Trapped and abused: migrant workers’ experiences in Lebanon

Mahi* was forced to sleep on the balcony even during winter. Martha* was sexually harassed—but no one believed her. Beatrice has to answer to another name. Makdes* was subjected to verbal, physical, and psychological abuse. These are just some of the experiences migrant workers have disclosed to Médecins Sans Frontières (MSF) medical and mental health teams in Lebanon’s capital Beirut.

An estimated 176,500 migrants are living in Lebanon (IOM)—about 70 percent are women. Most emigrated from Asian and African countries, predominantly Ethiopia, Bangladesh, and Sudan. Almost half of the migrants in Lebanon are domestic workers, which means they live with their employers, often in very challenging environments. 

MSF runs a clinic in Bourj Hammoud, a northern suburb of Beirut that serves as a hub for many vulnerable communities in Lebanon, including migrants, due to its affordable housing, proximity to major public transport stations, and vibrant community spaces, including markets and diverse religious spaces. While the clinic’s services are open to all, the majority of our patients are from migrant communities.

Often people have chosen to leave their home country in search of a better life but find themselves trapped in a system that excludes them from the laws that protect other workers’ rights. 

It can rob them of their choices, rights, and even their voice.

Les travailleurs migrants arrivent au Liban grâce au système de parrainage de la kafala. Dans ce système – que les militants et les organisations de défense des droits humains qualifient, dans ses pires manifestations, d'« esclavage moderne » –, les travailleuses domestiques migrantes sont surmenées et sous-payées, voire pas du tout, et ne bénéficient souvent d'aucune pause ni de jours de congé. Nos équipes ont constaté les graves conséquences de ces conditions sur la santé des travailleurs migrants.

Migrant workers come to Lebanon through the kafala sponsorship system. Under this system—which at its worst is described by human rights activists and organisations as amounting to “modern-day slavery” (Human Rights Watch)—migrant domestic workers are overworked and underpaid or not paid at all, often given no breaks or days off. Our teams have witnessed the serious implications these conditions have on migrant workers’ health.

Many women decide to leave the houses they’re confined in, but it is not always possible. Some find support within the migrant communities, but many are left homeless, without legal documents, and in need of urgent assistance. Should they choose to go back to their country, they might not have the resources for arranging their paperwork or even buying a flight ticket. Some choose to stay in Lebanon despite the hardship because they have nowhere to go, or simply because they need to feed their families.

Migrants’ access to health care in Lebanon is severely limited. Under kafala, an employer can deny women their right to seek health care. Other migrants not bound by kafala are frequently turned away from hospitals and primary health care centres, either for not having legal documents or simply because they’re not Lebanese. Some of them even avoid seeking hospital care altogether, fearing they will be turned away, deported, or asked for money, which can further complicate their medical conditions.

At the MSF clinic in Bourj Hammoud, our teams are responding to migrants’ medical needs, offering primary health care consultations, sexual and reproductive health services, and mental health services, including psychiatric consultations. We also have been covering the cost of referrals for hospitalisation in life-threatening cases, including for psychiatric emergencies.

In 2024, psychiatric consultations in the Bourj Hammoud clinic have doubled compared to the previous year,” says Elsa Saikali, MSF mental health supervisor. 

“This highlights the huge mental health needs among migrant communities. Migrant workers are often dehumanised, subjected to racism and discrimination, and exposed to physical and sexual abuse. All this has deep repercussions on their psychological wellbeing.” 

One of the challenges facing migrants in Lebanon is the language barrier, which further limits their ability to access health care. They’re obliged to sign documents and converse in Arabic to survive, which is why at MSF’s clinic, things are done differently.

“My job is to refer patients to services that are beyond MSF’s ability to respond to,” says Hanan Hamadi, MSF social worker at the Bourj Hammoud clinic. “The patients who come to me have the most basic needs, such as shelter, food items, and cash assistance. I refer them to other organisations offering these services.”

Migrants’ socio-economic situations were exacerbated during the recent Israeli war in Lebanon. Many migrants have disclosed to MSF teams that they were abandoned by displaced families, leaving them on the streets or locking them up in their houses in war-affected areas.

During that period, migrant community leaders helped MSF teams reach the migrants most in need of assistance in overcrowded shelters and apartments, where we donated essential relief items and delivered medical care through a mobile clinic.

D'autres programmes d'aide aux migrants au Liban, gérés par des organisations locales et internationales, ont vu leurs effectifs diminuer au fil des ans. Certains ne fonctionnent que pendant une période limitée, ce qui crée un manque de ressources pour les migrants après leur fermeture.

Other programs targeting migrants in Lebanon run by local and international organisations have reduced over the years—some only operating for a limited period, leaving a gap in resources for migrants once they close.

“It is getting increasingly difficult to refer our patients to other organisations offering assistance to migrants in Lebanon,” says Hanan Hamadi. “This is due to the scarce funding allocated to programs supporting migrants and the defunding or closure of others. This is not a recent issue, as it’s been happening for a while.”