Inflammation and stories on Lebanon

Vaccine Inequity
At the height of the pandemic, the critical global message was “no one is safe until everyone is safe.” It referred to the common-sense view that vaccinating everyone was the only way to control COVID-19. However, vaccine inequity among the stateless presented a barrier to raising global vaccination rates.

In countries such as Montenegro, Lebanon and the Dominican Republic, vaccine inequity among the stateless was characteristic of the exclusion and marginalization that stateless people typically experience for reasons ranging from politics to discrimination. Other major reasons include administrative issues stemming from affected individuals lacking specific documentation.

Stateless people have historically suffered unequal access to health care due to systems that provide services based on nationality and faced disproportionate impacts of the COVID-19 pandemic. Vaccine inequity among the stateless presented a further devastating blow for some of the world’s most vulnerable people.

Vaccine Inequity in the Dominican Republic

Vaccine inequity among the stateless in the Dominican Republic existed due to a policy decision to exclude the affected individuals. In 2021, the president announced that only Dominicans would be included in the COVID-19 vaccination rollout, thus excluding illegal migrants or stateless people. The problem of discrimination and anti-Haitianism directed toward those born Dominican has been historically rife in the country. In fact, an overnight and discriminatory court decision in 2013 revoked the citizenship of Dominicans of Haitian descent. The court ruling stood as another example of furthering discrimination, even if it ran counter to the public health imperative.

However, several community responses echoed in unison to drive positive change. A community-based organization in the south of the country held persuasive talks with local government officials to convince the officials to consider residency status, name and age as sufficient for vaccination. Eventually, the localized vaccination distribution meant that some Dominicans without documentation could receive their shots.

Moreover, the Caribbean Migrants Observatory, a body set up in 2009 to facilitate migration and social development, also stepped in. Apart from developing the first migratory profile of the Dominican Republic, its advocacy talks with government officials led to a reversal in discriminatory vaccine policy and a subsequent commitment to universal vaccine access in the country.

Vaccine Inequity in Montenegro

Vaccine inequity has also affected the Roma community in Montenegro. A population at risk of statelessness, members of the Roma community face high fees for health care access during non-pandemic times. This is because Roma people are not on the official records for government health programs as they lack the required documentation.

The directive in the first stages of the vaccination rollout held that stateless people would be last in line to receive vaccines despite living in densely populated areas with significantly high risks of contracting the virus. Fortunately, following advocacy by the community-based organization Phiren Amenca, which emerged in 2012 to advocate for the rights of the Roma community, the new government changed the policy.

The government placed community members in a priority group, adding that all residents, regardless of citizenship status and health insurance, could receive the vaccine. Further clarifications revealed that this new development also included those in the process of resolving their legal status and those without legal documents. Phiren Amenca has also succeeded in extending the deadline for the registration of Roma people. A Roma doctor also visited a settlement to educate the community on the importance of vaccination and to deliver vaccine shots.

Vaccine Inequity in Lebanon

Vaccine inequity among stateless people in Lebanon existed primarily due to administrative issues. Oummal, a community-based organization set up in 2010 to provide universal health coverage that includes stateless people, had an eye-opening discovery. It found out, through community interviews, that stateless people could not register to receive the vaccination as no category existed for ‘no nationality’ on the registration portal. Furthermore, a lack of awareness about the importance of vaccination alongside fears of hospitalization and its associated costs stood as issues.

Oummal advocated for the inclusion of a ‘no nationality’ category on the registration platform. The organization set up a vaccination hotline for inquiries on documentation and vaccination. It also accompanied people to get their documents and receive vaccinations. Lastly, another resolution came about by waiving hospitalization costs for stateless people after meetings with the Ministry of Health. Oummal supported about 1,500 people, 1,068 of whom registered for vaccinations. The dedicated hotline for stateless people received 134 calls and the organization recorded 63 cases to follow up on regarding documentation and vaccination.

Advocacy and Community Work

Stateless people suffer from exclusion and discrimination, but the costs of exclusion during a global pandemic are far higher. Several countries excluded stateless people from accessing vaccines due to discrimination, lack of documentation and administrative issues. However, the influence of community work and advocacy resulted in the vaccination of many stateless people.

– Ottoline Spearman
Photo: Flickr

Maternal Mortality Rates in Lebanon
The economic crisis in Lebanon, during which the pandemic worsened, has pushed more than 80% of the population into poverty, leading to high costs of living and decreased health care quality for mothers-to-be. Lebanon previously succeeded in reducing maternal deaths, but these rates have tripled over the last few years. Therefore, there is an urgent need to act to reduce maternal mortality rates in Lebanon. However, the Lebanese Order of Midwives, with support from the United Nations International Children’s Emergency Fund (UNICEF), is leading an initiative to provide vulnerable mothers-to-be with door-to-door emergency health care.

Lebanon’s Downfall

Lebanon experienced an economic crisis followed by the pandemic and the Beirut port explosions that led to massive unemployment and poverty for families throughout the region. According to UNICEF, 84% of households did not have enough money to cover fundamental necessities in 2022 and 23% of children went to bed on an empty stomach.

Additionally, Lebanon’s insufficient supply of foreign currency meant the government could not secure essential medical supplies and resources. The government’s inability to pay debts owed to hospitals also impacted health care services. As a result, Lebanon could not provide critical maternal and child health care services.

The Health Impact

Amid several concurrent crises in Lebanon, a rapid assessment, which UNICEF conducted in March 2022, showed a “12.6[%]drop in maternal bed capacity, with the Bekaa and Baalbeck Hermel (BB) governorates the worst affected at 28.6[%], followed by Beirut and Mount Lebanon (BML) at more than 25[%].

Furthermore, hospitals’ availability of pediatric intensive care unit beds decreased by 12% and the availability of newborn intensive care unit beds dropped by 5.5%. The decreased capacities arose as a consequence of the massive exodus of health care workers between 2019 and 2021 due to the economic instability in the nation.

Lebanon’s economic crisis pushed 40% of doctors and 30% of midwives to leave the country from October 2019 to September 2021, significantly decreasing the health care system’s efficiency. As a result, the medical system became overburdened and hospitals had no choice but to deny some medical care.

In October 2021, UNICEF declared that the number of neonatal deaths among refugees in Lebanon increased from 65 in the first quarter of 2020 to 137 in the third quarter across four different provinces. Additionally, a third of the children did not have access to health care in October of the same year. Lastly, transportation costs rose from a lack of subsidies and high fuel costs, impacting the ability of low-income pregnant women to reach the health centers. Therefore, after progress in reducing maternal deaths to 13.7 in 2019, maternal deaths increased to 37 per 100,000 live births by 2021.

The Lebanese Order of Midwives and UNICEF

UNICEF began supporting the Lebanese Order of Midwives council in November 2022. The council sends midwives to aid in the deliveries of pregnant women in the most at-risk areas of the country. The midwives go door-to-door and serve as emergency aid for the women. The council has already hired 57 midwives and plans to employ 300 more local community-based midwives to travel throughout the country until 2025. The council will primarily target women who hesitate to reach out for maternal care and need the service to identify early complications. Additionally, UNICEF will pay the cost of hospital transportation for the women if a case becomes too complicated for the midwives.

The rise in maternal mortality rates in Lebanon represents a regression in the country’s health care progress. Nevertheless, by funding local initiatives, international humanitarian organizations serve as valuable partners for solving pressing global issues in the most impoverished communities.

– Andres Valencia
Photo: Flickr

Rule of Law in Lebanon
Once dubbed the “Paris of the Middle East,” Beirut, the capital of Lebanon, was well-known for its vibrancy. It comprised culture, music, art and a spirited social life inspired by France after it gained independence in 1943. Until 1975, Lebanon was in a state of peace and prosperity and it was a popular tourist destination and center for international trade. While that all changed when a 15-year-long civil war raged on and completely changed the governance of the nation socially and politically, the Lebanese people never lost their celebrated resilience.

About the Rule of Law in Lebanon

The aspiring future of Lebanon was heavily altered after the 15-year civil war of 1975 that left Lebanon in a rather unique state of fragility. While the nation had both an open political system and economy after gaining independence from the French, with low poverty levels compared to others in the region, the War greatly impacted Lebanon’s sense of safety, political regimes and infrastructure. Thus, in efforts to rebuild the state and end the war in 1989, the government signed the National Reconciliation accord in Taif, Saudi Arabia.

Notably, the amended Lebanese Constitution that followed called for establishing a constitutional court and enhanced the power of the Sunni Muslim Prime Minister, Rafic Hariri, over the Maronite Christian president and the Shi’a Muslim speaker of Parliament.

This judiciary structure and political system of Lebanon, which both French and Ottoman models inspired, had a multi-confessional structure. It called for equality before the law and equal representation of Lebanese civilians, protecting their freedom of religion, and respecting rights for the Cabinet to act as a mechanism for fairness between the religions. Furthermore, it also allowed the Syrian forces that remained in Lebanon as a result of the Syrian occupation of 1976 to stay in the country as a stabilizing force.

However, it suffered significant division following the war, as warlords began holding seats in Parliament after a national amnesty in 1990. There were also exchanges of personal benefits between the government and parliament, and conflict over sectarian interests that deeply impacted the rule of law in Lebanon. Despite this, Lebanon still managed to see five prosperous years starting in 2000, until the assassination of Prime Minister Hariri in 2005.

The Way This Has Impacted the Nation

The year Prime Minister Hariri was assassinated, the Syrian occupation ended, and thus, Syrians received permission to remain in Lebanon and increase their military power. Because of this, they began interfering in Lebanese political affairs, and a series of events followed that included continuing assassinations, a war between Israel and militant group Hezbollah, Hezbollah’s retaliation and their invasion of Sunni areas in Beirut as well as further religious showdowns, corruption and economic mismanagement.

The Lebanese government’s structure meant that it needed to include all factions, which led to leaders monopolizing their shared power amongst themselves, and then using that power to pursue their own agendas and interests, allowing for sectarian divide. This political unrest and breach of Lebanon’s security, as well as threats from neighboring countries, severely rattled rule of law in Lebanon.

Thus, Lebanon grew to become the most indebted country after the assassination of Prime Minister Hariri, as the nation became financially reliant on internal and external borrowing. Lebanon was unsuccessful in producing long-term economic growth, despite the fiscal, monetary and central bank policies that attempted to reduce its deficits.

With this debt and other economic disasters, the political structure of Lebanon adopted a clientelist structure as the productive sector only favored elites, making the economy unproductive and undiversified, worsening poverty levels and deepening inequality. In 2020, the top 10% of Lebanese workers received 56% of the total income earned from 2005 to 2014 and the lowest 50% of the population received only 11%.


All the political unrest amongst leaders in government created an ethnoreligious identity and social dynamic that formed multiple political parties, creating a strong sense of community amongst the people and militias who support each other despite contributing to an insurgency in the country.

In October 2019, citizens across Lebanon stormed Beirut streets as they protested against a tax on WhatsApp calls, which was meant to act as one of Beirut’s solutions to combat economic pressures. However, these protests eventually turned into nationwide protests that lasted for months, as the Lebanese people saw these tax measures issues as only favoring the elite at the expense of the lesser privileged middle class.

This shows that hope still exists for the future of Lebanon, as Lebanese people have taken measures to improve the rule of law in Lebanon. Following the protests in October 2019, Lebanon saw an increase in community-based and grassroots networks, as well as public mobilization, looking for peaceful change. After the explosion in Beirut in 2020, for example, youth groups, women’s networks and Chief Starting Officers joined together to assist vulnerable families and keep community tensions under control, as well as tackle the spread of fake COVID-19 news.

Among these initiatives is the Grassroots Lebanon Non-Profit Organization (GLNPO), a network of Lebanese citizens looking to take action into their own hands to improve the standards of living that Lebanon’s fragility impacted. GLNPO encourages a sense of belonging and looks to promote a high sense of solidarity and agency among the community by tackling poverty, improving education, providing medical support and raising awareness of a number of issues impacting society. So far, GLNPO has provided relief after the Beirut explosion in 2020, distributed aid to schools and hosted cultural events among many other projects that aim to benefit the future and people of Lebanon.

– Noura Matalqa
Photo: Flickr

Cholera Outbreaks in Lebanon
As of November 4, 2022, Lebanon has reported 18 deaths and more than 400 others infected with the notoriously contagious digestive disease, cholera. The World Health Organization (WHO) has classified the disease as a global threat to “public health.” Because the disease is so virulent, it has the ability to affect hundreds of people at once if spread through sewer and water systems within a community.

Current State of Lebanon

Since July 2021, the economic crisis in Lebanon seems to be one of the worst in the world since the 1800s. Banks are beginning to freeze withdrawals. As hospitals and pharmacies began to run out of medication and services to provide patients, the health of not only the people but also the economy began to take a dark turn. As of 2020, approximately 1.7 million refugees could be residing in Lebanon in extremely close-contact, low-budget camps. Furthermore, as of late 2019, “approximately three-quarters of Lebanon’s population” lived below the poverty line.

What is Cholera?

Cholera is a disease that spreads through the ingestion of food or water contaminated with the bacterium. The disease causes infected persons to experience a harsh acute diarrheal infection, eventually leading to severe dehydration. It can kill in hours if left untreated. The World Health Organization has reported that cholera transmission is “closely linked to inadequate access to clean water and sanitation facilities.” Commonly referred to as a “disease of poverty,” cholera outbreaks typically affect the world’s poorest people due to a lack of public sewage systems. As a result, human waste can mix with water that people use for drinking and cooking.

Cholera Outbreaks in Lebanon

After almost 30 years without a single case, cholera has re-appeared in Lebanon following a recent outbreak in Syria. Syria has recently reported more than 20,000 suspected cases and 75 deaths. There has been a high influx of Syrian refugees traveling to Lebanon. Consequently, the transition of the disease most likely occurred because of high population densities within the refugee camps. Reporter Daniel Stewart writes that the increase in cholera outbreaks is “mainly due to increased flooding, drought, conflict, migration and other factors affecting access to clean water.”

A Disease Linked to Poverty

In his research published in the National Library of Medicine, Arturo Talavera wrote that cholera outbreaks are key indicators of social development within a region. Cholera outbreaks remain a serious challenge in countries where people do not have assured access to safe drinking water and adequate sanitation. Talavera explained that cholera outbreaks affect low-income countries more than middle or high-income countries. Economic development is an important factor in determining how deadly an outbreak may be.

Solutions to the Cholera Outbreaks in Lebanon

Thankfully, France is delivering vaccines to Beirut. However, the World Health Organization warns that if not curved soon, the disease may begin to spread more rapidly. French Ambassador Anne Grillo explains that the recent cholera outbreaks in Lebanon are “a new and worrying illustration of the critical decline in public provision of access to water and sanitary services.”

The key to stopping cholera outbreaks is to provide communities with water security. Furthermore, vaccines can drastically curve the contraction of the disease. As more than 13,000 doses have already arrived in Lebanon with more to come, hopefully, Lebanon will be able to halt the spread of the disease with the help of foreign aid.

– Opal Vitharana 
Photo: Flickr

National Poverty Targeting Programme in Lebanon Lebanon’s first “poverty-targeted social assistance” program, the National Poverty Targeting Programme (NPTP), created in 2011, works to directly impact impoverished households in Lebanon. Lebanon’s Ministry of Social Affairs (MoSA) and the Presidency of the Council of Ministers (PCM) established the program.

The NPTP’s Partnering Organizations

The NPTP in Lebanon works alongside various other outside humanitarian organizations, including the World Food Programme (WFP), the World Bank and the UNHCR. The WFP, specifically, has been working alongside the NPTP since 2014,  supplying food-restricted money transfers, “redeemable in WFP contracted shops.”

Problems Facing Lebanon

The money transfers are valued at $20 per person per month along with a supplement of $25 per household per month. This benefit has been especially useful for the country’s most vulnerable populations who are struggling amid rising food prices and other economic challenges. Specifically, the Lebanese pound has dropped in value by nearly 95% since 2019 resulting in a severe increase in the cost of living. Additionally, the gross national income of Lebanon has decreased by over 50% in the last four years.

As purchasing power falls and the cost of living rises, the number of affected households does too. By the end of 2021, over 50% of the population required assistance to access basic needs. By the second half of 2021, food insecurity in Lebanon reached nearly 50% and severe food insecurity doubled, according to WFP Lebanon.

Some Statistics Regarding the Affected Population

Of the total 237,000 recipients of the NPTP’s support in 2022, over 10% are illiterate and were never enrolled in an educational institution. Over 34,500 recipients of aid are disabled to an extent. Additionally, less than 6% of beneficiaries own a car and 99.7% of beneficiaries do not own a computer. Nearly 60% of beneficiaries do not own their current place of dwelling.

According to the UNHCR, of the estimated 1.5 million Syrian refugees living in Lebanon and 90% of them live in extreme poverty.

Successes of the NPTP to Date

According to statistics published by the NPTP in Lebanon, the program directly benefited roughly 430,000 households in 2022, including 11,000 people above the age of 64 and 22,500 children 5 years and younger, according to the Presidency of the Council of Ministers.

Along with assistance provided by the WFP, as of October 2022, the NPTP in Lebanon has reached 64,000 households with monetary transfers and expects to reach as many as 75,000 by the end of the year. This is a significant increase in distribution since the inception of this collaboration, compared to 2014 when only 5,000 households received assistance from the NPTP.

The UNHCR has also aided the NPTP in Lebanon by providing shelter rehabilitation support to the most severely affected people.

How the NPTP Continues to Improve

Importantly, the National Poverty Targeting Programme in Lebanon has not only increased the scale of its assistance since 2014, but it has also worked to ensure that the method of assistance remains the most effective for those in need. For example, because of the current economic crisis, the MoSA has modified the traditional method of food assistance from the distribution of food baskets to food-restricted cash, as providing higher-value cash allows beneficiaries to purchase more food over a longer period of time, WFP Lebanon reports.

– Chris Dickinson
Photo: Flickr

Rural Delights in Lebanon
The Lebanese non-governmental organization (NGO) Atayeb-Al Rif or Rural Delights in English, is committed to rural development and economic opportunities for women in Lebanon. Since its founding with the funding of USAID, Rural Delights in Lebanon has partnered with worker cooperatives to employ women in processing traditional Lebanese treats and trinkets such as jams, syrups, dried fruits, honey, olive oil and molasses. The organization also offers business training to Lebanese women as part of its services.

About Rural Delights

In an interview with The Borgen Project, May Traboulsy, Chairperson at Rural Delights, commented on its mission of economically empowering Lebanese women; “Our mission focuses on empowering women socio-economically, but also touches on other players in the sector of food processing, such as farmers and refugees, through productive activities as food processing, while enhancing women’s role at the level of their communities as well as at the level of relevant value chains.”

Rural Delights in Lebanon and its emphasis on job opportunities for women could be a welcome step to alleviating national poverty especially as the country is experiencing negative economic growth. The country’s unemployment rate as of 2021 stands at 14.5%, while inflation skyrocketed to 154.8% in the same year.

The alarming economic situation in the country underscores the importance of organizations such as Rural Delights and how they can contribute to alleviating the economic situation in the country by creating economic opportunities for women, a largely untapped resource in the Lebanese economy. Lebanon’s female labor participation rate stands at only 24.5% as of 2021.

Rural Delights in Lebanon, therefore, plays an important role in the economic empowerment of women to reduce poverty through the creation of economic opportunities and entrepreneurial skills Rural Delights in Lebanon focuses on. Traboulsy commented on the importance of women’s economic participation in the same interview by stating that “AAR considers that when women are capacitated to become productive members within their society, this, in turn, provides them with empowered tools that could elevate their livelihood, improve resilience and therefore reduce poverty by translating women’s actions into income-generating activities.” Rural Delights in Lebanon has not only committed itself to reduce poverty through increased female labor participation but its current activities on the ground have achieved concrete results.

The Biocoop Program

Rural Delights in Lebanon has initiated a number of projects achieving concrete economic gains for women in business. The Biocoop program, which USAID funded, has focused on vocational training for women. This project aimed to increase labor skills for women in food processing, hygiene, general health practice, good manufacturing practice and marketing practice. Such a program can reduce poverty through the skills it offers women to succeed in business generating more income-earning opportunities and higher living standards over time.

The Stimulating Markets Program

Rural Delights in Lebanon also launched the Stimulating Markets program from 2002-2006 with funding from USAID. This project meant to create more food processing centers for women to work in and boost production, benefiting 2,500 rural Lebanese women and 36 rural communities. The project also achieved the establishment of 37 food processing centers and five production farms, expanding economic opportunities for women in the process to contribute to poverty reduction.

The Sustainable Opportunities for Fair Trade Project

Rural Delights in Lebanon has not only focused on the establishment of businesses that create opportunities for women but also implemented programs to ensure they remain competitive in the national and regional economy in the long term. The Sustainable Opportunities for Fair Trade project, with funding from the Middle East Partnership Initiative, worked with 22 female worker cooperatives in Lebanon to promote entrepreneurial skills and business acumen for women. The project featured training on managerial work, fair trade practices, international norms and standards, supply management, purchase of production equipment and participation in local and foreign food shows to prepare women to compete in the national and regional economies.

Traboulsy commented on the project and its aims by stating that “In that project, 14 food-processing cooperatives and 8 small-to-medium entrepreneurs were targeted. The project aimed to reduce the producers’ cost of production, expand their market linkages and enhance their know-how and practice in product/ business development.” Such a project shows how Rural Delights in Lebanon has committed itself to both creating opportunities for women itself and going beyond to ensure women possess the skills to succeed and grow their businesses in the long term with respect to the food processing industry being the most productive and contributing to poverty reduction.

The Promoting Sustainable Livelihoods Project

Rural Delights in Lebanon has two major projects currently underway that will conclude at a later date. The first is the Five Year Project (2020-2025), called Promoting Sustainable Livelihoods Project. Traboulsy commented on the project and its goals by stating; “This project is funded by USAID and aims to improve the livelihoods of residents of target municipalities across Lebanon by improving and/or upgrading existing assets through training, technical assistance, infrastructure rehabilitation, and access to markets. The project’s goal is to improve the livelihoods of 31,500 households across 105 municipalities in the North, Bekaa, South and Mount Lebanon areas.” Such a project underscores Rural Delights’ commitment to promoting the sustainability of women-led businesses and workers once opportunities are first created to ensure maximum productivity in the long term to reduce poverty.

The Women’s Economic Empowerment Project

The second project, which launched in 2019 and will last until 2022, is the Women’s Economic Empowerment Project. It received funding from Canada and in partnership with the Maowad Foundation. This project aims to further promote economic opportunities for women and raise awareness about the importance and value of female labor participation in economic development and poverty reduction.

Traboulsy commented on the goals of this project by stating that “The WEP project aims to (1) Increase local awareness and support to women’s rights, notably economic empowerment and right to decent work, (2) boost local recognition of women’s role in non-traditional economic development and (3) foster competences of local women, individuals and groups, to access the market based on competitiveness and innovation in selected value chains.” This project further shows Rural Delights’ goal of promoting the role of women in the economy and recognizing its importance for poverty reduction by achieving higher living standards and more economic development overall when half of a country’s population is part of the workforce.

Rural Delights since its creation in 2002 has launched a number of ambitious projects that have created economic opportunities for women previously unavailable in Lebanon. Given the economic problems Lebanon is experiencing, Rural Delights is providing opportunities at an important time and improving the quality of life for Lebanese on the ground who its activities impacted. As a nonprofit, it can serve as a testament to the importance of a vibrant civil society to have NGOs on the ground doing the work to reduce poverty and improve quality of life, and to have an environment where more NGOs can thrive and accomplish similar goals to reduce poverty.

– John Zak
Photo: Flickr

Empowering Lebanese Women
The Beirut explosion in August 2020 underlined the symptoms of poor governance and political polarization embedded within Lebanese politics. The explosion resulted in eminent human and material costs amid economic deterioration and social unrest, which the COVID-19 pandemic further exacerbated. The ramifications of hurting stalemate and a global pandemic particularly impact women amid increased inequality pertinent to income and opportunity. For this reason, empowering Lebanese women is critical.

Issues Lebanese Women Face

Unemployment during the pandemic disproportionately affected Lebanese women as women experienced layoffs at a greater rate than men and faced greater wage cuts, further reinforcing discriminatory practices and income disparities. According to the World Economic Forum’s Gender Gap report of 2021, Lebanon ranked 132 among 158 countries in terms of gender inequities.

Period poverty is one of many manifestations of the economic conditions impacting Lebanese women. The local non-governmental organization Fe-male projected that by December 2020, more than 50% of women in Lebanon experienced period poverty as a result of the price of sanitary products surging by 500%, highlighting the primacy of empowering Lebanese women and promoting income equality.

Empowering Lebanese Women on a National Level

To empower Lebanese women and support women-led cooperatives and income equality, U.N Lebanon, through the support of partners, mobilized around $4.4 million worth of funding. Through this effort, U.N. Lebanon delivered support to 94 different cooperatives across varying Lebanese villages, including Deir Al Ahmar and Qana. The project supplies such cooperatives with the necessary equipment, raw material and cash to sustain their operations, especially in light of the pandemic and multiple other crises in the country.

The project has reinforced the financial resilience of a minimum of 6,000 individuals, further strengthening income equality and inclusive growth. Such projects empower Lebanese women as these efforts establish job opportunities in a country where many women struggle to access employment. This is evident in World Bank data from 2019 where 14.3% of the female labor force endured unemployment in comparison to 10.2% of males.

A Specific Outlook on Al Atayeb Cooperative

Al Atayeb, “a Lebanese women-led cooperative based in Kfardebian town, north of Beirut,” produces traditional Lebanese food, such as fruit jam and the traditional Lebanese makdous. Samira Zoughaib Akiki is the chairperson of Al Atayeb cooperative and has about 20 years of experience in the food industry.

During her career, Akiki ran “food processing workshops and training sessions for women,” U.N. News reported. This inspired her to launch the Al Atayeb cooperative to create employment opportunities for other women. She tells U.N. News, “Teaching food processing skills was my way of empowering women.”

Today, the cooperative consists of 13 women whose primary responsibilities entail processing and preparing food. These women receive both salaries and profit shares as financial compensation for their work. The cooperative purchases its ingredients from local farmers as another way to uplift communities.

With the emergence of COVID-19, Akiki sought support from the U.N. to maintain financial capacity. “This addressed our financial needs, replenishing our capital and compensated our losses: we were able to resume our activities at a time when many businesses were shutting down,” Akiki told U.N. News.

Empowering Lebanese women in these ways contributes to greater income equality and equal employment opportunities. In times of political and economic struggle, it is important to sustain support and efforts such as U.N. funding can go a long way in promoting economic security for women.

– Noor Al-Zubi
Photo: Flickr

Step-by-Step ProgramIn the battle against poverty, health care stands as an important factor in improving the lives of individuals. One aspect of health that people often overlook due to the precedence of immediate needs, lack of resources or social stigma is mental health. With the onset of the COVID-19 pandemic, which forced society to increasingly interact virtually, and unstable situations in countries where long-term access to trained professionals may not be an option, communities welcome a virtual service that offers mental health support. The program called Step-by-Step is making a difference to mental health in Lebanon.

Step-by-Step Program

In recent years, the World Health Organization (WHO) has prioritized mental health services. It extended its Mental Health Action Plan (2013-2020) to the year 2030  in hopes to increase coverage and services related to mental health.

The WHO created Step-by-Step in 2015 with numerous partners such as the Ministry of Public Health Lebanon and Fondation d’Harcourt. The program serves Lebanon, particularly Syrian refugees.

The goal of the program is to address disparities in treatments in low and middle-income countries. A virtual option for seeking mental health support offers a private self-guided space without societal judgment and potentially reaches larger groups in areas with internet connection but no professional treatment facilities.

A program called the WHO’s Problem Management Plus preceded the current version of Step-by-Step. This initial system targeted a range of mental health issues and provided treatment using a facilitator. The current Step-by-Step program utilized the feedback from the Problem Management Plus program. Step-by-Step now mainly targets depression and focuses on simple, adaptive “behavioral activation” as a means of treatment.

Mental Health in Lebanon

The Step-by-Step program began in Lebanon where there remains a high disparity in accessing and receiving mental health treatment. The disparity is due to a lack of resources, a high influx of refugees and social stigma. Lebanon is a Middle Eastern country located along the coast near the Mediterranean Sea. It borders Syria and Israel, and therefore, sees a large influx of Syrian refugees. The WHO hopes to address problems with mental health in Lebanon through the new digital model that is customized for the various groups in Lebanon.

The WHO and partners completed two randomized control trials with the Lebanese population and Syrian refugees, respectively, and found successful outcomes for addressing mental health issues. After the completion of the trial, the WHO partners continued to provide the service to the larger population of Lebanon in order to gather more data before implementing the program elsewhere.

Current Challenges

In the past, Lebanon experienced political and economic hardships and the onset of the COVID-19 pandemic worsened the situation. The Beirut explosion in August 2020 also exacerbated issues related to health and mental health in Lebanon. Currently, due to the combined effect of these problems, there is a shortage of medicines to treat mental health disorders. Due to the lack of supply, medication grew increasingly expensive in recent years. As 74% of Lebanon faces poverty, according to U.N. data from September 2021, the limits to access to treatments for physical and mental health in Lebanon are progressively more worrying.

Similarly, due to the proximity to Syria, the refugee crisis significantly impacts Lebanon, bringing in many refugees that also need access to mental health services in Lebanon. Internal events within Syria resulted in 13.4 million Syrians facing displacement, and inevitably, the traumas associated with the violence of the country. Prior research studies indicate higher risks for mental disorders among refugees, especially women and children. Estimates from the beginning of the Syrian crisis indicate that more than 2 million people in Syria struggled with depression and anxiety.

Step-by-Step for Syrian Refugees

The WHO and partners completed the Syrian randomized control trial in the initial research of Step-by-Step in December 2020, with positive results that mirrored the trials of the Lebanese civilians. Out of the 569 Syrian adult participants in the trial, women accounted for 58.3% of these participants, a notable factor considering the prior knowledge of the effects of mental health on women and children.

Participants accessed the program using mobile devices or web browsers. The Step-by-Step program consists of “[five] illustrated story sessions with audio recordings of the text to support accessibility” and recommendations of various practices to adopt in response to mental health struggles. Individuals who utilized the program noted “improvements in symptoms of anxiety, post-traumatic stress, well-being and personal problems, with all improvements maintained at 3-month follow-up,” says the WHO.

Given the ongoing hardships that Syrians experience and the medication shortage in Lebanon, Step-by-Step has the potential to advance mental health in Lebanon. The WHO and its partners continue to implement the program within Lebanon with the hope of eventually expanding the program to other countries that cater to specific populations. Upon successful expansion, the program will begin to address the mental health treatment gap in low and middle-income countries.

– Kaylee Messick
Photo: Flickr

Wheat Crisis
Lebanon is facing a crippling economic crisis that forced more than three-quarters of its population into poverty, and the latest manifestation of this is its wheat crisis. Following the 2020 Beirut explosion, the country lacks any national reserves and relies on foreign imports for wheat. Before the conflict in Ukraine, the country imported approximately 80% of its wheat from Russia and Ukraine. Lebanon is currently struggling to find new markets that satisfy its wheat demand, given its low purchasing power amid the pandemic inflation.

Current Situation

Ever since the start of the war in Ukraine, Russia has blocked all Ukrainian grain exports via the black sea, resulting in a hefty surge in bread prices in Lebanon. Although Ukraine and Russia, through negotiations facilitated by the U.N., have signed an agreement expressing intent to restart grain exports, the deal’s legitimacy is in question as Russia attacked the Ukrainian port city of Odesa less than 24 hours following the initiation of the agreement. In fact, the offense pushed grain prices even higher.

According to the Lebanon Crisis Analytics Team at Mercy Corps, the price of wheat flour has increased by 209% since the beginning of the Russian invasion. The annual food and beverage inflation, which rose to a staggering 332% in June, exacerbates this. As of today, 22% of Lebanese households are food insecure.

International Aid

Lebanon has already received a $150 million loan from the World Bank to fund immediate wheat imports to provide poor and vulnerable households and other displaced populations with affordable food options. Lebanon’s Minister of Economy and Trade, Amin Salam, projects that the loan will cover food supplies for six to nine months. As the global price of wheat has been decreasing, Salam believes that the loan will most likely last for eight months. During this timeframe, Salam seeks to receive an additional $3 billion loan from the International Monetary Fund (IMF) as part of a promised package of support pending approval.

In addition to importing food, Lebanon also plans to build two new grain silos, which will cost approximately $100 million. According to Salam, several countries have already expressed interest in supporting the project, including Germany, the United States, France, the United Arab Emirates and Qatar.

The project received official approval following the technical feasibility study that the European Bank for Reconstruction and Development conducted. The current plan is to construct two grain silos north of Beirut in the Tripoli Port and the eastern Bekaa Valley. The new silos will be fully operational in around a year and will hold approximately 125,000 tons of grain, equivalent to nine months of reserves.

Building the new grain silos is a significant step forward for Lebanon’s crisis management. In addition to easing the pressure of wheat imports, which are expensive and at times slow, the silos also point to the beginnings of more organized economic planning, which might well lift the country out of its economic collapse.

– Emily Xin
Photo: Flickr

Debt Default Crisis
The COVID-19 pandemic and the war in Ukraine have had countless consequences across the globe, namely public health emergencies and economic shutdowns. In many developing and low-income countries, one now sees what economists are calling a debt default crisis, which means that the economic burden of the pandemic and supply chain shortage has piled up so high on some countries that they are defaulting on their loans from foreign bondholders. A full-blown debt default crisis is dangerous because essential commodities and resources could become impossible to access in low-income countries, forcing many into poverty.

Debt Crisis Looms as Global Economy Worsens

Over the last six months, the number of emerging markets with sovereign debt and distressed trading levels has “more than doubled,” according to Bloomberg. This means that many low-income countries are trading and investing with money that they do not have, making these nations more vulnerable to debt crises. Debt default crises are particularly dangerous for low-income countries because the prices of necessary commodities such as food, fuel and medicine are skyrocketing due to inflation, interest rates are rising and job markets are failing. Economists point to 19 countries that house more than 900 million individuals who are particularly vulnerable to a debt default crisis, as well as a few countries that are already experiencing debt crises, including Sri Lanka and Lebanon.

Consequences of a Debt Default Crisis

Developing countries and emerging economic markets comprise about 40% of the worldwide GDP, which is part of the reason why a looming debt default crisis is worrisome to economists. Foreign bondholders are at risk of losing almost $240 billion if developing countries are unable to pay back their debts. Crushing international debt would be disastrous for not only low-income countries but developed countries as well.

The supply chain shortages could worsen, emergency health care responses could slow down and unemployment could rise. The international community is already seeing serious fallout from the debt default crisis in Sri Lanka, where disastrous fuel and food shortages are causing civil unrest.

Across low-income countries, hunger is increasing and millions more are at risk of falling into extreme poverty. Loan restructuring plans and international organizations are not working fast enough to prevent this devastation, hence the lack of essential emergency aid and foreign assistance.

Action from International Organizations

Shortly after the onset of the pandemic, the International Monetary Fund (IMF) and G20 established the Debt Service Suspension Initiative (DSSI) in anticipation that the pandemic would cause significant economic issues for low-income nations. This initiative provided about $13 billion of debt relief to close to 50 nations.

However, this short-term “safety net” drew to a close at the end of 2021, around the same time that many high-income countries, including the United States, significantly reduced their foreign COVID-19 aid. Additionally, G20 met again earlier in July 2022 to discuss potential plans of action to hold off a looming debt default crisis but failed to issue a communiqué after the summit. International leaders are struggling with cooperation because of the complicated relationship between Russia and Ukraine.

After the DSSI, the G20 developed the Common Framework for Debt Treatments, but it requires further refining to “provide meaningful relief to countries that need it.” The World Bank and IMF have provided guidelines in this regard.

Moving Forward in a Debt Crisis

Many low-income countries are approaching a debt default crisis, which would cause a perfect storm of economic hardships including inflation, higher interest rates and slowed job markets. International organizations like the IMF and G20 need to prioritize loan restructuring plans so that the global economy does not suffer from the loss of $240 billion. High-income countries like the United States can play a more significant role by prioritizing foreign aid to minimize devastation from the COVID-19 pandemic. Amid the fallout from the pandemic and the supply chain issues from the war in Ukraine, international leaders can take prompt and effective action to avoid a devastating debt default crisis.

– Ella DeVries
Photo: Flickr