The United Nations Children’s Fund (UNICEF) has trebled the volume of emergency supplies trucked into Syria from 800,000 to 2.5 million litres of water a day. Credit: Bigstock

By Kanya D'Almeida
UNITED NATIONS, Jul 24 2015 (IPS)

Caught in the grips of a summer heat-wave, in a season that is seeing record-high temperatures worldwide, residents of the war-torn city of Aleppo in northern Syria are facing off against yet another enemy: thirst.

The conflict that began in 2011 as a popular uprising against the reign of Bashar al-Assad is now well into its fifth year with no apparent sign of let-up in the fighting between multiple armed groups – including the Islamic State in Iraq and Syria.

Caught in the middle, Syria’s civilians have paid the price, with millions forced to flee the country en masse. Those left inside are living something of a perpetual nightmare, made worse earlier this month by an interruption in water supplies.

While some services have since been restored, the situation is still very precarious and international health agencies are stepping up efforts in a bid to stave off epidemics of water-borne diseases.

“These water cuts came at the worst possible time, while Syrians are suffering in an intense summer heat wave,” Hanaa Singer, Syria representative of the United Nations Children’s Fund (UNICEF), said in a statement released Thursday.

“Some neighborhoods have been without running water for nearly three weeks leaving hundreds of thousands of children thirsty, dehydrated and vulnerable to disease.”

An estimated 3,000 children – 41 percent of those treated at UNICEF-supported clinics in Aleppo since the beginning of the month – reported mild cases of diarrhoea.

“We remain concerned that water supplies in Aleppo could be cut again any time adding to what is already a severe water crisis throughout the country,” Singer stated on Jul. 23.

The U.N. agency has blasted parties to the conflict for directly targeting piped water supplies, an act that is explicitly forbidden under international laws governing warfare.

As it is, heavy fighting in civilian areas and the resulting displacement of huge numbers of Syrians throughout the country has been extremely taxing on the country’s fragile water and sanitation network.

There have been 105,886 cases of acute diarrhoea in the first half of 2015, as well as a rapid rise in the number of reported cases of Hepatitis A.

In Deir-Ez-Zour, a large city in the eastern part of Syria, the disposal of raw sewage in the Euphrates River has caused a health crisis among the population dependent on it for cooking, washing and drinking, with UNICEF reporting over 1,000 typhoid cases in the area.

To date, UNICEF has delivered 18,000 diarrhoea kits to help sick children and is now working with its partners on the ground to provide enough water purification tablets for about a million people.

With fuel prices on the rise – touching 2.6 dollars per litre this month in the northwestern city of Idleb – families pushed into poverty by the conflict have been forced to cut back on their water consumption.

Water pumping stations have also drastically reduced the amount of water per person – limiting supplies to just 20 litres a day.

UNICEF’s efforts to deliver water treatment supplies took a major hit earlier this year when the border crossing with Jordan was closed in April, a route the agency had traditionally relied on to provide half a million litres of critical water treatment material monthly.

Despite this setback, the Children’s Fund has trebled the volume of emergency supplies from 800,000 to 2.5 million litres of water a day, amounting to 15 litres of water per person for some 200,000 people.

Organisations like OXFAM, the Syrian Arab Red Crescent and the International Committee of the Red Cross (ICRC) are all assisting the United Nations in its efforts to sustain the Syrian people.

In addition to trucking in millions upon millions of litres of water each month, UNICEF has also helped drill 50 groundwater wells capable of proving some 16 million litres daily.

Still, about half a million Aleppo residents are at their wits’ end trying to collect adequate water for families’ daily needs.

Throughout Syria, some 15 million people are dependent on a limited and vulnerable water supply network.

Edited by Kitty Stapp

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.

An elderly displaced man carries a sack of rations on his shoulder. The Pakistan Army has distributed 30,000 ration packs of 110 kg each. Credit: Ashfaq Yusufzai/IPS

By Ashfaq Yusufzai
PESHAWAR, Pakistan, Jul 1 2014 (IPS)

Three days ago, Rameela Bibi was the mother of a month-old baby boy. He died in her arms on Jun. 28, of a chest infection that he contracted when the family fled their home in Pakistan’s North Waziristan Agency, where a full-scale military offensive against the Taliban has forced nearly half a million people to flee.

Weeping uncontrollable, Bibi struggles to recount her story.

“My son was born on Jul. 2 in our own home,” the 39-year-old woman tells IPS. “He was healthy and beautiful. If we hadn’t been displaced, he would still be alive today.”

“My wife is expected to deliver a baby within a fortnight, But the doctors say the child will be premature due to the stressful journey we undertook to get here." -- Jalal Akbar, a former resident of the town of Mir Ali in North Waziristan Agency
But Bibi does not have the luxury of grieving long for her little boy.

Soon she will have to dry her eyes and begin the grim task of providing for herself and her two young daughters, who now comprise some of the 468,000 internally displaced people (IDPs) seeking refuge from the Pakistan army’s airstrikes on the militant-infested mountainous regions that border Afghanistan.

Launched on Jun. 15, the army’s campaign was partly motivated by terrorist attacks on the Karachi International Airport that killed 18 people in early June.

Having failed since 2005 to flush out the militants from the Federally Administered Tribal Areas (FATA), the army is now focusing all its firepower on the 11,585-square-kilometre North Waziristan Agency, where insurgent groups have enjoyed a veritable free reign since escaping the U.S. occupation of Afghanistan over a decade ago.

Some political pundits are cheering what they call the government’s “hard line” on the terrorists. But what it means for a civilian population already weary from years of war is homeless, hunger and sickness.

Most of the displaced have collapsed, fatigued from hours of travel on dirt roads in 45-degree heat, in massive camps in Bannu, an ancient city in the Khyber Pakhtunkwa (KP) province.

Already groaning under the weight of nearly a million refugees who have arrived in successive waves over the last nine years, KP is completely unprepared to deal with this latest influx of desperate families.

With tents serving as makeshift shelters, and the blistering summer heat threatening to worsen over the coming weeks, medical professionals here are warning of a full-blown health crisis, as doctors struggle to cope with a long line of patients.

Many traveled for hours on dirt roads, in 45-degree heat, to reach safe ground, with no food or water along the way. Credit: Ashfaq Yusufzai/IPS

Muslim Shah, a former resident of North Waziristan, has just arrived in Bannu after a 45-km journey on an unpaved road with his wife and children.

He is being treated at a rudimentary ‘clinic’ in the camp for severe dehydration, and recovering from a stomach flu caused by consumption of contaminated water along the way.

The frail-looking man tells IPS he is concerned for his family’s health in an unsanitary environment, gesturing to a nearby filthy canal where his children are bathing amongst a herd of buffalos.

“We have examined about 28,000 displaced people,” Dr. Sabz Ali, deputy medical superintendent at the district headquarters hospital (DHQ) of Bannu, told IPS.

About 25,000 of these, he said, are suffering from preventable diseases caused by sun exposure, lack of nutrition, and consumption of unclean water.

On Jun. 29, the government relaxed its curfew, giving families a tiny window of escape before resuming its operation Monday.

Families who left in the allotted timeframe are expected to descend on Bannu soon, prompting an urgent need for preemptive and coordinated efforts to avert an outbreak of diseases, Ali asserted.

“Given the soaring temperatures, we fear outbreaks of communicable water and vector-borne diseases, like gastroenteritis and diarrhoea, as well as vaccine-preventable childhood diseases such as polio and measles,” he said.

Seeking some relief from the 41-degree heat, displaced children in Bannu join a herd of buffalos for a bath in a filthy canal. Credit: Ashfaq Yusufzai/IPS

Ahmed Noor Mahsud (59) and his family of four epitomise the unfolding crisis.

Mahsud himself is bed-ridden as a result of a heat stroke caused by walking 40 km in sweltering heat, while his sons – aged 14, 15 and 20 – have been suffering with diarhhoea, fever and headaches since they arrived in the camp on Jun. 22.

The family has had very little access to clean water for nearly a week, which is exacerbating their illness.

According to public health specialists like Ajmal Shah, who was dispatched by the KP health department, exhaustion among IDPs has even led to some cases of cardiac arrest.

Out in the desert, families are also at risk of snake and scorpion bites, and could suffer long-term psychological stress as a result of the trauma, Shah told IPS.

About 90 percent of the displaced are extremely poor, having lived well below the poverty line for over a decade due to the eroding impacts of terrorism on the local economy. Few can afford private care and must wait patiently for thinly-spread doctors to make their rounds.

But for people like 30-year-old Jalal Akbar, a former resident of the town of Mir Ali in Waziristan, patience is almost impossible.

“My wife is expected to deliver a baby within a fortnight,” he told IPS anxiously. “But the doctors say the child will be premature due to the stressful journey we undertook to get here. She requires bed rest, but we have been unable to find a proper home.”

The exhausted man fears their eviction will deprive him of his first child.

Another major crisis looming on the horizon is a food shortage, which will only add to the woes of the displaced.

According to a Jun. 30 assessment report by United Nations Office for the Coordination of Humanitarian Affairs (OCHA), “The Pakistan Army has distributed 30,000 ration packs each of 110 kg. The WFP has provided food rations to over 8,000 families while a number of NGOs and charity organisations are also carrying out relief activities.”

Still, those like Ikram Mahsud, a displaced tribal elder, fear that the worst is yet to come.

“We lack good food, and the non-availability of sanitation facilities like latrines, detergent and soap [means] our people are destined to suffer in the coming days,” he told IPS, adding that requests for clean water and sanitation facilities have fallen on deaf ears.

Women and children currently comprise 74 percent of the IDPs, prompting the World Health Organisation (WHO) to point out, in a Jun. 30 report, the urgent need for “mass awareness campaigns among women to promote use of safe drinking water, hygienic food preparation and storage.

“Information regarding benefits of hand-washing before eating and preparation of food, use of impregnated bed nets to avoid mosquitoes’ bites and prevent occurrence of malaria should also be encouraged,” the agency noted.

WHO says it had sent medicines for 90,000 people to Bannu, but experts here feel this will fall short in the face of a spiraling crisis.

(END)