September - Nahr al-Bared Camp Reconstruction

Nahr al-Bared (NBC) Old Camp in northern Lebanon was completely destroyed, and the largely unregistered buildings in the New Camp were badly damaged in a 15-week battle in 2007 between the Lebanese army and Islamist militant group Fatah al-Islam, which killed more than 400 people and displaced up to 30,000 Palestinians.

UNRWA Commissioner-General Karen Abu Zayd spoke of the rebuilding of Nahr al-Bared being "the largest project ever undertaken by the agency". Yet over two years after the camps' destruction thousands remain displaced, waiting to be re-housed. Indeed the camp's foundation stone was only laid in early March of this year.

MAP spoke with a UN official involved in the camp's reconstruction:

"The rebuilding of NBC has been a very rough ride. We've experienced the entire A-Z catalogue of Lebanese law during our efforts to build housing for the thousands who were displaced by the fighting.

The initial problems we faced were linked to land expropriation. According to Lebanese law, once the camp had been destroyed its rebuilding required the permission from the original landlord. However the camp was originally built in 1949 by the Red Cross. Eventually the right documents and connections were made and with $11m in donor money, largely from Oman, the Lebanese government was able to purchase the land from Lebanese landowners, paving the way towards the camps reconstruction.

Despite this progress, land ownership remains a real problem in the adjacent areas of the camp where Palestinians struggle to find the correct documents to prove ownership of land they've lived on their entire lives. What is more, changes to Lebanese law in 2000/2001 have impacted on the ownership rights of Palestinians living outside the camp, making it a lot harder for Palestinians to inherit property, thus forcing people back into the camps.

The next stage of the rebuilding involved the removal of rubble from the camp. However, during the excavations for the new buildings foundations, a series of Roman ruins were discovered. Lebanon is littered with ruins, including the famous temples of Baalbek and the large hippodrome located on the outskirts of Al-Bass refugee camp in the south. The Lebanese Directorate General of Antiquities eventually came to a deal to build upon the ruins once they were carefully backfilled over with two metres of protective foundations. This led to significant design changes in the structures of the camp.

There have been numerous challenges in planning, largely linked to the absence of a unified Lebanese or Palestinian planning authority. There is also a plethora of issues linked to security around the camp. The pervasive presence of the Lebanese army and the permit system that has been enforced on the residents of the camp has meant that any chance of the rebuilding uniting and improving Palestinian-Lebanese relations has been lost. People's homes are now at the centre of a military zone".

A visit into the camp proves the difficulty of balancing a decent standard of life with the saturation of security checkpoints and soldiers. Before the fighting the camp was a trade hub, with a bustling market helped by its close proximity to Syria. Today army checkpoints ring the camp, stifling life for its beleaguered residents. In an interview with IRIN (UN Humanitarian News Service) Charlie Higgins, UNRWA's project manager for the reconstruction of Nahr al-Bared, explained how the "Lebanese used to do their shopping in the adjacent area and in Nahr al-Bared camp, but they don't do it anymore as the market place that was highly integrated with the surrounding Lebanese local communities has not been restored."

MAP's work in Nahr al-Bared

MAP is working to minimise the impact of the camp destruction on maternal and child health, implementing home visits by a team of midwives to monitor the wellbeing of mothers and children living in inadequate temporary housing, shipping containers stacked on top of one another known as 'the barracks'. Supported by Irish Aid, the project works alongside UNRWA to maximise access to an integrated maternal and child health care system.

MAP knows that improving a infant's chance of survival, health and development, particularly for infants at risk, born either premature or with a disability, is dependent on the quality of the interaction between the parent and child. While refugees remain displaced in temporary housing, there is a continued negative impact on their health.

Frequent bouts of illness, watery and bloody diarrhoea, viral hepatitis, fevers and intestinal infestations all limit children's its basic growth, this during early childhood has a critical impact on developing basic intellectual and social skills.

To ensure both success and sustainability, MAP's project utilises community-based health initiatives directed at pregnant women and infants. One of the core components - a community outreach nursing team comprising of midwives and nurses - is successfully working from a well-resourced clinic which provides adequate space for the variety of activities.

Dr Ali Dakwar, MAP's project co-ordinator, is based in the clinic together with a part-time paediatrician, an administrator and ancillary staff. Dr Ali told MAP how the midwives work alongside MAP's community mothers scheme to "promote a sustainable approach to health through education and empowerment combating the effects of child stunting. In particular nutritional courses are critically important in protecting the health of the next generation. Promoting exclusive breast feeding to ensure an infants natural immunity, and proper growth. Breast feeding als makes sure that a mother maintains her health and has adequate nutrition, and is a natural aid to safe family planning.".

Newborn paediatric care is also available in the clinic. The team is providing coverage which currently stands at just over 50% of the patients accessing UN services. Between January and April 2009 the project staff have carried out 947 home visits to 442 families.

Some of the key outcomes of this project's work to date include:

â—? Managing and containing nutritional deficiencies and anaemia, which are wide spread among pregnant and post-natal mothers

â—? Safe motherhood practices are being embedded in the community. This has required a capacity building approach which has involved cooperation with other NGOs in the field

â—? Maternal and child health are supported through home nursing interventions and support.

â—? The nutritional status of children at risk and their families is being improved through current promotion of exclusive breastfeeding. This requires continued training and support of staff. Mothers explained how home visits were welcome and that they appreciated advice and the time taken per visit. Housing is the current priority for families as well as an expansion of services offered at the clinic to include facilities for the delivery of babies

August - Latest developments in Nahr al-Bared reconstruction

Click here to read the report.

June 2009 - Life in Lebanon's Shadow

Dispatches from Bourj al-Barajneh refugee camp

Lebanon has been in the news a lot recently in the lead up to the parliamentary elections that were held on 07 June. Yet behind the eternal political wrangling and intrigue that characterises much of Lebanese politics, the desperate humanitarian situation for hundreds of thousands of Palestinian refugees in the country remains unaddressed.

According to the United Nations Relief and Works Agency, the international body established to ensure the welfare of Palestinian refugees, the highest percentage of Palestinian refugees who are living in abject poverty reside in Lebanon. An estimated 300,000 Palestinian refugees in Lebanon live in appalling social and economic conditions-most of them in crowded camps that lack proper infrastructure.

Bourj al Barajneh camp is situated near Beirut International Airport in south Beirut. It was established by the League of Red Cross Societies in 1948 a Palestinian refugee camp in the southern suburbs of bustling Beirut.

MAP hosted Olfat in the United Kingdom at the end of last year. In addition to delivering a powerful key note address in Glasgow at MAP's Scottish Dinner, Olfat provided important briefings in London at the Council of Arab-British Understanding and the Houses of Parliament.

MAP asked Olfat what the Palestinian refugee community's reactions to the elections were:

"It was a strange situation as Palestinians have nothing to do with the elections but it directly affects our future. All over the camp people were glued to their televisions to see what was happening, I stayed awake until 4am to catch the results.

Sadly, very few of the Lebanese political parties talked about the humanitarian situation in the camps. The only talk was about security and during the elections there was a curfewplaced on Ein el Helweh camp. People here are very worried as they don't want to see another nightmare like the destruction of Nahr al-Bared camp

(Click here to learn more about MAP's work in Nahr al-Bared).

People need to address the humanitarian situation in the camps first, putting people's needs above endless politics"

In June 2005, the Lebanese Ministry of Labour relaxed some of the work restrictions on Palestinian refugees, lifting the ban on around 50 professions but keeping an estimated 20 professions off - limits. However as Olfat made clear, there is a continuing chasm between nominal agreements and real change on the ground for the Palestinian refugees.

As organisations such as Human Rights Watch have made clear "the fulfillment of the basic human rights of Palestinian refugees in Lebanon does not in any way prejudice their right to return, which is guaranteed under international law".

In addition to over 25 years experience of running emergency and health development projects on the ground, MAP continues to advocate for improvements to the humanitarian situation in Lebanon's Palestinian refugee camps.

March 2009 - Field Visit to Nahr el-Bared Refugee Camp

For the last 40 years, Palestinian refugee camps in Lebanon have been self-governing enclaves, beyond the control of the state.

This absence of security and control allowed an external organisation, Fateh al-Islam to move into Nahr el-Bared camp in 2006. Subsequent fighting between this militant group and the Lebanese army lasted four months from May 2007. Hundreds were killed, the camp almost totally destroyed and the camp's refugee population displaced yet again.

Situation Update

Two years on hundreds of families remain adrift on the outskirts of the camp. MAP's Programme Coordinator, Libby Powell, visited Lebanon in March to see how MAP's programme of 'Neo-Natal and Maternal Health care' was progressing.

"We entered the camp through Lebanese army checkpoints which monitor the long queue of traffic trying to get in. Despite the fact that the fighting was years ago it still seems as if it could have happened yesterday.

Much of the old camp is still totally destroyed and the majority of people are living in cramped shipping containers stacked on top of each other. Children play amongst the barbed wire and rubble of their former homes.

Conditions in these temporary homes are desperate. Even in the cool spring weather it was sweltering. Up to seven people are crammed into these units as they wait for their homes to be rebuilt".

MAP's clinic is run by Dr Ali, who has over forty years of experience working with the United Nations. He explained how the clinic's eight midwifes improve the lives of thousands of the camps residents through their home visits programme.

"The midwifes work alongside MAP's community mothers scheme to promote a sustainable approach to health through education and empowerment. To combat the effects of child stunting, nutritional courses are critically important in protecting the health of the next generation".

Yet projects like MAP's clinic offer a glimmer of hope against a background of continued suffering. Karen AbuZayd, the head of UNRWA, explained that "a disappointing donor response" to the agency's Nahr al-Bared appeal "will allow us to construct only the first two of the eight phases envisaged for the project," she said, and urged donors to be "more forthcoming and generous."

"The refugees from Nahr al-Bared will remain in a state of displacement for months to come, living either in rented housing or temporary shelters UNRWA has built with the support of donors," AbuZayd said.

Despite the majority of media and institutional focus being on the situation in Gaza, MAP remains committed to its Lebanon Programme and improving the lives of vulnerable Palestinians in camps such as Nahr al-Bared.