WHATEVER THE WEATHERSYRIAN REFUGEES STRUGGLING TO SURVIVE

A young boy attempts to clear snow at the makeshift Khoder Hawash settlement on the outskirts of Baalbek in Lebanon's Bekaa valley.

T

Khoder Hawash makeshift settlement for refugees on the outskirts of Baalbek in Lebanon's Bekaa valley.

A brutal stretch of winter has just passed, but Syrian refugees living in Lebanon’s Bekaa Valley are still struggling amidst the deplorable living conditions they’ve endured for years now.

The season is almost irrelevant at this point. If it’s winter, they must contend with frigid nights and heavy snowfalls that often collapse their flimsy tents. In summer, they’re exposed to extreme, arid heat. Rains at any time bring floods and mud as well. And regardless of the month, they have little access to the sort of health care so many of them urgently need.

Staff at the four clinics Doctors Without Borders/Médecins Sans Frontiers (MSF) runs in the Bekaa regularly see patient numbers rise when the elements get particularly harsh, their ailments a reflection of the situation the war in their country drove them into.

Regrettably, the circumstances are as dire as they were predictable. "Almost four years have passed since the beginning of the conflict in Syria,” says Thierry Coppens, MSF Head of mission in Lebanon. “Families are living in despicable conditions in informal tented settlements spread all over the country”— settlements hastily set up in vacant lots, abandoned buildings, garages, and sheds on farmlands. “Support and assistance to this vulnerable population should remain constant,” Coppens adds. This crisis cannot be forgotten.”

Of particular concern is the lack of access to free, high-quality health care. The needs are evident. In December 2014, MSF teams in the Bekaa provided some 5,000 consultations; the count for January will easily surpass that number.

“Respiratory infections are on the rise among Syrian refugees at the moment,” says Dr. Bilal Kassem, an MSF doctor in Baalbek. “It’s a direct consequence of the harsh winter combined with extremely poor living conditions. People living in these settings suffer from very limited access to water and hygiene, so the risks of communicable diseases are very high as well. And that’s not even mentioning the struggle they face to find food, which also leads to health complications.”

WHATEVER THE WEATHERSYRIAN REFUGEES STRUGGLING TO SURVIVE

The photographs in this story can be viewed and downloaded online from the MSF Media Library at:

http://media.msf.org/Package/24BHRGIZWTX

To register for a free account on the MSF Media Library with access to the latest photography and video coverage from our projects around the globe, visit:

ALL PHOTOGRAPHS BYGHAZAL SOTOUDEH / MSF

Khoder Hawash makeshift settlement for refugees on the outskirts of Baalbek, Lebanon

MSF staff not only receives patients in their clinics but also goes out into the settlements to find people who need assistance. One MSF social worker, Khaled Osman, recently visited Khoder Hawash, where eight Syrian families are huddled together in one of the smallest and most isolated settlements in the Bekaa.

“Have you seen how it snowed last week?” asked an 8-year-old girl named Asma. “Now the snow is melting and we are living in the midst of mud. I feel cold.”

She was sharing a blanket with her cousin Sara, staying as close as they could to a burning stove that will keep them warm for no more than an hour. “The worst is at night,” Asma continued. “Sometimes I do not feel my feet and I am scared. Blankets are humid and we do not have wood to light a fire.”

Both Sara and Asma, who were struggling with respiratory issues and recurrent fevers, were treated at MSF’s clinic in Baalbek. Even as temperatures rise in the Valley, however, they will still be vulnerable to the illnesses so many refugees regularly contract—and the threat of burns that come with having stoves in such cramped quarters.

“I wonder how they cope with this level of misery,” Khaled said later. His job entails continuously visiting the most vulnerable families to report on the needs and refer patients to the MSF clinics. “People boil snow to make drinking water and they use cardboards or plastic garbage to warm up. Most of them have a stove but no wood or proper fuel. It is freezing inside their tents and they barely have enough blankets for the whole family. These situations are unbearable and the most vulnerable are children and the elderly, who we see in high numbers in our facilities.”

Further north, MSF teams this week also distributed urgently needed winter essentials to Syrian refugees in Akkar district, where few aid groups are active and the fear of being deported back to Syria is widespread. The distributions focused on villages up in the mountains where the winter temperatures have been bitterly cold. Around 900 families—4,700 people in all—have received stoves, fuel, and blankets.

In Lebanon, MSF is assisting refugees including Palestinians and Syrian and vulnerable host community including Lebanese returnees from Syria through primary health care such as treatment of acute and chronic diseases, immunization, reproductive health care and mental health care, as well as distributing relief items. In 2014, MSF teams provided more than 260,000 primary healthcare consultations to Lebanese, Syrian and Palestinian patients in Lebanon.

Threat of burns come with having stoves in such cramped quarters especially for children. Access to health care remains the most challenging issue these families are facing all through the years.

Khoder Hawash makeshift settlement for refugees near Baalbek, Lebanon

Melting snow has devastated living conditions in the Khoder Hawash makeshift settlement for Syrian refugees, near Baalbek, Lebanon

A pregnant Syrian woman inside her tent in the makeshift settlement of Khoder Hawash.

“An MSF nurse is monitoring my condition continually, I do not eat well and with this cold I can only imagine what my baby feels.”

MSF provided 5,000 consultations in December 2014 to refugees in this region and the numbers keep increasing, according to MSF medical team in the Bekaa Region.

Families with young children make their way through snow, mud and

melt waters as freezing temparatures continue to bring misery to residents

of the Khoder Hawash makeshift settlement for refugees

“We fled the war in Syria and now we live in a

miserable cold garage.

My 15 years old girl suffers from anorexia

and still has serious nightmares from the

bombings in our village. My husband lost his

audition abilities and without support and

international aid, we will be starving.

My mother in law also live with us. She is old

and suffers from Diabetes. She is being

taken care of at the MSF clinic here in Baalbek,

but the problem is that I do not know how to help

her with lack of food.

I do not know how to continue and if she is

going to survive."

The season is almost irrelevant at this point. If it’s winter, people

must contend with frigid nights and heavy snowfalls that often

collapse tents due to heavy snow on the roof. In summer, they’re

exposed to the opposite extreme, an arid and stifling heat.

A child colelcts plastic bags and other materials to use as fuel as freezing temparatures hit the Khoder

Hawash makeshift settlement for refugees

A child sorts through firewood amongst washing lines as freezing fog surrounds the Khoder Hawash makeshift settlement for refugees

A pregnant woman peers out from her tent home as freezing fog surrounds the Khoder Hawash makeshift settlement for refugees

Young children make their way through snow, mud and melt waters as freezing temparatures continue to bring misery to residents of the Khoder Hawash makeshift settlement for refugees.

Snow and hail fell heavily 07 January in Lebanon’s Bekaa valley, where some 400,000 Syrian refugees are sheltering in a number of makeshift camps.

A man clears snow outside a tent in a makeshift settlement of Syrian refugees in

Soleiman on the outskirts of Baalbek

A woman cleans her cooking pan in the snow at the makeshift settlement for Syrian refugees of Khoder Hawash on the outskirts of Baalbek

Almost four years have passed since the beginning of the conflict in Syria. Families

who fled the violence find themselves living in despicable conditions in informal tented

settlements spread across Lebanon. In January 2015 a winter storm brought snow,

hail and freezing fog to Lebanonís Bekaa valley where many are sheltering.

Fatma, 31, says she is very worried for her baby daughter

as she does not eat properly and keep coughing. An MSF doctor diagnosed her with a respiratory tract infection as well as with a gastroenteritis at the MSF Baalbek clinic in

Lebanon's Bekaa valley.

5000 consultations have been provided in December and the

number keeps increasing.