A waste collection bin awaiting the city council's collection. Markets are one of the places the SADC hygiene strategy is targeting. The picture was taken around 5 am as people gathered for the market day. It is a stone’s throw away from the health centre featured in the story. ​Credit: Charles Mpaka​/IPS​​

By Charles Mpaka
Blantyre, Malawi, Jan 10 2022 (IPS)

The toilets in the maternity wing of Namatapa Health Centre in the populous Bangwe Township in Blantyre, Malawi’s commercial city, fell into disrepair a few years ago. So, pregnant women who come to deliver their babies and their guardians use two pit latrines.

The faulty facilities also serve as bathrooms.

Visiting the bathrooms and toilets is an act of courage, says Thokozani Paulo, who spent four days at the centre in November 2021, during the birth of her first child.

“When you want to bath or relieve yourself, the image is dreadful because half the time, there is a mess, and the stench is terrible,” she tells IPS.

At night, there is no light, and the rooms are swarming with mosquitoes.

In addition, there is not much dignity and privacy for users either. There are no doors, so women improvise using their wraps for privacy.

“So, you are bathing, and someone comes in looking to relieve themselves,” says the 23-year-old in an interview with IPS at her home. Her month-old baby girl is sleeping peacefully on her lap.

Workers at the facility clean the two toilets – but without detergent and only once every day in the morning. One day, the women in the ward and their guardians pleaded with the workers to clean the toilets at least twice a day.
“They shouted at us saying we were not the ones paying their salaries and that we should just focus on what we had gone to the health centre for,” Paulo says.

The only basin for handwashing in the ward was never supplied with soap in the four days she was at the health centre.

In November, this experience, and the experiences of many others like Paulo were top of the agenda at a meeting of health ministers from the Southern Africa Development Community (SADC) in Malawi’s capital, Lilongwe.
At that meeting, among other things, the ministers endorsed the SADC Hygiene Strategy (2021-2025).

According to the strategy developed by the SADC Secretariat, analysis of national blueprints in the region on health, water, sanitation, environmental health, and nutrition indicates there is “an enabling environment” for implementation of hygiene practices.

However, there are still considerable gaps in most of the 16 member states.

“There is still need to mainstream and integrate hygiene in most of the national policies in order to broaden the enabling environment base for effective and sustainable promotion of hygiene practices,” it reads.

The framework, therefore, challenges SADC governments to increase hygiene coverage and behaviour change across all settings. These settings include health care facilities, schools and day-care centres, workplaces and commercial buildings, prisons, markets and food establishments, transport centres and places of worship.

The key hygiene behaviours include handwashing with soap, safe drinking water management, faecal disposal, food hygiene, menstrual hygiene, and waste management.

In the case of health care centres, these need to have a safe and accessible water supply, clean and safe sanitation conveniences, hand hygiene amenities at points of care and toilets, appropriate waste disposal systems and environmental cleaning.

According to the strategy, infrastructure that supports hygiene and healthcare waste management practices helps prevent the spread of diseases within the health service facilities and in the surrounding community.
The strategy was developed with the support of UNICEF and WaterAid Southern Africa.

Maureen Nkandu, Regional Communications Manager for WaterAid Southern Africa, says the policy underlines the need for leadership, commitment, and accountability “to create a culture of hygienic behaviour and practices across all levels of society and to enable hygiene services, behaviour change and promote basic sanitation”.

“For these objectives to be effective, there will be a requirement for strong planning, financial resourcing, implementation, monitoring, and evaluation systems in each of the SADC countries,” Nkandu tells IPS.

She says WaterAid has rallied key partners, including WASH-oriented civil society and development agencies, to demand adequate resources to implement the strategy effectively.

Further, achieving sustainable hygiene behaviour across generations needs innovative behaviour change programmes of scale. This can be realised through adequate financing, coordination of relevant sectors and political leadership, Nkandu says.

For Malawi, the strategy presents an opportunity for the country to push harder towards attaining Sustainable Development Goals (SGDs) targets related to hygiene, says Maziko Matemba, a community health ambassador appointed by the Ministry of Health.

Matemba corroborates Paulo’s experience, observing that many healthcare facilities in Malawi are a source of infection for patients, guardians, and visitors because of poor hygiene.

“Sanitation and hygiene in most of our public health facilities is a serious concern. People go to hospitals to get treated, but we have cases where patients and guardians have returned home with new health conditions contracted due to poor hygiene,” he says, citing washrooms as hotspots.

Matemba argues that healthcare facilities could promote good hygiene in Malawi and SADC.

“People gather in these facilities to seek services. That’s a huge advantage to drive home awareness messages and demonstrate by own standards how people can promote good hygiene in their homes,” says Matemba, who is also Executive Director for Health and Rights Education Programme (HREP), a local organisation.

But in all this, funding is a major factor, he observes.

“Hospital administrators tell us that if they have no money for a primary commodity like drugs, hence these perennial drug shortages we see, how can mops, handwashing materials and chemicals to clean toilets with become a priority?”

Matemba tells IPS that although civil society organisations have been campaigning for ages for the government to address the critical shortage of funding to hospitals, not much has changed.

“Development budget is always inadequate. Recurrent expenditures, already less than required, are further cut, and the little that remains hardly goes to the facilities in time. Treasury always says the resource envelope is limited,” says Matemba.

He says the strategy challenges Malawi as SADC Chair to lead the way for member states to improve the hygiene situation in the region by fixing their own.

A spokesperson for the Ministry of Health, Adrian Chikumbe, tells IPS that the SADC strategy is an important approach in minimising transmission of infection in health facilities and communities.

According to Chikumbe, a recent assessment by the ministry reveals that almost a third of Malawi’s health care facilities lack running water and 80 percent of patient latrines had no associated hand washing facility.

The assessment also found that environmental cleanliness was generally below average, characterised by poor waste management practices.

He says most of the lower-level facilities in the country lack resources to maintain functional WASH infrastructure.

“The Government recognises that it cannot do everything alone. It, therefore, has plans to mobilise partner support led by district authorities to plan and prioritise water, sanitation and hygiene infrastructure in all health facilities,” he says.

CLEAN-India is an environmental assessment, awareness, action, and advocacy programme that promotes behavioural change among young city dwellers in India. As part of the programme, a group of female students learns about the importance of clean water. Credit: Development Alternatives

By Prerna Sodhi
NEW DELHI, May 16 2015 (IPS)

“Swachh Bharat”, or Clean India, is a slogan that most Indians today associate with the country’s Prime Minister Narendra Modi and his first nation-wide campaign launched soon after taking office in 2014.

The call has definitely awakened popular consciousness on cleanliness but whether citizens follow it or not is another matter. In fact, it is commonplace to find people calling out “Swachh Bharat” as they toss garbage onto the street.

However, while the campaign may not have brought about the change it was aimed to usher in, a dialogue has started and it is a watershed moment for all those working in this area to capitalise on its momentum.The call for “Swachh Bharat”, or Clean India, has definitely awakened popular consciousness on cleanliness but whether citizens follow it or not is another matter

The idea of cleaning India up is not new, and neither is the term “Swachh Bharat” which has been used by many in the past and has now been “patented” by Modi. For decades, there has been concern with instilling an awareness of the need for cleanliness among citizens, many of whom even defecate in the open.

The current initiative by the government may address the issue of cleanliness at citizens’ level, but activists in the field of sustainable development argue that it should also cover issues related to water, energy and sewage disposal cleanliness.

Access to clean water is one of the main problems that the country faces. According to a report by UNICEF (the U.N. Children’s Agency) and the Food and Agriculture Organisation (FAO), every year around 37.7 million Indians are affected by waterborne diseases, 1.5 million children die of diarrhoea alone and 73 million working days are lost due to waterborne diseases.

The problem does not appear to lie in the lack of availability of water treatment methods, but rather in the unwillingness of people to adopt these methods.

“From the field, we observed that the lack of adoption of water purification techniques is not due to low awareness levels and it was not even illiteracy, as is often assumed,” said Kavneet Kaur, field manager for Development Alternatives (DA), a social enterprise set up in 1982 to tackle the serious impact of climate change on society and the environment.

“There was an evident lack of effort and prioritisation of safety among people to undertake one or more options consistently that made drinking water safe,” she added.

Most slum dwellers, for example, “opted for methods that did not cost their pocket a penny. Those who did have access to cheaper methods of treatment, like chlorination and solar water disinfection (SODIS), avoided adopting these methods because they were time consuming.”

For the last 30 years, DA, which works primarily in Bundelkhand in central India, has been addressing the behaviour change necessary for people to adopt water treatment methods.

According to Dr K. Vijaya Lakshmi, DA Vice President, out of the three interrelated components of water, sanitation and hygiene, “hygiene behaviour has been shown to have the biggest impact on community health.”

However, she notes, “despite its merit as the most cost effective public health intervention, ironically there was no global target to improve hygiene during the Millennium Development Goal (MDG) era. It has become evident that the MDG framework has fallen short of addressing quality, sustainability and equity issues.”

To date, DA has reached out to 50,000 households and 26 schools through intensive advocacy campaigns in urban villages, offering training on how to adopt safe water treatment methods such as SODIS, boiling, chlorination and sieving, despite meeting strong resistance from the local population.

For example, storing water in a PET (polyethylene terephthalate) bottle exposed to sunlight can kill up to 99 percent of the bacteria in the water, an “innovation” that uses nothing but natural ultraviolet (UV) light to provide safe drinking water for consumption. Water can also be purified by sieving boiled water.

Apart from advocating the adoption of these simple water purification methods, DA has also come up with innovations like the Jal-TARA Water Filter, which removes arsenic, pathogenic bacteria and excess iron from contaminated water, TARA Aqua+ (a sodium hypochlorite solution for purifying water), and TARA Aquacheck Vial, a device that tests for the presence of pathogenic bacteria.

Nevertheless, these innovations are not destined to go very far unless there is a major change in the mindset of the Indian people, and this extends to the “Swachh Bharat” campaign, not just in terms of clean water but also of a cleaner environment.

This idea has also been the driving force behind a youth-led social media campaign known as CLEAN-India ‘The City I Want’, launched by SA and now covering ten Indian cities – Mirzapur, Mohali, Vadodara, Alwar, Ambala, Bharatpur, Indore, Nashik, Mussoorie and Rishikesh.

CLEAN-India (where CLEAN stands for Community Led Environment Action Network) is an environmental assessment, awareness, action and advocacy programme that promotes behavioural change among young city dwellers. It has so far mobilised 28 NGOs, 300 schools, 800 teachers and over one million students.

The campaign is flanked by a number of other citizens’ groups such as resident welfare associations, parent forums, local business associations and clubs, which are actively participating in activities for environmental improvement.

“Going forward, it is crucial that civil society organisation practitioners interface with academic institutions in evidence gathering and inform policy-makers and investors in order to create enabling conditions where scalable innovation can flourish,” says Lakshmi.

Edited by Phil Harris   

Excerpt:

Africa must now go beyond household water access indices to embrace water as a key development issue, say experts at the Jan. 15-17 U.N. International Water Conference in Zaragoza. Credit: Miriam Gathigah/IPS

By Miriam Gathigah
ZARAGOZA, Jan 15 2015 (IPS)

Although African countries have been lauded for their efforts towards ensuring that people have access to safe drinking water in keeping with Millennium Development Goals (MDGs), they have nonetheless come under scrutiny for failure to prioritise water in their development agendas.

Thomas Chiramba, Head of Freshwater Ecosystems Unit at the U.N. Environment Programme (UNEP) in Kenya, told IPS that in spite of progress on the third component of MDG7 – halve the proportion of the population without sustainable access to safe drinking water and basic sanitation by 2015 – water scarcity still poses a significant threat to sustainable development in Africa.

Attending the United Nations’ International Water Conference being held in this Spanish city from Jan. 15-17,  he said that “there is too much focus on household water access indices and not enough on linkages between water and sustainable development.”While there are now more people in Africa with improved sources of water and sanitation, experts say that this is not enough. The continent is still facing water scarcity, with negative implications for growth and health.

While there are now more people in Africa with improved sources of water and sanitation, experts say that this is not enough. The continent is still facing water scarcity, with negative implications for growth and health.

In view of the rapid and unpredictable changes in environmental systems, Chiramba said that unless Africa broadens its national and international water goals the region will find it difficult to remain economically resilient.

“Water is key to the agricultural and energy sectors, both critical to accelerating growth and development in Africa,” he added.

The theme of the Zaragoza conference is ‘Water and Sustainable Development: From Vision to Action’ and is at the heart of adaptation to climate, also serving as a key link among climate systems, human society and environment.

One of the main aims of the conference is to develop implementing tools, with regard to financing, technology, capacity development and governance frameworks, for initiating the post-2015 agenda on water and sanitation.

More than 300 participants representing U.N. agencies and programmes, experts, the business community, and governmental and non-governmental organisations have converged with the main aim of addressing water as a sustainable development goal.

“Although water goals and targets were achieved under the MDGs, the main focus was on Water, Sanitation and Hygiene (WASH), all geared towards poverty reduction,” said Chiramba. “But there was no explicit focus on addressing the sustainability aspect.”

As a result, say experts, water management issues were never comprehensively addressed at the national or international level, nor was the key role that water can play in growing the various sectors of the economy.

This year is also the last year of the International Decade for Action ‘Water for Life’ which began in 2005, and will set the tone for World Water Day to be marked on March 22, which will also focus on ‘water and sustainable development’.

The primary goal of the ‘Water for Life’ Decade has been to promote efforts to fulfil international commitments made on water and water-related issues by 2015. The Water Decade has served to forge cooperation at all levels so that the water-related goals of the Millennium Declaration are achieved.

The end of the Decade also marks the beginning of new water campaigns, “this time, with great focus on the impact of water on development,” said Chiramba.

The Zaragoza water conference has brought to the fore the fact that the Decade has achieved the difficult task of isolating water issues as key to the development agenda and has provided a platform for governments and stakeholders to address the threats that water scarcity poses to development, experts say.

“It has also been a platform for stakeholders and government to discuss the opportunities that exist in exploiting water as a resource,” said Alice Shena, a civil society representative at the event.

As a result of the Water Decade, Shena noted, a broader international water agenda has been established that goes beyond universal access to safe drinking water, sanitation and hygiene.

“The agenda now includes the sustainable use and development of water resources, increasing and sharing the available benefits which have significant implications for every sector of the economy,” she said.

According to environment expert Nataliya Nikiforova, as a new era of development goals begins under the Sustainable Development Goals (SDGs), it is clear that water will play a critical role in development.

She said  that if managed efficiently and equitably, water can play a key enabling role in strengthening the resilience of social, economic and environmental systems in the light of rapid and unpredictable changes.

Edited by Phil Harris

Many pharmacies and herbalists in Egypt prescribe their own 'wasfa' (secret drug or herbal elixir). Credit: Cam McGrath/IPS

By Cam McGrath
CAIRO, Aug 10 2014 (IPS)

Magda Ibrahim first learnt that she had endometrial cancer when she went to a clinic to diagnose recurring bladder pain and an abnormal menstrual discharge. Unable to afford the recommended hospital treatment, the uninsured 53-year-old widow turned to what she hoped would be a quicker and cheaper therapy.

A local Muslim sheikh claimed religious incantations, and a suitable donation to his pocket, could cure the cancer. But when her symptoms persisted, Ibrahim consulted a popular herbalist, whose wasfa (secret drug or herbal elixir) was reputed to shrink tumours.

“I felt much better for a few months and thought the tumour was shrinking,” she says. “But then I got much worse.”

When she returned to hospital the following year, tests revealed that the tumour was still there, and the cancer had spread to her lymph nodes. Moreover, the herbal mixture she was taking had caused her kidneys to fail.“Successive [Egyptian] governments have done a poor job at both regulating the medical sector and educating the public on health issues, leaving Egyptians unable to afford their country’s two-tiered health care system vulnerable to ill-qualified physicians, spurious health claims and quackery” – Dr Ahmad Bakr, Egyptian health care reform lobbyist

Egypt is a “minefield” of bad medicine, says paediatrician Dr Ahmad Bakr, a health care reform lobbyist. He says successive governments have done a poor job at both regulating the medical sector and educating the public on health issues, leaving Egyptians unable to afford their country’s two-tiered health care system vulnerable to ill-qualified physicians, spurious health claims and quackery.

“Our health care system is deeply deformed,” Bakr told IPS. “It’s not just a matter of low funding and corruption, ignorance (pervades every tier of) the health system, from government and doctors to the patients themselves.”

He says Egypt’s lax regulation and poor enforcement has created room for unqualified doctors to perform plastic surgery out of mobile clinics, peddle snake tonic on satellite television, and dabble dangerously in reproductive health.

It is estimated that one in every five private medical clinics in Egypt is unlicensed, and thousands of medical practitioners are suspected of using false credentials or having no formal training.

“There are a lot of so-called doctors who practise medicine in Egypt,” says Bakr. “They mostly work out of small clinics, but you’ll even find them in the most prestigious hospitals.”

The incompetency goes all the way to the top.

In February, Egypt’s military announced it had invented a device to remotely detect hepatitis C – along with acquired immunodeficiency syndrome (AIDS), swine flu and a host of other diseases. The device, which is said to work by detecting electromagnetic waves emitted by infected liver cells, is based on a fake bomb detector marketed by a British con artist.

The military also claimed that it had invented a revolutionary blood dialysis machine that can cure hepatitis C, AIDS and even cancer in a single treatment.

“I was shocked when I saw these incredible claims were being made with barely any clinical evidence,” says Dr Mohamed Abdel Hamid, director of the government-run Viral Hepatitis Research Lab (VHRL). “With any new medical treatment you should perform peer-reviewed, double-blind clinical trials before announcing it.”

Critics say Egypt’s government contributes to a climate of medical irresponsibility. State media routinely exaggerates health threats and feeds public hysteria, while the knee-jerk reactions of government authorities – including high-ranking health officials – are coloured by popular sentiment and political motives.

Reacting to the global swine flu pandemic in 2009, overzealous parliamentarians passed a motion to slaughter all of Egypt’s 300,000 pigs.

There was no evidence that pigs transmitted swine flu to humans, nor had the virus been detected in Egypt. But officials, swayed by the Islamic prohibition on eating pork, appeared to seize the opportunity of a like-named virus to rid the Muslim-majority nation of its swine.

“The pigs were kept almost exclusively by poor Christian zebaleen (rubbish collectors), who used them to digest the organic waste,” says Milad Shoukri, a zebaleen community leader. “Thousands of families lost their livelihoods to this absurd decree, which had no scientific basis.”

Global pandemics such as severe acute respiratory syndrome (SARS), avian flu and the latest contagion, Middle East Respiratory Syndrome (MERS), have presented golden opportunities for Egypt’s myriad quacks and swindlers to fleece the uninformed masses.

“With each health scare we see the same patterns,” says Cairo pharmacist Amgad Sherif. “People panic and throw science out the window. The low level of education and high illiteracy among Egyptians makes them susceptible to believe even the most ridiculous medical claims.”

When a swarm of desert locusts descended on Cairo, enterprising charlatans took out ad space in local newspapers offering a “locust vaccine” to anxious citizens.

Not surprisingly, the injected serum, which turned out to be tap water dyed with orange food colouring, offered no protection against “locust venom”. But it did leave duped households poorer, and at risk of blood contamination or hepatitis C infection from jabs with unsterilised needles.

“The people doing this only care about getting money from people who don’t know any better,” says Sherif. “They know nothing about medicine and do not follow even the most basic hygiene practices.”

In one popular scam, people claiming to be state health officials troll low- and middle-income neighbourhoods offering costly “preventative medicine” for infectious diseases. The fake medical personnel, dressed in lab coats and wearing official-looking badges, administer bogus vaccinations to unsuspecting families.

“Sometimes they give people injections – who knows what’s in them,” says Sherif.

Health officials say the sham physicians create confusion that affects legitimate health campaigns, such as Egypt’s national door-to-door polio eradication campaign.

Egyptian authorities have also found themselves in a cat-and-mouse game with thousands of “sorcerers”, whose superstition-based folk medicine draws desperate working-class patients suffering physical and psychological ailments. The self-proclaimed doctors and faith healers are particularly difficult to catch, say prosecutors, because they tend to work out of rented apartments and advertise mostly by word of mouth.

An Egyptian judicial official told pan-Arab newspaper Al Arabiya that despite attempts to prosecute sorcerers for swindling and fraud, most cases are dropped when the sorcerers reach a settlement with their victims. “There is almost one sorcerer for every citizen,” he concluded.

(Edited by Phil Harris)

Syrian mother and child near Ma'arat Al-Numan, rebel-held Syria, in autumn 2013. Credit: Shelly Kittleson/IPS

By Shelly Kittleson
BEIRUT, Jul 19 2014 (IPS)

Gaunt, haggard Syrian children begging and selling gum have become a fixture in streets of the Lebanese capital; having fled the ongoing conflict, they continue to be stalked by its effects.

Most who make it across the Syria-Lebanon border live in informal settlements in extremely poor hygienic conditions, which for many means diarrhoeal diseases, malnutrition, and – for the most vulnerable – sometimes death.

By the end of January, almost 40,000 Syrian children had been born as refugees, while the total number of minors who had fled abroad quadrupled to over 1.2 million between March 2013 and March 2014.Most who make it across the Syria-Lebanon border live in informal settlements in extremely poor hygienic conditions, which for many means diarrhoeal diseases, malnutrition, and – for the most vulnerable – sometimes death.

Lack of proper healthcare, food and clean water has resulted in countless loss of life during the Syrian conflict, now well into its fourth year. These deaths are left out of the daily tallies of ‘war casualties’, even as stunted bodies and emaciated faces peer out of photos from areas under siege.

The case of the Yarmouk Palestinian camp on the outskirts of Damascus momentarily grabbed the international community’s attention earlier this year, when Amnesty International released a report detailing the deaths of nearly 200 people under a government siege. Many other areas have experienced and continue to suffer the same fate, out of the public spotlight.

A Palestinian-Syrian originally from Yarmouk who has escaped abroad told IPS that some of her family are still in Hajar Al-Aswad, an area near Damascus with a population of roughly 600,000 prior to the conflict. She said that those trapped in the area were suffering ‘’as badly if not worse than in Yarmouk’’ and had been subjected to equally brutal starvation tactics. The area has, however, failed to garner similar attention.

The city of Homs, one of the first to rise up against President Bashar Al-Assad’s regime, was also kept under regime siege for three years until May of this year, when Syrian troops and foreign Hezbollah fighters took control.

With the Syria conflict well into its fourth year, the U.N. Security Council decided for the first time on July 14 to authorize cross-border aid without the Assad government’s approval via four border crossings in neighbouring states. The resolution established a monitoring mechanism for a 180-day period for loading aid convoys in Turkey, Iraq and Jordan.

The first supplies will include water sanitation tablets and hygiene kits, essential to preventing the water-borne diseases responsible for diarrhoea – which, in turn, produces severe states of malnutrition.

Miram Azar, from UNICEF’s Beirut office, told IPS that  ‘’prior to the Syria crisis, malnutrition was not common in Lebanon or Syria, so UNICEF and other actors have had to educate public health providers on the detection, monitoring and treatment’’ even before beginning to deal with the issue itself.

However, it was already on the rise: ‘’malnutrition was a challenge to Syria even before the conflict’’, said a UNICEF report released this year. ‘’The number of stunted children – those too short for their age and whose brain may not properly develop – rose from 23 to 29 per cent between 2009 and 2011.’’

Malnutrition experienced in the first 1,000 days of a child’s life (from pregnancy to two years old) results in lifelong consequences, including greater susceptibility to illness, obesity, reduced cognitive abilities and lower development potential of the nation they live in.

Azar noted that ‘’malnutrition is a concern due to the deteriorating food security faced by refugees before they left Syria’’ as well as ‘’the increase in food prices during winter.’’

The Syrian economy has been crippled by the conflict and crop production has fallen drastically. Violence has destroyed farms, razed fields and displaced farmers.

The price of basic foodstuffs has become prohibitive in many areas. On a visit to rebel-held areas in the northern Idlib province autumn of 2013, residents told IPS that the cost of staples such as rice and bread had risen by more than ten times their cost prior to the conflict, and in other areas inflation was worse.

Jihad Yazigi , an expert on the Syrian economy, argued in a European Council on Foreign Affairs (ECFR) policy brief published earlier this year that the war economy, which ‘’both feeds directly off the violence and incentivises continued fighting’’, was becoming ever more entrenched.

Meanwhile, political prisoners who have been released as a result of amnesties tell stories of severe water and food deprivation within jails. Many were detained on the basis of peaceful activities, including exercising their right to freedom of expression and providing humanitarian aid, on the basis of a counterterrorism law adopted by the government in July 2012.

There are no accurate figures available for Syria’s prison population. However, the monitoring group, Violations Documentation Centre, reports that 40,853 people detained since the start of the uprising in March 2011 remain in jail.

Maher Esber, a former political prisoner who was in one of Syria’s most notorious jails between 2006 and 2011 and is now an activist living in the Lebanese capital, told IPS that it was normal for taps to be turned on for only 10 minutes per day for drinking and hygiene purposes in the detention facilities.

Much of the country’s water supply has also been damaged or destroyed over the past years, with knock-on effects on infectious diseases and malnutrition. A major pumping station in Aleppo was damaged on May 10, leaving roughly half what was previously Syria’s most populated city without running water. Relentless regime barrel bombing has made it impossible to fix the mains, and experts have warned of a potential humanitarian catastrophe for those still inside the city.

The U.N. decision earlier this month was made subsequent to refusal by the Syrian regime to comply with a February resolution demanding rapid, safe, and unhindered access, and the Syrian regime had warned that it considered non-authorised aid deliveries into rebel-held areas as an attack.