Lebanon throws migrant workers onto the streets as the war rages on

As caregiving remains a lifeline for households in the Middle East, migrant workers battle loneliness, exploitation and inadequate protection amid regional crises

October 29 marks the International Day of Care and Support, a day dedicated to recognizing and raising awareness about the crucial role of healthcare providers. The UN created this day to spark conversations about the importance of care work, both paid and unpaid, which is the backbone of society and allows individuals and systems to thrive and function smoothly. These conversations have special significance in the Middle East, which relies heavily on migrant domestic workers to provide care to the elderly and disabled.

Despite the crucial contribution of migrant caregivers in Middle Eastern households, most still face unfair and unsafe working conditions, including long hours, minimal rest periods and vulnerability to exploitation. Legal protection and social guarantees for these healthcare providers are often inadequate or poorly enforced.

Concern for migrants is especially widespread in the Gulf Cooperation Council countries. According to Migrant-Rights.org, a GCC-based advocacy organization focused on promoting the rights of migrant workers, more than 90% of Kuwaiti households employ migrant domestic workers. Kuwait’s 620,000 migrant domestic workers represent more than 22% of the country’s total workforce. These workers often face significant differences in wages and working conditions.

In Bahrain, domestic migrants represent 10% of the total labor force and 37% of the female labor force. Migrant workers dominate the domestic work sector in Saudi Arabia and the United Arab Emirates, making up 95% of all domestic workers and personal assistants. About 20% of all foreign workers in the UAE do domestic work.

About 96% of families in the Emirates hire domestic workers to care for their children. These approximately 750,000 workers fulfill an estimated 80% of parental duties, surpassing family members in 22% of Emirati households. Domestic workers make up about 20% of the country’s total foreign workforce.

Domestic workers in Saudi Arabia face extremely long working hours, averaging 63.7 hours per week – the second highest rate in the world. Similarly, domestic workers in Qatar work an average of 60 hours per week.

Wages remain a major issue for migrant domestic workers. In Qatar, domestic workers earn less than 30% of the average national wage, while in Kuwait their income is less than 30% of the average national wage. The minimum monthly wage for domestic workers in Kuwait is US$147, but enforcement mechanisms to ensure this payment are insufficient. In Saudi Arabia, domestic workers from Sri Lanka earn only 20% of the private sector minimum wage and receive around $80-$100 per month.

Home care in Israel is also highly dependent on foreign workers. More than 75,000 foreign healthcare providers were working in Israel at the end of 2023, according to data from the Population and Immigration Authority. The caregivers come from a wide range of countries, with the largest groups coming from the Philippines (26,673), India (19,924) and Uzbekistan (12,335). Many also come from Moldova, Sri Lanka and Ukraine. About 60,000 of the workers have documents to work in Israel, and the remaining 15,000 do not.

Meytal Russo, deputy executive director of Kav LaOved, an Israeli nonprofit dedicated to securing equal employment rights for all workers, told The Media Line that foreign healthcare providers in Israel face a complex and challenging bureaucracy.

“About 95% to 99% come with legal documentation, which allows them to stay here for five years and three months,” Russo said. That period applies to all foreign workers, but healthcare providers can apply to extend their stay to continue helping the same elderly or disabled patient they were caring for.

“There’s a lot of bureaucracy involved,” Russo said.

Healthcare providers must be available 24 hours a day, six days a week and are required to stay at the patient’s home

“Caregivers must be available 24 hours a day, six days a week and are required to stay with the patient at home,” she says. These employees receive only the minimum wage without overtime and are excluded from the law requiring breaks. “This exclusion stems from a Supreme Court ruling that found it impossible to quantify a caregiver’s rest time due to the nature of his or her work,” Russo explains.

She also expressed her concerns about the high brokerage fees that healthcare providers pay to come to Israel.

“Many workers pay between $7,000 and $30,000 in fees, which imposes significant financial burdens,” she said, noting that most workers still rely on private employment agencies despite government efforts to regulate the process through bilateral agreements. “The situation remains business-to-business, with undocumented payments being made to private entities abroad and sometimes to entities within Israel.”

The vulnerability of a migrant woman working in a shelter is very high

The vast majority of migrant caregivers in Israel are women, and these female caregivers face significant risks of sexual harassment and assault, Russo said. Often the perpetrator is a dementia patient or a family member of the patient. “The vulnerability of a migrant woman working in a shelter is very great,” Russo explains.

The physical demands of the job also increase the challenges faced by caregivers, with many experiencing orthopedic problems due to heavy lifting and inadequate professional support. Living in a patient’s private home and developing a relationship with the patient and family can also be challenging. “There’s a broad spectrum, with some very good relationships and some that are pretty bad,” Russo said.

All of these challenges can lead to migrant caregivers experiencing burnout. “If you’re burned out in a regular job, you can find another one,” Russo said. “But here you are tied to the same employer, which creates a dangerous situation for both the healthcare provider and the patient.”

Santhosh, a 35-year-old caregiver from India, came to Israel last year. “My patient is in very good condition and very supportive, so I am happy to be here,” he told The Media Line. But he quietly added that he found the unforgiving nature of the job and the distance from his family challenging.

“It’s very lonely,” Santhosh said. “Facebook and WhatsApp help, but I miss my family. I feel a constant loneliness.” Despite the difficulty, he expressed a sense of determination. “I want to keep working and I’m grateful for the opportunity,” he said.

For a healthcare provider from the Philippines who wishes to remain anonymous, the emotional isolation is the hardest part of the job. “I was prepared for hard work, and I do it to support my family,” she told The Media Line. “But here I became very lonely.”

“I feel like my whole life is online and the rest of the time I’m just working. Nothing else, she said.

In Lebanon, a country facing widespread destruction and displacement due to the conflict with Israel, migrant care workers are among the most vulnerable populations.

Bram Frouws, director of the Mixed Migration Center, highlighted the high vulnerability of migrant care workers in Lebanon amid the ongoing conflict.

Since the escalation of the war began, many employers have fled the country or fled north, leaving their migrant workers without wages, shelter or food, and many were left behind.

“Since the escalation of the war began, many employers have fled the country or fled north, leaving their migrant workers without wages, shelter or food, and many were left behind,” he told The Media Line. “Many migrant workers are now sleeping on the streets, without access to basic needs or humanitarian aid. Shelters often only allow access to Lebanese citizens.”

The immigration status of migrant workers in Lebanon is tied to the individual employer, Frouws explains, leaving Lebanon’s 175,000 migrant workers exposed to exploitation and abuse even in peacetime. Now that vulnerability has increased.

Many of these migrant workers do not have access to their passports, which are held by their employers. “The lack of financial resources and documentation makes it virtually impossible to escape,” said Frouws. Language barriers, limited mobility, limited social networks and discrimination all worsen the situation.

Frouws expressed concern that migrant workers are being left out of government and humanitarian responses to the humanitarian crisis in Lebanon. “This is often the case with migrants caught up in sudden conflict,” he said.