VZCZCXYZ0000
PP RUEHWEB

DE RUEHAM #0458/01 0491337
ZNR UUUUU ZZH (CCY AD307562 MSI7649-695)
P 181337Z FEB 09
FM AMEMBASSY AMMAN
TO RUEHC/SECSTATE WASHDC PRIORITY 4490
INFO RUCNRAQ/IRAQ COLLECTIVE PRIORITY

UNCLAS AMMAN 000458 
 
SENSITIVE 
SIPDIS 
 
C O R R E C T E D COPY CAPTION 
E.O. 12958: N/A 
TAGS: EAID IZ JO LE PREF SY
SUBJECT: FINE TUNING REFUGEE ASSISTANCE IN LEBANON, SYRIA 
AND JORDAN 
 
 ¶1.  (SBU) Summary:  To keep pace with the most recent 
information about Iraqi refugees, PRM refugee assistance in 
Lebanon, Syria and Jordan should be fine tuned to address 
specific vulnerabilities in the Iraqi population in the three 
countries.  Advanced health care for the chronically ill, 
post-secondary education opportunities for the adolescent 
Iraqi population, psychosocial programming to offset the 
effects of extended refugee status, and well-monitored 
monetary assistance would best promote the USG goal of 
repatriating Iraqis with dignity and in security.  End 
Summary. 
 
¶2.  (SBU) UNHCR in Lebanon, Syria and Jordan estimate that at 
the end of 2008, there were 257,132 registered Iraqi refugees 
in the three countries.  Government numbers of Iraqis in the 
region far exceed registration numbers.  However, those 
registered should serve as a model for assistance.  Iraqis 
showed a higher incidence of chronic illness than did the 
host country populations, with 40,795 chronically ill in 
Syria alone.  In Lebanon, Syria and Jordan, UNHCR and UNICEF 
judged that approximately 12,000 of the school aged Iraqis 
were at risk of economic exploitation as they illegally seek 
work in economies where consumer prices increased by 14 
percent over 2007.  In addition this group is vulnerable to 
sexual exploitation.    Consequently, their medical, 
psychosocial and humanitarian assistance needs have changed 
over the past year. 
 
HEALTH CARE--BEYOND PRIMARY HEALTH CARE 
--------------------------------------- 
 
¶3.  (SBU) Medical professionals in all three countries report 
that Iraqis present a higher incidence of cancer, high blood 
pressure and heart disease than the host country nationals. 
Iraqi children are especially hard hit by chronic illness 
requiring medicine and therapies either not available or 
prohibitively expensive in the region.  These patients 
require monitoring and long-term care which is beyond the 
current resources of local hospitals and PRM partners. 
RECOMMENDATION:  Current health programming in Lebanon, Syria 
and Jordan provide Iraqis with basic health care and limited, 
short-term access to more demanding, expensive care.  PRM 
should explore with IOs and NGOs extended care programs for 
critically ill Iraqis in countries of refuge. A corresponding 
increase in services inside Iraqi could prevent chronic 
health care from becoming a pull factor in Lebanon, Syria and 
Jordan. 
 
¶4. (SBU) Mental health partners note an increase in reports of 
domestic violence and in requests for psychosocial supports 
such as peer counseling and mental health consultations among 
refugees.  Community workers link the increase in violence to 
economic difficulties and a resulting loss of identity 
suffered by family members.  The 2009 Iraqi CAP contained 
approximately USD 19.3 million in proposed psychosocial 
programming.  RECOMMEDATION:  Successful PRM psychosocial 
interventions in Lebanon, Syria and Jordan were geared to 
providing safe spaces for vulnerable women and children and 
basic counseling services.  Those efforts should be coupled 
with a whole family/community approach to psychosocial work 
to address the effect of displacement and hopelessness among 
the adult and adolescent male population--authors of much of 
the violence.  In Lebanon single males are the largest 
demographic group among Iraqis.  The psychosocial needs of 
this group, many of them war survivors, should be addressed 
to ease their reintegration into Iraqi upon repatriation. 
Partners like Relief International, International Medical 
Corps, and Mercy Corps made early progress in this field in 
all three hosting countries and could do more. 
 
EDUCATION--REACHING ENDANGERED YOUTH 
------------------------------------ 
 
¶5.  (SBU) Iraqi students in Lebanon, Syria, and Jordan have 
access to free or inexpensive primary education.   School 
attendance numbers in secondary education programs drop off 
sharply as young people seek jobs, prepare for resettlement, 
or lose interest in education that does not prepare them for 
an uncertain future.  Attracting students to secondary 
education presents a challenge in all three countries. 
Education partners report that employment as laborers on the 
gray and black markets is a major cause of teenage 
absenteeism from schools, particularly as Iraqi refugees 
consider young people as potentially less likely to be picked 
up by host country authorities for working illegally. 
Separately, the potential for exploitation of adolescent 
dropouts is great.  RECOMMENDATION: Education partners should 
be encouraged to consider programming to support post 
secondary education in either vocational schools or 
universities in the region.   Early versions of the 2009 Iraq 
pillar II CAP listed approximately USD 55 million in 
non-primary education program proposals for Iraqis in the 
 
Syria, Lebanon, and Jordan and approximately USD 3.7 million 
would directly address the needs of youth. 
 
FINANCIAL ASSISTANCE FOR THE BASICS 
----------------------------------- 
 
¶6.  (SBU) In all the countries in the region worsening 
economic conditions have impoverished refugees, even those 
who were middle-class when they first sought refuge. 
Presently, assistance is not based on needs assessments 
informed by an economic survey of local conditions.  UNHCR 
and WFP are using international standards for humanitarian 
assistance and applying them to estimations of population 
size without the benefit of accurate, independent numbers. 
In Syria, food assistance proved vulnerable to 
misappropriation and sale.  Present levels of cash assistance 
in the region are insufficient to meet local costs in 
countries such as Jordan which has seen a 14 percent increase 
in consumer prices in the last year. 
Syria and Lebanon registered similar hikes in the cost of 
basic consumer goods and rents.  Embassies continue to press 
Jordan, Lebanon and Syria to grant Iraqis legal status and 
the right to work legally.  Governments resist on the basis 
of economic hardships among host communities, which have long 
accommodated large numbers of Palestinian refugees, and the 
principle that Iraqis are not seen locally as de jure 
refugees.  Political leaders in Jordan, Lebanon and Syria 
have increasing shown a willingness to discuss the economic 
welfare of the Iraqis in their countries.   However, national 
policies allowing Iraqis to work remain restrictive and 
anecdotal evidence suggests that refugees are falling into 
poverty at a rapid rate.  In Syria and Jordan, Iraqis cannot 
seek legal employment.  In Lebanon, Iraqis can work under 
limited circumstances. 
 
¶7.  (SBU) UNHCR and partners are working with a mixed bag of 
cash/voucher/food assistance programs with WFP and other 
partners.  The most successful, but time intensive of the 
programs is cash assistance, which should be expanded. 
Private donors have used food vouchers successfully in 
Lebanon and Jordan.  Controlling the distribution of cash 
and vouchers is much more demanding than monitoring food 
distributions, but the advantages of cash distribution to an 
urban population are considerable.  Refugees receive 
assistance through a system of bank ATMs that record 
transactions and allow refugees the dignity of withdrawing 
funds in a way that does not mark them as refugees.  Cash and 
vouchers allow refugees to use the local economy and 
eliminate the need for importation, storage and safeguarding 
of bulk food.  As demonstrated in Syria in 2008, distributing 
large quantities of bulk food invites refugees to sell their 
rations at dumping prices, angering local merchants and 
putting refugees on the wrong side of the law. 
RECOMENDATION: UNHCR and WFP should be encouraged to work 
together to establish innovative solutions to nutritional 
assistance that include cash distribution systems on a 
regional basis to prevent refugees from "benefit shopping". 
Anti-fraud technology could be used to prevent  the abuse of 
vouchers or cards, such as frequent renewal  requirements and 
issuance of picture imprinted cards. 
 
¶8.  (SBU) Access to fair employment could reduce refugee 
dependence on assistance.  Partners have been successful in 
working with paid Iraqi volunteers in professional and 
semi-professional aspects of programming.  Iraqi doctors work 
in health clinics in Jordan and Lebanon.  Iraqi volunteers 
conduct surveys for NGOs throughout the region.  Governments 
have proven tolerant of the practice of paying volunteers for 
their long-term service to NGOs.  RECOMMENDATION: Partners 
should be encouraged to recruit and retain qualified Iraqis 
for positions within USG funded and other assistance 
programs.  Volunteerism is not proposed as a solution to the 
right-to-work problem, but employing volunteers is a limited 
stop-gap solution for a handful of educated beneficiaries. 
 
REPATRIATION--PREPARING THE ROAD HOME 
-------------------------------------- 
¶9.  (SBU) Future USG assistance efforts in Lebanon, Syria and 
Jordan should focus on preparing for repatriation while 
securing humanitarian space for Iraqis.  RECOMMENDATION: 
UNHCR should be encouraged to seek blanket  Iraqi Government 
recognition of the academic and occupational training 
credentials of Iraqis who studied in countries of refuge. 
Advanced occupational classes conducted by NGOs in Jordan, 
Syria and Lebanon should be accredited by the Government of 
Iraq to reassure refugees that their credentials have worth 
once they return home.    Supporting higher education for 
Iraqis in Lebanon, Syria and Jordan could offer a possible 
future to Iraqi youth who would otherwise fall prey to 
predatory employers or worse. 
 
Visit Amman's Classified Web Site at 
 
http://www.state.sgov.gov/p/nea/amman 
Beecroft