FINE TUNING REFUGEE ASSISTANCE IN LEBANON, SYRIA

UNCLAS AMMAN 000458

SENSITIVE
SIPDIS

C O R R E C T E D COPY CAPTION
E.O. 12958: N/A
TAGS: EAID IZ JO LE PREF SY
SUBJECT: FINE TUNING REFUGEE ASSISTANCE IN LEBANON, SYRIA
AND JORDAN


1. (SBU) Summary: To keep pace with the most recent
information about Iraqi refugees, PRM refugee assistance in
Lebanon, Syria and Jordan should be fine tuned to address
specific vulnerabilities in the Iraqi population in the three
countries. Advanced health care for the chronically ill,
post-secondary education opportunities for the adolescent
Iraqi population, psychosocial programming to offset the
effects of extended refugee status, and well-monitored
monetary assistance would best promote the USG goal of
repatriating Iraqis with dignity and in security. End
Summary.


2. (SBU) UNHCR in Lebanon, Syria and Jordan estimate that at
the end of 2008, there were 257,132 registered Iraqi refugees
in the three countries. Government numbers of Iraqis in the
region far exceed registration numbers. However, those
registered should serve as a model for assistance. Iraqis
showed a higher incidence of chronic illness than did the
host country populations, with 40,795 chronically ill in
Syria alone. In Lebanon, Syria and Jordan, UNHCR and UNICEF
judged that approximately 12,000 of the school aged Iraqis
were at risk of economic exploitation as they illegally seek
work in economies where consumer prices increased by 14
percent over 2007. In addition this group is vulnerable to
sexual exploitation. Consequently, their medical,
psychosocial and humanitarian assistance needs have changed
over the past year.

HEALTH CARE--BEYOND PRIMARY HEALTH CARE
--------------


3. (SBU) Medical professionals in all three countries report
that Iraqis present a higher incidence of cancer, high blood
pressure and heart disease than the host country nationals.
Iraqi children are especially hard hit by chronic illness
requiring medicine and therapies either not available or
prohibitively expensive in the region. These patients
require monitoring and long-term care which is beyond the
current resources of local hospitals and PRM partners.
RECOMMENDATION: Current health programming in Lebanon, Syria
and Jordan provide Iraqis with basic health care and limited,
short-term access to more demanding, expensive care. PRM
should explore with IOs and NGOs extended care programs for
critically ill Iraqis in countries of refuge. A corresponding
increase in services inside Iraqi could prevent chronic
health care from becoming a pull factor in Lebanon, Syria and
Jordan.


4. (SBU) Mental health partners note an increase in reports of
domestic violence and in requests for psychosocial supports
such as peer counseling and mental health consultations among
refugees. Community workers link the increase in violence to
economic difficulties and a resulting loss of identity
suffered by family members. The 2009 Iraqi CAP contained
approximately USD 19.3 million in proposed psychosocial
programming. RECOMMEDATION: Successful PRM psychosocial
interventions in Lebanon, Syria and Jordan were geared to
providing safe spaces for vulnerable women and children and
basic counseling services. Those efforts should be coupled
with a whole family/community approach to psychosocial work
to address the effect of displacement and hopelessness among
the adult and adolescent male population--authors of much of
the violence. In Lebanon single males are the largest
demographic group among Iraqis. The psychosocial needs of
this group, many of them war survivors, should be addressed
to ease their reintegration into Iraqi upon repatriation.
Partners like Relief International, International Medical
Corps, and Mercy Corps made early progress in this field in
all three hosting countries and could do more.

EDUCATION--REACHING ENDANGERED YOUTH
--------------


5. (SBU) Iraqi students in Lebanon, Syria, and Jordan have
access to free or inexpensive primary education. School
attendance numbers in secondary education programs drop off
sharply as young people seek jobs, prepare for resettlement,
or lose interest in education that does not prepare them for
an uncertain future. Attracting students to secondary
education presents a challenge in all three countries.
Education partners report that employment as laborers on the
gray and black markets is a major cause of teenage
absenteeism from schools, particularly as Iraqi refugees
consider young people as potentially less likely to be picked
up by host country authorities for working illegally.
Separately, the potential for exploitation of adolescent
dropouts is great. RECOMMENDATION: Education partners should
be encouraged to consider programming to support post
secondary education in either vocational schools or
universities in the region. Early versions of the 2009 Iraq
pillar II CAP listed approximately USD 55 million in
non-primary education program proposals for Iraqis in the

Syria, Lebanon, and Jordan and approximately USD 3.7 million
would directly address the needs of youth.

FINANCIAL ASSISTANCE FOR THE BASICS
--------------


6. (SBU) In all the countries in the region worsening
economic conditions have impoverished refugees, even those
who were middle-class when they first sought refuge.
Presently, assistance is not based on needs assessments
informed by an economic survey of local conditions. UNHCR
and WFP are using international standards for humanitarian
assistance and applying them to estimations of population
size without the benefit of accurate, independent numbers.
In Syria, food assistance proved vulnerable to
misappropriation and sale. Present levels of cash assistance
in the region are insufficient to meet local costs in
countries such as Jordan which has seen a 14 percent increase
in consumer prices in the last year.
Syria and Lebanon registered similar hikes in the cost of
basic consumer goods and rents. Embassies continue to press
Jordan, Lebanon and Syria to grant Iraqis legal status and
the right to work legally. Governments resist on the basis
of economic hardships among host communities, which have long
accommodated large numbers of Palestinian refugees, and the
principle that Iraqis are not seen locally as de jure
refugees. Political leaders in Jordan, Lebanon and Syria
have increasing shown a willingness to discuss the economic
welfare of the Iraqis in their countries. However, national
policies allowing Iraqis to work remain restrictive and
anecdotal evidence suggests that refugees are falling into
poverty at a rapid rate. In Syria and Jordan, Iraqis cannot
seek legal employment. In Lebanon, Iraqis can work under
limited circumstances.


7. (SBU) UNHCR and partners are working with a mixed bag of
cash/voucher/food assistance programs with WFP and other
partners. The most successful, but time intensive of the
programs is cash assistance, which should be expanded.
Private donors have used food vouchers successfully in
Lebanon and Jordan. Controlling the distribution of cash
and vouchers is much more demanding than monitoring food
distributions, but the advantages of cash distribution to an
urban population are considerable. Refugees receive
assistance through a system of bank ATMs that record
transactions and allow refugees the dignity of withdrawing
funds in a way that does not mark them as refugees. Cash and
vouchers allow refugees to use the local economy and
eliminate the need for importation, storage and safeguarding
of bulk food. As demonstrated in Syria in 2008, distributing
large quantities of bulk food invites refugees to sell their
rations at dumping prices, angering local merchants and
putting refugees on the wrong side of the law.
RECOMENDATION: UNHCR and WFP should be encouraged to work
together to establish innovative solutions to nutritional
assistance that include cash distribution systems on a
regional basis to prevent refugees from "benefit shopping".
Anti-fraud technology could be used to prevent the abuse of
vouchers or cards, such as frequent renewal requirements and
issuance of picture imprinted cards.


8. (SBU) Access to fair employment could reduce refugee
dependence on assistance. Partners have been successful in
working with paid Iraqi volunteers in professional and
semi-professional aspects of programming. Iraqi doctors work
in health clinics in Jordan and Lebanon. Iraqi volunteers
conduct surveys for NGOs throughout the region. Governments
have proven tolerant of the practice of paying volunteers for
their long-term service to NGOs. RECOMMENDATION: Partners
should be encouraged to recruit and retain qualified Iraqis
for positions within USG funded and other assistance
programs. Volunteerism is not proposed as a solution to the
right-to-work problem, but employing volunteers is a limited
stop-gap solution for a handful of educated beneficiaries.

REPATRIATION--PREPARING THE ROAD HOME
--------------

9. (SBU) Future USG assistance efforts in Lebanon, Syria and
Jordan should focus on preparing for repatriation while
securing humanitarian space for Iraqis. RECOMMENDATION:
UNHCR should be encouraged to seek blanket Iraqi Government
recognition of the academic and occupational training
credentials of Iraqis who studied in countries of refuge.
Advanced occupational classes conducted by NGOs in Jordan,
Syria and Lebanon should be accredited by the Government of
Iraq to reassure refugees that their credentials have worth
once they return home. Supporting higher education for
Iraqis in Lebanon, Syria and Jordan could offer a possible
future to Iraqi youth who would otherwise fall prey to
predatory employers or worse.

Visit Amman's Classified Web Site at

http://www.state.sgov.gov/p/nea/amman
Beecroft