International Journal of Migration, Health and Social Care

Introduction: Bedouin in Lebanon: Migration, Settlement, Health Care and Policy

Dawn Chatty
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To cite this document:
Dawn Chatty, (2011),"Introduction: Bedouin in Lebanon: Migration, Settlement, Health Care and Policy", International Journal
of Migration, Health and Social Care, Vol. 6 Iss 3 pp. 19 - 20
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http://dx.doi.org/10.5042/ijmhsc.2011.0060
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 Open access credit:
European Commission, Directorate General Research, FW6 INCO DEV, Project no. 015362, Bedouin Health

Introduction:
Bedouin in Lebanon: Migration, Settlement,
Health Care and Policy
Dawn Chatty
University Reader in Anthropology and Forced Migration, and Deputy Director, Refugee
Studies Centre, University of Oxford, UK

Basic health care for pastoral peoples and other Nadia Abu Zahra and Ms Nisrine Mansour served
marginal rural populations has been difficult to as research assistants to Dr Chatty, who supervised
provide in the Middle East. In part this is due to the project from the University of Oxford. The
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their relative remoteness from urban centres and
the inaccessibility of their camps and informal
settlements; in some cases it is due to their
mobility. These marginal, sometimes mobile and
generally remote populations have largely been
excluded, or have excluded themselves, from
government health care provision because of
their lifestyle. In 2006 the European Commission
funded a research project which focused on
the quality of provision and barriers to use of
accessible health care for the marginal peoples
in desert and rural settings mobile and recently
settled pastoralists of the southern Mediterranean
Rim. The four papers which follow are a result
of a study carried out in Lebanon in 2007 and
2008. The framework and study design for this
two-country study were elaborated in detail in
the EU project document, Improving Access
to and Quality of Reproductive and Child
Health Care to Marginal Peoples: Bedouin of
Lebanon and Jordan. This study was set in
the central Bekaa Valley of Lebanon where the
highest concentration of Bedouin households
were known to be settled and where a number
of rural government and private clinics operate.1
The first year of the project focused on hiring
and training the country team, which consisted of
the Team Leader Dr Faysal El-Kak, lecturer in the
Faculty of Health Sciences, American University of
Beirut, Ms Choua Desouki, and Mss Nadia Bou Ali,
Samar Kanafani, Hiba Morcos and Farah Barbir,
also from the American University of Beirut. Dr
1 The EU project no. 015362, Improving Access to and Quality of Reproductive and Child Health Care to Marginal Peoples: Bedouin of Lebanon
team gathered quantitative data from the rural
health centres in the central Bekaa Valley relating
to Bedouin primary health care delivery and
immunisation campaigns. Preliminary qualitative
data was also collected during this first year by
interviewing key personnel and health staff in
government and in the international aid sector,
both individually and in groups; data on the scope
of the health care provision was also collected at a
select number of clinics, both public and private,
in the study area.
In the second year, formal survey and semi-
structured interviews with women visiting health
facilities took place. A sub-sample of Bedouin
families were selected for in-depth interviewing
to explore household health-care seeking, the
medical and reproductive histories of children and
women respectively, the size and conditions of
their herds, their immediate health concerns and
their movements over the past year. Narratives of
critical incidents when health care was used were
elicited, as well as views about health and illness
and their own needs. By the close of the second
year, a fairly accurate picture of the problems
confronting health care professionals when
dealing with the Bedouin population had emerged.
In the third year of the project, dissemination of
findings and participatory workshops resulted in
the definition of a possible model intervention
to improve access to and quality of reproductive
and child health care. After nine months of
participatory dissemination of findings among

and Jordan, was co-ordinated by Professor Gillian Lewando Hundt at the University of Warwick. Professor Hundt was the PI responsible for managing
the Jordanian team; Dr Dawn Chatty, University of Oxford, was the PI responsible for the Lebanese team.

10.5042/ijmhsc.2011.0060
International Journal of Migration, Health and Social Care Volume 6 Issue 3 November 2010 Pier Professional Ltd 19
 Introduction: Bedouin in Lebanon: Migration, Settlement, Health Care and Policy
policy makers, practitioners and the Bedouin
community in the Bekaa, the general consensus
was to establish a Community Health Volunteer
Programme which created locally recognised and
trained health liaison individuals to bridge health
communications, practices and capacity.
In detail, the four papers which follow were
built on the data collected and included the
following.
Sixteen individual semi-structured interviews
with key national and local policy makers and
providers. These interviews elicited the views
of these key actors on current and future
policy and practice at regional, national and
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local levels. A topic guide was developed for
these semi-formal interviews.
Two focus and natural group interviews with
health personnel in the clinics in the study site
area using participative tools. A topic guide
was developed for these interviews.
Ethnographic observation of six clinics
undertaken by the research fellows at six
clinics in the Bekaa Valley. The research team
shadowed health staff during clinic sessions
for a period of one week in order to record
the routine of the clinics, the pattern of daily
work and staffpatient interactions. Detailed
field notes were taken.
Six audits of health records and clinic facilities
with the local health care workers in the
selected clinics. A review of the records of
the use women and children made of the
health care of the clinics was undertaken
at these six clinics and analysed in order to
establish the scope of primary health care
delivery, immunisation, maternal and child
20 International Journal of Migration, Health and Social Care Volume 6 Issue 3 November 2010 Pier Professional Ltd
health, and preventative and curative care
of Bedouin families in order to gain a broad
general understanding of current coverage and
the systems in place. Additionally an audit of
equipment, staffing and coverage (MAQ) was
undertaken using a standardised instrument.
One hundred and eleven formal surveys
screening mothers seeking care for themselves
or their children. These interviews took place
when they were visiting rural government
health centres or private clinics for their own
or their childrens requirements.
Forty-two in-depth, semi-structured interviews
were conducted with women on the health-
seeking behaviour and experience during the
last six months of the women and the children
in the family. A topic guide was developed for
this purpose.
The project is currently in its final phase
and negotiations are on-going to hand over the
Community Health Volunteer Programme to a
local NGO with the support of the Outreach
Programme in the Faculty of Health Sciences at
the American University of Beirut.
Address for correspondence
Dr Dawn Chatty
Refugee Studies Centre
Department of International Development
3 Mansfield Road
Oxford University
Oxford OX1 3TB
UK
Email: dawn.chatty@qeh.ox.ac.uk
 This article has been cited by:

1. Nisrine Mansour, Dawn Chatty, Faysal El-Kak, Nasser Yassin. 2014. They aren't all first cousins: Bedouin marriage and
health policies in Lebanon. Ethnicity & Health 19, 529-547. [CrossRef]
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