The International Catholic Migration Commission
serves and protects uprooted people: refugees, internally
displaced persons and migrants, regardless of faith, ethnicity or nationality.
serves and protects uprooted people: refugees, internally
displaced persons and migrants, regardless of faith, ethnicity or nationality.
   Humanitarian Assistance to Vulnerable Iraqis in LebanonLEBANON December 31, 2005 - ICMC partnership work with the Caritas Migrants Center -Interim Narrative Report . This interim narrative report fulfills the requirements in the cooperative agreement between the United States Department of State Bureau of Population, Refugees and Migration and the International Catholic Migration Commission (ICMC) for the project providing Humanitarian Assistance to Vulnerable Iraqis in Lebanon. This report covers the activities implemented in partnership between ICMC and the Caritas Lebanon Migrants Center. This partnership continues to be an essential factor in the success of the project. - Summary Summary The fourth year of the project to provide humanitarian assistance to vulnerable Iraqis in Lebanon has begun very smoothly and successfully. The project is well ahead of schedule for receiving and identifying vulnerable families and serving them with essential, and in some cases even life-saving, assistance. Demand for project services continues to be high as families arrive in desperate straits, or become vulnerable after catastrophic illnesses or other problems that occur after their arrival in Lebanon. The following table presents a summary of the state of the program at the end of this reporting period, four months into the 12-month project: Service End of Project Objective Achieved Total Families 550 343 The following sections address the goal and objectives of the project proposal submitted to the US State Department. The goal of the program is the alleviation of the alienation and suffering of 550 vulnerable Iraqi families, approximately 2,750 individuals in Lebanon. In this fourth year of the program, sick, disabled, minor, and elderly persons constituted the priority of the EVI team intervention plan. With the expanded social work team, families received additional visits and follow-up attention on the medical, humanitarian and educational levels. As of the end of December 2005, 343 families had been assisted. The planned objective for the end of December in the proposal was 250 families. The end-of-project objective was 550 families. The project is therefore well on its way to achieving its goal ahead of schedule. Of the 343 families, 36.4% were new cases and 63.6% old cases. Also of this total number of families, 54% of them are Muslim and 46% Christian. Objectives At least 700 vulnerable persons will receive effective out patient medical care. By the end of this reporting period, 508 individuals benefited from outpatient medical care. In most cases, the beneficiaries received a medical consultation at a Caritas medical center or another dispensary that assists vulnerable Iraqi families. These consultations were conducted by both general and specialist doctors. After being seen by the doctor, individuals were referred to governmental hospitals or specific medical centers that provide Caritas with special rates if any lab exams or radiology were required. The assistance frequently included buying prescribed medicines with a special discount of 18% to the project from a pharmacy that had made this offer. For the first time this year, a second pharmacy offered the same 18% discount. This year the team also began referring to new medical centers present in different areas in Lebanon to facilitate access for families living far from Beirut. Outpatient Care Case Examples: Case No. 1: After being attacked in Iraq, R, 42 years old, came to Lebanon in 2001. The family situation is as follows: The family lives in Baalbek in an apartment, having neither water nor electricity. The financial situation is very critical since the father supports the family by himself with a salary of L.L 200 000 per month ($133). On October 4th, R's wife gave birth to baby M, and since then the Caritas Migrant Center EVI team was contacted for support. Fees of $500 were paid to Riyek Hospital. At the age of 4 months, baby M. suddenly stopped reacting to anything and suffered a total relaxation of the muscles. His sick mother took him all the way from Baalbek to Beirut in order to meet a doctor, who concluded that the boy suffered from symptoms of WEST disease. From this point onward, Caritas provided financial and social support to the boy and his family. The boy went through examinations, blood tests, an MRI, electro-analysis etc. After this, Caritas, in collaboration with Sesobel (a specialized NGO for handicapped children), referred the baby to a doctor to review the tests. The doctor concluded that the baby had to be hospitalized in order to clean his lungs properly, after which drugs and therapy could be assigned. The cleaning of his lungs was done in Baabda Hospital. Following this, the doctor prescribed a monthly medication, weekly therapy, and an adaptable chair that he now requires. All of this was financed by the EVI project through the ICMC/Caritas EVI project team. Psychological support is also provided to the mother in order to keep her motivated and hopeful. The medical situation for M. continues to be very critical. Case No. 2: Y, 38 years old, came in May 2005 to Lebanon, escaping from the hard times in Iraq, together with her family that consists of: The family lives in a one room flat that lacks basic resources such as proper furnishings. The rent fee for the room is $100. The only source of revenue is Y's salary of $ 200 per month and T is unemployed. The oldest daughter N. has asthma while the two younger children are regularly sick, with high fevers and the flu. One day T. came to Caritas with N. after she went through a very serious asthmatic attack and needed urgent treatment. Caritas sent N. to a specialist where full examinations were made and concluded that N. suffered from infections and needed immediate hospitalization. The EVI project supported all the necessary costs. In addition, medicines and diapers were given to the family and rent for one month was paid by the project while the social workers counseled the family. At least 150 vulnerable persons will receive effective inpatient medical care. By the end of this project period, 74 persons were assisted for treatment or surgeries in public hospitals. For particularly urgent and critical cases the patients were referred to private hospitals that offered services unavailable in the public hospital. Examples of these patients included persons who needed open-heart operations, cancer treatments, or postnatal intensive care for newborn babies. Inpatient Care Case Examples: Case No. 1: K, 29 years old, arrived six years ago to Lebanon. He is married to S, 43 years old and together they have two children, A. 2 years and Z, while S has seven children from a previous marriage.The only source of income is K. Nine members of the family live together in a single room without basic and necessary services, furnishings, or a healthy environment. They pay L.L 110 000 (about USD 75) monthly in rent. The family problems started when S. gave birth to Z. and, according to her, Z. was placed in an orphanage that allowed her to see him once a week. Her husband does not believe her, and claims that the baby was given to the doctor that was present at the delivery of S. K is still searching for the baby without success. One day, S. came to Caritas with a black eye and with blood running from her nose. She told the social worker that she had fallen down some stairs; however, to the social worker it appeared that someone had hit her. While at the office, she fainted and could not be revived. The project team called a Red Cross ambulance and she was transferred urgently to the hospital for fear that she might be hemorrhaging internally. The Caritas EVI project team took S. in their charge and arranged for her hospitalization, where she was given the treatment that she needed for several days. Currently, the social worker is following the case on both a legal and a social level in order to help the family. Case No. 2: A. is a 64 years-old widow who had to leave Iraq and come to Lebanon. She has three children, C. 36 years old, S. 30 years old and A. who is still in Iraq. The only source of revenue is S. earning $ 250/ month. One day A. came to Caritas and was in a very bad health, her lungs were filled with fluid and it was obvious that she needed urgent treatment. Caritas sent her to Sacré Coeur hospital, a private hospital, where the necessary action was taken. In addition to regular examinations, proper heart tests were taken and it was concluded that A. had to go through an open-heart surgery. A. is now awaiting recommendations from her doctor on when she can have the operation, Caritas is ready to finance part of the costs. At least 120 children will continue their education in regular accredited primary schools. During the reporting period, the EVI project team received more requests to assist children in paying their primary school tuition than the objective. The practice, however, is to commit to providing this assistance as long as the children remain in school until the spring and maintain regular attendance. Therefore, during this period Caritas only paid for 38 children who were registered in public schools, where it is necessary to pay the tuition up front to ensure enrollment. For the other families attending private and quasi-private schools, social workers collected all the requests in order to prioritize the needs and then the team conducted visits to schools during the academic year to check the attendance of each child and evaluate the school results. Primary School Support Case Examples: Case No. 1: After a serious political incident that occurred during the war in Iraq, P., who was born in 1966, had to leave the country and escape to Lebanon on 1997.The family situation is as follows: A, her husband, is 42 years old 2 Children: L, 14 years old and LI., 12 years old A. works as a doorkeeper in one of the buildings in Achrafieh and in exchange, he is offered one room to live in together with his family. Therefore, he does not receive any cash. P., his wife, works as a maid, and from her salary the family has to live. P. suffers from severe pain in her kidney that sometimes prohibits her from working. She is very conscious of the importance of education for her children but cannot afford to pay the fees even if the children were enrolled in a public school. Caritas investigated the case very carefully and decided to pay the school fees and for schoolbooks for both children. Case No. 2: A. is a 50 year old woman, unemployed and divorced. She left Iraq in 2005 because of the hard times the country is going through. A. has one single child, R, born in 1994, who suffers from diabetes. A. is depressed as she feels very lonely and unable to raise the child by herself. A. has no relatives and no one to depend upon. A. and her child share a small house with another family, a total of six people live together. The family has no source of income as A. suffers from problems in her eyes, which led to an inability to work. A. went to see a doctor and after examinations he told her that she will need a surgery costing L.L 900 000 per eye. An instrument to check the level of diabetes has been bought for her daughter, in addition to assistance on how to use it. Furthermore, Caritas covers part of the insulin that the child will need. A. requested a scholarship for her daughter; Caritas has already paid for all fees for the school, including the cost of transportation to and from school due to the vulnerability of the family. At least 300 extremely vulnerable families will receive humanitarian assistance to provide for their basic needs. By the end of this reporting period, 136 families received humanitarian assistance to ensure their basic needs were met. The families live in very unsanitary conditions. Their houses are overcrowded, very humid, and without any furniture. The assistance delivered depended on the vulnerability of each family, but the most common items were the following: food packages, milk and diapers for newborn babies, rent fees for very few extremely vulnerable cases, transportation fees, blankets, sheets, heaters (mainly during the winter season), mattresses, used beds, cupboards, and clothes. Humanitarian Assistance Case Examples: Case No. 1: The hard economic situation, war and various political reasons forced family B to leave Iraq and come to Lebanon, in October 2005. All members came except the father. The family situation is as follows: The mother I, is 49 years old and suffers from high blood pressure. 8 children: J. married and has one child JM., 29 years old R. married and has one child JC, 27 years old JR., 23 years old RA., 21 years old RM., 19 years old A., 9 years. All the family members mentioned above live together in a small room that is humid, dark and dirty. The family hardly has space to stand! The family owned neither a heater nor a carpet. The rent fee is $ 150 and sources of revenue include R. and RA. who earn L.L 200 000 ($133) each. Caritas was contacted for humanitarian assistance. A social assistant went to investigate the room and found it very crowded and as described above. Caritas donated a carpet and a heater to the family to improve their situation. The family also benefited from a food package and the social worker is still doing follow-up in order to help them find another house with better conditions. Case No. 2: A, 36 years-old, left Iraq and came to Lebanon in 2004 in order to earn his living and provide food and shelter for his family. The family consists of his 37 year-old wife and 2 children A., 5 years old and M., 5 months old. A. works in construction as an informal daily worker. A. has problems in his ears which make him deaf in one of them. Caritas offered the family humanitarian assistance through the donation of diapers and milk to the children. Furthermore, the children were referred to a doctor and underwent full examinations. One of his children is now attending the non-formal education classes. At least 150 children will remain in or return to the formal primary educational system by receiving non-formal education. 154 children are currently attending the non-formal classes. This activity started in November 2005. The courses take place every Saturday from 9.00 till 12.00. The objective of these classes is to support children who are enrolled in schools to keep up with their homework. For children who were not able to enter a normal school due to several reasons, they are attending the classes so that next year they will manage to integrate into a normal school. As in previous years and because it made things more organized, children were divided in 2 groups: This year and for the Christmas season, one group of social work students from Saint Joseph University volunteered to prepare an activity for the children. The activity was prepared in partnership with Caritas. The students paid for the gifts and for the lunch while Caritas paid for the theatre entrance fees and the bus. The program of the day was as follows: The children were very happy. The activity included Muslim and Christian children. The parents also expressed their gratitude because their children don't have the chance to attend such activities.At least 80 young adults will successfully complete vocational training programs. By the end of this reporting period, 36 young individuals were assisted to attend vocational training courses. These persons benefited from trainings in English, computers, esthetics and make-up, hairdressing, and AutoCAD. Some others beneficiaries wanted to learn English because they were accepted for resettlement in Australia and wanted to get acquainted with the language so they can be integrated and find employment easily. In several cases we asked for minimal financial participation from the beneficiaries to engage them in the process. Sometimes they pay for their own books, or they pay for their travel from their house to the learning center. In a few cases that could afford partial payment, they paid for one course and the project provided the rest because they wanted to complete 4 or more courses. Vocational Training Case Examples: Case No. 1: H is a 36 year-old woman that arrived in Lebanon in 1998 to earn a living. She has the following family situation: The family lives in an apartment and pays a rental fee of L.L 200 000/ month (USD 133) but there is no source of revenue. When H. first came to Caritas she had been very seriously physically abused by her husband. The abuse led to gynecological problems and pain in her uterus. Caritas paid the medical expenses that led to H's recovery. Suddenly, H's husband left her and the children and traveled all the way to Germany, since then one of the children has become very hyperactive. H. came to Caritas and the EVI project team and asked desperately for help, as she urgently needed a job. Caritas supported her by offering her diapers and milk, but the major help offered was to put H. on one of the special courses (handicrafts) offered at Caritas. For her to be able to attend class, Caritas paid nursery fees for her children. Recently one of the children reached school age and Caritas paid a fee of $150 for primary school support as well. Case No. 2: Political persecution made C.B leave her entire family in Iraq and come by herself to Lebanon. Fifteen years old, C.B lives now with her aunt, who is married to a Lebanese man, but can unfortunately not afford to pay for C.B's daily requirements. C.B sought out the EVI project for support. Her request was to start courses and take English and computer classes. Caritas gave her the freedom to choose any institution, provided that they gave her a detailed confirmation of all fees. CB's case was accepted after being carefully investigated and now C.B is registered at the Saint Louis center enrolled in the courses she chose. In addition, C.B asked Caritas to provide for the transportation costs necessary, which also was accepted due to her dire situation. Caritas covered all fees and transportation costs necessary., and in order to afford her own food and shelter C.B will soon start a job. At least 70 women will successfully participate in 15 group seminars on health and social topics. 79 women from different age groups, young, newly married, and even grandmothers are taking part in the group work. This activity started in December 2005. 3 meetings were completed under the following topics: The last meeting was a trip to the Chouf area. The women visited Moussa Castle - a very famous castle in the region, and Beit el Dine Palace. This outing was chosen because the women rarely leave their urban setting and it was an opportunity to reduce the stress they are typically under. They were very pleased with the opportunity and grateful to the project as it provided them with an opportunity to see Lebanon, as well as ease their feelings of depression and tension. The refugee context for Iraqis in Lebanon Iraqi families continue to come to Lebanon to escape the dire situation in Iraq. Many families assisted this year are new families. Some of them came recently to Lebanon, while others have been in Lebanon for some time but did not previously require assistance. For this latter category, it is sometimes a catastrophic illness and sometimes the simple fact of having used up all of their savings that leaves a family in a newly vulnerable position. The beneficiary population continues to represent a Muslim majority. However, the number of Christian families arriving continues to increase. All families continue to arrive illegally by paying smugglers in order to cross the borders between Iraq and Syria and then from Syria to Lebanon. The amount paid can vary from US$200 to US$400 per person. Iraqi families are now all under temporary protection status according to UNHCR. This does not afford them the opportunity to work legally. As men are usually more vulnerable to being picked up by the Lebanese police, women and children are more likely to work to support the family. This causes a significant change in the traditional family dynamic. The responsibilities between the members of the families are switched; as the mother and the oldest children become responsible for providing for the basic needs of their families. Usually, women work as cleaners and the oldest sons leave school in order to work as daily laborers because the risk of their arrest is less. Young daughters also do not go to school. Instead, they stay home to take care of their younger brothers and sisters because their mothers are working. In some cases, they accompany their mothers and help them in their cleaning jobs. For the Muslim families, women frequently do not work because the cultural bias against it is too strong. There is a high rate of depression among Iraqi families, especially among women. Women feel fully responsible for the future of their families and cannot see a positive future. Paradoxically, the temporary protection status afforded to all Iraqis means that UNHCR is no longer processing applications for resettlement for a significant number of these families. This was the one route that many families hoped to use to find a better future. The Australian embassy, which was taking applications for humanitarian admissions, has also reduced their acceptance rates The main challenges now facing Iraqi families can be summarized as follows: -Lack of access to education or interrupted schooling; -Health problems being mainly dermatological diseases due to humidity and unsanitary living conditions, respiratory infections, and chronic diseases; -The medical problems are compounded by the families' inability to afford medical treatment; Mental and psychological disorders for children, women and men due to the situation back in Iraq and in Lebanon; -Extreme poverty; and Unemployment and/or exploitation in employment due to their illegal status. The majority of Iraqi families live in Beirut, but there are also significant populations in the south, the Bekaa valley, and the north near Tripoli. The populations outside Beirut have higher rates of vulnerability. They choose to live in far away areas because housing is cheaper and there is less of a risk of being arrested. Context issues of the program (staffing, security...) Based on prior experience, this year a new social worker was hired on a full time basis in order to do more intensive social intervention for families. This year also, the Danish Refugee Council (DRC) conducted a study on the situation of Iraqi families in Lebanon. The feedback concerning the EVI project and the Caritas Migrants Center was very positive. Families appreciate Caritas's method of intervention. The families mentioned that the team respects them, receives them in dignity, and listens to their problems. The families also noted that they appreciated the regular home visits by the project team social workers. Not a single incident related to the EVI team of social worker's field activities was reported for the period. In December, an ICMC trainer came to Lebanon to organize an assessment of the training needs of the EVI team of social workers. In its approach toward training, Caritas Lebanon noted that the identified training needs were common to more than one project. In consequence, Caritas Lebanon reviewed the possibility to include additional staff from other relevant project teams so the latter could benefit from it as well. The coordination of the training activities has been delayed as it has been difficult to find a common time when all concerned staff could be available as everyone was busy with their respective activities. While ICMC acknowledges some delay in the implementation of the training with respect to the project document, a future timing has been agreed with sufficient notice so no further change will delay its implementation. Caritas has been providing a vehicle for the last four years of the project, which, due to its poor condition, can no longer be relied upon as the sole vehicle for project activities. While Caritas and ICMC have proposed the purchase of a Sedan vehicle in the fourth phase of the original proposal, the purchase process has revealed to be lengthier than expected due to a combination of factors. The models matching with the best price/quality ratio were bound by an ordering period of several months. However, it should be noted that the re-evaluation process for selecting the most appropriate model between ICMC and Caritas Lebanon has let a considerable amount of time pass. However, this does in no way question the validity of a need for a vehicle besides the current used vehicle. ICMC, in consultation with Caritas Lebanon, has decided to draw a lesson from this experience and cancel the purchase of a Sedan vehicle. A better use of the funds has been identified and recommends for the $20,000 in budgeted funds to be shifted towards optimizing the impact of the current program. ICMC will outline a proposal for the most appropriate use of those funds in a separate written correspondence to PRM. Coordination and interaction with other relevant actors: UNHCR, NGOs and the government Coordination continued to expand and improve with UNHCR. For the first time, UNHCR provided financial support to the project for medical (outpatient medical care), educational (Primary School Tuition) and legal assistance. Caritas and the EVI team were able to assist additional vulnerable cases due to this support. The EVI project team continues to collaborate with governmental institutions directly involved in client care. These include mainly public hospitals such as Baabda, Quarantaine, Beyrouth, Dahr El Bachek and Tannourine. These hospitals have very low rates, quality care, and they are very collaborative. Iraqis surveyed in the DRC study cited the ICMC/Caritas program as the main source of organized assistance in Lebanon. The UNHCR Chief of Mission also recently noted that the ICMC/Caritas EVI project team was well known for its policy of non-discrimination and that this had been recently confirmed in a series of focus group discussions of Iraqis in Lebanon organized by UNHCR. The acceptance and recognition of the valuable social work of Caritas Lebanon as a neutral service provider can be viewed as a reward for close to four years of discreet but effective field work. In a time of sectarian tension, there is considerable value in the fact that a Lebanese Christian organization (Caritas) provides services to a primarily Muslim beneficiary group. During this reporting period the Chaldean church received funds to assist Iraqi families. Coordination was organized in order not to duplicate assistance, especially for the humanitarian aid because several kinds of similar assistance were given such as mattresses, covers, heaters, and food packages. The two project teams shared names to avoid duplication. Conclusion The fourth year of the program to assist vulnerable Iraqis in Lebanon has begun in a highly successful fashion, making progress towards the goal and objectives well ahead of schedule. The expanded project team has been able to increase its social work support as foreseen in the proposal. The project has also begun to attract resources from other donors. Both ICMC and Caritas Lebanon Migrants Center are grateful to the US State Department PRM's continued support for this essential work.
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