In January, the British government told its diplomats to start finding 50–70% cuts in aid funding. In March, it was revealed it was slashing aid funding to Syrian refugee projects by a third. Among the many casualties of those cuts is a project in Lebanon.
Two centres – in Zahlé and in Beirut – offer specialised services, such as speech and physiotherapy, for disabled Syrian refugees who can’t afford to pay for them.
This year, an average of 7,200 rehabilitation and psychosocial support sessions will no longer be delivered, affecting 1,500 disabled people directly and 9,000 people indirectly, including caregivers and wider communities.
Since 2011, when the war in Syria began, more than 1.5 million people have crossed in neighbouring Lebanon to avoid bombs and fighting. When basic food and shelter are in scant supply, the needs of people with disabilities get left behind.
Humanity and Inclusion (HI) is a charity that provides support to disabled people and their families in Lebanon, in a project primarily funded by UK aid, as well as the People’s Postcode Lottery. The Foreign, Commonwealth and Development Office (FCDO) will no longer continue its funding, severely disrupting the centres’ work. Some support from the People’s Postcode Lottery will continue, but in a much-reduced capacity.
Amira Fleety, a physiotherapist in Zahlé
“I’m a physio and have worked with HI since 2019 as a rehab technical adviser, doing capacity building for local NGOs who offer physio services. Last year, we did a survey in Lebanon and found that there is a big gap in community services for people with disabilities. Prices for these services in the private sector are very expensive. Right now in Lebanon, the economic situation is very bad and nobody has any money.
“Ending funds for our rehab services will have a big impact on people who need long-term rehabilitation, and there will be a deterioration in their conditions which could result in increased disfigurements.
“Moaz is a child who has spina bifida, brain atrophy and hydrocephalus (fluid on the brain). He is only two years old, and if he isn’t able to get rehabilitation sessions during this developing period, his mother won’t be able to manage the deterioration in him. He will lose the mobility in his joints, and won’t be able to sit in a wheelchair. He will just grow up lying, looking at the ceiling.
“There are a lot of refugees with disabilities – and there are now no services available for them.”
“We came from Homs – the situation was very bad there. My husband was taken prisoner for 10 months. They broke the bridge of his nose, ripped off his fingernails, tortured him and then let him go.
“As soon as he was released, we fled to Lebanon with our two children. Moaz was born here along with my youngest child. Both were born in hospital but there was a problem at Moaz’s birth and he was starved of oxygen. We found out about the Mousawat centre a year ago, and have been coming once or twice a week for physio for Moaz. I’m very worried what we will do when the centre closes, as it is the only place we can get these services for free. There are other physio services, but if we use them we have to pay, and we just don’t have any money. Moaz is now two years and three months old. Every few months he has to have a shunt put in his brain to drain the fluid. This is very expensive.
“He also needs a CT scan every six months that we have to pay for. HI and the Mousawat centre were helping us to pay all of these costs. Without his physiotherapy his limbs are going to seize up. I think he will die without the support he needs.
“My hope is that he will be able to learn to walk, but this won’t happen if the service stops. I am very worried about the economic situation here in Lebanon as it is getting worse. Nobody knows where Lebanon is heading. There have also been demonstrations, and people are getting worried for their safety.”
Lemeh, originally from Idlib, contracted polio at the age of six, and has difficulty walking. He was studying Arabic at university in Aleppo when he was wounded by shrapnel in a bombing raid. His house was also destroyed, so he walked over the mountains to join his mother and two brothers in a settlement in Zahlé.
“I have been regularly visiting the Mousawat centre and getting physiotherapy for my legs – it has really helped. I also received a wheelchair but it is still hard to get around the camp and access the toilet, and other areas of our shelter. I joined a support and advocacy group. Now the centre is closing I don’t know where I can get any of the services I need.
“I want to travel outside Lebanon to get treatment and to live in a proper house for a disabled person. I want to live a good life, maybe in Europe, England. I know others who have gone; there is nothing to keep us here now.”
“We came here in 2013, because of the war and the bombings and killing. Our house was destroyed, so I travelled with my wife and nine children, my mother and my second wife. Our biggest challenge is the winter – we are living in a tent and the rain goes everywhere, water comes inside the tent and the ground floods. We pay rent for the tent, and the prices are going up.
“Two years and a half ago, I had a stroke that affected my right side and am now taking medication. I wasn’t able to move or walk; they had to carry me to the toilet. I went to Damascus by car to get medicine legally, because it is cheaper there. But I had to come back here illegally on the mountain road, by horse.
“I came to the Mousawat centre and had three months of physiotherapy. I wasn’t able to move my leg and my right side was dead. My sons had to carry me when I first came here – but they taught me to walk again. When I wasn’t able to move, I felt very angry and frustrated. I was able to get therapy sessions to reduce this anger and help me cope. Now, I can walk with a stick. We are very sad the centre is closing. When we come here, we feel that we have somewhere to go other than our home. When we see other beneficiaries, we feel very grateful. It is hard to say what our hope for the future is. Our children went to university in Syria but were not able to finish their studies because of the war. We just wait for death.”
“When the fighting started, our house was destroyed, so we followed my husband to Lebanon. My husband works in a furniture warehouse as a labourer. We have six children: four girls and two boys. G’hazzi is the youngest, at eight. He was born prematurely by two weeks and was sent home because we were told he was healthy. When he was one, I started to notice that he was unable to sit, so we took him to the doctor and he was diagnosed with epilepsy and cerebral palsy.
“We didn’t get any help from the health ministry – we are the ones who have to buy his medication and it is very expensive. Then we heard about HI and they have really helped us, and provided us with occupational and speech therapy, a pushchair and a standing board to help him stand. We have seen a big improvement in G’hazzi – his mobility is better and he is able to move a lot more comfortably. His language is more fluent and he can communicate with us. He has also become more active, and is a lot brighter. Before the physio he couldn’t sit upright in a chair but now he is more stable.
“We stopped receiving the service at the end of February when the programme was cut. I am very sad for him. I also received psychological support from the Mousawat centre, which helped me to cope better with his disability. It made me more patient and understanding, and made me realise I had support. Our family love G’hazzi very much and our immediate community are supportive, but when we go into the wider community, we feel that some people don’t treat us normally. It is hard and sometimes makes me feel uncomfortable.”
“Nada was born with a lack of oxygen, which affected her brain. Her parents divorced when she was one so she has been living with me since then. She was going to a special school that helped her to socialise and manage her mood, but the school is now closed because of coronavirus.
“When the blast happened [at Beirut port in August], Nada was very scared and ran outside the house because it was shaking. She fell and broke her ankle – we didn’t think she would walk again. Our front door was broken and so were the windows, the door frame in the kitchen, the kitchen stairs and ceiling fell in. After the blast, people from the Mousavat centre and HI came to see us and gave Nada physiotherapy. Now she is able to walk again.”
“My sister Aydah is blind from a hereditary issue: when she was born she could see, but developed the problem when she was 30. Our brother is also blind [because of] the same problem. I don’t work because I need to look after Aydah and her brother. Life in Beirut is very hard. One of our brothers is in Germany, so he sends us money when he can. At the moment he is also suffering from financial problems, so the amount he is sending has reduced. There is a downturn in the economy because of coronavirus and the blast. Our house was very badly affected – the glass doors to the balcony were shattered, the toilets were broken and another room was destroyed. During the blast Aydah was injured. She was outside when it happened and, because she is blind, she panicked, fell and broke her ankle.
“HI have provided her with physiotherapy and given her a walker, plus a white stick. As a care giver, I was given physio for my neck and back. It really helped us understand how we could do home exercises and improve our wellbeing. Now they have stopped, there is no hope. The situation is very hard, but I have to stay strong because my family needs my support.”
Caroline Duconseille, head of mission for HI in Lebanon
“The drastic funding cuts by the FCDO are not about HI. HI is supporting local organisations and through these we are supporting local services for people living with disabilities – that is the point of HI, and if it leaves these services will disappear.
“This is about the loss of an entire support structure built over years of engagement, which has offered disabled people services that didn’t previously exist in Lebanon. There was no plan around stopping this funding. It will take years to rebuild what is being lost. In the meantime, children like Moaz will not have the support they need to be able to develop as best they can. It is devastating for them and their families.”
“We came from Idlib in Syria in 2013, just after getting married. There was a lot of war and fighting, and it wasn’t safe any more. We now have three children – two boys and one girl. Nada is the eldest at eight. Nada was born healthy, but later she couldn’t walk properly and used to fall all the time. She had surgery, but after that couldn’t walk at all. We started going to the Mousawat centre where Nada was able to get physiotherapy, which helped her bend her legs. They also gave her braces, and said with more therapy she could walk again.
“We don’t know what to do now the centre is closed. There is nowhere else like that around here.
“I’m afraid for her future if she can’t walk. It is very bad for disabled people here, and life is hard for girls like her. We don’t have a wheelchair so we have to carry her everywhere. Now she is getting bigger this is hard. Her father can still carry her because he is strong, but if he isn’t around she just sits in the same corner all day. Our hope for the future is that Nada will be like her brothers, so they can run and play. We don’t want to go back to Syria. There is nothing left there – it isn’t safe.”
“We have been in Lebanon for six years. We came from Halab (Aleppo) in Syria because of the war. There was a lot of explosions and bombings, it wasn’t safe so we had to leave. We came to live in a settlement in Zahlé but had to leave because one of my daughters, Zam Zam, was sexually harassed in the camp. She was only 12 and the guy who was trying to harass her was 15. We were powerless to do anything. We went to the police but they said they couldn’t arrest the boy because he was under 16. We have six children; three are disabled: Bayan is 15, Zam Zam is 12 and Hamad is 10. They can’t walk and have learning difficulties.
“It is a genetic issue, because I am the first cousin of my husband. Nobody told us it would be a problem when we got married. I never went to school and my husband only went to school until he was 13, so we didn’t understand [these things]. In Syria we had a farm and grew our own food, had animals like chickens and a cow. It was only a small farm but it was OK for us. The government took all of our land and home, and destroyed it. There is no life for us there any more.
“If we go back we will have to declare our children and men to see if they are the right age to go into the military, so nobody wants to go. My brother was in the military there six years ago but left to come to Lebanon. When he went back he was arrested and put in prison for deserting. I never want to go back.
“Our biggest challenge is finding treatment for our children. There is no money for diapers, for milk. It was only the NGO Mousawat, and HI, who helped us with the physio sessions. They also helped us with medicines and vitamins that the children need. Everything is expensive because of the economic crisis.
“With my three disabled children there is always a worry. Every year their needs increase as they become bigger. Before, they used to be able to walk but now they can’t – Hamad can still walk a bit, but the girls nothing. So their care needs increase. There is no school for them and because of Covid they can’t go out. We only have two wheelchairs, but one is in very poor condition, and one walker, so we don’t know how we are going to manage now that HI and Mousawat are closing.
We used to go to the Mousawat centre every week and they all received speech, occupational therapy and physio; I was also in the self-help group for parents. Now the services have stopped it is very sad for us, and they will just sit at home. They can’t move and don’t do any kind of activity, and they can’t practise their speech and language so have no means of learning how to communicate. Zam Zam received support for what happened to her, and now she is feeling depressed and is really struggling.”
Federico Dessi, regional director of HI’s Middle East programme
“HI’s work has had such a positive impact on the lives of people who would otherwise be excluded or forgotten, providing them with vital rehabilitation and psychosocial and support. If no alternative funding is found, thousands of Syrians, Lebanese and Jordanians with disabilities will lose access to essential services, autonomy in their daily living, and the opportunity to live in health and dignity.
“Hundreds of infants with disabilities will not receive assistance in their early years, impeding the development of their full potential and increasing the risk that their disabilities will become permanent.
“Hundreds of members of local staff, such as physiotherapists and social workers, will lose their jobs, as health services have to scale down or close completely. Years of investment in local health care systems are at risk of going to waste.”