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BMJ 2015;350:h1552 doi: 10.1136/bmj.

h1552 (Published 23 March 2015) Page 1 of 1



Syrian doctors risk arrest and deportation for treating

fellow refugees in Lebanon and Jordan
Sophie Arie

Syrian doctors who have fled the countrys civil war to Lebanon populations (Lebanon had 4.38 million people in 2011; Jordan
and Jordan are being prevented from treating fellow refugees had 6.05 million in 2010) and plenty of physicians (14 025 in
despite their huge healthcare needs, because of laws protecting Lebanon in 2011, equal to 3.2 in 1000 people, and 15 729 in
the livelihoods of local health professionals. Jordan in 2010, equal to 2.6 in 1000; by comparison, the United
Lebanon and Jordan are not allowing Syrian doctors to practise, Kingdom has 2.8 in 1000).
even to treat Syrians, said Redwan El Khayat, a UK based It is not clear how many Syrian doctors are now refugees in
Syrian psychiatrist and member of the Paris based Union of neighbouring countries, how many may be working without
Syrian Medical Relief Organizations. licences, or how many have been arrested or deported for doing
Four years after the Syrian conflict began 3.8 million Syrian so.
refugees are now living in Lebanon, Syria, and Turkey in what The health ministries and medical associations of Jordan and
the United Nations High Commissioner for Refugees has Lebanon did not respond to our inquiries. Health services in
described as the biggest humanitarian crisis since the second both countries have become increasingly inaccessible to refugees
world war. Their healthcare needs are huge, most cannot afford because of cost. Lebanons health system is largely private, and
the cost of local health services, and aid agencies are struggling refugees are charged the same rates as Lebanese people. Jordan
to care for them. Amnesty International has reported that some announced in November that it could no longer offer free
refugees are forced to return to Syria in search of treatment for healthcare for Syrian refugees, and it now charges them the
chronic disease.1 same as uninsured Jordanians, which is prohibitive for most.
Lebanon and Jordan have longstanding laws that prevent The UN covers 75% of the cost of lifesaving and emergency
foreigners from practising medicine and many other professions, care for registered refugees, but many cannot cover the
to protect local peoples jobs. Four years since the conflict began remaining 25%. It is not known how many Syrians have died
the presence of large numbers of refugees is increasingly from the lack of healthcare, but the Syrian American Medical
straining local services and causing tension. Society estimated in March 2014 that the figure could be 200
000more than the number killed at that stage from the violence
In Jordan in recent months, five or six unlicensed clinics set up
of war.
by Syrian doctors have been raided and forced to close, Human
Rights Watch has said. In one case the refugee patients who Otmar Kloiber, president of the World Medical Association,
were present when an illegal clinic was raided were deported said that, if asked, he would advise that Syrian doctors in these
back to Syria.2 countries could be given restricted licences, as has been done
elsewhere in the past, so that they can work with refugees. I
In Lebanon, where refugees now make up 25% of the total
dont see any reason why this cannot be done, said Kloiber.
population, Wael Abou Faour, the countrys health minister,
It is an administrational act that can be done in a very short
said last year that authorities had stopped Syrian doctors from
time. It requires the will to do it.
opening clinics or working at hospitals after receiving
complaints from the syndicate and from (Lebanese) doctors.3 1 Amnesty International. Syrian refugees in Lebanon desperate for health care amid
However, he said that Syrians were volunteering at clinics international apathy. 21 May 2014.

treating refugees in border areas. We cannot stop a physician 2

Human Rights Watch. Jordan: Syrian medical workers deported. 8 December 2014. www.
from helping his compatriots, Abou Faour said.
3 Naharnet. Report: Syrian refugees practicing medicine in Lebanon. 2014. http://m.naharnet.
Before the conflict began in 2011 Syria had a population of 22 com/stories/en/137730-report-syrian-refugees-practicing-medicine-in-lebanon.
million and an estimated 15 000 physicians, including generalists
and specialists (the World Bank notes that Syria had 1.5 Cite this as: BMJ 2015;350:h1552
physicians for every 1000 of 22 million people in 2010). The BMJ Publishing Group Ltd 2015
neighbouring countries of Jordan and Lebanon had smaller

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