Long lines of Iraqis form early in the morning at the compound of a Damascus non-profit agency that provides social services for Iraqi refugees. About 100 men, women and children patiently wait their turn to meet with the agency’s case workers. Some of the older women begin to tire and move slowly away from the line to sit on benches located along the compound’s old walls. Most of the men remain standing in the queue. They are busy attending to their young children, while their wives are caring for the babies. Most look anxious, and they fidget, wary of the long wait ahead. To pass the time, some make small talk, but generally the crowd is quiet.
Many of these people are middle-class Iraqis who have fled their homeland to escape the horrors of war and the ongoing sectarian violence. Ahmad is an engineer; Wa’il is a pilot; and Samia is a schoolteacher. Now they are merely faceless refugees whose dignity has been stripped away; subsisting on rapidly dwindling resources, they are forced to plead for aid. Many go to the agency to seek help for their sick, and often traumatized, children, or to enroll them in the few educational programs available. Others are there to request basic staples to feed their families. But all are in desperate need of help, and aid is slow in coming because the rest of the world seems oblivious to their plight.
In February 2007, UN High Commissioner for Refugees António Guterres declared the exodus of Iraqis the biggest population shift in the Middle East since the displacement of Palestinians following the establishment of the state of Israel in 1948. If the trend continues, the International Organization for Migration said in the same month, the unrelenting violence in Iraq could force an additional one million Iraqis to flee before the year is out. Most of the Iraqi refugees have settled in Jordan and Syria, but there are sizable communities in other neighboring states. According to the UN High Commissioner for Refugees (UNHCR) and local NGOs, the number of Iraqis in Jordan and Syria is over two million, and it is estimated that about 40,000 live in Lebanon, 100,000 in Egypt, 54,000 in Iran and 10,000 in Turkey.
The massive flight of Iraqis has created a humanitarian crisis of dire proportions, yet it was not until recently that governments, the UN and the global media began to appreciate the scope of the tragedy. Initial investigations have revealed an uprooted and destabilized people, who fell from relative prosperity to disenfranchisement within a short time. Many Iraqi refugees are now living on the margins of society in the host countries, and their overall condition is deteriorating. Most are restricted from obtaining gainful employment, and have limited access to services such as education and medical care. As a result, increasing numbers of Iraqis have now depleted their savings. The extremely vulnerable among them live in deplorable conditions, unable to meet basic needs for shelter, sanitation, nutrition and education for their children. In spite of these conditions, however, the majority of the exiled Iraqi population express no desire to return to Iraq. The mayhem they have witnessed in person back home still plays on the nightly news, and naturally, concern for their own safety has so far outweighed all other considerations.
Iraqi refugees face many of the same challenges in every bordering state, but in each state there are also distinct elements.
The number of Iraqis living in Jordan is estimated at 750,000 persons.  According to UNHCR, the influx of Iraqis has leveled off somewhat in recent months, partly because of tighter restrictions at the borders. In February 2007, Iraqis seeking entry into Jordan were advised they must carry the recently issued new type of Iraqi passport in order to be admitted. Due to excessive regulations, however, countless Iraqis find these new passports difficult to obtain, and consequently false travel documents have begun to circulate. Diligent Jordanian customs officials are turning away anyone carrying what appears to be a fake or illegally obtained passport.  In addition, the Jordanian government has imposed a new policy prohibiting males between 20 and 40 years of age from entering. 
The Jordanian authorities consider Iraqi asylum seekers to be “guests,” a designation implying temporary visitor status. Through early March, no more than 23,000 had registered with UNHCR,  due in part to that agency’s incapacity to process the sheer number of people. These few registered Iraqis could in the future benefit from the protection offered by refugee status, as they are deemed by UNHCR to be persons of concern, thus qualifying for UNHCR’s “durable solutions”—repatriation, integration in the host country or resettlement to a different country. Since Jordan has not designated any Iraqis as refugees, integration would not seem to be a visible option, however. And the vast majority of Iraqis in the country remain in complete legal limbo.
Jordan has hosted Iraqi refugees since the early 1990s, including political exiles, upper-class elites and intelligentsia fleeing Saddam Hussein’s regime. This group is, for the most part, well-established and relatively comfortable in Jordan. Others in the 1990s wave, however, and most of the new arrivals, are not so prosperous. The majority of the latest wave are from the now obliterated urban, professional middle class, while others are laborers and farmers from war-torn areas. Most of the refugees are Muslims, both Sunnis and Shi‘a, but significant numbers of Christians have also fled. Whatever their circumstances in Iraq, many refugees are now struggling to get by because they had to leave in a hurry, abandoning homes, possessions and most of their savings.
With a population of only six million, Jordan is chafing at having to absorb more than 750,000 new people, most of whom have come between 2004 and the present. Press reports attribute the overburdening of infrastructure and social services to the increasingly large numbers of Iraqis. Iraqis are also blamed for the rise in the cost of housing and the greater incidence of traffic jams, among other things, particularly in neighborhoods around the capital of Amman, where most of them reside. 
Syria has historically implemented relatively generous policies for Iraqi asylum seekers, granting free admission to schools and, to a limited extent, access to government health care facilities. As a result, compared to other neighboring countries, Syria has the larger share of Iraqi refugees. While exact figures are not available, the number of Iraqis living in Syria has been estimated at 1,400,000. The bulk of the Iraqis, many of whom have been in Syria since 2003, are concentrated in neighborhoods in greater Damascus. There are also other populations in locations in northern Syria, such as al-Hasaka, Qamishli and Dayr al-Zawr. UNHCR confirms that the increasing numbers of Iraqi refugees have made a significant impact “on Syria’s social services, economic infrastructures and the daily lives of many Syrian citizens.”  Observing this impact, the Syrian government has implemented increasingly restrictive immigration rules and greater limitations on access to health and social services.
Before the summer of 2007, most Iraqis arrived legally in Syria through the country’s open (for citizens of Arab countries) border policy that allowed them a six-month renewable visa. But now, according to UNICEF, refugees get a 15-day permit; when it expires, they must leave the country for a month before they can return. The Syrian government has also further restricted Iraqis’ right to work legally, and many end up working in informal sectors of the economy. According to some reports, the unemployment rate among Iraqi refugees is over 50 percent for men and over 80 percent for women. Syria’s policy shift created anxiety among Iraqi refugees, because they are now at risk of deportation to Iraq. Hence, UNHCR reports a dramatic increase in the number of Iraqis wanting to register with the agency over the past several months. As of March 2007, 55,000 had registered and many more were lining up attempting to do so.  Upon registration at UNHCR, Iraqis are issued a letter declaring them prima facie refugees, qualifying them for consideration for durable solutions. Many Iraqi refugees have expressed a strong interest in resettling to countries in the West, creating concerns within UNHCR about a secondary exodus.
Similar to Jordan and Syria, the numbers of Iraqi refugees in Lebanon have risen significantly in 2006 and 2007. In early 2007, the estimated population of Iraqis in Lebanon was approximately 40,000, up from 25,000 in the previous year.  There are also undisclosed numbers of Iraqis who are smuggled over land from Syria into Lebanon. This group is automatically barred from access to public schools and forbidden to work.
Many Iraqis—most of them Shi‘a fleeing Saddam’s regime—have been living in Lebanon since the 1990s. Since 2005, there has been a steady flow of Iraqis coming to Lebanon from central and southern Iraq. They are mainly of middle-class background; many are Christians, although there are sizable Shi‘i and Sunni communities. Most are single young men, but there are also some large families. Unlike their cohorts in Syria and Jordan, Iraqis in Lebanon are not concentrated in particular city neighborhoods. While 80 percent of them live in the capital, Beirut, there are significant populations in the south, in the Bekaa Valley and in the north around Tripoli. In June 2007, UNHCR reported that 6,500 Iraqis were registered asylum seekers, an upsurge from the previous year. It is believed that the rise in registration is due in part to a new UNHCR policy to give Iraqis the prima facie status that obtains in Syria. Upon registration, Iraqis are issued a one-year refugee certificate that confers official status and serves as an identification document.
Furthermore, as a result of lobbying efforts by UNHCR, in June 2006 Lebanon implemented a policy of non-refoulement, the principle that protects refugees from being forcibly returned to the country where their lives may be in danger. While Lebanon has not gone so far as to give full protection to Iraqi refugees, there is an unspoken policy of leniency. No Iraqis have yet been deported, though many are arrested at checkpoints and other public places, usually for lack of identification, or because the arresting officers are not aware of the tolerant stance the government has adopted.
Similarly, judges may display a subjective approach to the application of Lebanese immigration laws. Some acknowledge the refugees’ “protected” status and release them immediately, while others apply a stricter interpretation of the law and find them guilty of overstay. The punishment for overstay is usually one month in jail plus a small fine. Lately, the number of detained Iraqis has grown exponentially, increasing from as few as 50 in May to 375 in early June. The deteriorating security situation in Lebanon is heightening suspicion of foreigners, in particular those without legal status in the country.
Aside from their legal predicament, Iraqis in Lebanon face high unemployment because of government restrictions on the issuance of work permits. In order to survive, many end up working in informal sectors of the economy as illegal day laborers, making them vulnerable to abuse and exploitation. Many of the jobs now filled by Iraqis were left vacant by Syrian laborers after the Syrian army pulled out of Lebanon in 2005. Lebanon’s high cost of living, coupled with inadequate incomes, makes it difficult for them to cover their basic needs. Moreover, they suffer discrimination at the hands of Lebanese citizens, many of whom face equally dim job prospects in Lebanon’s unstable economy, rendered still shakier by the summer 2006 war.
Housing and Education
As non-citizens, Iraqis are not eligible for most of the benefits offered to the nationals of these host countries. Nonetheless, their presence in large numbers has put severe strain on the host countries’ social, economic and health systems. There are no refugee camps to house them; rather, they live in high-density neighborhoods mostly in and around capital cities. Many occupy marginal housing, paying spiraling rents for overcrowded accommodations without proper ventilation, electricity or water. In a number of cases, report Caritas workers in Jordan and Syria, poor housing is the direct cause of health problems, particularly among children.
UNHCR, its implementing partners and other NGOs have made an effort to provide humanitarian assistance for the most vulnerable families. Caritas, for example, offers home visits to “extremely vulnerable individuals” during which case workers identify particular needs and allocate assistance accordingly. (Criteria for extreme vulnerability include mental or physical disability or trauma, being a female head of household or single parent, being an unaccompanied elderly person or minor, being elderly or a family with children in extreme poverty or in need of specialized care, and being children or women victims of violence.) The assistance can consist of repairing a broken window, installing a lock on the door of a family home, providing heaters, blankets and mattresses, and many other basic necessities.
The demand for humanitarian assistance is steadily rising because it is difficult for the Iraqi refugees to work legally. UNHCR estimates that about 15 percent of the refugees qualify as extremely vulnerable individuals. Their modest savings gone, some Iraqis are contemplating secondary migration to other contiguous countries like Egypt and Turkey, and a number of them have uprooted their families again in search of better prospects.
Another problem faced by many of the Iraqi refugees relates to the education of their children. In Jordan, access to public schools was initially restricted to those with a valid residency permit. Under international pressure, the Jordanian government claimed several times to have relaxed these restrictions, but the policies were confusing and ambiguous, and several Iraqi parents reported that in practice the restrictions remained in place.  Finally, after receiving funding from UNHCR and UNICEF, Jordan announced on July 26, 2007 that all Iraqi students could enroll in public schools. Although Syria and Lebanon offer free access to education for school-aged children, the influx of refugees, many of whom have large families, has given officials pause. As the state-run al-Baath newspaper complained: “75,000 Iraqi students have enrolled in Syrian schools…overburdening the education sector and overcrowding schools.” 
Even if accepted, many of these refugees cannot afford books and uniforms, or transportation to get to school. Indeed, it is estimated that about 30 percent of children in Syria are currently unable to attend school,  contributing to rising delinquency among Iraqi adolescents,  and boding ill for the skill and education levels of these children in the future. The dire economic situation of Iraqi refugees is forcing many youths to leave school and seek menial jobs in order to supplement the family’s meager income. There are also reports of girls as young as 12 being driven into prostitution for the purpose of earning a living for themselves and their families.
Another factor explaining why Iraqi refugee children do not attend school is the lack of official documentation issued to children by their Iraqi schools. This paperwork is a requirement for registration in public schools, particularly in Syria, and in many cases, Iraqi students are being placed in lower grades than where they belong. For these reasons, some families are forced to seek private schooling for their children, if they can afford it. NGOs such as the International Catholic Migration Commission, operating through Caritas and Terre des Hommes, have been instrumental in assisting Iraqi children with buying books and uniforms. In addition, these organizations support non-formal education, where students are able to acquire vocational training and other employment skills. Children are also benefiting from recreational and educational activities such as a weekend retreat in the countryside. It is believed by NGOs that such interventions help keep these children from falling into delinquent behavior.
Health and Psychological Care
While health care is partially subsidized in Jordan, it is not free in Syria and Lebanon. Consequently, many Iraqi refugees are not able to afford basic medical care. Local NGOs report a steady increase in demand both for outpatient and inpatient assistance. To alleviate the problem, Caritas offers subsidies of expenses like doctor fees and medication, and the group has also established strong ties with a number of medical institutions, including clinics located in areas with high concentrations of refugees. In Lebanon, critical cases are directed to private doctors, but given the high cost of health care, preference is given to emergency intervention, as well as delivery of babies and natal care.
In addition to inflicting physical wounds on Iraqis, war and displacement is having devastating psychological effects on those who have lost loved ones or witnessed horrendous violence. Such effects were apparent among the previous wave of displaced that left Iraq in the Saddam Hussein years.  Today, NGOs report a number of refugees fleeing the present Iraq war who complain of symptoms akin to post-traumatic stress disorder. Care Jordan, an international NGO operating locally, is proposing to broaden the scope of the almost non-existent treatment programs to include more referrals to counselors and social workers specializing in psychological care for trauma victims.
Moreover, the sustained contact with refugees recounting horror stories experienced prior to leaving Iraq is having an adverse effect on the case workers themselves. Many report having nightmares and other post-traumatic symptoms, such as burnout and depression. They, too, are in great need of psychological support in order to continue serving the increasing numbers of refugees efficiently.
The Human Face of the Tragedy
Statistics may convey the magnitude of the Iraqi disaster, but the depth of the human tragedy cannot be measured purely in data. The Iraqi people are trapped in the fallout of the 2003 invasion with no prospect of relief any time soon. Indeed, their choices are to take their chances in Iraq, amidst the daily carnage of war and sectarian conflict, or to migrate to a neighboring state and live without official status, in dreary and uncertain conditions, subject to exploitation and poverty.
The intensity of civil war has left indelible psychological scars on the Iraqi refugees, many of whom have witnessed horrific brutality, and, in most cases, had one or more family members victimized or even murdered. Husni, a storeowner from Baghdad, is one of the refugees standing in the line at the aid agency in Damascus. He weeps while telling of what led to his flight from Iraq. Holding his ten-year old son’s hand, he said, “I am here to ask for diapers for my son. He started wetting his bed after witnessing his sister and his cousin being killed by a suicide bomber.” A haggard man standing behind him interjects, “My mother and father were murdered in their beds. We are Sunnis and they are targeting anyone who they suspect of collaborating with opposing factions. But my parents were simple folk with no political affiliation.” Another man in line, Mansour, was a pharmacist at one of the main hospitals in Baghdad. His voice indignant, he says, “Look at me…this is where I ended up! I am an educated man. I had a good job back home, and now I am reduced to a beggar! I can’t afford to buy medicine for my own sick child.” Pointing to his wife, sitting on a bench a few feet away, he whispers, “Her father and two brothers were killed last month by insurgents. She is barely eating, and most times she stays in bed not wanting to get up and face another day.”
Maryam’s name is called. She has been waiting in line for over three hours. An elegantly dressed middle-aged woman, she sits passively across the table from the social worker. The dark circles around her hollow eyes reveal deep sadness and pain. She answers the questions in an almost inaudible monotone: She was an engineer working at the central Baghdad power station. She was kidnapped along with four others by armed men, who questioned her and her colleagues about their political affiliations and accused them of directing electricity away from Shi‘i areas. Maryam pauses for a minute, her chest heaving as she struggles to overcome the urge to cry. Then, with a quavering voice, she recounts the horrifying events that followed: “One my colleagues was a young woman just out of engineering school. The kidnappers kept touching her inappropriately, which prompted one of my male colleagues to object. At that point, the thugs turned to him and dragged him to the other end of the room. He was placed in front of a machine that had hooks and clamps. They skinned him alive…and then they took my female friend to another room and took turns raping her. I heard her muffled screams all night long.” Maryam is sobbing uncontrollably. Catching her breath, she goes on to say that after she was released two days later, she went home and hustled her elderly mother and disabled aunt, who lived with her, off to the airport, to board the first flight to Damascus. Later, she heard that her house was ransacked and all her valuables stolen.
Compelling stories like these are heard all too often at these centers. The violence in Iraq does not discriminate between combatant or civilian, man or woman, young or old, Sunni or Shi‘i. They are all unwilling participants in a war that has thrown their country into chaos and lawlessness, causing unthinkable damage and trauma.
Scratching the Surface
Apart from the obvious destruction wrought by the ongoing conflict in Iraq, the demographic disintegration of an entire country has serious implications for the whole region. The escalating civilian death toll of many tens of thousands, compounded by the internal displacement of an estimated 10 percent of Iraq’s population and the other 10–12 percent that have fled the country, are likely irreversibly to alter Iraq’s historically established ethnic and religious balance, as well as rob Iraq of its professionals and other sources of economic vitality for years to come.
Moreover, the sheer numbers of Iraqi refugees, in proportion to the population of surrounding countries, may gravely affect the geopolitical stability of the region, resulting in further tension, as well as social, economic and political chaos in an area already hampered with uncertainty and discord. Syria, Lebanon and, in particular, Jordan already have large populations of Palestinian refugees, who (for the most part) have been living in a limbo of their own since 1948. Furthermore, many of Iraq’s neighbors are already dealing with internal crises, and therefore have limited capacities to absorb large numbers of refugees, or even to host them for any sustained period without domestic consequences.
Short-term repatriation prospects for these refugees are very slim, and even with improved security in Iraq, many will undoubtedly be forced to remain in exile for a number of reasons. Widespread killing and destruction has left them with no family, home or job to return to, and some may fear retribution from opposing factions or recrimination from the new power centers.
One consequence of the war in Iraq is the disruption of the proclaimed US vision of a “new Middle East,” one that is democratic and enlisted in efforts to fight terrorism. The ethnic and religious polarization in Iraq, felt across the region because of the refugee exodus, is not conducive to political stability and indeed may engender further terrorism. Indeed, the Iraqi middle class usually thought necessary for democracy to flourish will be far more difficult to rebuild when many of its members have fled the country. In addition, middle classes in host countries are made anxious by the masses of refugees in their midst, who they believe are causing disruption to the social fabric, increasing ethnic and religious divisions, and generating competition for jobs and other scarce resources. In this sense, the US project in Iraq may have hindered more than it helped the cause of democracy in the region.
The unfolding human tragedy of the Iraqi refugee crisis is great, but the greater tragedy lays in the world’s apathy and indolence in response. The large numbers of refugees assert a claim on their host countries’ limited resources, and increasingly tax these countries’ limited patience and hospitality. Nonetheless, these refugees are not the responsibility of Iraq’s neighbors, although these countries have been forced to shoulder the main burden of hosting them.
International aid is trickling in from Europe and the United States, but it is only scratching the surface of this enormous and continually mounting problem. The US, for instance, announced in March $18 million in contributions to the work of UNHCR and other charitable organizations operating in the region, and the European Commission is donating ten million euros. After persistent appeals from UNHCR, the State Department agreed to resettle about 7,000 Iraqis to the US; Canada also raised its projected intake of Iraqi refugees from 500 to 1,400 for 2007.  So far Sweden has been the most welcoming, having absorbed about 9,000 Iraqis in 2006 alone, almost half of the 22,000 that other Western nations received in that year.  Recent reports, however, indicate a tightening of asylum policies there as well.  Unless other countries take a proactive role in alleviating this crisis, the Iraqi refugees will remain in a perpetual state of hopelessness, their plight potentially sending a ripple effect throughout and well beyond the Middle East.
 This estimate was gleaned from several sources, including a Danish Refugee Council study in 2005, local NGO reports, and data obtained from the Lebanese General Security Service based on the number of visas issued to Iraqis, as well as estimates of those who have stayed after their visas expired.
 C. Gorst-Unsworth and E. Goldenberg, “Psychological Sequelae of Torture and Organized Violence Suffered by Refugees from Iraq: Trauma-Related Factors Compared with Social Factors in Exile,” British Journal of Psychiatry 172 (1998).