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DRC experiences of cash assistance to non-camp refugees in Lebanon and Turkey

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By Louisa Seferis

Louisa is the MENA Regional Livelihoods & Cash Advisor for the Danish Refugee Council (DRC). She has worked for three years with the DRC for the Syrian crisis on livelihoods, cash and emergency programming in Syria, Lebanon, Turkey and Iraq. Prior to 2011, she worked for four years in Africa on conflict and displacement through protection, livelihood, and reconciliation initiatives with international NGOs. She holds a master’s degree in humanitarian assistance and conflict resolution from Tufts University.

The author would like to thank the DRC teams for their continued work with Syrians across the region, in particular the DRC Turkey and DRC Lebanon teams for their dedication to beneficiary-focused, evidence-based programming. Thank you also to DFID for its innovative approach to funding DRC in Turkey, and to ECHO and UNHCR for their regional partnerships with DRC on the Syrian crisis. 

The abstract was submitted for the ENN Technical Meeting on nutrition at Oxford (7-9 October 2014), and DRC will present the concept during the marketplace presentations. The box on benefits and risks of cash transfer programming was also published in a DRC Evaluation and Learning Brief. 

Cash programming has been used on an unprecedented scale in the Syrian crisis, largely due to the urbanised nature of the Syrian refugee caseload in affected countries and the well-developed markets and banking systems. This article outlines the main contexts in which urban Syrian refugees find themselves and their specific vulnerabilities, especially with regards to access to labour markets, credit and assistance. Unusually, we have found a need to understand and respond to the psychosocial needs of men, given how the crisis has undermined their provider role in the family. Until now, the humanitarian response has failed to address this issue adequately.  The article will also review, from the Danish Refugee Council (DRC)’s perspective, how humanitarian programming for non-camp refugees in Lebanon and Turkey has evolved in order more holistically to meet refugees’ changing needs in the face of protracted displacement, incorporating more traditional humanitarian responses with innovative and large-scale cash programming. Finally, the article will explore DRC’s experiences and share observations around conditional versus unconditional cash. 

Programming context

DRC/IMPR Community Centre in Urfa province, TurkeySince the beginning of the Syrian crisis in 2011, Syria’s neighbouring countries have dealt with the refugee influx in various ways – building numerous and well-equipped camps in Turkey, providing blanket assistance to all registered refugees in Lebanon, and establishing massive camps and processing centres at the Syrian border in Jordan. Regardless of the initial approach, by 2012, Syria’s neighbours all hosted a significant number of non-camp refugees, many of whom settled in urban areas in the hopes of accessing income opportunities. In 2014, Syrians outside of camps constitute the majority of Syrian refugees in the Middle East1.

DRC has been present in the Middle East, and in particular in Syria and Lebanon, since 2007. While programmes in Syria focused on mainly Iraqi and Somali refugees in urban areas, in Lebanon, DRC started a small programme to support Palestinian youth vis-à-vis livelihoods and self-reliance. The onset of the Syrian crisis shifted DRC Lebanon’s focus to provide emergency assistance to Syrian refugees, later expanding the intervention to a holistic approach involving protection, community services and livelihood initiatives. DRC began its operations in Turkey in early 2013, modelling its response after successful interventions in Lebanon and elsewhere that concentrated on non-camp refugee populations. Given the scale of needs and the urban displacement context, DRC considered cash transfers a relevant and cost-efficient way to provide assistance. In late 2013, DRC Lebanon embarked on a large-scale unconditional cash assistance programme to support families during the winter2, and in 2014, DRC Turkey initiated cash assistance through a DFID two-year grant aimed at providing assistance to vulnerable families and transitioning to livelihoods support in 2015 (project on-going). 

The situation in Turkey

Turkey is the host country with the largest network of camps for Syrian refugees (civilians and combatants). While the number of refugees within camps in Turkey peaked by the end of March 2014 at just over 224,000 people, according to UNHCR, the number of non-camp refugees has steadily increased to over 564,000 by mid June 2014 – a 61.1% increase since the end of 2013. The majority of non-camp refugees live in southern Turkey in provinces along the border, with the largest concentrations in Gaziantep, Sanliurfa, Hatay and Kilis provinces. There are over 166,262 non-camp refugees in Gaziantep, 108,349 in Sanliurfa, 134,275 in Hatay, and 45,200 in Kilis3. There are probably more non-camp refugees in these provinces who have not registered with AFAD (Disaster and Emergency Management Presidency of Turkey) and are therefore not reported by UNHCR. The majority of non-camp Syrian refugees in Turkey live in urban or peri-urban areas, renting and sharing accommodation with an average of 1-4 other families and surviving through temporary employment (mainly daily/monthly labour) and minimal assistance. Since May 2014, DRC Turkey has assessed 2,100 Syrian families in Hatay province, southern Turkey. Their main concerns, challenges, income and rental costs are shared in Box 1.

The majority of households assessed (75%) share all expenses between the households and individuals sharing a dwelling, which includes food and heating.

Box 1: Assessment results of 2,100 Syrian families in Hatay province, southern Turkey

Refugees’ main concerns and challenges (households could report more than one concern):

  • 86% reported a lack of job or self-employment opportunities
  • 66% reported they had an insufficient food supply 
  • 60% faced discrimination by the host community 
  • 77% reported difficult access to humanitarian assistance 

Income per month:

  • 16% of households assessed earn 800 TL or more (approx. 400 USD)
  • 34% earn between 500 and 800 TL (approx. 250-400 USD)
  • 22% between 300 and 500 TL (150-250 USD)
  • 9% earn between 100 and 300 TL (50-150 USD)
  • 1% earn between 1 and 100 TL (up to 50 USD
  • 18% reported zero income

70% of households reporting a monthly income said the main source of income was labour. 

10% indicated that their main source of income was selling assets and/or using savings.

Rent:

  • 43% pay rent between 100-300 TL (50-250 USD)
  • 41.5% between 300-500 TL (150-250 USD)
  • 11% pay rent of 500 TL or more (250 USD)
  • 1.5% pay up to 100 TL (50 USD), and 3% do not pay rent (hosted by other families)

Number of people per dwelling:

  • 45% of households live in dwellings with 6-10 people
  • 34% of households live with 1-5 people
  • 21% live with over 10 people in a dwelling

The majority of households assessed (75%) share all expenses between the households and individuals sharing a dwelling, which includes food and heating.

In Turkey, refugees outside of camps face integration challenges such as language barriers4 and very few social ties, resulting in higher tensions with local communities and difficulty finding employment. Syrians in Turkey have very few opportunities to access credit with shops, and landlords generally demand rent/utility payments every month without exception or flexibility. Syrian men who do manage to find temporary jobs (daily, weekly, or sometimes monthly) often complain that they are not paid at the end of the work, and they cannot pursue any legal recourse because they have no right to work in Turkey5. They say the Turkish employer will just find another Syrian to replace him, and generally not pay him either. Refugees say that working more in Syria means improving your quality of life; “in Turkey, working more means just trying to survive.” 

Syrian Kurds are the notable exception, as they can integrate into Kurdish areas of southern Turkey (e.g. Urfa Province) and enjoy better access to social networks and community support. This is also consistent with findings from DRC’s livelihood programming in the Kurdish regions of Iraq, where Syrian Kurds who receive business grants have a high success rate due to their social networks and therefore access to credit, resources, connections and a customer base. 

The situation in Lebanon

Lebanon hosts the largest number of Syrian refugees in the region, both in terms of absolute numbers (over 1,138,000 refugees) and as the greatest proportion of its population (over one-fifth of the total population currently in Lebanon is now Syrian)6. Given the initial small number of refugees and significant humanitarian presence, agencies provided assistance to all registered refugees (with some organisations focusing on the smaller number of unregistered refugees). Between 2012 and 2013, the refugee population grew exponentially and the humanitarian community struggled to maintain the same level of assistance. At the same time, the government did not change its ‘no camp’ policy, which meant refugees sought shelter through any means possible – renting with other families, inhabiting unfinished buildings, living in informal tented settlements, etc. Hosting “fatigue” and reduction in humanitarian assistance compounded refugees’ difficult situations; since the end of 2013, the humanitarian community has drastically reduced its assistance, from providing cash and in-kind assistance to 70% of registered refugees to now planning cash assistance to 5-10% of refugees.

Finally, the cost of living in Lebanon is also extremely high and meeting basic needs is difficult, especially for Syrians used to the same standard of living for much less. The cost of living in Syria remains significantly lower than in Lebanon. Despite inflation within Syria due to the conflict, many basic goods (food/non-food) are still subsidised by the Syrian government or produced locally – albeit in a much more limited capacity than before the conflict. Moreover, the devaluation of the Syrian pound offsets the increased prices in the black market, which is still cheaper than Lebanese markets.

Lebanon v Turkey context

In both Lebanon and Turkey, Syrians face challenges to generate stable income, which in turn affects their ability to meet basic needs as assistance wanes. Oversaturated labour markets, particularly for unskilled workers, either mean that there are fewer job opportunities or the jobs available put Syrian refugees in competition with the host community labour force. Syrians, generally willing to work for less pay than the host community, often crowd out local labour. This is particularly true for sectors such as construction, agricultural work, daily or temporary work and the service industry. For example, restaurants in some parts of southern Turkey often now employ young Syrian boys, starting from around 10 years old, to clear tables, wash dishes and translate for Arabic-speaking customers.

While many programme elements are similar between Turkey and Lebanon because non-camp refugees in both countries face similar challenges (lack of employment, high cost of living, especially rent/food, etc.), there are also marked differences. In Lebanon, there are no camps so all refugees are essentially ‘non-camp.’ The ties that existed between Syria and Lebanon prior to the conflict have eased refugees’ integration – notably the language and exchange of goods and services (approximately 500,000 Syrians worked in Lebanon prior to the conflict, many of them seasonally). Syrians in Lebanon also have access to credit in local shops to buy foods and goods, or with landlords to delay rent payment when families have no income. However, the existing ties and similarities between Syria and Lebanon have also given rise to tensions based on communities’ affiliations, many of which are exacerbated by humanitarian assistance to Syrians only. Syrians were perceived to receive huge amounts of assistance, while the Lebanese received nothing, and Syrians were “stealing” jobs from local communities because they were willing to work for much less. In Turkey, the social ties between refugees and local communities are minimal (Kurds being the exception), which means Syrians faced integration issues from the beginning. They also have limited to no access to credit, so they rely more on assistance, income and selling assets to make ends meet per month – landlords and shop owners rarely give refugees a ‘grace period’ to pay bills. 

The psychological effects of the Syrian crisis 

The majority of humanitarian protection and social responses concentrate on services to women and children, who are perceived as the most marginalised groups. However, in this crisis, men also need support. The psychological impact of the crisis on Syrian men across the region is quite specific, as many feel that they cannot assume their traditional role as breadwinners and providers to the family. “Just give me a job, let me work. The rest, I can take care of myself.” DRC staff observed many physical disputes and instances of domestic violence, not just with project beneficiaries, but also in everyday life. With the prioritisation of services provision to women and children, there is little space for men to socialise outside of the house in settings where they feel comfortable sharing their stories. In DRC’s community centres in Turkey, which serve mainly non-camp Syrian refugees, there was a marked difference when activities and facilities were designed taking into account both men and women’s interests (including mixed-gender activities). In particular, DRC introduced story-telling activities for adult men, as staff found this group to be the ones struggling the most to deal with trauma and displacement. Men expressed gratitude in having the space to come together outside of the pressure of everyday life to find a job or act in a certain way. 

Use of cash assistance by urban refugees

Syrian refugees outside of camps live in urban environments and engage with markets every day. Countries such as Lebanon and Turkey, particularly in the urban areas, enjoy relatively free and generally informal markets – businesses can start (and close) easily, and there are few regulations on small and ad-hoc enterprises such as grocers, coffee shops, barbers, etc. Moreover, refugees need cash to meet basic needs, which across the region they identify as mainly food, shelter, and health (education, hygiene items, etc. are generally less prioritised). In these areas, cash programming makes sense. However, many humanitarian agencies prefer either to give items in kind or provide conditional assistance (e.g. cash for training) or restricted through vouchers (paper or electronic), such as food vouchers. Many agencies are concerned that refugees will not spend the cash as organisations intend. This is because there is still a perception that in-kind or restricted cash will better meet needs, because “we don’t know what they will buy with cash.” This is despite extensive research worldwide on displaced populations and the use of cash in humanitarian assistance, demonstrating that the vast majority of recipients do spend responsibly7. Research shows that the amount of cash or voucher transfers, proportional to a family’s estimated minimum expenditures, determines how much food the family can purchase, which is “obviously critical to the effectiveness of the transfer in improving consumption (amount of food able to be purchased, dietary diversity, negative coping mechanisms, etc.)8.” Anticipated expenditure is an aspect of household consumption that is not considered in most assessments or evaluations –it is already quite difficult for refugee households to estimate their actual expenditures. The main response we hear about planning expenditures is that there is no planning – when an emergency comes up (usually medical), refugees will borrow money or drastically reduce other expenditures (delay rent payment, eat only basics or rely on family/friends for food, etc.). 

Refugees across the region have reported household priorities and the fact that they cannot meet all of their basic necessities9. Although needs vary in each refugee context and for different groups, the majority of Syrian refugees cite their main needs as food and shelter. Thus far, agencies in Turkey have not had a precise understanding of the minimum expenditure basket (MEB) of a Syrian family. Indeed, transfer values appear extremely low compared to prices of food. The Turkish non-governmental organisation (NGO) Support to Life estimates that a family of six people needs about 470 TL (approx. 235 USD) per month to eat a balanced diet, including fresh food. Most agencies are providing around 25% of this in food assistance via e-cards that must be redeemed in specific shops, whose prices are generally fair but often above bazaar or street vendor prices, particularly for fresh food. 

DRC therefore has shifted much of its in-kind direct assistance for refugees to cash modalities and in particular, unconditional cash. DRC considered unconditional cash the best option given the vulnerability of families eligible for monthly assistance (as compared to all households assessed), and their necessity for flexibility and choice to meet needs monthly. The monthly cash assistance will not be able to cover 100% of a family’s monthly needs, so maximising purchasing power is essential. Moreover, establishing and maintaining conditional or restricted cash assistance programmes is extremely labour-intensive and counter-productive in such flexible and developed urban markets – artificially restricting markets (by selecting and only working with certain vendors) can encourage discrimination against voucher holders, including potentially influencing price inflation. Instead, DRC prefers to emphasise the beneficiary selection process, in order to identify and assist the most vulnerable families, and to focus on the monitoring process to track how the money is spent and its impact on households’ situations.

Impact of coping on food diversity, quantity and quality 

In any displacement situation where refugees do not have access to reliable income or sufficient assistance, families will restrict the quantity, quality and diversity of food consumption. Syrian refugees are no exception. However, prior to the crisis, even poor Syrian families enjoyed varied and plentiful diets, due to the low cost of living in Syria – largely because of the vast array of locally produced goods and subsidised staple foods (flour, milk, even fuel and cooking gas). This means that any change in food consumption will be experienced more dramatically and is a stark reminder of their displacement. DRC assessments show that Syrian refugees almost immediately sacrificed food quality to meet basic needs. In addition to this, families assessed in Hatay Province in Turkey adopted a number of coping strategies, in order to meet food needs (see Table 1).

Table 1: Coping strategies to meet food needs adopted by Syrian refugees, Hatay province, Turkey (2,100 households)

Coping mechanism (Families could list more than one)

% of total

Consumed less preferred or less expensive foods

84%

Reduced the number of meals per day

73%

Reduced spending on non-food items

72%

Limited portion size

49%

Spent savings on food

30%

Restricted adult consumption (so children could eat)

16%

Purchased food on credit or borrowed money to buy food

16%

Had school aged children working

13%

Asked for food (including begging)

12%

Skipped entire days without eating

4%

Not applicable

5%

In addition to these coping mechanisms, families mentioned that in order to meet food needs in the next three months, the adults planned to find employment (85%), they would ask for help (43%), or put children to work (15%).

Anecdotal evidence and monitoring data suggest that Syrian refugees in the Middle East are restricting dietary diversity due to high prices, even when receiving electronic vouchers for food10. They are mainly purchasing and consuming cereals/grains, pulses, oil, and limited quantities of cheese, while they forgo meat and other dairy products such as milk. It is unclear if this will have a lasting negative impact on health and nutrition, since refugees do manage occasionally to buy small quantities of fresh foods and protein; it is also unclear how humanitarian assistance could address dietary diversity concerns, given the fact that delivering fresh food in-kind is not feasible. One suggestion is to increase the cash transfer value provided to each family, but given evidence from other contexts and the huge needs, many households have gone so long without assistance that given additional cash, they might prioritise other expenditures such as rent, health, education, etc. 

Moreover, evidence from other contexts demonstrates that consumption patterns change over time11 and also with regards to the type of shocks, i.e. families required to move may prioritise shelter over food, while household level shocks, as when someone falls ill, may require expenditure on health care. Therefore, while refugees will nearly always spend a large portion of cash assistance on food, further research is needed to understand to what extent they are sacrificing dietary diversity, quality or quantity of food consumption to meet other equally pressing and basic needs. 

Discussion

The Danish Refugee Council distributes food, hygiene kits, baby kits, blankets and cooking sets to refugees from SyriaMost of DRC’s direct assistance to refugees has followed the general trend of humanitarian aid in the region – starting as in-kind support (food parcels and non-food items) and gradually moving towards cash-based responses, such as food vouchers or conditional cash for rent. The acceptance of unconditional cash, both by host governments and the international humanitarian community, only came about in full force by mid-2013. This shift to cash is part of DRC’s overall strategy to respond as holistically as possible to Syrian refugees’ needs outside of camps, with a dual protection and livelihoods approach. The need to create safe spaces, such as community centres, where refugees and host communities can access information and services and socialise is essential. At the same time, vulnerable individuals and families want support to meet self-defined needs, to decrease dependence on humanitarian assistance, and plan for the future. The first step is to assist directly those most in need, which DRC believes is often done most efficiently through cash, as well as move towards more sustainable support such as skills development, job placement and facilitating business development, when feasible. It is much more difficult to influence or support sustainable livelihood solutions for refugees in urban contexts where labour market or supply trends have a greater effect on people’s ability to earn a reliable income; moreover, many vulnerable refugee households may not be able or willing to generate income. Cash is therefore a key tool in providing direct assistance to vulnerable families to meet self-identified needs and provide temporary income to alleviate economic vulnerability. The question remains how to transition from cash to more sustainable support in urban environments. 

Box 2: Considering cash: benefits and risks

Benefits 

Dignity: Cash recipients do not queue visibly to receive assistance, the content of which is determined by external actors in the “best interest” of beneficiaries.

Empowerment: In any conflict or displacement context, vulnerable families have to prioritise certain needs over others, regardless of the levels of assistance they receive. With cash, families can choose directly which needs to prioritise; even with conditional cash (e.g. food vouchers), recipients can select what is most important to them. Cash can also improve certain members’ decision making within the household in a positive manner.

Cost efficiency: Cash reduces operational costs and provides more “cash in hand” to beneficiaries (although it is important to note that this is not always the case). Because recipients meet self-identified needs, there is generally a lower rate of aid diversion or sale.

Multiplier effects: Cash transfer programming can directly benefit local markets more than providing in-kind assistance, and can revitalise/strengthen local economies as well as benefit host communities.

Improved monitoring and evaluation: Strong cash programming emphasizes monitoring and evaluation as the core activity to determine how cash is spent and its impact on households, markets and communities. Cash programmes can therefore provide more comprehensive feedback on people’s needs, vulnerabilities and coping strategies, in addition to the humanitarian impact on local contexts and communities.

Risks

Markets: If improperly assessed beforehand, some cash modalities can negatively affect markets by causing inflation or supply shortages.  

People (households, individuals): Cash can exacerbate existing household tensions or negatively impact dynamics between household members (e.g. the head of household chooses not to spend money on food for the children). In extreme cases, cash given to a woman could increase her exposure to domestic violence, for example. In addition, cash programmes without end points/exit strategies and complementary assistance (counselling, training, etc.) run the risk of creating dependency rather than meet needs; although this is also the case for in-kind assistance programmes, it is especially concerning for cash because the assistance is another form of income and families can become reliant on it (like remittances or other external support).

Community dynamics: Depending on how beneficiaries are selected and existing community dynamics, cash can worsen relations between recipient and non-recipient groups (although the same can be argued for in-kind assistance). This is especially pertinent between refugee and host communities, particularly in countries where governments may not have the means to provide social safety nets / cash assistance to its economically vulnerable citizens.

Cash allows families to meet self-identified priorities, as well as giving choice and dignity. There are both benefits and risks to this programming approach (see Box 2). Conditional cash, which seems to offer a more straightforward transition from traditional sector-based humanitarian responses, has drawbacks in terms of stigma, discrimination by vendors, and pricing issues (taxation and artificial control of market dynamics). At the same time, unconditional cash raises concerns about agencies’ loss of control / diversion of assistance, compromising nutrition, and creating dependency. There has been a lack of technical nutrition rigour in informing cash programming design and evaluation and implications of this on urban refugees in the Syria crisis response. This will require renewed focus in future responses.

For more information, contact Louisa Seferis, email: Louisa.Seferis@drclebanon.dk or LMSeferis@gmail.com


1http://data.unhcr.org/syrianrefugees/regional.php?

2For more information, please see http://www.cashlearning.org/resources/library/417-unconditional-cash-assistance-via-e-transfer-implementation-lessons-learned-?keywords=danish refugee council.

3UNHCR SitRep, 7 July 2014

4In Hatay Province, 66% of Syrian families assessed by DRC reported that the language barrier was a main problem they faced in Turkey.

5In order to apply for a work permit, Syrians must have residency papers – these are difficult to obtain in general, and the most vulnerable families do not have valid passports (required for the residency application). In 2014, Turkish authorities may loosen restrictions on applying for work permits through bylaws (exemptions for certain sectors/occupations or geographic areas). 

6Source: UNHCR, 2014. http://data.unhcr.org/syrianrefugees/country.php?id=122

7Sarah Bailey 2013

8Sarah Bailey 2013

9 In Lebanon, qualitative (focus group discussions) and quantitative (household surveys by phone) in 2014 indicate that refugees’ main needs are food, shelter and healthcare. In Turkey, focus group discussions revealed the main needs as food and shelter; refugees have very little access to credit/debt sources, and therefore have limited time to accumulate enough money to buy food and meet rent/utility obligations.

10Source: Household monitoring visits with non-camp refugees in Turkey and Lebanon, 2014.

11See Longley et al, 2012. As summarised by Bailey (2013): “The use of the transfer changes according to changing needs, seasonality, livelihoods and the objective of the programme. In this case, the first transfer had the highest proportion spent on food, and transfers towards the end of the intervention were more geared toward supporting recovery.”

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