BADIL Resource Center for Palestinian Residency and Refugee

90
Survey of Palestinian Refugees and Internally Displaced Persons (2006-2007)
health services are divided into four main categories: medical care services; environmental health in refugee camps;
nutrition and supplementary feeding; and programme management.
Medical care services are divided into
primary, secondary and tertiary care.
Primary medical care is provided
directly and at no cost to refugees
registered with UNRWA. This
includes a comprehensive maternal
and child programme, family
planning, treatment of common
diseases, and dental care. UNRWA
also provides specialist care, including
physiotherapy, radiology, cardiology
and ophthalmology.
UNRWA runs one of the most
cost-effective health services in the
region, with comparable or better
results than other health services in the region. However, medical resources are stretched, especially when compared
to host authorities. While an ideal average number of consultations per doctor per day is 70, the Agency-wide
average is 95, with the highest number of patient consultations per doctor occurring in the occupied West Bank
(108 consultations daily), the occupied Gaza Strip (95), and Jordan (92). 64
UNRWA Health Center, Tulkarem refugee camp, occupied West Bank, October 2006. © Anne Paq.
Some environmental health services, such as the installation of sewerage, drainage and water networks, and the
provision of safe drinking water in refugee camps, are also provided by UNRWA, particularly in Lebanon and the
OPT, through contractual arrangements with local municipalities or private contractors.
National health assistance is important given that UNRWA does not generally operate secondary and tertiary
health facilities for Palestinian refugees. Hospital beds in public and private hospitals are paid for by the Agency,
with the exception of one Agency-run hospital in the occupied West Bank town of Qalqilia. UNRWA provides
financial assistance for vital secondary health care services (such as hospitalization for life-saving treatment), while
tertiary care provided by the Agency includes prosthetic devices, specialized medical investigations, and life-saving
medicines. Refugees share health-care costs through co-payment (between 5% and 25%, depending on their
socio-economic status) towards secondary and tertiary care. Because socio-economic conditions in Lebanon are
especially harsh, refugees there are exempt from the co-payment system for secondary and tertiary care, although
co-payments are required for specialized life-saving treatment.
Table 3.5: Access to Government Health-care Systems for Secondary and Tertiary Care Services
Access to health care
services and insurance
Syria Jordan Lebanon OPT
Access – Universal
health coverage + costsharing
with UNRWA.
Access – On average,
50% of refugees have
insurance + cost-sharing
with UNRWA.
Limited access –More
than 90% of refugees
do not have insurance.
UNRWA covers nearly
all costs.
Access – On average,
50% of refugees have
insurance + cost-sharing
with UNRWA.
In Syria, Palestinian refugees have access to the state-run public health system, which provides universal health
coverage. 65 This includes hospitals, clinics and mother-care centres. Prenatal care and primary care for children
under the age of three is available free of charge at government clinics. Although the public health system
provides universal coverage, it is struggling to meet the demands it faces as a result of population growth. 66 In