In Lebanon, an emergency within an emergency

For Syrian refugees across Lebanon, lack of clean drinking water and increasing food insecurity have rendered children, especially infants, vulnerable to water-borne diseases and malnutrition.

Miriam Azar
In a makeshift refugee settlement in the Bekaa region of Lebanon, UNICEF Ireland Ambassador Donncha O'Callaghan playing with kids at the refugee camp.
Mark Stedman
02 July 2013

In a remote settlement in northern Lebanon, just a few kilometres from the Syrian border, the cries of infants fill the air.

We have just arrived with a small team from UNICEF Ireland, and right away we notice an unexpected and disturbing sight: two fragile infants, visibly suffering from malnutrition.

Ismael, 8-months old, stares ahead with blank eyes. His mother says he is suffering from chronic diarrhoea and vomiting. A man approaches with his young daughter, Aisha, her bones protruding from her chest. He tells us she has lost her appetite.

“The thing that shocks me is seeing these little children – the same age as my two daughters – with tiny little wrists, tiny little bones,” says Donncha O’Callaghan, UNICEF Ireland Ambassador and a star rugby player in his homeland. He is surrounded by children from the settlement. “You wonder what you would do if they were your children, and you’d do anything you could. These children badly need our help.”

Water is the priority

The refugees here tell us that their main need is water.

Compared to this time last year, demand for water has grown substantially. Last June, 22,530 Syrians were registered or awaiting registration as refugees. Today the number has skyrocketed to more than 572,000 people.

“Diarrhoea is a huge problem here, with more and more adults and children getting ill. The water is contaminated, but we have no choice – we need to drink,” Mustafa says. He is the camp leader and a former owner of a transportation company in Syria.

“I don’t care about my future anymore,” he adds. “But I care about the future of these children.”

When I ask the children where they get their drinking water, a young girl points to a cloudy stream. There is rubbish in the water, and the open sewage nearby poses a high contamination risk. The borehole is unprotected from stagnant water.

“With the arrival of hot temperatures in summer, we need to mitigate the likelihood of water-borne disease outbreaks by providing better access to safe drinking water,” says WASH specialist Talal Tabikh. “This is urgent, especially in the tented settlements that are scattered across the country and have inadequate water and sanitation coverage.”

Living off potatoes

One of the refugees we meet is Amina. She invites us to her tent, where she lives with her four children, aged 12 to 18 years. Her husband is dead, and their house in Syria was destroyed.

Amina tells us they cannot afford cooking gas, so they collect wood for fire. Since they have no money, they pick potatoes from the field behind the settlement. She has sent her 17-year-old son several times to find work, but he has found nothing.

Amina’s desperation is evident. She breaks down and sobs, covering her face with her hands. Her children stay silent. Her 12-year-old daughter forces a smile while her eyes fill up with tears.

Life-saving response

Following the mission, UNICEF and its partners – the Ministry of Public Health, local NGO Beyond Association, and international NGO Première Urgence-Aide Médicale Internationale (PU-AMI) – organize an immediate response.

A mobile clinic is sent to the settlement the next day, and provisions for safe water are provided: chlorine tablets, water filters and water tanks. The contaminated borehole is rehabilitated, and pits dug for dirty water and emergency latrines.

Amina, a widow, fled to Lebanon from Syria with her four children. Without money, she struggles to feed her children.
Mark Stedman

To address child malnutrition, UNICEF has received therapeutic and supplementary foods for severe and moderate acute malnutrition. Training has started for technical staff and paramedics, and seven malnutrition management centres will be set up through the Ministry of Public Health and its network.

After being taken to hospital for immediate treatment, Ismael and Aisha are in stable condition and slowly recovering. They are likely to survive because they were treated on time.

Malnutrition is unusual in Lebanon. To better understand, prevent and respond to this situation, a nutrition assessment will be conducted in mid-July.

The challenge is immense, as Syrian refugees are scattered across some 1,400 villages in Lebanon. To stop this silent emergency within an emergency, assistance will need to be agile and creative if it is to be a truly life-saving intervention.

In a makeshift refugee settlement in the Bekaa region of Lebanon, UNICEF Ireland Ambassador Donncha O'Callaghan holds 8-month-old Ismael as his mother explains the boy's condition.
Mark Stedman