Lebanese Residents Research Articles

Vaccine coverage for Lebanese citizens and Syrian refugees in Lebanon.

Following the refugee crisis in Lebanon, the on-going inflow of Syrian refugees presented new challenges to optimal immunization coverage for all the children living in the country. Healthcare facilities have been overburdened during this period and the country witnessed outbreaks of many infectious diseases. Thus, the evaluation of vaccine compliance for mandatory and non-mandatory vaccines as well as the factors affecting the vaccination rate among Lebanese residents and Syrian refugees is fundamental. Since 2012, Lebanon has hosted around 1.2 million Syrian refugees, a high number in a country whose population does not exceed 4.4 million. Healthcare facilities have been overburdened during this period, which has led to the spread of many infectious diseases, including outbreaks of measles, mumps and hepatitis. At the appearance of such outbreaks, it becomes essential to evaluate vaccine compliance and the factors influencing the vaccination rate among Lebanese residents and Syrian refugees in infants and children up to 15 y of age. A total of 571 infants and children were recruited in Beirut and Mount Lebanon, two governorates that together host half of the Lebanese population. A very high rate of vaccine compliance was seen for mandatory vaccines, whereas an intermediate to very low rate of compliance was found for non-mandatory vaccines. Both bivariate and multiple regression analyses indicated that age group and regular consultation of a pediatrician were independently associated with immunization coverage. Bivariate analysis indicated that parental age, occupational and educational status of parents, family size and vaccine price were also independently associated with immunization coverage. Incomplete vaccination coverage was associated with socioeconomic factors. From these results, it becomes apparent that it may be necessary to reassess vaccination priorities considering the current socioeconomic situation.

Violence, displacement, contact, and attitudes toward hosting refugees

How do individuals’ personal experiences with various aspects of political violence affect their attitudes toward hosting conflict refugees? More specifically, how do their personal exposure to violence, their own personal experience of being displaced, and their recent contact with refugees influence these attitudes? To explore answers to these questions, we draw upon a recent survey of 2,400 Lebanese residents where we identify individuals who experienced violence during the Lebanese civil war (1975–90), those forced to flee their homes during that conflict, and those who enjoy recent contact with Syrian immigrant and/or displaced populations. We examine whether these distinct experiences affect respondents’ regard for members of the Syrian refugee population. Results demonstrate that historical exposure to violence and experience of displacement have no discernible impact on individual attitudes toward hosting refugees. We find much stronger evidence that attitudes are associated with whether individual respondents have had contact with Syrians in Lebanon; those with such interactions are significantly more likely to support hosting refugees, to consider hiring a refugee, or to allow one of their children to marry a refugee. Our findings suggest exposure to violence by itself does not correlate to positive sentiments toward refugees, especially over time. Further, finding ways to create positive contact between refugees and native populations may be associated with improving attitudes and relations between the two populations.

Introduction to the Special Issue: Bordering the Middle East

ABSTRACTSeven years after the beginning of the Syrian uprising and thirteen years after the transformation of Iraq into a federal state, one can notice the permanence of the nation state borders in the Middle East despite the worst prediction of a general breakdown of the colonial lines. But the Middle East, like no other region in the world, seems to face such a challenge to the state border system with the lasting internal fragmentations in Syria, Yemen, Libya and Iraq. In reaction to this threat, governments erected sophisticated and costly fences at the edge of the states, transforming the regional landscape, raising issues of states’ sovereignty and regimes’ legitimacy; they are also highlighting the existence of the local communities (religious, ethnic or tribal) that are largely straddling across the international borders, defining alternative boundaries of belonging. This special issue intends to deal with two main questions: how do borders influence actors’ identity building? And how do identity politics at the local or national level re/define borders and boundaries? Six case studies stemming from intensive fieldwork research provide insights on state-community relationships through the lens of border issues in the Machreq and the Gulf areas thanks to different disciplinary approaches. Through IS territorialisation, Jordanian Bedouins, Kuwait’s national identity representations, Israel’s Lebanese residents, Oman’s construction of political sovereignty and representations of Gulf and Middle Eastern borders, authors highlight multi-scalar processes of identity building and representations through the bordering of the national, tribal or religious group.

Discreet and Hegemonic Borderscapes of Galilee: Lebanese Residents of Israel and the Israel–Lebanon Border

ABSTRACTFollowing the processual shift in border studies, recent concepts such as “borderities” and “borderscapes” allow for original analyses that give voice to multiple agents alongside that of the nation-state in bordering processes, elucidate the links between border representation and border experience, and establish borders as both “markers of belonging and places of becoming”. This article will explore the potentials of these concepts when applied, not to the highly mediatised Separation Fence in the West Bank, but to a less studied border that reveals parallel evolutions in Israeli borderities and contemporary Middle Eastern borderscapes: the Israel-Lebanon border. It will focus on a marginal and little known phenomenon, that of the migration of Southern Lebanese to Israel. The creation of the State of Israel at the expense of Pan-Arab and Palestinian national aspirations has laid the foundations for a diversified relation to this border amongst inhabitants of the Galilee today depending notably on their belonging to the indigenous Arab population, or the more recently settled Jewish population. Through an analysis of two groups of Lebanese migrants, who, although originating from the same villages in Lebanon, settled respectively on opposite sides of the Arab/Jewish divide in Galilee, we will see how different patterns of border crossings produce different levels of interiorisation of the Israel-Lebanon border and different uses of categories of identity and meaning defined by it. Reterritorialised in either of Galilee’s superimposed geographies, Southern Lebanese migrants reveal two alternative Galilean borderscapes, one normative and hegemonic, partaking in the “national order of things”, the other discreet and alternative.

The master cockroach: scrap metal and Syrian labour in Beirut’s informal economy

ABSTRACTIn Lebanon, where over one million Syrians have taken refuge in the last five years, the informal sector has risen dramatically, particularly in the capital Beirut. Yet, the informal economy is not a recent phenomenon in Beirut and Syrian labour has long contributed to it. With the accelerated rate at which the informal sector has increased, new features that are distinctive to conflict and displacement are arising out of the interface with the formal sphere. In this article, I explore from an anthropological perspective some of the tensions that surface due to encounters between Lebanese residents who belong to informal political networks in a working class neighbourhood in Beirut and Syrian workers at a local informal scrapyard that specializes in salvaging different types of scrap metal from discarded items in Lebanon’s garbage. By taking an ethnographic approach to studying the informal economy, this article looks at some of the ways in which tensions within a community can facilitate the social reproduction of a disparately unequal labour regime in the country. In the case of this particular neighbourhood, narratives of social inequality were often centred on the cockroach, at once a pest and a heroic figure—and whose fate rests on its ability to remain obscure and out of sight.1

Hyperreactive airway disease in adults: data from a national study in Lebanon.

Asthma and hyperreactive airway (HRA) disease are a major cause of health resource utilization and poor quality of life worldwide; its prevalence in adults may widely vary according to the definition used. It is mainly a childhood disease, but its natural history till adulthood is not well known. This is due to other confounding factors such as smoking and environmental factors that may lead to misdiagnose asthma as chronic obstructive pulmonary disease. Correct and timely diagnosis of asthma and HRA is important because it can be treated successfully and affected individuals may achieve good control of their disease. To evaluate the prevalence of asthma and HRA in Lebanese adults, their symptoms and predictors. A cross-sectional study using a multistage cluster sample was carried out in Lebanon, between October 2009 and September 2010.Lebanese residents aged 40 and above participated to the study; a post-bronchodilator spirometry was performed to confirm diagnosis. Out of 2201 individuals, 218 (99%) were considered to have HRA. The following factors were found associated with HRA in the Lebanese population: Northern (ORa: 3.54) and Bekaa Plain (ORa: 2.44)] versus other regions; occupational exposure to toxic gases and fumes (ORa: 2.08); heating home with wood (ORa: 1.75); having a family history of chronic respiratory disease (ORa: 2.19), a history of childhood lung problem (ORa: 5.53), and father smoking during childhood (ORa: 1.47). Added to these factors, HRA was also predicted by female gender (ORa: 1.81); lower education (ORa: 120); older age (ORa: 1.28) and low birth weight (ORa: 3.14). This is the first epidemiological study in Lebanon that determined physician diagnosed asthma prevalence and hyperreactive airway disease and their associated factors among Lebanese adults. It also provides useful contributions that local health organizations may use for national programming and a foundation for health researchers to pursue further study in asthma research. Public awareness about the increased risk of asthma associated with heating homes with wood and exposure to passive smoking should be raised; Lebanese policy makers should also generate higher efforts to implement and reinforce the smoking ban law in public places.

Mississippi Mahjar : Lebanese Immigration to the Mississippi Delta

[ILLUSTRATION OMITTED] As anyone who has studied history of South knows, racial hostility was ubiquitous across Mississippi Delta throughout hundred years following Civil War. But contrary to dominant narrative, conflict there was not purely limited to relationships between blacks and whites. As Haseeb George Abraham, a Lebanese peddler who immigrated to Mississippi Delta in 1885, discovered, those who came to Delta from elsewhere had to learn customs of region before they were accepted into social culture there. Gregory Thomas of Vicksburg describes how his great-grandfather traveled across region peddling his wares, once unintentionally asking a lady on a Delta plantation to sleep with him, instead of asking if she could provide shelter for night. Knowing little English, he soon found himself upon back of a horse with a noose around his neck, prepared for his hanging. Only when another Lebanese man came along and inquired as to what had happened was mistake made clear and Abraham's life spared. (1) Haseeb Abraham's experience provided him a crash course in ways of Delta. Generally, itinerant peddling gave immigrants opportunity to gradually learn and adapt to prevailing social customs of South, including its stringent social codes and harsh judicial practices. Interactions with rural farmers and, occasionally, townsfolk gave peddlers chance to view culture as somewhat passive observers in sense that they were perpetually passing through. MOVING TO THE MISSISSIPPI DELTA Between 1880s and end of World War I, a combination of famines, epidemics, extreme poverty, and religious and political genocide led to more than 100,000 deaths in Mount Lebanon region of Ottoman Empire-controlled Syria. During that same period, over 100,000 Lebanese residents of predominantly Christian region participated in a mass migration that scattered them across globe to places such as Australia, Brazil, Mexico, and United States. While most of these Lebanese citizens intended to emigrate only until conditions at home had improved, many eventually realized that life of an emigrant in United States was preferable to that on what was commonly known as the Mountain. Ironically, many Lebanese fleeing hardship and oppression found themselves in Mississippi, settling in caste-based, Jim Crow Delta, where they were considered neither black nor white. These Lebanese immigrants--mostly male--found work peddling wares to blacks and whites across Delta, forming close economic bonds in and with black communities and hoping one day to assimilate into economically and socially dominant white community--all while retaining vital elements of their own cultural heritage. (2) For decades, observers from within and beyond mostly rural Mississippi Delta have chiefly defined region as a black/white dichotomy that consisted primarily of planter-class and poor whites, and slaves-turned-sharecroppers-turned-impoverished blacks. William Alexander Percy furthered that notion in his 1941 autobiography Lanterns on Levee: [T]he cloth of Delta population--as of whole South--is built of three dissimilar threads and only three. First were old slave holders, landed gentry, governing class; though they have gone, they were not sterile; they have their descendants, whose evaluation of life approximates theirs. Second were poor whites, who owned no slaves, whose manual labor lost its dignity from being in competition with slave labor, who worked their small unproductive holding ignored by gentry, despised by slaves. Third were Negroes. (3) [ILLUSTRATION OMITTED] The reality, however, is that region has long been peopled with inhabitants as diverse and distinctive as its soil is fertile. …

<em>The Complexities of Citizenship among Lebanese Immigrants in Sierra Leone</em>

This article examines exclusionary citizenship practices in Sierra Leone toward people who are not racially Black. As far back as the 1919 “anti-Lebanese riots,” Blacks associated their lack of opportunities with economic privileges that the Lebanese enjoyed under British colonialism. British favoritism contributed to the denial of full citizenship to non-Blacks during the construction of a postcolonial state. Non-Blacks who were citizens of the British Empire became defined as “noncitizens” under a 1962 (amended) Sierra Leonean constitution, which excluded persons of “non-Negro African descent” from their right to citizenship by birth. Lebanese residents had no option but to naturalize. The laws excluded naturalized citizens from political membership. The Citizenship Act of 1973, the Citizenship (amended) Act of 1976, the 1991 Constitution, and the Citizenship (amended) Act of 2006 reinforced the exclusion of non-Blacks from natural citizenship. Legal restrictions ensured that Lebanese could not mount an independent political challenge. Lebanese continue to occupy both an economically privileged and politically isolated position in Sierra Leone. They have responded to citizenship discrimination by strengthening their economic activities, taking advantage of bureaucratic corruption to obtain passports, and/or maintaining multiple citizenships. Their membership to Sierra Leone is based on “entrepreneurial citizenship.”

Cigarette smokers' profile in Lebanese adults.

The objective of this study was to describe cigarette smoking prevalence among adults in Lebanon and to evaluate the profile of light cigarette smokers compared to never and heavy smokers. Data were taken from a cross-sectional study carried out from October 2009 to September 2010, using a multistage cluster sampling all over Lebanon. Lebanese residents aged 40 years and above were enrolled in the study with no exclusion criteria. After an oral informed consent, subjects answered a questionnaire, including detailed smoking history and cigarette dependence. SPSS version 17.0 was used for data analysis. Out of 2201 individuals, 1320 (60.0%) had ever smoked cigarettes, out of whom 10.1% were light cigarette smokers. The adjusted odds ratio estimate of cigarette smoking was 3.08 for males compared to females (P<0.001), 1.13 for lower education (P=0.016), 1.87 and 3.12 for retired and jobless compared to working (P=0.001 and P<0.001) respectively, 1.17 for older age (P<0.001), 1.68 for presence versus absence of a family history of chronic respiratory disease (P<0.001), and 5.27 and 1.99 for presence compared to absence of at least one smoker at home (P<0.001) and at work (P<0.001) respectively. This is the first epidemiological study in Lebanon that determined cigarette smoking prevalence at the national level. In Lebanon, males of the older generation seem to have higher smoking prevalence and dosing.

The impact of emigrants’ homeland relations on air travel demand in a security volatile market: a case study on Lebanon

The impacts of international migration have been heavily studied. Much of this analysis has been carried out within the framework of the economic and social effects of migrants, to both host and home countries. This paper looks at the impact of Lebanese emigrants’ homeland relations on air travel demand in a security volatile market. The emphasis is on two particular features: first, the principal impact of liberal air transport policies in facilitating emigrants’ home visits; and second, the sensitivity of passenger-GDP relation. The paper pulls together data and other cases on the Lebanese emigration evolution and explains its impacts on the economy as well as on the air transport market in Lebanon. The study findings suggest that in Lebanon and due to the presence of interrelated factors, the variation and the strength of the relationship between traffic levels and GDP are neither consistent nor static. The considerably huge expatriate communities, which are three times greater than the Lebanese residents, are said to defy the negative impact of security instability on the air passenger growth through frequently visiting expats. Moreover, the emigrants’ economic support to Lebanon through remittance inflows is observed to dampen the sensitivity of the relationship between passenger and GDP in times of war and peace. The results should be looked at as indicative of trends to encourage policy makers to consider how best to make use of these human and financial flows.

Lower Prevalence of Cigarette and Waterpipe Smoking, But a Higher Risk of Waterpipe Dependence in Lebanese Adult Women Than in Men

The objective of this study was to evaluate whether nicotine dependence was higher in Lebanese women smokers compared with men smokers. Data were taken from a national cross-sectional study. Lebanese residents aged ≥ 40 years were enrolled between October 2009 and September 2010. After informed consent, participants answered a standardized questionnaire about smoking behaviors and dependence (measured by the Fagerström-Test-Nicotine-Dependence for cigarettes and the Lebanon-Waterpipe-Dependence-Scale 11 for waterpipes): 1,066 males and 1,134 females were interviewed. 58.7% versus 42.9% of them, respectively, ever smoked cigarettes, while 6.9% versus 6.7% ever smoked a waterpipe (p < 0.001). Moreover, 57.5% in male versus 49.1% in female cigarette smokers (p = 0.041), 35.9% versus 51.6% in waterpipe smokers (p = 0.076), and 67.9% versus 43.6% in mixed smokers were tobacco dependent. A dose-effect relationship was observed with increased rates of women versus men with waterpipe dependence) and an increased odds of dependence among women in multivariable analysis (ORa = 2.28). Positive (smoking waterpipe for pleasure and conviviality) and negative (smoking waterpipe to relax nerves and improve morale) reinforcements were significantly more frequent in women, while no significant sex difference was observed for nicotine dependence or psychological craving. In exclusive waterpipe smokers, significantly higher respiratory diseases and symptoms prevalences were found in females compared with males. Women who smoke waterpipes should receive attention during tobacco health education and smoking cessation.

Correlates of COPD and chronic bronchitis in nonsmokers: data from a cross-sectional study

PurposeOur objective was to assess the prevalence of chronic bronchitis and chronic obstructive pulmonary disease (COPD) and their correlates among a Lebanese nonsmoker group.Material and methodsA cross-sectional study was conducted between October 2009 and September 2010, using a multistage cluster sample throughout Lebanon including Lebanese residents aged 40 years and above with no exclusion criteria. Pre- and postbronchodilator spirometry measurements were performed and carbon monoxide level was measured in exhaled air. COPD was defined and classified according to the Global Initiative for Chronic Obstructive Lung Disease guidelines or according to the lower limit of normal (forced expiratory volume in 1 second/forced vital capacity postbronchodilator < 5th percentile of the healthy population having the same age and sex). Chronic bronchitis was defined by the declaration of morning cough and expectorations for more than 3 months a year over more than 2 years in individuals with normal spirometry.ResultsOut of 2201 individuals, 732 were never-smokers: 25 (3.4%) of them had COPD, and 86 (11.75%) fulfilled the definition of chronic bronchitis. Correlates of COPD included a childhood respiratory disease, house heated by diesel, and older age. On the other hand, correlates of chronic bronchitis included childhood respiratory diseases, living in southern Lebanon versus other regions, heating home by gas, older age, number of smokers at work, and lower height.ConclusionA substantial percentage of the nonsmoking population may exhibit chronic bronchitis or COPD. The significant correlates mentioned above should be taken into consideration in order to reduce the risk of developing such chronic and debilitating respiratory diseases.

Dually Divided?

INTRODUCTIONCanada's dual citizens have become the object of increasing attention from policymakers and researchers in immigration and international affairs. A number of unrelated events have triggered the recent interest in such matters. The evacuation of Canadian citizens from war-torn Lebanon in the summer of 2006 has perhaps been the most important catalyst in the current fuss over dual citizenship. Author Andrew Cohen contends that purportedly long-time Lebanese residents used Canada as a temporary haven, invoking their Canadian citizenship and calling upon the government of Canada to fulfill its obligations to rescue them.1 Other matters that drew public attention to the issue of dual citizenship were the revelations that both the governor general of Canada, Michaelle Jean, and the leader of the federal Liberal party, Stephane Dion, held French citizenship. In their cases concerns were raised over potential loyalty conflicts from certain segments of the population and calls were issued for Jean and Dion to renounce their French citizenship (Jean did so). Indeed, the cumulative effect of these issues is likely reflected in the results of a survey that found that some four in 10 Canadians disapproved of dual citizenship. Disapproval was especially strong amongst persons over the age of 55, who were split evenly on the matter, in contrast to persons between the ages of 18 and 34 where one in four felt that Canadian citizens should be allowed to hold citizenship in a country other than Canada.2Underlying these issues are debates about the strength of Canadian identity and concerns over immigrant integration, multiculturalism, and social cohesion-a notion that is often loosely defined by researchers and policymakers. Author Yann Martel referred to Canada as the greatest hotel on Earth upon accepting a Booker Prize in 2002, Michael Bliss has called Canada a working non-nation, Andrew Cohen a virtual nation, and Allan Gregg a no-name supermarket. According to a senior policy analyst at Foreign Affairs, these seemingly abstract sociological musings raise important questions about directions in Canada's foreign policy and a harbinger of future debates.3 That may be true. However, those who make the claim that Canadian identity is fragile and that dual citizenship erodes our collective sense of Canadianness have yet to provide strong evidence (empirical or otherwise) in support of such claims.Nonetheless there is a gap between the public perception that Canadians take their citizenship for granted and thus do not possess a strong enough sense of belonging to Canada, on the one hand, and the degree to which Canadians positively evaluate their own degree of belonging to the country and the significant value they accord to their citizenship, on the other. I would contend that the gap exists largely as a result of the manner in which some analysts have chosen to frame public debate over citizenship and identity. Critics of dual citizenship as a threat to social solidarity and social cohesion often see identity and citizenship in zero-sum terms in which one inevitably detracts from the other.There is no doubt that many people associate their citizenship with their sense of belonging to Canada. Moreover, the federal government is well within its right to support a sense of belonging to Canada amongst its citizens regardless of whether they are single or dual. However, the federal government should not tie citizenship to a strong sense of belonging to the country. While it may be regrettable, citizens of Canada have the right to not feel a strong sense of attachment to the country. Such an idea runs counter to Canada's central role in the promotion of cultural diversity abroad and in so doing risks inadequately reflecting the diverse peoples we are. In the next sections of the article, I explore the gap between citizenship and belonging to Canada and suggest a refraining of the debate to avoid the pitfalls associated with the federal government explicitly making such a connection. …

Dollarization in Lebanon

Lebanon has experienced large-scale dollarization during and after its 15-year long civil war. This paper analyzes the driving forces behind the dollarization of the Lebanese economy, using two econometric models that, apart from determinants commonly included in empirical studies on the dollarization phenomenon, also specifically take into account the limited reversibility of the dollarization process. The latter is modeled through the inclusion of a ratchet variable, which implies an asymmetric substitution process between domestic and foreign currency. The ratchet effect, in the different definitions applied, is found to be significant. In addition, the expected depreciation, a stock adjustment variable and, when cross-border deposits of Lebanese residents are included in the analysis, also the interest rate differential are other statistically significant determinants of the dollarization process in Lebanon.

“Inside and Outside the Hospital, People Were Screaming: ‘Haddad, Kataeb, Israel—Massacre’”

Editor's Note: Ellen Siegel went to Beirut on September 2, 1982 to volunteer her skills as a registered nurse. She was working in Gaza Hospital, run by the Palestine Red Crescent Society, in Sabra refugee camp, when the Israel Defense Forces permitted Phalange and Haddad militia into the camps and hundreds of Palestinian and Lebanese residents were massacred. Ms. Siegel testified before the Israeli Commission of Inquiry on November I, 1982. In the following exclusive interview, she tells the Journal's Assistant Editor Lynne Barbee what she told the Commission about those harrowing four days in Beirut.