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BMJ Glob Health. 2019 Feb 4;4(1):e001122. doi: 10.1136/bmjgh-2018-001122. eCollection 2019.

Displacement, deprivation and hard work among Syrian refugee children in Lebanon.

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Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Public Health Policy Evaluation Unit, Imperial College London, London, UK.
Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.



The protracted Syrian war resulted in the largest refugee crisis of our time. The most vulnerable are children who face separation from parents, interruption of schooling and child labour. This study explores the living and working conditions of Syrian children in Lebanon.


In this cross-sectional study, we randomly selected 153 informal tented settlements and conducted interviewer-administered surveys among Syrian refugee working children in the Bekaa Valley in Lebanon. Those aged 8-18 completed a questionnaire on sociodemographic and occupational characteristics; those aged 4-8 years were surveyed through a household questionnaire.


We surveyed 1902 households, including 12 708 individuals and 4377 working children. Female-headed households were poorer and more food-insecure than male-headed households. Among working children (4-18 years), the average age of starting work was 10.9 years and 74.8% worked in agriculture. Compared with boys, girls earned less and were less likely to be enrolled in school. For 96.3% of working children aged 8-18 years, forced exodus to Lebanon was associated with a first child labour experience. Working conditions were harsh and worse for girls who compared to boys were less likely to receive their salary on time and take time off work. Girls worked longer in the sun and cold and were more likely to report having a health symptom at work, working under pressure and using sharp or heavy objects at work. Seventy-nine children reported knowing another child who died following a work accident.


Children, as young as 4, are forced to work, and many are compelled to forgo educational opportunities in favour of harsh and harmful labour due to difficult economic conditions. State policies facilitating access to work for adult refugees will help families meet basic needs and decrease their dependence on child labour as a coping strategy.


Lebanon; child labour; children and adolescents; occupational health; refugees

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