An Integrated Approach to Syrian Refugees’ Health Care in Lebanon

The purpose of this paper is to learn from the integrated health care approach for the Syrian Armenian refugees by the HKCC （Howard Karagheusian Commemorative Corporation） in Burj Hammoud in Lebanon from the perspective of the beneficiaries themselves, i.e. the Syrian Armenian refugees. One hundred families who had been residing in Burj Hammoud and who had been regularly benefiting from the health services of the HKCC for at least one year were interviewed. The interviewees used a semi-structured questionnaire. Data were analyzed and emerging themes were mapped. The Syrian Armenian refugees who participated in this study generally expressed their satisfaction with the equitable access afforded by the HKCC’s integrated health care approach. There were several reasons why the HKCC’s integrated approach to serve refugees and the local population on equal footing was given positive reviews by the sampled refugees. Based on the responses of the refugees, these reasons are mainly （a） the convenient location of the center, which is walking distance for most refugees; （b） the ability of the treating doctors to communicate with the refugees in Armenian, which facilitates diagnosis and understanding of the health problems; （c） suitable opening hours; （d） friendly staff; and （e） thorough doctors. The results do not statistically represent the overall refugee population that is served by the HKCC; due to the study’s limited demographic scope, the results cannot be generalized. This limitation was due to lack of funding to cover the whole beneficiary Syrian Armenian refugee population. The HKCC’s approach has helped in providing access to treatment and preventive measures to a refugee population that was in need of it; as a consequence, it may have improved the health outcomes of this refugee population, especially in regard to the immunization of children. An integrated approach to healthcare which provides “equal ability by refugees and host nationals to access the same healthcare resources from the same providers” seemed to have been successful in the case of the HKCC. This paper provided first exploration of an integrated health approach for refugee healthcare provision in Lebanon.

Aligning Europe： The Syrian Refugee Crisis and the Geopolitics of the Region

This article examines the Syrian refugee crisis as a case study in order to understand how foreign policy practices developed by the US in the Middle East and Europe＇s refugee policy for handling mass influxes are interconnected. With international politics evolving in a dynamic and not static manner, the authors note that the conflicts driving today＇s refugee crisis are symptomatic of the shifting structure of international system that has been developed over the past 70 years with the emphasis being placed on the regional realities and the geopolitical competitions in the Middle East. In this respect, the authors provide an overview of the changing nature of the foreign policy strategy of the US in a globalizing multi-polar world and its linkage with migration movements in the Middle East. By acknowledging and taking advantage of one of the oldest and most enduring concepts of international relations, the authors outline the dynamics of the balance of power strategy in an emerging multi-polar world and describe the prudent pursuit of an ＂offshore balancing＂ grand strategy by the US and firmly consistent with America＇s global interests. By bringing forward a fi＇amework analysis which recognizes the soaring refugee and migration flows as the spillover effect of the US sponsored ＂offshore balancing＂ regional strategy for setting the principles and paving the way towards gradually establishing a functional balance of power in the Middle East, the authors draw special attention to the influential role of the EU and its incomplete attempt, via the refugee crisis, to adjust to the US＇s grand strategy which allows for fairer shifting of global burdens and security threats with profound repercussions on regional and international stability.

Intensive care outcomes of refugee patients in Turkey between 2013 and 2019: A retrospective descriptive study

Objectives:To assess the outcomes of the intensive care of Syrian refugees under temporary protection (SRUTP). Methods: The sample of the study was composed of 110 SRUTP patients who were treated at a tertiary intensive care unit (ICU) between 2013 and 2019 in Istanbul, Turkey. Baseline information and clinical data of the patients were collected by scanning the hospital's electronic database and clinical decision support system. Results:The mean length of ICU stay was 97.6 (36.3-187.8) h. Among the patients, 71 (64.5%) had comorbid diseases, and ICU mortality was 40%. The median cost of health care for each patient was 2144 (1060-4471) USD, and the total health care cost of all patients was 534012USD. Conclusions: Use of vasoactive drug, hemodialysis application, and low Glasgow Coma Scale scores are independent risk factors of the mortality. More researches are needed to clearly reveal the health and cost consequences of war.

Arrested Development in Beirut： Migration, Security and Dilemmas of Consociational Democracy

This article analyses two major dilemmas in contemporary Lebanon： Firstly, based on the theory of consociational democracy it identifies an increasing divide between the state that is building on a national security consensus among the power sharing elites and the society, which suffering from the political paralysis concerning reforms is depending on the market, the private initiative and the international donor community in coping with the challenges rooted in inadequate infrastructure, failing public services, corruption, and migration including the influx of Syrian refugees. Secondly, it discusses the contradiction between the cosmopolitan self-image of Beirut versus social exclusion of Palestinians, Asian and African migrant workers, and sexual minorities. Even if the Lebanese government points to terrorism and the refugees crisis as the biggest threats to the Lebanese state a closer analysis points to the increasing divide between state and society, which leads to a rise to a social crisis that involves all layers in the Lebanese society except the elite. Much of the discontent with this situation among Lebanese citizens and the Palestinians is today directed against the Syrians who are portrayed as the roots of the problems in Lebanon. It is an open question though that how long time the Lebanese society accept this narrative： the mass mobilization behind first You Stink movement in 2015 and then Beirut Madinati in 2016 indicates a political awareness in Beirut that holds the government and political system responsible for the huge problems and at the same time acknowledges that political reforms leading to a better economic distribution of Lebanese resources and power sharing not only for the elites but for the Lebanese society as such is the only way ahead and the best bulwark against a breakdown of the state.

Securitization and De-securitization􀋖Turkey-Syria Relations since the Syrian Crisis

The article focuses on the nature of the relations between Turkey and Syria during the Syrian crisis.Although the relationship between Turkey and Syria had undergone some ups and downs in the last several years,both countries tried their best to improve their economic,political,cultural,and diplomatic relations.Indeed,Turkey introduced its model,“Moderate Islamic ideologies”,through Syria in the Middle East and North Africa(MENA).The“Arab Spring”of 2011 was a very good opportunity for Turkey to introduce its democratic Islamic dogmas which were welcomed by the Muslim Brotherhood leaders in some Arab Countries.But,the President of Syria,Bashar Al Assad,and his allies were very critical of Turkey’s policy.Thus,the article mainly explores the role of Turkey in Syria’s internal affairs,in particular,Erdogan’s policy towards Syrian crises.Besides,it examines Turkey’s domestic challenges and how Turkey has presented itself as a big supporter of the Arab Spring in the MENA.However,the article has found out that the current policies of Turkey towards the Syrian crisis are critical within the Middle East region.In other words,the conflicts and the wars against the Islamic State(ISIS)and the Kurdistan Workers’Party(PKK)weakened the bilateral relations.The Syrian refugees and the PKK are posing overwhelming challenges to Turkey’s economy and internal security.