Coronavirus heightens mental health crisis in Lebanon's claustrophobic Palestinian refugee camps
"It is already a difficult situation in the camps," said Maha Hodroj, a clinical psychologist working with children and their families in camps and healthcare centres around Tyre in southern Lebanon. "The coronavirus situation is suffocating them even more."
Where she would normally expect to meet her clients in their homes or at healthcare centres, restrictions on movement and social distancing measures necessitated by the response to the pandemic have forced her instead to interact with them through her phone or her computer.
"We are giving them instructions on how to have a day-by-day plan, focus on the present and not think too much about the long term," Hodroj said, explaining that interactions with children and their parents might take place over a call, text message, voice note or video calls.
"Even though we aren't physically together we are assuring them that we won't leave them and we will stay in touch with them."
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Hodroj and her colleagues at the NGO Beit Atfal al-Soumoud, which provides a variety of healthcare and educational services across the Palestinian camps in Lebanon, have had to adapt their support to take into account a rapidly deteriorating economic situation.
The Lebanese lira has lost more than half its value in unofficial exchange houses due to a shortage of dollars, sending prices skyrocketing for everyday goods.
"We send small, quick and clear text messages to parents on how to take care of themselves and their children, even with what they eat - especially now with the increased prices of eggs, meat and food items. It's not only about mental health, now we are talking about basic needs as well," Hodroj explained.
While the country as a whole is in the grips of a financial crisis, Palestinians have been facing economic challenges stretching back years.
|It is already a difficult situation in the camps. Coronavirus is suffocating them even more
UNRWA, the UN agency tasked with providing support and services to Palestinians across the region, has struggled to meet its funding requirements since the administration of US President Donald Trump cut its contributions from $360m to zero between 2018 and 2019.
Furthermore, more than 20 professions in Lebanon are barred to Palestinians, who are limited to working jobs in construction, small crafts, and administrative positions.
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far from over
Their situation was exacerbated in the summer of 2019 when Lebanon's Ministry of Labour cracked down on businesses hiring foreign workers without permits, forcing many Palestinians and Syrians out of work.
Lebanon's financial crisis, which started to be felt around September last year, further depleted job opportunities. The ensuing wave of nationwide protests against government mismanagement saw roads sporadically closed by protestors across the country, making it more difficult for those that had work to reach their jobs.
Both the Lebanese economy and the Palestinian labour market were dealt further blows by the spread of Covid-19. Isolation measures have forced many into particularly challenging circumstances, according to Khawla Khalaf, a field coordinator for Beit Atfal al-Soumoud.
"The houses in the camp are very small. They consist of two or three rooms," she said. "Sometimes six, seven or eight members of the family are living in the same room, sometimes eating or sleeping the whole day in the same room."
"We cannot disentangle the socio-economic conditions from the risk of ill mental health," said Rabih El Chammay, the head of Lebanon's National Mental Health Programme who until 2018 worked as a consultant psychiatrist in one of the camps close to Tyre. The NMHP was launched in 2014 and set out to include marginalised groups such as Palestinians and Syrian refugees.
|While the country as a whole is in the grips of a financial crisis, Palestinians have been facing economic challenges stretching back years
The Programme's action plan to respond to Covid-19 included measures to assist those groups as well as Lebanese citizens. "The system that we're building to provide support for people in quarantine will be open to provide services for Palestinians in quarantine also," said El Chammay.
"Our role is to ensure that everyone is getting the care they need regardless of their nationality, their background, their religion, their political affiliation or whatever."
The coordination with the NMHP has so far proved positive for Beit Atfal al-Soumoud, which according to Khalaf, its field coordinator, makes good use of the additional support it provides. She is nevertheless uncertain about the road ahead.
"The situation is not clear in front of us, but it will be difficult. Staff are under stress, families are under stress," she said.
Finbar Anderson is an independent journalist based in Beirut, Lebanon. He was as a staff reporter for Lebanon's The Daily Star between 2017 and 2019
Follow him on Twitter: @andfinbar