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Background: 2013

This is an extract from our latest Activity Report, looking back on our work in the previous year.

An estimated one million Syrian refugees have made their way to Lebanon, a country with a population of only four million. 

Despite tremendous efforts by the Lebanese authorities and the provision of international aid, the various structures and schemes put in place to assist refugees are unable to cope with their numbers.

As a consequence of the huge increase in new arrivals, tensions grew in 2013 and refugees were living in dire conditions with very little assistance. According to Médecins Sans Frontières/Doctors Without Borders (MSF) assessments, access to hospital care and free medicines for Syrian refugees were severely limited, and obstetric care was not available. It was difficult for them to benefit from health services because of the charges they had to pay – most had left everything behind and were struggling to support themselves.

In 2013, MSF was present in Tripoli, the Bekaa Valley, Beirut and Sidon (Saïda), delivering medical care to people directly or indirectly affected by the Syrian crisis, including Syrian refugees, irrespective of registration status, vulnerable Lebanese, Palestinian refugees, and Lebanese returnees from Syria.

The majority of Palestinian refugees from Syria have gathered in Sidon at the vastly overcrowded Ein-el-Hilweh refugee camp, where there are regular security incidents and clashes between political factions. The camp has existed since 1948 and is the largest Palestinian refugee camp in Lebanon, with an estimated population of 75,000. As many people are experiencing symptoms of trauma and distress, an MSF mental health programme at Human Call hospital and two clinics in the camp provide psychological support. They also offer medical and psychological care for victims of sexual violence.

In June, a team began to carry out consultations for people with chronic diseases at Human Call hospital. Outside the camp, MSF offers mental healthcare to Palestinian and Syrian refugees, as well as local residents, at the Saïda governmental hospital and the Palestinian Red Crescent hospital. A team implemented psychosocial activities for Syrian refugees living in unfinished buildings in the area.

In Tripoli, Lebanon’s second largest city and home to most of the Syrian refugees, MSF provided medical care for acute and chronic diseases, reproductive healthcare and routine vaccinations at Dar al Zahraa hospital in Abou Samra district. Clinicians, staff training, emergency management and donations of medical supplies were provided to the Tripoli government hospital. A mental health programme run out of the government hospital was handed over to the International Medical Corps in September. Treatment for acute diseases, reproductive healthcare and routine vaccinations were available at the Jabal Mohsen and the Bab el Tabbaneh dispensaries.

Misery Beyond the War Zone

Bekaa Valley

A large number of Syrians crossing into Lebanon enter through the Bekaa Valley. Many people arriving here have suffered as a result of disrupted treatment for chronic diseases such as hypertension, asthma and diabetes. Those who stay in the region live in overcrowded conditions with host families or in scattered settlements in unheated abandoned or unfinished buildings, courtyards and tents. MSF worked in Baalbek, Majdel Anjar (West Bekaa), and Aarsal and Hermel (North Bekaa), providing treatment for acute and chronic diseases, as well as reproductive healthcare. Patients included Syrian and Palestinian refugees, and Lebanese returnees.

As winter approached, MSF began distributing blankets, fuel vouchers, washing kits and stoves to the most vulnerable new arrivals.

Teams also helped refurbish public buildings in Aarsal in order to accommodate new arrivals. Five buildings were finished by the end of the year, two of which were already sheltering Syrian families.


MSF works in the Shatila camp in Beirut, where many Palestinians from Syria have sought refuge, focussing on the basic and mental healthcare needs of children, pregnant women and patients suffering from chronic diseases. The team set up a system for supporting patients with emergency surgical needs, and refers them to two hospitals with which MSF has agreements.

A small team based itself in Southern Lebanon in February to provide basic healthcare for refugees. This project is ready to expand if there is another influx of refugees. 

At the end of 2013, MSF had 127 staff in Lebanon. MSF first worked in the country in 1976.

Patient story

Malak, 23 years old, Syrian refugee

My mother came yesterday with my two younger brothers from Qara. She had a very difficult journey because there was constant shelling on the way.

It took them 18 days to get here. They moved from one neighbourhood to another until it was safe for them to cross the border.

My husband and I took a van with our two children (four and two years old) 10 days ago.

People were calling on each other in all Qara to leave. The situation was going to be very dangerous. The first couple of days we didn’t move; we thought they were after young men for the army service.

But then we understood that even women and children would be targeted. So we left. 

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