November 2020


  1. COVID-19 has deepened the 'pandemic of poverty' for Palestinian refugees in Lebanon
  2. Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa
  3. GCSE results: the hidden but enduring effects of parental social class

COVID-19 has deepened the 'pandemic of poverty' for Palestinian refugees in Lebanon


Social and economic upheaval in Lebanon in 2020 has deepened and magnified the poverty of Palestinian refugees.

As Lebanon goes for another full lockdown to contain the rapid spread of COVID-19 which has so far resulted in 116,476 cases and 900 deaths, Palestinian refugees are left to ruefully reflect on how they can possibly maintain physical distancing in densely populated and highly impoverished camps. As Philip Alston, the outgoing UN Rapporteur on Extreme Poverty and Human Rights, has suggested, coronavirus’ ‘wholly disproportionate impact on poor people and marginalised communities is inescapable’. This has particularly been the case for Palestinians living in 12 refugee camps in Lebanon where COVID-19 has deepened and magnified the social and economic malaise that has accompanied 72 years of refugee status. Now, this pandemic of poverty has been exacerbated by the wider social and economic upheaval that has impacted Lebanon itself.


The impact of Syria’s war on Lebanon

Over 470,000 Palestinian Refugees Lebanon (PRL) are registered with the United Nations Relief and Works Agency (UNRWA); the UN mission established to provide for the welfare of Palestinian refugees following the ethnic cleansing of Palestine in 1948. In the absence of a census, UNRWA estimates on the basis of take-up of its services, that 180,000 Palestinian refugees are residing in-country. The lack of precision in regard to numbers is in large part owing to the Palestinian Refugees Syria (PRS) who fled to Lebanon after the start of the war in Syria in 2011. Sixty per cent of PRS (262,000) have been displaced at least once by the war, 4,000 have been killed and 50,000 are estimated to have left the country.

An estimated 29,000 of the PRS have taken refuge in the 12 camps in Lebanon which has increased competition for employment and helped to suppress wages. Before the pandemic, the unemployment rate for PRL was 23% and 52% for PRS; these figures are likely to rise owing to the economic contraction that accompanies lockdown.

Palestinians are excluded from 36 occupations in Lebanon (including medicine, farming and fisheries) which confines them to low-paying, low-skilled occupations in the informal sector. 86% of PRL don’t have contracts with employers which means they are often ‘subject to harsh, exploitive and insecure working conditions’. 53% of PRS are paid on a daily basis and nearly all (97%) have nothing more than verbal agreements with employers.

During periods of lockdown caused by COVID-19, Palestinians are likely to lose their income without any compensation from the state or their employers. To help mitigate the impact of COVID-19 on Palestinian refugees, UNRWA has committed to provide ‘one round of cash assistance of US$ 40 per person, covering 50% of the minimum basic food requirements’. However, this is unlikely to represent the kind of sustained support needed to weather the pandemic.

In September 2020, UNRWA launched an emergency COVID-19 funding appeal calling on donors to contribute the $94.6m it estimated as needed to provide healthcare, hospitalisation, education services, food and cash assistance to the 5.6m Palestinians under their care across all their fields of operation, including Lebanon. By 9 November, however, UNRWA’s financial crisis had worsened to the point that it appealed for emergency finance of $70m to pay the salaries of its 28,000 employees to the end of 2020. The main source of this funding crisis was the withdrawal of United States (US) support for the agency by the Trump administration in 2018, which amounts to approximately one third of its $1.1bn annual operating budget.


COVID-19 in Palestinian camps

The largest Palestinian refugee camp in Lebanon’s capital, Beirut, is Burj Barajneh which according to UNRWA has 19,539 registered refugees. However, this figure almost certainly excludes incoming PRS and other Syrian refugees not registered with UNRWA but are resident in the camp. The area of the camp is one kilometre square and the Lebanese government prohibits the expansion of this area which means the only way to increase capacity is upward.

The camp is a labyrinth of narrow alleyways with low-hanging inter-twining water pipes and electricity cables that have caused more than 50 fatalities, mostly children, from electrocution. The tight alleyways and overhanging buildings mean that large areas of the camp are denied natural light. A combination of poor sanitation, a limited diet, low incomes and inadequate housing contribute to illness and mental health problems. 63% of PRL and 75% of PRS live with a relative with an acute illness in the last six months.

All of these factors could accelerate the spread of COVID-19. Dr Firas Al-Abiad, the General Director of the Rafic Hariri Government Hospital in Beirut, has reportedly found the mortality rate among Palestinians as ‘more than double Lebanon's 1% rate’. With camp residents sharing accommodation with at least 5 to 10 other people, physical distancing is well-nigh impossible. This could explain why I saw just a handful of residents in Burj Barajneh and Shatila camps during a visit in October wearing face coverings. There may be a fatalism at work here with the possible calculation that donning a face covering in such a confined, densely populated area may offer limited protection. Other factors that may explain refugees’ ignoring coronavirus include: a lack of information about proper procedures in the event of contracting the virus, and a fear of hostility and being scapegoated by host communities if cases are detected. There may also be a natural suspicion among refugees of the validity of public messaging by politicians on coronavirus in a region where misinformation about the virus for political ends has been spreading.

According to an UNRWA source, as of 19 November, there have been a total of 2,695 registered COVID-19 cases among Palestinian refugees in Lebanon since February 2020 with 330 active cases, 52 current hospitalised cases and 89 deaths. A 96-bed quarantine and isolation centre at UNRWA’s Training Centre (STC) campus in Siblin, south Lebanon, has been in use since 6 May 2020 and a second 50-bed isolation centre at in Ein El Hilweh refugee camps is ready for use.

UNRWA has committed to ‘cover the costs of COVID-19 testing and related hospitalization needs, including intensive care units (ICU)’ for Palestinians, expressing confidence that president-elect Joe Biden will restore the funding withdrawn from UNRWA by the Trump administration in 2018. However, on more substantial matters of policy, Biden stated during the recent US election that he would not reverse president Trump’s decision to move the US embassy in Israel to Jerusalem or Washington’s recognition of Israel’s annexation of the Golan Heights. This suggests there may be no significant shift in US Middle-East policy between the Trump and Biden administrations.


Lebanon in crisis

The wider economic context for Palestinian refugees in Lebanon has deteriorated rapidly with a series of crises that have enveloped the country in 2019-20. In October 2019, a wave of anti-austerity protests triggered by a proposed tax on WhatsApp, that was hastily withdrawn, vented deeply felt anger at longstanding graft and corruption overseen by a sectarian political system which ensures that the Lebanese prime minister is a Sunni, the president a Maronite, and the speaker of parliament a Shia.

Two governments have been formed and collapsed over the past year as political machinations by the old order tried to reheat the same political formula that the people had rejected. The economic crisis in Lebanon created by successive administrations and compliant lenders has resulted in a national debt of $93 billion; the highest debt-to-GDP ratio in the world. In March 2020, Lebanon defaulted on a $1.2bn Eurobond, the first sovereign default in the country’s history, which sent the currency into freefall. The Lebanese pound, normally pegged to the Dollar at LBP 1,507 was trading at LBP 7,200 in October and had lost 80 per cent of its value.

However, yet another national calamity befell the country on 4 August 2020, when 2,750 tonnes of ammonium nitrate stored in Beirut’s port ignited to cause an enormous explosion that resulted in 203 deaths, 6,500 injuries, and made 300,000 people homeless. The cost of the property destroyed by the blast is calculated at US$15 billion and this latest national trauma reignited public anger and protests as it emerged that the chemical had been negligently stored in a warehouse in the port for six years.

This appeared to be more evidence of government neglect and evasion as calls for an independent enquiry were swatted away. UNRWA expressed its ‘fears that this latest catastrophe will push vulnerable communities in Lebanon further into despair, including Palestinian refugees, who are already amongst the most marginalized groups in the country’. The devaluation of Lebanon’s currency threatens food security as prices will inevitably increase and wages will be worth less. In a lockdown scenario, an already vulnerable community is at severe risk of a loss of income and will be pushed even further to the social and economic margins.


Forgotten refugees

The Palestinians in Lebanon are often described as ‘forgotten’ refugees’, bereft of international support and almost totally dependent on UNRWA, which is itself facing an economic crisis. Their situation could be immeasurably improved if the restrictions impeding their economic status were lifted and they were allowed to work in the formal economy. Enabling Palestinians to become more integrated into the Lebanese economy with labour restrictions removed could benefit wider Lebanese society as well as Palestinians.

Because they are not formally citizens of another state, Palestinian refugees are trapped in a permanent foreigner status in Lebanon, in which they are effectively excluded from most civil and socio-economic rights. In June 2019, the Lebanese Ministry of Labour enforced existing legislation requiring all foreigners, including PRL and PRS, to obtain work permits. According to the UN refugee agency, ‘obtaining a work permit reportedly involves a lengthy administrative process, for which the refugees depend on the goodwill of their employers’. Removing this obstacle to employment could markedly improve the employment prospects of Palestinians in a period of severe economic hardship exacerbated by the pandemic.


By                        :                  Stephen McCloskey

Date                    :                  November 23, 2020

Source                :                   Open Democracy

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Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa



The COVID-19 pandemic has spread rapidly since the first case notification of the WHO in December 2019. Lacking an effective treatment, countries have implemented non-pharmaceutical interventions including social distancing measures and have encouraged maintaining adequate and frequent hand hygiene to slow down the disease transmission. Although access to clean water and soap is universal in high-income settings, it remains a basic need many do not have in low- and middle-income settings.

We analyzed data from Demographic and Health Surveys (DHS) of 16 countries in sub-Saharan Africa, using the most recent survey since 2015. Differences in the percentage of households with an observed handwashing place with water and soap were estimated by place of residence and wealth quintiles. Equiplots showed wide within-country disparities, disproportionately affecting the poorest households and rural residents, who represent the majority of the population in most of the countries.

Social inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa. Interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies should be scaled up to reach the most vulnerable populations.

The COVID-19 pandemic has spread across 185 countries [1] with overwhelming rates of viral transmission. The sub-Saharan African region is believed yet to reach its peak of the epidemic curve, with over 46,000 cases reported as of May 12th [2]. Lacking a safe and effective vaccine, countries have implemented strategies to slow the transmission of disease and prevent the overburdening of their health systems. However, social inequalities in this region challenge an equitable response to the pandemic.

Social distancing measures such as home-stay policies and curfews have been put in place globally. These measures, though necessary, are difficult to implement in a region like sub-Saharan Africa, where more than 40% of people live under 1.9 USD a day [3], and up to two thirds of jobs come from the informal sector [4], precluding many from health insurance and secured income. Overcrowding and informal settlements further exacerbate the feasibility of such mitigation strategies, particularly in a region where the median average household size is 4.8, surpassing 8 in countries such as Senegal and The Gambia [5].

Besides home-stay policies, handwashing with water and soap [6, 7] is one of the most effective interventions, recommended by the WHO and the CDC, to minimize the risk of infection at community-level. While access to water and sanitation is universal in high-income settings, it remains a basic need that many do not have in sub-Saharan Africa.

We analyzed the most recent Demographic and Health Surveys (DHS) of 16 countries in sub-Saharan Africa since 2015. The DHS are nationally-representative household surveys that provide data on health and population indicators [8]. Our main outcome was the proportion of households having water and soap where a place for handwashing was observed. Inequalities were estimated using absolute differences between urban and rural, as well as richest and poorest households, and visualized using equiplots weighted by the population size.

The results from 16 countries in sub-Saharan Africa indicate that, on average, only 33.5% of households with an observed handwashing place at home have water and soap. We found large differences across countries, with national estimates ranging from 5% in Burundi to 64% in Angola, albeit covering different time periods between 2015 and 2018. Rural residents, who represent the majority of the population in the region, have a much lower access compared to their urban counterparts. Urban-rural disparities are wide in all countries, reaching up to 41.8 percentage points in Rwanda, where rural residents represent 82.8% of the total population and only a quarter of them have access to handwashing with water and soap. This basic need remains astonishingly low even in urban areas in countries such as Malawi (16.9%), where the urban-rural gap is narrower. In contrast, Angola presents a different pattern where more than 50% of both urban and rural residents have access to adequate hand hygiene.

Inequalities between the richest and poorest households are as alarming, revealing gaps as large as 63.7 percentage points in South Africa. Burundi had the lowest access regionally, showing 3.8% of rural residents and 1.7% of the poorest households having water and soap at home. Equiplots by place of residence and wealth are shown in Fig. 1. Our findings are based on the households in which a fixed or mobile place used for handwashing was observed, which ranges from 99% in Burundi to 11% in Rwanda. Thus, households that did not have a handwashing place in the dwelling or did not allow the interviewer to observe the facility are not included in our analyses.  

As the region faces a ravaging and highly contagious virus, many still do not have the basic human right of clean water nor soap for handwashing in their homes. It has never been more urgent to ensure access to essential hand hygiene needs, especially for the rural and poorest who are in a battlefield without this simple, yet powerful, shield against COVID-19. The relevance of access to adequate hand hygiene to prevent the spread of disease ought to be considered by public health officials and scientists for program implementation and disease transmission modelling purposes, respectively.

Action has been taken on this front in several countries in the region where handwashing stations with soap were implemented at public transportation sites in the past months as an early response to the pandemic [9, 10]. Similarly, “tippy taps” have been put in place and are designed to enable safe handwashing specifically in rural areas with no running water [11]. We applaud these strategies and suggest that interventions such as mass distribution of soap and ensuring access to clean water, along with other preventive strategies be widely scaled up, particularly in rural areas and informal settlements.


The datasets generated and/or analyzed during the current study are available at or



1. Johns Hopkins University. COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. (Accessed 12 Apr 2020).

2. World Health Organization. Coronavirus disease (COVID-2019) situation report-113. Geneva: WHO; 2020. (Accessed 12 May 2020).

3. Atamanov A, Castaneda Aguilar RA, Diaz-Bonilla C, et al. Global poverty monitoring technical note 10: September 2019 PovcalNet update what’s new. Washington, D. C.: World Bank Group; 2019. (Accessed 12 Apr 2020).

4. Media L, Jonelis AW, Cangul M. The informal economy in sub-Saharan Africa: size and determinants. Washington, D. C.: International Monetary Fund; 2017. (Accessed 12 Apr 2020).

5. UN Department of Social Affairs and Economics, Population Division. Patterns and trends in household size and composition: evidence from a United Nations dataset. 2019. (Accessed 12 April 2020).

6. World Health Organization. Clean care is safer care. (Accessed 12 April 2020).

7. Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): how to protest yourself & others. (Accessed 12 April 2020).

8. The demographic and health survey program. (Accessed 12 Apr 2020).

9. Dalglish SL. Correspondence COVID-19 gives the lie to global health a role for CT in really tell us so far. Lancet. 2020;395:1189.

10. Anita Powell. ‘Wash your hands’ is tough message across Africa. 2020. (Accessed 12 May 2020).

11. World Health Organization Regional Office for Africa. Hand washing with the tippy tap. (Accessed 12 May 2020).


Jiwani, S.S., Antiporta, D.A. Inequalities in access to water and soap matter for the COVID-19 response in sub-Saharan Africa. Int J Equity Health 19, 82 (2020).

International Journal for Equity in Health :



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GCSE results: the hidden but enduring effects of parental social class


Sarah Stopforth, Vernon Gayle, and Ellen Boeren discuss the enduring nature of social class-based inequalities in the UK and demonstrate the magnitude of the gap between pupils from the most advantaged and those from the less advantaged social classes.

GCSE results day is now an annual newsworthy event. Every August we watch live broadcasts of nervous young people opening envelopes containing their examination grades. This year, the annual TV ritual takes place in the midst of the unfolding crisis surrounding results in school qualifications during the COVID-19 pandemic and the cancellation of examinations.

GCSE results are important because they shape young people’s choices and chances in education, training, and the labour market. Here we wish to draw attention to the effects of parental (or family) social class on pupils’ school GCSE attainment. News items on gender differences in results, or on gender participation in different subjects, are common. Some media reports focus on inequalities in results for pupils from different minority ethnic groups. By contrast, the media very rarely reports on the sizeable and persistent parental social class differences in school GCSE outcomes.

In a recent study, we examined the relationship between parental social class and pupils’ school GCSE results over two decades. We found remarkable consistency in social class inequalities, despite the overall improvement in GCSE results. We used two large scale, nationally representative household panel studies: the British Household Panel Study, and Understanding Society to which administrative GCSE data can be linked from the National Pupil Database. Together, these two data sources provided a unique 22-year window of observation from the early 1990s to the early 2010s. GCSE subjects in this period were graded from A* to G, with A*-Cs considered ‘good’ passes.

There are many approaches to measuring social class. In our study we used the official UK National Statistics Socio-Economic Classification (NS-SEC). This is an occupation-based social class measure in which members of a social class are considered to share a similar ‘market situation’ (e.g. levels of income, economic security, and chances for economic advancement), and a similar ‘work situation’ (e.g. authority and control). Members of a social class have similar lifestyles and comparable life chances. There are eight NS-SEC class categories, with more advantaged classes such as higher professional occupations (e.g. doctors and lawyers) at the head of the scheme, and less advantaged classes such as routine occupations (e.g. hairdressers and cleaners) at the foot of the scheme.

We found that pupils with parents in higher professional occupations on average gained eight GCSEs at grades A*-C, compared with pupils in routine occupations who on average gained only four (see Table 1). Alarmingly, many pupils in less advantaged social classes also fell short of the national policy benchmark of five or more GCSE passes at grades A*-C.

Parental social class effects were important even when additional influential factors such as parental education, gender, housing tenure, ethnic group, and school-year cohort were included in the analyses. Young people from less advantaged social class backgrounds not only struggled to attain any GCSEs at grades A*-C, but those that did overcome this initial hurdle were then also much more likely to miss the policy benchmark of five or more ‘good’ GCSE passes.

Although GCSE results have improved over time, there is still a persisting gap between pupils from the most advantaged and less advantaged social classes. The results in our study convince us that the effects of parental social class are nuanced and would not be adequately captured by simple proxy measures such as Free School Meals eligibility, or geographical measures of deprivation. Social class inequalities at the individual level continue to be a key determinant of education outcomes for some of the most contemporary cohorts of young people in England.

It is difficult to predict how the specific problems associated with the cancellation of exams will be resolved. The situation has, however, exposed existing socio-economic inequalities in the education system. In the five decades since the introduction of comprehensive secondary schools there have been a raft of policies introduced to tackle social inequalities. Despite changes to the curriculum, assessment, qualifications, and the structure and organisation of schools, parental social class continues to affect educational outcomes.

The enduring nature of social class based inequalities is troubling enough, but the magnitude of the gap between pupils from the most advantaged social classes and those from the less advantaged social classes is deeply concerning. It is especially alarming that many pupils from the least advantaged social classes do not even achieve the benchmark of five GCSEs at grades A*-C.


About the Authors

Sarah Stopforth is a Research Fellow at the University of Sussex.

Vernon Gayle is Professor of Sociology and Social Statistics at the University of Edinburgh.

Ellen Boeren is Professor of Education at the University of Glasgow.

*To view the table, please visit the webpage (link below).


Date                       :                      August 20, 2020

Source                   :                     LSE British Politics and Policy

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