Flooded sewage at a Syrian refugee camp in Arsal on May 12th, 2024. (Credit: Sawaed al-Kher organization on Facebook)
BEIRUT – Lebanon's Minister of Health, Firas Abiad, raised concern that diseases may spread in Syrian refugee camps in the Bekaa, as funding cuts may make it harder for international aid agencies to provide clean drinking water.
Abiad said, last Friday, that cases of jaundice, a medical condition involving yellowing of the skin or whites of the eyes usually caused by a liver disease, and skin rashes have reportedly increased in informal Syrian camps in Lebanon, due to a lack of clean water.
"This is especially concerning as [the underlying diseases that cause] jaundice can be contagious and the conditions in the displacement camps could lead to further spread, as well as the emergence of other epidemics," he added. There are particular concerns about the town of Arsal in the Bekaa.
Raising the alarm amidst funding cuts
Minister Abiad was informed earlier this month by Ivo Freisen, the UNHCR Representative in Lebanon, that there has been "approximately a 50 percent reduction in health care coverage for Syrian refugees in Lebanon." The justification for these reductions relates to budget cuts in healthcare due to ongoing global crises, from the outbreak of the war in Ukraine and Gaza.
UNICEF's representative in Lebanon, Edouard Beigbeder, announced in a statement published on Monday that there has been a decrease in funding for UNICEF's water, sanitation and hygiene (WaSH) services in informal settlements, falling significantly below anticipated levels.
"This year, UNICEF requires a minimum of $12 million to deliver through its partners the minimum acceptable level of WaSH services to refugees in informal settlements. To date and due to additional funding cuts, less than USD 4 million are available," he added.
According to Yazbeck, the "reduction of UNICEF services due to the reduction of donor countries' aid to this humanitarian organization ... is leading to a real humanitarian disaster, starting with skin rashes, hepatitis and scabies."
The Ministry of Health's director of medical care, Joseph Helou, told L'Orient Today that the ministry is raising the alarm as UNICEF and UNHCR have contracted their work in refugee camps due to funding cuts. He is concerned that this, coupled with the growing need for water as the warm summer approaches, could prompt disease to spread.
Temporary arrangements for water supply and sanitation are provided by international aid groups in informal settlements where permanent infrastructure is not allowed.
Contacted by L'Orient Today, Lebanese Forces MP Ghayath Yazbeck, who is also the head of the Parliamentary Environment Committee, said that the situation in Arsal can evolve at any time and become a pandemic.
"Arsal is the only place where Syrian migrants are living alongside the residents of the village meaning that migrants rented apartments in the village’s houses and are living with the townspeople," he said. "This means that, in two seconds, an important spread of the diseases can happen."
A ongoing problem
MP and member of the Parliamentary Health Committee, Abdel Rahman Bizri, questioned why these concerns are being raised now. "We’ve been in this problem for a while, I do not know why there is a fuss about the issue now," he said. "Lebanon has been struggling for approximately two years from jaundice which has been present in the Bekaa and the Baalbeck-Hermel where there is a high presence of Syrian refugees," he added.
He added that "the Lebanese government needs to pressure the UNHCR and UNICEF to provide sanitation and clean water" and said that the "government should maintain the country's sewage system."
L'Orient Today contacted the medical NGO Doctors Without Borders for information about whether waterborne diseases are increasing in the Arsal area. "After discussing with our medical team, we can say that observations at either clinic do not allow us to provide a definitive answer regarding a spread or outbreak, there are cases of waterborne diseases and skin-related conditions – as is the case year-round – but it is early to draw a full picture or report a remarkable rise from the numbers we see in our clinics," the NGO said.
Although UNICEF said that it is still committed to delivering water and sanitation services in informal settlements in Lebanon, Yazbeck said that now UNICEF has "stopped providing drinking water and the budget for desludging wastewater decreased by 20 percent, causing the "accumulation of wastewater on the streets of Arsal." This, in turn, increases the probability of waterborne diseases.
A Syrian living in one of the refugee camps in Arsal, who did not want to be named due to safety concerns, told L'Orient Today that waste water is not being dislodged in some camps. Another said that they some people have had Hepatitis, but have since recovered.
"Last year, there were way more Hepatitis cases," adding that some numbers that are "being spread in the media are incorrect," stated Helou. There are, however, no cholera cases currently reported in Lebanon, after tests were made for suspected cases among Arsal residents. Between October 2022 and January 2023, a cholera epidemic hit Lebanon, with 671 confirmed cases and 23 deaths.
Calls for the return of Syrians
In the background of a heavily politicized conversation around the status of Syrians in Lebanon, Abiad called for the repatriation of Syrian migrants to their homeland. Abiad said last Friday said that the country "cannot bear additional burdens, and the international community must take responsibility by finding a lasting solution for refugees that allows for their safe and possible return to their home country."
The Lebanese government continues to discuss plans for repatriating illegal migrants, while the international community opposes any non-voluntary return to Syria, especially concerning political refugees who risk persecution in their own country. In early May, the President of the European Commission, Ursula von der Leyen, announced one billion euros in aid for Lebanon during a visit to Beirut. Several Lebanese media outlets and officials have likened this funding to a means of 'bribing' authorities to keep Syrian refugees and migrants in Lebanon, which the government denies."
