BADIL Resource Center for Palestinian Residency and Refugee

Assistance
2005, the Syrian government increased the costs of hospitalization by 460%, which has affected the capacity
of both UNRWA and the refugee population to cover the cost of hospitalization. 67 Private clinics and hospitals
and UNRWA play a more significant role than government clinics and hospitals in treating refugees. Nearly all
refugees have public insurance in Syria. 68
Refugees also have access to the public health system in Jordan, which covers most health services and also
provides pharmaceuticals. 69 Nearly two-thirds of 1948 and 1967 refugees outside camps lack health insurance,
while only half of the camp population has insurance. 70 Prenatal care and primary care for children under the
age of three is available free of charge at government clinics. Government-sponsored family planning is not
available in Jordan. Government and private health clinics and hospitals and UNRWA play an equal role in
treating refugees; however, few non-camp refugees use UNRWA health facilities.
Refugees have limited access to public health care in Lebanon. 71 Public health insurance programmes cover up
to 80% of the costs of consultations, medicines and hospitalization. However, few refugees (less than 10%) are
covered by insurance. 72 Few refugees can afford private health care in Lebanon, which plays a larger role in the
delivery of secondary and tertiary health care than private health care facilities in other Arab host countries. The
importance of the private sector can be attributed to the under-developed state health care system in Lebanon.
As happened in the 1967-occupied Palestinian territory, private health care expanded significantly during periods
of conflict, as state health services collapsed. UNRWA and private health clinics and hospitals therefore tend
to play a greater role than government hospitals and clinics in treating refugees.
In the OPT, refugees have the same status as local residents, and have equal access to the public health system
operated by the Palestinian Authority, the Palestine Red Crescent Society, and private providers. 73 Prenatal care
and primary care for children under the age of three years is available free of charge at public clinics. Women
with public health insurance may use maternity services at public hospitals free of charge. However, public
facilities charge for postnatal checkups. As in Jordan, sponsored family planning is not available in the OPT.
UNRWA and private clinics play a greater role than do public clinics in treating refugees. 74 Approximately 50%
of refugees lack health insurance. 75 Vulnerable low-income households can apply to the PA Ministry of Social
Welfare for temporary insurance (six months).
3.2.3 UNRWA Relief and Social Services
The goal of UNRWA’s relief and social services programme is to provide aid to the most vulnerable and needy
refugees, in particular the elderly, female-headed households, and the sick and disabled. UNRWA began to offer
special assistance to refugee households qualifying as special hardship cases in 1978. 76 Relief and social services
constitute approximately 11% of the Agency’s total budget, with the largest share allocated to assist “special hardship
case” (SHC) families. This programme employs around 670 persons.
At the beginning of 2006, 249,648 persons (5.7% of the refugee population) were classified as SHCs. 77 The
largest number of households receiving special assistance are in Lebanon, followed by the occupied Gaza
Strip and the West Bank. Eligibility criteria for the special hardship programme were extended in 2005,
and at the beginning of 2006, 674 refugee women married to non-refugees were added as SHC. 78 However,
financial constraints forced UNRWA to limit its services and the admission of new hardship cases, thereby
excluding many vulnerable persons in need of assistance. (See box on UNRWA funding.)
The relief services programme provides food support for SHC families, shelter rehabilitation, and selective
cash assistance; SHCs are given priority in social services programmes and in enrolling for vocational training
courses. Food assistance includes five basic commodities distributed on a quarterly basis (flour, 79 sugar, rice, milk
and oil). In 2006, food subsidies were reduced from US $110 to $86 per person per year in Jordan, Lebanon
91