'Vulnerable' but not 'Valuable': Older refugees and perceptions of deservingness in medical humanitarianism

Soc Sci Med. 2022 May;301:114903. doi: 10.1016/j.socscimed.2022.114903. Epub 2022 Mar 19.


In a crisis, there is widespread recognition and acceptance that not all lives can be saved. But whose lives can legitimately be saved and who decides? Recent scholarship has begun to examine how refugees perceived as 'vulnerable', such as women and children, are frequently prioritized over other groups in humanitarian responses. Such analyses, however, fail to adequately explain why some groups - such as older persons - are considered vulnerable and yet are largely neglected. Based on the case of older Syrian refugees in Jordan, this article critically examines the ways in which humanitarian health actors make sense of the humanitarian principle of 'impartiality' in the face of limited resources. Based on 61 interviews and observational data collected in Jordan between 2017 and 2019, my results show that humanitarians routinely classify older refugees as 'vulnerable' and in need of medical assistance. Yet I find that three neoliberal considerations - including perceptions of the reduced lifespan, disproportionate disease burden, and limited contributions to the economy of older refugees - make this demographic low 'value for money'. This article expands our understanding of how medical humanitarian understandings of 'deservingness' are increasingly shaped by market-driven logics, and how these (re)create ageist, gendered and racialized hierarchies within refugee health.

Keywords: Humanitarian deservingness; Jordan; Medical impartiality; Older refugees; Refugee health; Syrian refugees; Vulnerability.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Altruism
  • Child
  • Cost of Illness
  • Female
  • Humans
  • Jordan
  • Refugees*
  • Syria