Identifying Potential Surgical Need and Examining Access to Surgical Care Among Syrian Refugees Living in Lebanon

BACKGROUND: The Syrian conflict has displaced over 14 million people since 2011, with Lebanon hosting over 1.5 million Syrian refugees, the highest per capita worldwide. Displaced Syrians living in informal settlements face significant unmet surgical needs, yet data on their access to care remains limited. To identify potential surgical conditions among displaced Syrians in Lebanon and assess access to and barriers to surgical care. METHODS: Cross-sectional, cluster-sample survey has been conducted over a period of 9 months (August 2020-April 2021). Household- and individual-level data were collected from informal refugee settlements across three Lebanese governorates. Heads of household (n = 1468) and two individuals per household (n = 2936) were interviewed to assess surgical conditions, care-seeking, barriers to access, and associated functional and psychosocial impacts. RESULTS: Among 2936 respondents from 1468 households, 4192 potential surgical conditions were reported. Wounds (55.2%), followed by deformities (35.8%), and masses (7.1%) were most common. 86.2% sought medical care, of which surgery was recommended in 19.0%. Of those, only 34.8% underwent surgery. Financial burden was the most cited barrier. Impacts included inability to work (20.8%), dependence in daily activities (7.1%), and shame (5.8%). Household mortality over 12 months was 6.4%, equivalent to 32 deaths per 1000 population. Among deceased, surgical needs suggested in reported conditions (e.g., masses, injury, deformities); only 19.6% received surgical care before death. CONCLUSIONS: Displaced Syrians in Lebanon report high unmet surgical needs, with wounds and deformities most common. Financial barriers limited surgical access, contributing to impaired quality of life and increased mortality. The surgical burden among refugees in Lebanon represents a critical public health concern, underscoring the need for equitable access to essential surgical care.