Media Backgrounder: Protecting refugees in towns and cities across the Middle East – innovative operations but no durable solution in sight

As UNHCR calls for states, municipal authorities and mayors, humanitarian agencies and civil society to meet the challenge of growing refugee populations in towns and cities worldwide, the Middle East has proved an innovative showcase for future operations - although durable solutions are not on the horizon.

With as many as 50 per cent of the 10.5 million refugees under UNHCR's mandate now living in cities and towns, UNHCR's new policy challenges states, municipal authorities, communities, humanitarian agencies and civil society to recognize this new reality - and work together to respond. "The plight of refugees, IDPs [internally displaced people] and other persons of concern can no longer be treated as simply a UNHCR issue or a humanitarian issue," says UN High Commissioner for Refugees António Guterres.

Framing what will be a global debate on this issue, Guterres adds, "We should remember that refugees' human rights travel with them. They are entitled to the same protection and services in cities and towns that they have received in camps".

Protecting refugees in towns and cities remains the primary responsibility of national governments and local authorities, states the policy, and calls for a spirit of increased solidarity and shared responsibility.

Key role of mayors and municipal authorities

The challenge looks very different from region to region. Middle Eastern countries have responded with generosity towards Iraqi refugees. In some places, cities extend support to refugees across borders and within cities. Not all regions are as hospitable however.

"While the issue is global, conditions vary greatly from region to region and so much depends on a local response. That's why, as well as working at government level, we are highlighting the roles of mayors and municipal authorities as being pivotal. We look to them in particular to help build understanding and cooperation between refugees and the local population on the ground. They can make a big difference," says Guterres.

When over two million Iraqis fled sectarian violence in their home country, the great majority took up residence in regional cities, including Damascus, Amman and Beirut. Syria, Jordan and Lebanon, though not signatories to the 1951 Refugee Convention, responded with generous admission policies. This generosity together with international support helped enormously. But the scale of the exodus, the urban setting and the atypical profile of the refugees posed new challenges for UNHCR.

Setting up shop in cities - new ways to reach out to refugees

Government cooperation and good levels of funding enabled UNHCR to deploy resources quickly in setting up efficient reception facilities. Within two years, the organization had registered over 350,000 Iraqis and referred more than 80,000 for resettlement.

Working in towns and cities, though, presented a basic challenge: how to make contact with refugees, determine their needs and identify the most vulnerable. Iraqi refugees were scattered amongst a much larger urban population across large areas. Some were immobile because of illness or family commitments, while others lived long distances from UNHCR's offices.

In response, UNHCR has adopted a number of new and proactive approaches. In Syria, mobile registration was used for the first time to register refugees living outside Damascus. In Damascus, and Jordan, UNHCR deploys refugee women as Outreach Volunteers, identifying and visiting vulnerable refugees and referring them to UNHCR as necessary. UNHCR has also set up a number of community centres where Iraqis, other refugees and members of the local population can come together, access services, information and advice, and socialize.

UNHCR used technology to communicate with refugees. With the great majority of refugees having mobile phones, the organization was able to call or send them SMS messages. In Syria, refugees had access to an interactive website providing them with information about food distribution. In all UNHCR facilities, flat-screen TVs are used to show videos with information about refugee rights and entitlements. In Syria and Jordan, a UNHCR information hotline has been set up, and information booklets are published in Arabic. In Syria, with many Iraqis listening to music on radio and TV, UNHCR launched communications with well-known Iraqi musicians to generate trust and confidence.

UNHCR has undertaken polls and surveys to gain a deeper understanding of the refugee population. Results have underlined the challenge that confronts UNHCR in seeking solutions for the refugees - as of 2008, some 90 per cent of refugees interviewed stated no immediate intention of going back to live in Iraq.

New ways of providing assistance

UNHCR is providing assistance in a number of ways in Jordan, Lebanon and Syria, providing food, cash payments, household items, sanitary materials, school uniforms and stationery. Again, UNHCR has been able to use innovative methods to support the distribution of assistance. In Jordan and Syria, UNHCR has introduced a scheme enabling eligible refugees to withdraw their cash from ATM machines where and when they choose. The scheme has proved effective and low on overhead costs - and is liked by refugees. In Jordan and Syria, UNHCR provides assistance updates to refugees through mass SMS messages. In Damascus, the information is posted on an Arabic-language website. A telephone hotline has been established in both Jordan and Syria to answer any queries that refugees may have concerning the assistance programme. In Damascus, mini-trucks transport refugees and their food from the main distribution centre at Douma to different neighbourhoods in the city. Moreover, a large number of women refugee workers have been mobilized to reach out to the most vulnerable among the refugee communities in Jordan and Syria and to help bring their plight to UNHCR's attention.

Responding to complex health needs across three countries

The profile of the refugee population differed markedly from the norm. Largely well educated and coming from professional jobs in Iraq, their expectations of life in exile have been high. With their dramatic decline in social status, and many having been victims of violence, mental health factors have been significant. Because they are not officially allowed to work, men can no longer be the family provider and as a result feel emasculated. A relatively large proportion is elderly or has complex medical problems. Many suffer physical disabilities or trauma.

In Jordan, Lebanon and Syria, UNHCR has been able to provide financial and infrastructure support to existing national health services which are then accessible to refugees. Iraqis have for years had access to the health care systems of countries in the region and their expectations regarding health care, in particular, are high.

UNHCR has had to develop strategies for addressing more complex health needs than previously encountered - for example, hypertension, diabetes and cancer. In addition, many Iraqi refugees suffer from psychological and emotional problems because of trauma and difficulties faced in their asylum countries. Services provided to Iraqi refugees are more sophisticated when compared to other urban refugee situations, and include tertiary health care as well as mental health, optical and dental treatment. To manage this complexity, UNHCR has appointed dedicated medical coordinators and health committees to assess and approve referrals for more costly treatments.

Monitoring the health needs of large and scattered refugee population has been a particular challenge - and in Syria, UNHCR is working with the Syrian Arab Red Crescent on piloting a system especially designed to do this. UNHCR is also looking into providing health services through health insurance schemes where these are already in place for the local population. As with the ATM delivery mechanism, the approach has low overhead costs and enables refugees to access services in a dignified way.

State education available - but drop-out rates point to an uncertain future

Large numbers of Iraqi children have moved with their families to Jordan, Syria and Lebanon and have been admitted to national schooling systems. UNHCR has helped these countries through school rehabilitation and reconstruction programmes, through providing school equipment and materials and by covering the costs of school uniforms.

Educational needs of Iraqi refugees have differed from country to country. While Syria has accepted increasing numbers of Iraqi pupils and students, attendance rates have been limited by the need for young people to earn money and by difficulties in following the Syrian curriculum after being out of school for some time. In Lebanon, the state system has welcomed refugee children - over 80 per cent of children between four and 17 are registered - with UNHCR providing education grants, school kits and winter clothing coupons. As in Syria, though and for the same reasons, drop-out rates are high.

There is a significant risk that Iraqi refugee children and adolescents are growing up as a lost generation robbed of potential and unable to live up to the high ambitions their parents may have for them.

Durable solution not in sight - lives remain in limbo

Though great progress has been made in meeting the most pressing needs of Iraqi refugees, a durable solution to their plight is not yet in sight. Real difficulties persist. Most Iraqis can only find informal work, and risk exploitative, dangerous working conditions. The income and assistance they receive is barely adequate to pay for high rents and everyday expenses. Some refugee children and young people claim they are discriminated against by classmates and teachers, with many dropping out of school to earn money for the family. The Iraqi refugee community remains divided, fearful and traumatized. Most are unwilling to return home, but do not have any immediate or realistic prospect of an alternative solution. As a result, their lives are very much in limbo.