Left out in the cold: Syrian refugees with disabilities in Lebanon

For International Day of People with Disabilities, Tabitha Ross reports from the Beqaa Valley in Lebanon where Christian Aid partner LPHU is supporting Syrian refugees with disabilities.

Hammoudi is six. He has the sweetest smile you can imagine and blows kisses at you if you smile back. He giggles when I pretend to catch and eat the kisses, then shuffles over on his bottom, and sits in my lap.

Hammoudi was born in Damascus with complex physical and mental disabilities, and was given two operations at birth on the Syrian health service. Those operations saved his life, but he was still unable to take food or drink by mouth, and was due to have another operation to correct this when he was two. By that time, however, violence had overtaken Syria, and his family was told he could no longer have the operation on the state.

While the Syrian health service was well-regarded before the conflict, it has now been shattered by four and a half years of war, Medical facilities in anti-government areas have been particularly targeted. At the end of 2014, only 45% of hospitals were fully functional. These hospitals are now coping with vast amounts of casualties from the war.

Hammoudi’s grandfather, Mohammed Dayoub, managed to pay for his operation privately, but in 2013 the family was forced to flee to Lebanon, where there is severely limited access to publicly funded health provision and private care is prohibitively expensive.

Hammoudi was unable to access any care in Lebanon until this year, when local organisation the Lebanese Physically Handicapped Union (LPHU), supported by Christian Aid, gave him physiotherapy, occupational and speech therapy. This has enabled him to walk for the first time, and his family are overjoyed with his progress. But the family still face enormous challenges. Hammoudi needs another operation to correct the curvature of his spine, and the family have no idea how to afford it. ‘He is the son of my son, but he is dearer to me than my own child,’ says Mohammed. ‘I’m doing everything I can to find him treatment, but nothing comes of it.’

There are now more than a million refugees from Syria registered with the UN in Lebanon (unregistered refugees bring the true total far higher). More than two thirds say healthcare is ‘inaccessible and unaffordable’.

This is certainly true for the family of little Zainab al-Zoori. At two years old, Zainab is the size of a baby, partly due to her Down’s Syndrome, but also no doubt due to the conditions she lives in. She shares a tent with her parents and three older brothers; in the summer it’s an oven, and in the winter, if it’s not snowing, it’s a mud flood.

Zainab’s parents received little follow-up after her birth, and her Down’s Syndrome was not recognised until she was eight months old. Even then, she received no specialist support until this year, when she started physiotherapy with LPHU. This has enabled her to sit unsupported for the first time.

Abu Ali was in the second year of a law degree when a bomb hit his house while he was studying inside. He was badly burnt and took a piece of shrapnel in the spine, which left him paralysed from the waist down. He was unable to go to an official hospital as people with injuries sustained in anti-government areas, particularly young men, are at risk of being accused of being part of the opposition, arrested and killed.

So, in fear for his life, his father brought him to Lebanon where they live in a tiny metal container in an informal refugee settlement. It’s just big enough for the bed Abu Ali cannot leave, with a narrow space next to it where I imagine his dad sleeps on the floor. They are charming and welcoming, but when it comes to photos, they request that faces not be shown, as they are fearful their family still in Syria will be targeted.

His father tells me: ‘Just here in this camp there are so many wounded. One has lost her eyes, another an arm, another a leg. There are many catastrophes as a consequence of the war.’

He’s right. More than a million Syrians have been injured in the conflict. While the global average for the proportion of a population with a disability is 15%, among Syrian refugees at least 22% have some form of impairment.

LPHU’s mobile team brought physiotherapy to Abu Ali, which has enabled him to regain some strength and coordination in his arms and trunk. You can see the trust and respect between Abu Ali and the LPHU case worker as soon as they meet.

LPHU have decades of experience working with people with disabilities. Indeed they were founded by people with disabilities, and many of their staff have some form of impairment. Christian Aid, through the Syria Crisis Appeal, has funded LPHU to develop two of their existing centres to support people with disabilities in Lebanon’s Beqaa Valley, one of the poorest areas of the country, with a high concentration of refugees. Specialist equipment was installed and staff recruited. Furthermore, there are education and outreach programmes and provision of assistive devices for local Lebanese people with disabilities, as well as Syrian and Palestinian refugees.

Disabled people are, according to the UN, the world’s largest minority group. So why are their rights and needs so often ignored, including in emergency contexts, when they make up an even greater proportion of the population due to injuries? We need more projects like that of LPHU. The needs of people with disabilities should be at the centre of humanitarian response, rather than being an add-on, or left only to specialised agencies. Instead, these people are being left out in the cold.

Christian Aid, alongside supporting local partners such as LPHU, has committed to strengthen its emergency response to ensure that people with specific needs are visible and receive appropriate assistance in a manner that is dignified and safe. It is currently rolling out Minimum Standards for Age and Disability Inclusion as part of a wider initiative supported by DFID to ensure that everyone has the chance to live an empowered and meaningful life and be included.

To support our Syria Crisis Appeal, or to find out more about our partners’ work on the conflict, visit the Christian Aid website.