Women’s Access to Health-Related Information in Lebanon

I did not receive any post operative care information at the hospital. I saw the doctor only when I was discharged from the hospital. I never received verbal or printed information about the nature of the treatment or any do's or don'ts before I started the treatment. My blood values showed a strong anemia and nobody gave me any nutritional advice. I had to check all of this information online, and honestly if I wasn't a nurse I would have not understood it.

-Bladder tumor (adenocarcinoma) Patient

Lebanon is a signatory to several international conventions that guarantee free access to information. There are no laws in Lebanon that restrict access to information.  Yet the legislature has not promulgated any provisions nor established any of the processes necessary to implement these freedom of information laws.  As a result, marginalized groups across the country-and especially women-are hamstrung by their lack of access to information, particularly in regard to health services, treatment options and the relative merits of various medical procedures and therapies.

The Partnership Center for Development and Democracy (Partnership Center) is using an Opportunity Fund grant for its "Women's Access to Health Rights and Information in Lebanon" project.  The objective of the project is two-fold: 1) to study the extent of the problem through case studies, a survey of opinion leaders and research and 2) work with multidisciplinary stakeholders to generate public awareness, propose legal and administrative solutions, and start the process of amending the laws in order to improve women's access to health care information.

Activities

There is still a lot of prejudice to be overcome. We must bring discussion of HIV/AIDS further into the open. AIDS should not only be mentioned in the media on 1 December, on International AIDS Day. It should be an everyday subject. This is the only way to fight it and for us to have some hope of living freely.

-An AIDS Patient

Ms. Lina Alameddine, the founder and director of the Partnership Center, is spearheading the Opportunity Fund project.  The project has already completed the following:

• A Report on AIDS in Lebanon that interviews a wide range of persons infected with AIDS, religious leaders, civil society leaders and health care professionals.  It found that although access to information about sexually transmitted diseases is legal in Lebanon, the social and cultural stigma associated with STDs makes it hard very difficult for those with the disease to be open about it and seek treatment and information.  This stigma also makes it hard for the government and NGOs to compile reliable statistics.
• From February - March 2009, a field study for the project was carried out by INTIMAA, a women's NGO.  INTIMAA visited 25 private clinics at hospitals, doctor's consulting rooms and dispensaries.  They catalogued all of the information available in each of the waiting rooms.  None of the sites had medical brochures or any other type of literature that provided patients with information about their medical conditions, prevention options or potential treatments and their relative merits.
• The project completed case studies of six women who were forced to deal with gender-specific medical conditions: Menopause, Breast Cancer, Mastectomy, Osteoporosis, OCD and a Urinary Tract Tumor.  In all six cases, the physician did not explain the diagnosis to the patient, refer her to a specialized nurse or give her any literature related to her medical condition.  The patients had no part in the decision-making process related to their treatment.

Beyond these activities, the project is:

• Conducting a survey of opinion leaders regarding women's access to health-related information.  The project is analyzing the results in order to determine how to proceed with its outreach and networking activities.
• Creating a report that will analyze the reasons why women are unable to access pertinent health information and present solutions for overcoming these barriers.  This report will be presented in the form of a recommendation to the Lebanese Parliamentary Administration and Justice Committee
• Creating and distributing a pamphlet about women's lack of access health information
• Coordinating multidisciplinary networking events and processes that engage lawyers, public health officials, women's rights activists, government officials and other influential members of Lebanese civil society on these issues.

Outcomes

This project has made critical connections within the medical community at a time when the Ministry of Health is reforming its structure.  Dr. Amal Mansour, head of the Mother and Child Division of the Ministry, the Department in charge of gender-specific health issues, has shown interest in using the findings and recommendations of the project as a basis for reforms.  Both Dr. Mansour and Dr. Rash Hamra, the head of the Department's research group, have contributed suggestions to the project and offered problem solving evaluations.  High-level engagement with the medical community will improve the recommendations in the final report and inject women's lack of access to medical information into the discussions at the Ministry of Health regarding its plan to restructuring.

The project is working with leaders from the legal, medical, public health and human rights sectors of civil society to build broad support for a law-based approach to achieving the objectives of the project.  Networking and engaging with multidisciplinary stakeholders will create bottom-up momentum for change while simultaneously fusing several perspectives into the comprehensive final report.  The final report will be presented to the Lebanese Parliamentary Administration and Justice Committee and distribute copies of these recommendations to Cabinet members, members of Parliament, civil society organizations and women's rights NGOs.

Replicability

This project is building a broad-based multidisciplinary coalition of civil society leaders in Lebanon that is committed to improving women's access to health-related information.  Establishing a strong network committed to these issues will allow the Partnership Center to engage this group on this and similar issues to importance well into the future.  Moreover, the recommendations offered to the Parliament can serve as a template for civil society leaders in other countries throughout the region who trying to overcome similar problems.  Finally, tracking the impact of the report and any of the recommendations that are adopted by Parliament or used by the Ministry of Health will allow the Partnership Center to analyze the impact of its recommendations and make changes accordingly.