The Status and Needs of Palestinian Camps and Communities in Lebanon

The Status and Needs of Palestinian Camps and Communities in Lebanon
Executive Summary
Field Study 2011
"Palestinians in Lebanon are under harsh living conditions", this is briefly what can be said about the status of Palestinian refugees in Lebanon. This can be simply observed by any person from only one visit to one camp of these refugees.
This study conducted by "The Palestinian Association for Human Rights (Witness)" in collaboration with "Humanitarian Relief for Development" confirms this reality by providing information and statistical evidence in addition to carrying out field inspection and surveys and interviewing concerned authorities. This is part of a series of studies and reports carried out and published by The Palestinian Association for Human Rights (Witness).

The study is divided into two major parts:
The first part describes the status of Palestinian camps in various fields, in which the situation is almost the same in most camps.
Although the status of education has been covered in many studies, but what's new in this study is that it goes beyond the academic level in UNRWA schools to investigate school facilities and services such as: buildings, classrooms, playgrounds, libraries, laboratories, drinking water, toilets, transportation, and teaching techniques.
It is clearly evident that the majority of UNRWA schools lack many installations. Libraries for instance, which are not found in all the schools, don't obtain recent scientific publications, books, and computers or appropriate furniture.
Playgrounds are small and unsuitable for sport activities. Laboratories are not equipped with the materials necessary for interpreting scholar scientific experiments.
Moreover, drinking water is not safe to drink, toilets are not clean, and minimum health requirements are not available.
Despite the attempt to introduce modern teaching methods, they were not applied thoroughly and the traditional method of memorization is still prevailing.
On the other hand, it is noticeable that the UNRWA takes better care of secondary schools than elementary and middle ones; this was also evident in the results of public examinations when secondary school students got impressive results compared to disappointing results of middle school students.
Deterioration of elementary and middle school services may be the reason behind enrolling the children of relatively wealthy Palestinians in private Lebanese schools or in supplementary academic programs which have been common in the last few years.

The following table shows the percentage of Palestinian students who are either enrolled in private schools or in supplementary programs or have a private tutor:

Students who receive  private tutoring Students enrolled in private schools District
55% 7% Sidon
25% 10% South
75% 10% North
25% 5% Bekaa

The UNRWA runs only one secondary school in each district, which means that most Palestinian camps have no secondary schools. This in turn forces secondary students to go to the only accessible school on their own expense because the UNRWA doesn’t offer transportation or cover its cost. This is the case of secondary students living in "Burj El-Shemali Camp" who have to go to "Aqsa Secondary School" of the "Rashidieh Camp".
Moreover, there are no programs to supervise students who quit schools before the ninth grade and go to the streets.
In addition, this study examines kindergarten education in Palestinian camps, knowing that kindergartens are mostly set up by Palestinian factions, since the UNRWA doesn’t hold any responsibility of this age group and it doesn’t run any kindergarten in any camp.
The study covers 30 kindergartens distributed among the districts as follows:
District Beirut Sidon South North Bekaa
Number of kindergartens 8 8 7 6 1
Kindergartens are mostly undersized and the number of classes is small compared to the number of students. The following table shows the average number of students per class in some camps:
Palestinian Camp Average number of students per class
Burj El-Shemali 22,3
El-Buss 24,5
Rashidieh 23,1
Ein El-Hilweh 23
Mieh w Mieh 30
Burj El-Barajneh 18,5
Shatila 18,7
Beddawi 25,9
Nahr Al-Bared 25
Wavel 20
Kindergartens are also short of toys and playthings. Some of them even have cracks in the walls which threatens the life of children.
Meanwhile, a considerable number of families don't pay fees or prefer to keep their preschool children at home because of expensive education costs.
The table below indicates some of the guidelines used to evaluate kindergarten schools:
 Beirut South Sidon North Bekaa
Not enough classrooms 75% 85.7% 0% 33.30% 0%
Inapt curriculum 12.5% 0% 0% 33.30% 0%
No teaching aid resources 87.5% 14.3% 12.5% 0% 0%
No playground 62.5% 28.6% 0% 0% 0%
No transportation system 87.5% 42.9% 0% 50% 0%
Wall cracks in building 50% 28.6% 0% 0% 0%

Health Situation:
The study presents a briefing about health institutions in Palestinian camps and services provided by them.
Palestinians depend primarily on health services offered by UNRWA and Palestinian Red Crescent whose role deteriorated in the past two decades; their secondary choice is local infirmaries and private clinics.
The study finds out several indicators relating to health concerns of Palestinian refugees and spots huge health problems.
Although UNRWA is the chief health destination for Palestinians, they are quite unhappy with the quality of its services. More than one hundred patients are reported to visit each health center daily, which worsens the care that patients receive; the number even rises to one hundred fifty patients in some centers, particularly those in Ein El-Hilweh and Beddawi camps. Working out the mathematics, this means that each person has only about three minutes with the doctor. This fact raises the following questions: Is three minutes enough for a doctor to know the patient's medical history then diagnose and find the suitable treatment for him/her? Consequently, is the patient being really checked upon and treated, or are medications being prescribed according to apparent symptoms, or does he/she receive inappropriate medication?
On the other hand, it is true that UNRWA gives the available medications for free but many medicines are not found while several others are not showing effect in curing certain diseases. This forces the Palestinian patient to buy medicine from other pharmacies for high prices.
Moreover, the laboratories of the UNRWA health centers perform routine blood and urine tests (FBS – CBCD – Urine Analysis) but they don't have equipment for doing specialized tests (Cultures – Hormones - …). Again the patient has to do these tests in private medical laboratories which are very expensive.
Furthermore, most UNRWA health centers have no diagnostic radiology department. For instance, there is only one such section in Tyre, particularly in El-Buss camp, which means that if anyone from other camps (Rashidieh, Burj El-Shemali, and other Palestinian communities)wants to have an x-ray they have to go to this only section; this is definitely unsuitable for emergency cases. Despite being the only x-ray center in the south district, this center only performs x-ray scans; it doesn’t have other scanning equipment (ultrasound, MRI, CT). Plus, the center's working hours are limited to several hours on few days of the week only.
Meanwhile, there is a big number of patients who need hospitalization, but only few of them get referrals. The reason is that the UNRWA is allotted only a limited number of beds per month in the hospitals that it deals with; this number is usually used before the middle of the month although the UNRWA only covers 30% of the cost of an operation.
On the other hand, the role and trustworthiness of Red Crescent has declined dramatically over the years.
In the meantime, the reliability of people turned away from various hospitals inside camps to five major hospitals: Hamsheri Hospital in Sidon – Balsam Hospital in Rashidieh Camp – Nasra Hospital in Bar Elias – Safad Hospital in Beddawi Camp – Haifa Hospital in Burj El-Barajneh Camp). This turned the neglected hospitals inside camps into emergency and first aid offices only.
This functional deterioration of UNRWA and Red Crescent services urged the setting of private infirmaries and clinics for the Palestinian refugees. These health institutions are doing well but their efforts are faced by lack of funding and specialized equipment. Thereby health needs are still not met properly especially at night when these institutions are not working.
The deficiency of medications offered by UNRWA forced people to open some pharmacies. However, pharmacies are run by nurses or college graduates not by specialized people. Also, some private health institutions have founded laboratories which perform routine blood and urine tests and have contracts with other private centers to perform specialized blood and urine analysis for a reduced cost.
On this issue, one can refer to a previous recent study published by The Palestinian Association for Human Rights (Witness) about The Health Reality of Palestinian Refugees in Lebanon.
Economic Situation:
Regarding the economic situation, most Palestinian refugees live under the poverty line; this goes back to high unemployment rates and to the fact that many professions are banned on Palestinian refugees in Lebanon.
During the time of preparing this study, the Lebanese parliament decided on some amendments on the labor law, particularly giving Palestinians the right of working in some vocations, but the effect of this is still unapparent yet. These amendments legalized some occupations for Palestinians but they are still inferior to Lebanese people by not being permitted any benefits from National Social Security Fund and prohibited from doing several occupations such as medicine, engineering, law, pharmacy…
The other factor of economic deterioration is the cutback of UNRWA services in various areas especially with the international surge of prices, particularly food supplies.
The study also looks at the social situation of Palestinian communities in Lebanon by examining several elements that affect their social life:
1- Housing:
Every Palestinian camp has dozens of houses unfit for habitation, either because of its zinc roofs or because of the cracks; both of which form danger on the life of its residents.
The UNRWA is currently reconstructing such houses in some camps but this project plan doesn’t include other camps.
In addition, most houses are small in area and are over crowded. Also, due to the incapacity of the (horizontal) expansion of the camps and the prohibition of Palestinian house ownership in Lebanon, Palestinian youths are obliged to build over their parents' houses (vertical expansion of camps).
2- Cemeteries:
Some camps have no burial grounds which forces its habitants to bury their dead in the cemeteries of other camps or in outside graveyards for expensive costs.
Other camps which have cemeteries have no more space in their graveyards, which has forced many Palestinians to bury more than one body over each other.
3- Environment:
Waste containers are inadequate in most camps, and they are often placed near sensitive facilities, as is the case in Rashidieh camp where waste containers are near schools, and in Burj el-Shemali camp where waste containers are facing the UNRWA clinic.
The majority of the containers is uncovered and it is not sprayed periodically with pesticides. Although cleaning workers collect waste every morning from front of the houses, but the absence of people cooperation and of respect to assigned times of waste collection, and the over crowdedness of the camps lead to accumulation of wastes near houses and in the alleys, emitting unpleasant odors and spreading insects and rodents.
Moreover, camps lack green areas, parks and agricultural lands.
4- Sanitation:
New sanitary networks have been constructed in most of the camps, the only problem in this regard is its recurrent plugging due to throwing hard wastes in it; certainly this always causes sanitary water to flow out on streets.
5- Drinking Water:
In most camps, drinking water is not safe to drink because of its high rates of pollutants, sodium and calcium. This fact brought about several water treatment centers, and they are very popular although there is no monitor on their satisfaction of health conditions.
6- Electricity:
The electricity in all Lebanon suffers from fuel shortage and cutback program; in addition to this, wires in Palestinian camps are worn out and intermingled, and people connect more lines than the adapters can hold which causes repetitive blackouts.
7- Roads:
Roads inside Palestinian camps are narrow and full of holes and random bumps. They are also bit by nearby houses which expand over the roads with no authority to stop them. Moreover, roads are dim with no lights and they are often used as parking lots because no other place to park the cars.
8- Other sectors:
Cultural activities have noticeably diminished, where as no more book fairs and general lectures are being held in the camps. And public libraries, which are scarce, complain about absence of visitors.
Despite the desperation that Palestinian youth live in Lebanon due to unemployment and one's inability to work by one's field of specialization and the ownership banning law, these youth find a breathing space through sport clubs and scout activities which are prevalent in Palestinian camps. However, those clubs face hardships because they lack equipped stadiums and enough funding.
Last but not least, another group in the Palestinian communities doesn’t get enough attention and care. In particular, this is the group of people with special needs who find only few special care services and centers.

The second part of the study suggests some solutions for the problems raised by the first part in different areas. These suggestions presumably ease the tragic life of Palestinian communities in Lebanon. Till now the solutions are just conclusions of the study, their significance is contingent to their implementation.
¤ Educational Needs
A- UNRWA Schools
1) Laboratories:
 Establishing scientific laboratories in the schools which have no laboratories, and supplying them with necessary equipment and material to explain all scholar scientific experiments.
2) Libraries:
Advancing well furnished libraries in the schools which have no libraries, and providing them with recent publications especially scientific ones. 
3) Drinking Water:
Examining water periodically to check its safety, attaching filters to make the water safe to drink, and repairing water tanks and pipes and taps whenever needed.
4) Toilets:
Enlarging the area of toilet rooms, building new additional ones where needed, rehabilitating and repairing the current ones, and supplying schools with cleaning detergents.
5) Transportation:
Offering free transportation for students who have to go to schools outside their camps.
6) Teaching Strategies:
• Stop working by the automatic raising system.
• Choose and use exclusive scholar books and curricula (problem solution kind of books) in addition to the books published by The Educational Center for Research and Development, especially in scientific subjects.
7) Teaching aid resources:
Providing schools with visual and auditory teaching aids and training the teachers on using them properly and efficiently.
8) Palestinian Return Culture:
Introducing two new subjects to the Palestinian schools curricula in all classes, particularly: Palestinian history and geography; and celebrating national anniversaries and occasions.
9) Other needs:
• Providing public examination classes' students (ninth and twelfth grades) with supplementary guide books.
• Providing students with school bags and stationery items especially for poor students.

B- Private Schools:
Establishing private Palestinian schools in Palestinian communities for reasonable fees.

C- Vocational Training Centers:
Establishing vocational training centers in various areas for students who quit schools before the ninth grade and don't get accepted at Seblin Training Center.

D- Kindergartens:
1) Launching free kindergarten by the UNRWA.
2) Supporting present kindergartens with financial grants.
3) Founding safe transportation for nonprofit fees.
 4) Rebuilding cracked walls in present kindergartens.
5) Increasing the space of kindergartens and building new classrooms, drawing rooms, playgrounds, and gardens.
6) Repairing windows, water networks, electrical networks, and sanitation networks on a periodic basis.
7) Supplying kindergartens with audio and visual teaching aids suitable for preschool curricula (recording devices, display screens, educational toys …).
8) Furnishing playgrounds with different safe play sets.

¤ Health Needs:
1) Building central hospital in every district which has Palestinian communities in it.
2) Urgent building of a collective infirmary in each camp, with specialized clinics in various domains.
3) Urgent building of central maternity care hospitals, with neonatal and cesarean section equipment.
4) Need of equipped ambulances and qualified medical groups for first aid and rescue operations while taking patients to the nearest hospital.
5) Absence of a special medical college which graduates qualified nurses and medical staff.
6) Urgent need of medical centers for the disabled and people with special needs.
7) Need of well equipped physiotherapy centers.
8) Rehabilitating the present Red Crescent hospitals and refurbishing its equipments and devices.
9) Necessity of electric generators in hospitals and infirmaries.
10) Urgent need of modern dialysis equipment in each district.

1) Increasing the number of doctors in the infirmaries as needed by the huge number of patients.
2) Signing contracts with doctors in more various fields and increasing their workdays.
3) Launching in each camp an emergency department which opens 24 hours 7 days in the week.
4) Advancing the laboratories found in infirmaries so that they can perform all lab tests.
5) Establishing an advanced center for diagnostic radiology in all clinics.
6) Making all medications available and in enough quantities.
7) Providing each camp with fully equipped ambulances.
8) Signing contracts with more hospitals and under better conditions for patients.

B- The Palestinian Red Crescent
1. Uniformly modernizing all Red Crescent hospitals without preferring one of them to another.
2. Enhancing hospitals and developing their laboratories, pharmacies, and radiology departments.
3. Raising the salaries of their employees and improving their living conditions.
4. Addressing financial and administrative corruption.
5. Designating equipped ambulances to each and every Red Crescent hospital and clinic.
C- The Lebanese Government
1. Allowing Palestinian doctors and pharmacists to pursue their professions.
2. Allowing Palestinians to benefit from the National Social Security Fund and to be treated in public hospitals free of charge.

D- Palestinian Factions and Popular Committees:
1. Building new health institutions in camps and enhancing present ones.
2. Supervising the water treatment business according to health standards.
3. Penalizing people who assault buildings and workers of health institutions.

¤ Social Needs:
1- Housing:
1) Reconstructing uninhabitable houses in all camps.
2) Requesting the Lebanese government to allow building material to enter Palestinian camps.
3) Expanding the area of the camps or establishing new places for Palestinian communities.
4) Allowing Palestinian ownership outside camps, which helps decrease the over crowdedness inside camps.
2- Cemeteries:
Extending grave yards or founding new ones where needed.
3- Environment:
* Installing more waste containers and placing it away from vital facilities and spraying pesticides periodically on all containers.
* Maintaing the daily waste collection and raising public awareness about cleanliness and cooperating with cleaners.
4- Sanitation:
* repairing plugged networks especially in winter.
* Spraying pesticides in sanitation networks to exterminate insects.
5- Drinking Water:
* Supplementing UNRWA water tanks with treatment equipment and conducting periodic tests to check if the water is safe to drink.
* Monitoring the satisfaction of health conditions in water sold by water treatment stores.
* Establishing free water treatment stations in various neighborhoods.
* Excavating new wells and building new tanks so that water supply becomes adequate to the growing need of water and increasing number of inhabitants.
6- Electricity:
1) Restoring the old electrical network and fixing its problems (chaotic extensions, non-insulated wires …).
2) Monitoring the adapters to prevent infringements. 
3) Providing private generators at reduced subscription fees.
7- Roads:
      1) Finding parking lots to decrease the problem of traffic and narrow roads.
      2) Removing random bumps and preventing new ones, as well as prohibiting    
      residents from abusing roads and alleys.
      3) Installing night lights and closing pits and open channels on the roads.
      4) Paving alleys and dirt roads.

¤ Economic Needs:
1- Giving Palestinians the right to practice all kinds of professions, to work with dignity, and to enjoy same rights as Lebanese workers in terms of compensation, health insurance, and taking not less than the legal minimum wage.
2- Establishing production plants to create new jobs for Palestinians.
3- Increasing UNRWA services at all levels to reduce the burdens on Palestinians (health, education, subsistence …).
4- Offering concessional loans for production projects and supporting existing ones.

¤ Cultural Needs:
1- Establishing public libraries in the camps, with recent books and publications.
2- Constructing a lecture hall for lectures and meetings and research and documentation centers inside the camps.
3- Conducting lectures, seminars, and conferences, developing studies and research in various areas, and organizing art exhibitions.
4- Establishing educational institutions to care for different academic and vocational areas, with applied models (whether artisanal, industrial, or agricultural).
5- Adopting the ideas of the intellectuals and encouraging them on publishing books, magazines, and newsletters.
6- Needs of cultural, sports, and scouts clubs:
1. Equipped stadiums.
2. Supporting clubs financially to help them sustain.
3. Providing clubs with office supplies and sports equipment.
4. Providing scout clubs with basic scout supplies.
7- Needs of special needs and disabled people:
1. Founding institutions which provide all care, rehabilitation, and education programs for persons with disabilities, and supporting existing such centers.
2. Insuring prosthetic devices and visual and hearing aids.
3. Insuring appropriate transportation means for moving disabled persons between their homes and the centers.
4. Processing public roads and alleys to fit and facilitate the movement of disabled persons.
5. Accessing various edcational and vocational training to the disabled.
8- Needs of the elderly:
Building specialized centers for elderly care in all camps, where different programs and activities are run to help them fulfill this critical stage of their lives.

The authors of this study (The Palestinian Association for Human Rights and The Humanitarian Relief for Development) hope that it invites researchers to the reality of the life of Palestinian refugees in Lebanon and that it acts as a guide for those seeking to help them.