK: They [Lebanese authorities] don’t like tents, but they don’t want anything that looks like a permanent structure. The rationale is that they have had Palestinian refugees now for so many decades, they believe that anything that looks permanent will be permanent. They have this instinctive reaction against that.

FP: Obviously, interventions take a lot of money. What are your needs?

NK: In the middle of last year, we came up with an international appeal of $1.6 billion. A little over 30 percent is funded, when you include what the government also asked for. We’re having great difficulty meeting the very basic needs of refugees in terms of shelter, health care, and education, but also in helping hosting communities that are really suffering because of the presence of refugee communities. There are pressures that come to bear on water and sanitation networks, on the loss of wages, on increased demand for limited health care services. The humanitarian appeal is not nearly adequately funded for us to be able to do our job appropriately. This is most disappointing to the Lebanese. They feel they have been abandoned by the international community.

FP: In what ways do you think more assistance for refugees could also be economically beneficial, socially beneficial for Lebanon?

NK: Many refugees are living in areas that are the most socially and economically depressed within the country. They were like that before the crisis, and they weren’t getting the right services. So if we do interventions to help the school system, to help the primary health care system, if we improve water and waste management, if we can take vacant building and improve them, then that can all be to the benefit of the Lebanese as well. That is really our rallying cry right now in the world: Please come forward and help this tiny country with this disproportionate burden.

FP: You mentioned before we began the interview that you think Jordan gets more international attention because it has a very large camp and that makes for better optics.

NK: That’s what journalists tell me: It’s much easier to go to a camp and see what going on there. I’ve had many journalists come to Lebanon and say, "It’s just not easy for us because we have to travel distances to tell the whole story."

FP: Lebanon has its own ongoing political crisis, and there have been reports that the presence of refugees is inflaming tensions with Hezbollah. What impact do you think refugee crisis might have on Lebanon’s overall stability? 

NK: With all of the refugees, there are Lebanese who feel under threat, and there are different confessional groups who say, "We are becoming a much smaller minority in our country." That creates great anxiety and a great risk to stability. But I can’t say that we’ve seen a spike in terms of outright confrontation between groups in the last two years. The rhetoric has always been relatively [charged], but the stability that has been maintained is amazing. I can’t think of a single situation in living memory when a country as small has taken in so many without more political instability than we’re seeing.

FP: Let’s talk about winter. This will not be the first winter Syrian refugees have spent in Lebanon, but it may be the harshest. What steps is UNHCR taking to prepare?

NK: Winter is something that you expect and you know about, so our shelter strategy and our distribution for non-food items necessary for winter starts at the beginning of every planning year. We have been working on a priority basis making sure that the most vulnerable shelter situations are sealed off from the elements, whether that’s tented settlements or rented garages, unfinished buildings, animal sheds. Then, in November, we start to distribute fuel and thermal blankets. But people continue to come and continue to settle, and keeping track of them is a challenge.

FP: Already, many refugee children are missing critical years of schooling. What sort of assistance for education have you been able to provide the government of Lebanon?

NK: Right at the outset, they said Syrian children can come to Lebanese schools. This year, we have 280,000 [school-age] Syrian children, almost equal to the entire number in the Lebanese public system, so the government said, "We think we can accommodate 100,000: 30,000 in regular classes and, if UNHCR and other partners come in, we can put in a second shift [in the school day] and accommodate another 70,000." That’s enormous. But it depends on funding, and it also tells us that nearly 200,000 children won’t have that opportunity. It’s not that the government isn’t willing, it’s just that the capacity has been reached. So now we have to work at finding other informal education options and plan for the longer term, because these kids are spread all across the country in all kinds of precarious circumstances and they need to be able to have some kind of educational support.

FP: What would informal options look like?

NK: It could be setting up mobile schools, which UNICEF has started for informal tented settlements. It’s also trying now to map out the skill sets of the refugees themselves [including teachers], to give them materials so they’re able to teach the children. It’s going to be a really new area for us, and the numbers are staggering, so we need all the help we can get.

FP: Children have particular needs, and there are other groups within refugee communities that fall into similar, special categories-for instance, LGBT individuals and women. What is UNHCR doing to support needs beyond the immediate, emergency ones, like food and shelter?

NK: We try to ensure a diversity perspective is in all our interventions, so that you’re also looking to the needs of children, women, the disabled, the elderly… street children, young people at risk of forced marriage. Our teams in the field are well-capacitated to identify them and refer them to appropriate services…. Can I say we are 100 percent successful? Absolutely not, and it’s one of the biggest challenges when you’re dealing with an emergency.

FP: In a similar vein, are there particular health concerns in Lebanon at the top of your list of what to pay attention to? There have been recent reports of polio spreading in Syria.

NK: You always worry about the spread of disease. When people leave their home country and their vaccinations have been interrupted, you worry about them not being immunized and being conduits to the hosting community. We do a number of things. First off, UNICEF has a vaccination center in all of our registration centers…. On polio, UNICEF, the WHO [World Health Organization], and government of Lebanon will be vaccinating everyone under age 5 throughout the country, regardless of nationality. In addition, we have health referral networks where we’re trying to ensure primary health care…. But the health care needs are astronomical. Lebanon is primarily a privatized health system, our scarce dollars are stretched very thin, and there are many cases that we are unable to treat. We try to treat all infectious disease, and, on secondary health care, we prioritize life-saving efforts. But those people who have a hip needing reconstructive surgery, or a baby that needs a cataract operation to be able to see, or someone who has a cleft palate, those are off the table. For those individuals, those are great disabilities they carry for the rest of their lives, but we just don’t have the money to pay.

FP: Look ahead, where do you see Lebanon in five or 10 years, in terms of the refugee situation?

NK: I cannot imagine a good scenario absent a good political solution in Syria. I think that has to be the focus of everybody because the consequences of that not happening are so incredibly dire that the world should not be sitting around accepting them. Short of that, if the situation continues as it is now, Syria will continue to be completely devastated, refugees will continue to flee, the stability of the surrounding countries will be challenged, and what we’re seeing in Syria could really expand to the rest of the region, to the detriment of global stability.