How do refugees wash their hands?
The explosion in Beirut on August 4th left 300,000 people homeless in the country that has been estimated to have the highest number of refugees per capita in the world, with almost 1.5 million refugees from Syria alone. At the same time, Lebanon has been having environmental problems, including deterioration of water quality and increasing water stress. The Lebanese government is not handling the situation well, violently putting down protests and blocking foreign aid. For countries in conflict, such as Syria, Iraq and Yemen, water and energy infrastructure have become collateral damage of warfare. Surrounding countries, such as Jordan, Lebanon and Egypt are often unprepared to supply water to large numbers of refugees. The North Africa and West Asia region will likely only get hotter and drier when the effects of climate change become more prominent.
After the Arab Spring in 2011, several civil wars in Arab nations resulted in an upsurge of migration and displacement. The Syrian civil war alone has resulted in the migration and displacement of 11 million people. During the Syrian civil war their healthcare system, one of the best in the Middle East, deteriorated. Over 60 percent of Syrian hospitals and medical facilities have since been destroyed. Along with this, there has been a dangerous lack of sanitation and hygienic care. COVID-19 will most likely hit the region hard because of this. Two-thirds of the Yemeni population did not have access to clean water in September 2019. In this article, I will look at the refugee crisis through the lens of water and sanitation access and quality, because the ability to wash your hands is one of the most important tools in combatting COVID-19.
Sustainable Development Goal 6
One of the most prominent international organizations monitoring water access and quality is the United Nations, with UN-Water. In September 2015 the General Assembly adopted 17 Sustainable Development Goals. These goals are supposed to be achieved in 2030. Goal 6 is to ensure availability and sustainable management of water and sanitation for all. The goal has been shortened to the acronym WASH, water, sanitation and hygiene. Water scarcity could displace 700 million people by 2030. As a result of climate change, population growth and unsustainable practices the world will be facing a 40 per cent shortfall in water in 2030.
Changes in the water supply and quality have a large influence on food security, energy security and the promotion of peace and stability. A 2016 report from the World Bank stated that ‘the impacts of climate change will be channelled primarily through the water cycle, with consequences that could be large and uneven across the globe.’ The poor are most vulnerable to climate change, and when there is not enough water, food security is hit hard as well. This link is called the water-food-energy nexus.
With economic growth, the energy consumption grows as well, especially on the continent Africa. The difficult negotiations surrounding the Grand Ethiopian Renaissance Dam illustrate this. The dam could be the energy supply for entire Ethiopia. 75 million Ethiopians could get access to electricity with this dam. With high production, they could sell energy to other countries. Egypt relies on the Nile for its water supply. The dam would decrease the amount of farming land in the Nile Delta in Egypt. According to Al Jazeera, if Ethiopia fills the reservoir behind the dam in 10 years, it would decrease 14 percent of Egypt’s water supply and 18 percent of its farmland. Water has a huge impact on quality of life for everyone.
Refugee camps and COVID-19
For refugees, access to water and sanitation can be difficult. UNHCR recommends one water tap per 250 people in a refugee camp, but many camps in the Middle East do not meet that standard. Data for access to water and water quality seems to be patchy. In 2008 a bigger review was published in scientific magazine Journal of Water and Health using data from 2003-2006. There has been no attempt to review the situation after that. With COVID-19 spreading around the world, this is a problem. There is no space to social distance in a refugee camp and with this many people sharing water taps, washing your hands regularly is a luxury not provided to refugees. The communities formed in the refugee camps do not have access to good medical systems or sanitation either.
The Middle East has a dry climate, with wetter winters and springs to fill up the water supply. Climate change will most likely increase the fluctuation in the water supply with more frequent droughts and floods. This will cause more people to be displaced and make the situation for refugees more dangerous. With most refugees living in camps, a flood ruins their shelter. A tent gives little protection, so they will not have the ability to keep their beds or belongings safe. On January 11th, the UNHCR posted a video on YouTube showing the effects of storm Norma on the Dalhamiya settlement in the Bekaa valley in Lebanon. The refugees explained that they were unable to keep their clothes or firewood dry from the water that was up to half a meter high in some areas of the settlement.
Supplying enough drinkable water to refugee camps is difficult. The water supply in Jordan and Lebanon is often strained as is, and the recent influx of refugees made the situation more difficult. The UN Refugee Agency, UNHCR, aims to provide 20 litres of water per person per day, the equivalent of flushing the toilet in your house about 4 times. The average an individual consumes in the EU is 128 litres per day. Yet in only 43 per cent of the camps UNHCR is able to reach this mark. WASH programmes are in place to stop waterborne diseases, such as diarrhoea or typhoid and now COVID-19. Not all refugees live in camps however, more than 20 percent of the Syrian refugees in Lebanon live in informal settlements, such as tents or school buildings.
As of the beginning of June, there was little concentrated effort to test refugees in Lebanon for COVID-19 due to lack of resources and testing kits. In April a Palestinian women tested positive in the al-Jalil camp. On top of that many refugees have underlying health conditions that leave them more vulnerable to COVID-19.
The water supply that is available is often not up to standard. Research on the water quality in two Palestinian refugee camps showed that the water quality in both camps was deteriorating, with a too high concentration of the E. coli bacteria in the water. The researchers recommended more systematic water testing and greater transparency in reporting the results to camp residents. The funds to do this are lacking. On July 9th UN-Water launched new plans to accelerate progress to achieve SDG 6.
There have been doubts over the effectiveness of the Sustainable Development Goals. The statistics and indicators used could give a skewed image of their success. A way to fix this is to evaluate differently but deciding which questions to ask on a global level is difficult. Another way to increase the effectiveness of the SDGs is to improve the statistics. There are gaps in global reporting of progress, which thwart the statistics. International, comparable data is not being produced at the moment. Many countries view the global indicator framework as an imposition by international organizations. Regional organizations proliferate, that tend to compete with the global framework.
UN-Water has made a data portal to bring together the global indicators and other parameters to track SDG 6’s progress. The data is compiled from national systems and verified by the responsible United Nations organizations. The global indicators are concerning wastewater, water quality, water availability and use, but also related to the systems managing water, such as data from integrated water resource management.
Because this data is largely compiled by national ministries, it is difficult to determine whether refugees are incorporated in this data. This is partly, because the languages I can read in are European and European nations tend to take in enough refugees to warrant a refugee camp. In 2017 Lebanon was had the smallest proportion of the population using a safely managed drinking water services in Northern Africa and Western Asia with 48 percent, but another 45 percent had access to a basic service. Access to basic service could mean that someone will have to more than half an hour to get to the water point. Another note to this data, not every country in the region provided the information necessary for this comparison, e.g. Egypt, Syria and Yemen were not part of the comparison.
Refugees are and have been vilified for years. Boris Johnson recently said that migrants crossing the Channel were ‘very bad and stupid and dangerous and criminal’. For clarification, seeking refuge is not a criminal activity. It is a human right. Refugees are among the most vulnerable in society, which makes them an easy statistic in discourse. They usually cannot share their story, because of their lack of resource. Populistic politicians take advantage of this position to further their own agenda.
At the beginning of July, the Dutch government voted against giving refuge to 500 children in Greek refugee camps, even though it was clear that the resources to give them shelter were available. Over a hundred municipalities said that they were willing to take in the refugee children. Refugee camps in Greece reportedly have an absence of running water and electricity, with up to 1,300 people sharing one water tap.
In Germany, COVID-19 is spreading in refugee camps, but the residents have little access to information in their language. In a Thuringia refugee camp refugees tried to flee after a lockdown was imposed, because they believed that they were being deported. 
Vilifying refugees to distract from national problems is a widespread tactic, making the situation more difficult more refugees. It illustrates a reluctance to treat refugees like people that deserve basic water access and sanitary services and by extension a reluctance to fund their basic rights. This attitude is widespread the finance gap for all 17 SDGs is estimated to be between 1.4 and 3 trillion USD per year.
There are ways to help refugees. Organisations like UNHCR and Doctors Without Borders are currently trying to provide medical services to refugees in the fight against COVID-19. Writing to your representative or a relevant political party to voice your support for refugees may help their position in your country. It is vital that the right people are in the right places, volunteering yourself might seems philanthropic, but often it is more helpful to fund a better equipped person to help.
 https://sdgs.un.org/goals/goal6  Routledge Handbook of Water Law and Policy.  https://www.aljazeera.com/programmes/start-here/2020/01/egypt-ethiopia-nile-dispute-start-200126115119579.html  https://www.unhcr.org/4add71179.pdf  Issmat I. Kassem & Hadi Jaafar, “The potential impact of water quality on the spread and control of COVID-19 in Syrian refugee camps in Lebanon,”Water International (2020).  https://www.youtube.com/watch?v=fIGWy5SynVw  https://www.theguardian.com/world/2020/apr/22/fears-realised-as-first-covid-19-case-diagnosed-in-lebanon-refugee-camp#:~:text=Fears%20realised%20as%20first%20Covid%2D19%20case%20found%20in%20Lebanon%20refugee%20camp,-This%20article%20is&text=Medics%20are%20scrambling%20to%20contain,the%20region's%20most%20vulnerable%20communities.  https://www.mdpi.com/2073-4441/11/4/670  https://sdg.iisd.org/commentary/guest-articles/are-we-serious-about-achieving-the-sdgs-a-statisticians-perspective/  https://www.sdg6data.org/about/data-sources  https://sdg6data.org/country-or-area/Lebanon  https://www.parool.nl/nederland/geen-500-asielkinderen-naar-nederland-reacties-gemengd~bea16a9dd/?referer=https%3A%2F%2Fwww.google.com%2F  Selma Nouri, “Effects of Conflict, Displacement, and Migration on the Health of Refugee and Conflict-stricken Populations in the Middle East,” International Journal of Public Health Science (2019).  https://www.globalhealthnow.org/2020-06/germany-and-covid-19-what-about-refugees
At the time of writing, Celine Louis is an MA History and Intensive Arabic Student at SOAS London.. Her interests are 19th and 20th century history, and Middle Eastern affairs.