Displaced Iraqis living in Egypt, Jordan and Syria should be eligible to receive health care on the same basis as the local population in these countries. This was one of the key agreements reached by participants at a ministerial consultation in Damascus on 29-30 July, convened by WHO to consider the health needs of Iraqis living in neighbouring countries.
More than two million Iraqis are estimated to be displaced, the majority of them living in Syria and Jordan, with substantial numbers also in Egypt, Iran, Lebanon and Turkey.
Host countries have been trying to meet the Iraqis’ health needs through the national health systems but these systems are rapidly becoming overwhelmed by the large numbers of displaced people arriving from Iraq.
The consultation was attended by the Ministries of Health and of Foreign Affairs of Egypt, Iraq, Jordan and Syria, as well as representatives of Red Crescent Societies, the International Red Cross and Red Crescent movement, the UN Refugee Agency (UNHCR), UNICEF, the United Nations Population Fund (UNFPA), the UN Office for the Coordination of Humanitarian Affairs (OCHA) and WHO.
Key commitment by host countries
“This was an important meeting and a key commitment on the part of the host governments concerned,” said Dr Hussein Gezairy, WHO Regional Director for the Eastern Mediterranean Region. “It means that displaced Iraqis are expected to be treated in the same way as the local population in getting access to health care.”
Participants discussed how to improve access to health care for Iraqis who have sought refuge in Egypt, Jordan and Syria. It was recognized that host countries were already making a very substantial contribution in providing for the health needs of displaced Iraqis living in their countries. Also, despite the increased burden on their health systems, host governments are at present receiving very little support for the heavy additional costs which they are incurring.
A substantial proportion of the displaced Iraqi population, particularly those requiring hospital or specialized care, are currently facing real difficulties in getting access to adequate health care.
Health care through existing services
Ministries of Health or their representatives from Egypt, Jordan and Syria reaffirmed their commitment to continue to provide health services for displaced Iraqis on the same basis as for their local populations, whether or not they were registered with UNHCR. They also wished to continue to provide care through existing services; they were not in favour of separate services for displaced Iraqis.
The representatives of the Iraqi Government also reiterated the commitment of their government to share these additional costs in collaboration with the international community. Participants at the meeting agreed that they would seek to mobilize the resources needed to support Ministries of Health of the host countries and other providers to assist in meeting the additional costs involved. Existing and alternative funding mechanisms would be considered for this purpose.
“It is a huge commitment on the part of the host countries,” said Dr Ala Alwan, WHO Assistant Director-General for Health Action in Crises. “There are very substantial extra costs involved. If equal access to health care is to be fully achieved, the international community and the Iraqi government must now respond by providing the necessary support. We made important progress at the consultation in agreeing practical measures to improve access but the implementation of these measures depends on the necessary resources being made available.”
Need for more information
The consultation also considered steps that could be taken to improve access to health care. It was agreed that better information was needed about the number and location of Iraqis living in neighbouring countries and about their health needs and access to health services. Steps should be taken to strengthen or adapt existing health registration and surveillance systems to provide this. Nutrition surveillance should also be strengthened.
It was also agreed that priority should be given to ensuring access for displaced Iraqis to the most essential health services. These were defined as primary health care, including both preventive and curative services, reproductive health and child health services; emergency medical care; and essential drugs and medical supplies including those required for treatment of chronic diseases.
It was accepted that there was a need to strengthen the coordination of support to the health sector to ensure that the matters discussed were followed through. Each government will develop coordination mechanisms with partner agencies: the Ministry of Health, the Red Crescent Society, UN agencies and NGOs. UNHCR will continue to coordinate assistance to and the protection of all displaced Iraqis in host countries across all sectors and will work closely with WHO to coordinate the work of UN agencies and other partners in the health sector.