War and earthquakes leave displaced people without water in Syria

The water and sanitation system of Jindiris had already been severely weakened by over 12 years of war when the earthquakes struck in February 2023.

Camp for displaced people in northwest Syria.

The once-magnificent city of Jindires, along the Syria-Turkey border, lies in rubble after relentless war and the catastrophic earthquakes that struck the region earlier this year. In northwest Syria, nine out of 10 people displaced by the earthquakes had already been displaced by the war at least once before. Many have found temporary shelter in camps, but they still lack stability as well as even the most basic necessity for survival: water.

Doctors Without Borders/Médecins Sans Frontières (MSF) teams are responding to these needs in Jindires’ recently established Al-Eman displacement camp, which hosts 2,130 people. Among those living in the camp is Emm Hassan, a mother of five, whose house collapsed recently. She had already been uprooted from western Aleppo due to the war.

“We have lost everything, including our normal life,” said Emm Hassan. “Life in the camp is incredibly difficult. With limited access to clean water and a lack of sanitation and hygiene facilities, our children are falling ill with diseases like cholera, scabies, and leishmaniasis. All five of my children contracted leishmaniasis, leaving scars on their faces that will take years to heal.”

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There was already a lack of clean water when people first arrived at the camp. Each person had nine liters of water available, while international standards requires 20 liters per day. There aren't enough latrines; just one for every 90 people. Additionally, there is no proper sewage system for waste disposal. 

“Water and sanitation infrastructure is severely limited in camps for the newly displaced,” said Halim Boubaker, MSF Medical Coordinator for Syria. “The lack of clean water and the use of contaminated water sources increases the risk of waterborne diseases such as cholera and hepatitis. Insufficient or inadequate latrines compromise hygiene and privacy and increases the risk of communicable diseases like scabies.”

WASH Assessment Idlib Camps
Over two thousand people displaced by the earthquakes in February live in the new Al Eman displacement camp in northwest Syria, where water and sanitation is lacking.
Syria 2023 © MSF

The substandard living conditions in camps has also created an environment conducive to the transmission of scabies, a contagious skin condition caused by the infestation of itch mites. MSF and our partners, through mobile clinics and community health activities, detected a significant rise in scabies cases in northwest Syria in May.

In Afrin, our Syrian partner organization, Al-Ameen identified over 3,600 scabies cases in an assessment of 10 camps housing approximately 13,000 people. More than half of the cases were in children under the age of 10. The disease is primarily linked to open sewage and continued water scarcity in the affected camps.

Water, sanitation, and hygiene activities are one of the main priorities in MSF's emergency response efforts to prevent the spread of disease across 100 displacement camps. We have distributed over 8,000 cubic meters of clean water; installed more than 1,000 water tanks and 130 mobile latrines; and have provided maintenance on 620 latrines and 90 showers. We’ve also distributed 111,000 relief items, including hygiene kits, kitchen kits, and menstrual kits for women.

An MSF staff member inspects a child during a WASH assessment in Idlib's camps for internally displaced people.
Lack of clean water and sanitation facilities increases the risk of waterborne diseases like cholera. Syria 2023 © MSF

A decade-long struggle for water

In addition to the damage on the water and sanitation system caused by war and recent earthquakes, Syria is also suffering from increasing water scarcity. The country has been relying on a combination of water trucking from humanitarian organizations and water pipe networks, which are hindered by the unstable power supply and high fuel costs.

During May, MSF teams conducted assessments in 48 displacement camps and two villages in northwest Syria, housing approximately 60,000 internally displaced people. The assessment found that 70 percent of the camps relied solely on water trucking as their source of drinking water. While all camps had latrines, half of them required maintenance, 70 percent of the camps lacked shower facilities, and 85 percent did not have fully operational wastewater networks.

“When we came to this camp five years ago, we never really solved the problem of having enough toilets and bathrooms,” said Manhal El-Freij, who manages a camp for displaced people in Idlib. “The land here is rocky and difficult to dig, so we couldn't make proper toilets.”

"The land here is rocky and difficult to dig, so we couldn't make proper toilets. Most of the makeshift sewage holes people dig using basic tools are not good enough."

Manhal El-Freij, manager of displacement camp

El-Freij added, “Most of the makeshift sewage holes people dig using basic tools are not good enough. This means that diseases like scabies and lice are common because we don't have proper sanitation. Families can only shower once every 10 days.”

Despite the urgent need for assistance, the water and sanitation sector in Syria has only secured around 8 percent of the funding it needs in 2023. This persistent lack of funding, combined with the inability to implement long-term sustainable projects, further hinders efforts to provide adequate water and sanitation services to those in need.

“The road to reducing the invisible health risks posed by [poor] water and sanitation to displaced people in Syria seems long and challenging,” says Boubaker. “To protect the health and dignity of those affected, immediate attention, more and well-oriented funding, as well as ensuring sustainable and impartial access to humanitarian aid are required.”