Negotiating Health and Life: Syrian Refugees and The Politics of Access in Lebanon.

Behrouzan, Orkideh; Parkinson, Sarah Elizabeth

Abstract

In the context of ongoing armed conflicts in Libya, Syria, Yemen, and Iraq, it is vital to foster nuanced understandings of the relationship between health, violence, and everyday life in the Middle East and North Africa. In this article, we explore how healthcare access interacts with humanitarian bureaucracy and refugees' daily experiences of exile. What are the stakes involved with accessing clinical services in humanitarian situations? How do local conditions structure access to healthcare? Building on the concept of “therapeutic geographies,” we argue for the integration of local socio-political context and situated knowledge into understandings of humanitarian healthcare systems. Using evidence gathered from participant observation among Syrian and Palestinian refugees in Lebanon, we demonstrate how procedures developed to facilitate care—such as refugee registration and insurance contracting—can interact with other factors to simultaneously prevent and/or disincentivize refugees' accessing healthcare services and expose them to structural violence. Drawing on two interconnected ethnographic encounters in a Palestinian refugee camp and in a Lebanese public hospital, we demonstrate how interactions surrounding the clinical encounter reveal the social, political, and logistical complexities of healthcare access. Moreover, rather than hospital visits representing discrete encounters with the Lebanese state, we contend that they reveal important moments in an ongoing process of negotiation and navigation within and through the constraints and uncertainties that shape refugee life. As a result, we advocate for the incorporation of situated forms of knowledge into humanitarian healthcare practices and the development of an understanding of healthcare access as nested in the larger experience of everyday refugee life.

Citation

Behrouzan, O., & Parkinson, S. E. (2015). Negotiating Health and Life: Syrian Refugees and The Politics of Access in Lebanon. Social Science & Medicine, 146, 324-331. https://doi.org/10.1016/j.socscimed.2015.10.008

• Journal Article Type: Article
• Acceptance Date: Oct 6, 2015
• Online Publication Date: Oct 14, 2015
• Publication Date: Oct 14, 2015
• Deposit Date: Sep 18, 2018
• Publicly Available Date: Sep 18, 2018
• Journal: Social Science and Medicine
• Print ISSN: 0277-9536
• Electronic ISSN: 1873-5347
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 146
• Pages: 324-331
• DOI: https://doi.org/10.1016/j.socscimed.2015.10.008
• Keywords: anthropology, conflict, Syria, Lebanon, health, public health, trauma, Middle East, war, therapeutic geography