The Reality of Women and Girl Refugees' Health in Lebanon - An underlying gender inequality issue

Opinion analysis by Aline Abou Chaar, Visiting Contributor

April 15th, 2022

“I work, I earn, I buy, I cook, I prepare, I feed, WE decide, but if he wants eggs… it should be eggs” – this intriguing quote uttered by a Syrian refugee woman in the Bekaa region portrays the control that men have as the heads of the household compared to women (El-Asmar et al., 2019). The phenomena of gender equality underlie equal prospects for both sexes, male and female, and envision equal rights economically, socially, culturally, nutritionally and politically with facilitated access to resources. Unfortunately, the reality of the middle-eastern society put all women and girls at a disadvantage, especially within the Lebanese population where around 1,349,955 are Syrian refugees, with over 50% of them being women and young girls (UNHCR, 2020; ICLA, 2016). Food insecurity is a common issue that leads to more complications in women at child bearing age compared to men, as it has severe effects on their children starting from the pre-embryonic stage to later on in life. A gender analysis of Syrian refugees released in 2021 claims that female-headed households are more food insecure (55%) than male-headed households (UN Women et al., 2021). According to the UN Women Regional Office for Arab States, it is difficult for 79% of Syrian female refugees to attend to their basic and household needs in Lebanon (UN Women, 2018). In addition, 45% of the women are unable to sustain an income, 10% are unable to secure basic needs such as shelter, while 6% cannot secure food, and 3% cannot secure water (UN Women, 2018).

Low Dietary Diversity and Food Insecurity

            Dietary diversity is accomplished when people have access to a wide variety of food which also suite their preferences; this diversity is not prevalent among the refugees across the Middle East. More specifically, the nutrition status of refugees in the Zaatri and Azraq camps in Jordan found that they are dependent on humanitarian aid from the World Food Program, and have a low intake of fruits and vegetables which are rich in vitamin A, as well as a low heme-iron rich food intake (UNHCR, 2016). In this case, females are put at an increased disadvantage as heme-iron deficiency is associated with premature birth and postpartum depression, while vitamin A deficiency affects the pregnancy during the third trimester with risks of preterm delivery and maternal anemia (Radhika et al., 2002; Mayo Clinic, 2019).

This forces parents to develop coping strategies to meet the needs of the household as they restrict their food intake and prioritize their children’s health, yet, males are favored due to the cultural traditions that men should join the labor sector to earn money, while women should work in the household. Low dietary diversity is predominantly faced by Syrian refugee mothers in Lebanon (63.3%) with a link to food insecurity at the moderate to severe level (34.4%), and severe level (12.5%) (Abou-Rzk et al., 2021). In addition, low income was related to low dietary diversity and food insecurity; this reinforces the notion that females are at a disadvantage as they earn 40% less than males (International Labour Organization, 2013).

Pregnant and Lactating Women

            Due to the economic crises in Lebanon, prices have skyrocketed, and this has a major effect on disadvantaged populations. Pregnant and lactating women who are affected by malnutrition are not only at risk themselves, but also, their children carry the burden which could determine their course of life. Females are more prone to iron deficiency anemia than males among Syrian Refugees in Lebanon; iron deficiency is prevalent mostly amid pregnant or lactating women (24.5%) which is also linked with anemia in children under five years of age (25.9%) (Tull, 2017). This issue could lead to complications that affect children at birth and later on in life as they could have low-birth weight and become stunted (Tull, 2017).

What can be done about this?

            Food insecurity continues to be a public health issue in the Syrian refugee community of the middle east – especially for women. To aid this situation, there are strategies that can be implemented to close the gender gap which will eventually enhance the nutritional status of women and the future generations – including men. An optimal situation is for women to become independently food secure. A reliable method would be to implement a program that provides courses on household knowledge and ideal diet practices, as well as decent hygienic and agricultural awareness campaigns. In addition, incorporating a program that provides educational and pragmatic skills on the different ways women can store and prepare food using the appropriate tools would be an effective approach. It is essential to note that although refugees are provided with tools and resources, most of the population would not reach out to utilize them. For instance, a report by UNICEF claimed that although malnutrition was screened for 182,000 pregnant and lactating women, only 1,400 of them received the appropriate treatment (Tull, 2017). To close this gap, awareness sessions can be held to ensure women have adequate knowledge on the importance of breast-feeding for their children later in life. Advocating for the gender gap also means challenging the traditional perspective and educating not only women, but also men, of the effects of inequality on women and their future children.

References

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UNHCR. (2020). Refugee population by country or territory of asylum - Lebanon. The World Bank. Retrieved December 10, 2021, from https://data.worldbank.org/indicator/SM.POP.REFG?end=2020&locations=LB&start=1960&view=chart.

ICLA. (2016, March). Women refugees in Lebanon and the consequences of ... - nrc.no. Norwegian Refugee Council. Retrieved December 10, 2021, from https://www.nrc.no/globalassets/pdf/reports/women-refugees-in-lebanon.pdf.

UN Women, UN High Commissioner for Refugees, UN Children's Fund, & World Food Programme. (2021, February 19). Gender analysis: 2020 vulnerability assessment for Syrian refugees in Lebanon developed in collaboration with UN Women - Lebanon. ReliefWeb. Retrieved December 10, 2021, from https://reliefweb.int/report/lebanon/gender-analysis-2020-vulnerability-assessment-syrian-refugees-lebanon-developed.

UN Women. (2018). Lebanon: UN Women - unpacking gendered realities in displacement: The status of Syrian Refugee Women in Lebanon - 2018. UNHCR Operational Data Portal (ODP). Retrieved December 10, 2021, from https://data2.unhcr.org/en/documents/details/72200.

UNHCR. (2016). Interagency nutrition survey amongst Syrian refugees in Jordan. SlideToDoc.com. Retrieved December 11, 2021, from https://slidetodoc.com/interagency-nutrition-survey-amongst-syrian-refugees-in-jordan/.

Radhika, M. S., Bhaskaram, P., Balakrishna, N., Ramalakshmi, B. A., Devi, S., & Kumar, B. S. (2002). Effects of vitamin A deficiency during pregnancy on maternal and child health. BJOG : an international journal of obstetrics and gynaecology, 109(6), 689–693. https://doi.org/10.1111/j.1471-0528.2002.01010.x

Mayo Clinic. (2019, October 25). Prevent iron deficiency anemia during pregnancy. Mayo Clinic. Retrieved December 11, 2021, from https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/anemia-during-pregnancy/art-20114455.

Abou-Rizk, J., Jeremias, T., Cocuz, G., Nasreddine, L., Jomaa, L., Hwalla, N., . . . Scherbaum, V. (2021). Food insecurity, low dietary diversity, and poor mental health among Syrian refugee mothers living in vulnerable areas of Greater Beirut, Lebanon. British Journal of Nutrition, 1-47. doi:10.1017/S0007114521004724

International Labour Organization. (2013). Assessment of the impact of Syrian refugees in Lebanon and ... International Labour Organization. Retrieved December 11, 2021, from https://www.ilo.org/wcmsp5/groups/public/---arabstates/---ro-beirut/documents/publication/wcms_240134.pdf

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