Trapped in her northern Syrian village by fighting, Mervat watched her newborn baby progressively shrink. Her daughter’s dark eyes seemed to grow bigger as her face grew more skeletal. Finally, Mervat escaped to neighboring Lebanon, and a nurse told her the girl was starving.
The news devastated her.
“They had to hold me when they told me. I wept,” the 31-year-old mother said, speaking in the rickety, informal tent camp where she now lives with her husband in the eastern Lebanese town of Kab Elias.
Her daughter Shurouk has been undergoing treatment the past three months and remains a wispy thing. The nine-month-old weighs 3.2kg — though she has become more smiley and gregarious.
Mervat spoke on condition she be identified only by her first name, fearing problems for her family in Syria.
Her case underscored how dramatically Syrian society has unraveled from a conflict that this weekend enters its fourth year. Such stark starvation was once rare in Syria, where Syrian President Bashar al-Assad’s autocratic state ran a health system that provided nearly free care.
That system, along with most other state institutions, has been shattered in many parts of the country where the fighting between al-Assad’s forces and the rebels trying to overthrow him is raging hardest. The war has killed more than 140,000 people and has driven nearly one-third of the population of 23 million from their homes — including 4.2 million who remain inside Syria and 2.5 million who have fled into neighboring countries. Nearly half those displaced by the war are children.
Now aid workers believe starvation cases are increasing in besieged areas of Syria and malnutrition is spreading among the poorest Syrian refugees.
Before the conflict, doctors inside Syria would see fewer than one case a month of a child with life-threatening malnutrition, now they tell UNICEF they encounter 10 or more a week, said Juliette Touma, a Middle East regional spokesperson for the agency.
In Lebanon, malnutrition grew from 4.4 percent in 2012 to 5.9 percent of Syrian refugee children, according to a recent UNICEF-led survey.
In all, an estimated 10,000 Syrian children in Lebanon are likely suffering malnutrition, said Dima Ousta of the International Orthodox Christian Charities, a non-governmental organization leading efforts to deal with the issue in Lebanon.
UNICEF said nearly 2,000 were at risk of dying because of acute malnutrition if they were not immediately treated.
A survey in Jordan found that 4 percent of Syrian refugee children under five needed treatment for moderate or acute malnutrition, the World Food Programme said on Monday.
Touma said UNICEF had not yet finished surveys for refugees in Turkey or inside Syria itself.
Malnutrition is the product of a series of ever-widening and interconnected problems.
Within Syria, fighting in the worst-hit areas can limit access to food supplies and healthcare for children. There and among refugees, children are vulnerable to diarrhea and other illnesses from drinking dirty water or being exposed to sewage.
Those conditions can exacerbate malnutrition and, in turn, malnourished children are less resistant to disease.
Social factors also play in. Rural Syrian women tend to marry as teenagers and rely on their mothers or other relatives to help in child-rearing.
However, as refugees, many lose that support network and without guidance do not know how to properly breastfeed their children — bringing a risk of malnutrition. As refugees run out of money and struggle to find work, many mothers do not have enough to buy supplementary food.
The poverty and poor hygienic living conditions at the root of the problem are likely only to worsen as Syria’s war drags on.
“Malnutrition is not an issue related to food. It’s a health issue,” Zeroual Azzeddine of UNICEF said.
In Lebanon, nearly 1 million Syrians are registered as refugees by the UN refugee agency. The poorest 140,000 live in 460 informal camps, where they live in poorly insulated tents with no clean running water and with sewage running down ditches between tents.
Aid workers are trying to track down the thousands of malnourished children they believe are in Lebanon.
“We need to find these children,” said Ousta, whose organization treated 170 cases since August last year.
UNICEF is training doctors to identify malnutrition among Syrian children undergoing immunizations and other medical checks.
The doctors weigh children, measure their upper-arm circumference and check their feet for water retention that can be a sign of acute malnutrition.
They are on alert for mothers who say their babies are always tired, another signal.
Mervat, who lived with her family in the northern Syrian village of Tel al-Daman, was too poor to buy food for her daughter, who kept vomiting the breast milk she gave her.
She watched Shurouk shrink and her stomach bloat, but the fear of clashes between rebels and government troops kept her from reaching a doctor in the nearby city of Aleppo.
Fearing her daughter would die, she fled to Lebanon four months ago.
Now she and her husband and eight children sleep in a tiny shack of wood, cardboard and plastic, with a small heater and thin mats. Her husband, a laborer, hurt his foot and cannot work.
Her older daughters decorated the tent with an old lace curtain, faded plastic flowers and a green-and-white teddy bear.
However, it does not protect them from the icy, wet cold, and Shurouk keeps falling ill.
When doctors first saw her in Lebanon, she weighed 3kg, climbed up to 4kg and then lost weight in a flu bout, said Maha Shoker, an aid worker monitoring her case.
Shurouk remains acutely malnourished and, making her situation more precarious, she also has gall bladder stones.
Refugees must grapple with another problem. The UN and partner organizations only cover basic care because there is not enough money. Syrian children with illnesses sometimes fall through the gaps — and because they are sick, they do not eat, and malnutrition becomes a side-effect.
Near Mervat’s tent, 15-month-old baby Juma Kheir’s dirt-streaked face contorted in pain from a hernia that has caused his testicles to swell.
His father, Mohammed, said doctors told him the hernia was not an urgent medical case, and so aid agencies could not cover the cost of treating it.
Meanwhile, Juma cannot eat and his mother feared he was wasting away. His twin was noticeably chubbier and heavier.
Mervat said her other children were often hungry because they had no money to buy food and relied on UN donations.
“I’m worried about them, I’m afraid of the future,” Mervat said.
A CAUTIONARY TALE: Bookseller Lam Wing-kee speaks of the danger that his adopted home Taiwan now faces and the ordeal of his detention in China Lam Wing-kee (林榮基) leaned forward in his chair, answering quickly and sharply to issue a warning to the people of his new home, Taiwan. “Be ready now,” Lam said. “We should be more alert as citizens, we should get ready,” the 64-year-old Hong Konger said. “If they can take Hong Kong back, the next place, I feel, is Taiwan.” Late in Taipei at Causeway Bay Books Mark II, on the 10th floor of a nondescript building, Lam, a wiry, gray-haired bookseller, was sitting at his desk with a bemused gaze behind thin oval glasses. The desk was neat, but crowded with books and a
‘POLICE EVERYWHERE’: A law that would criminalize the publication of images of police officers was passed by the National Assembly and awaits Senate approval Violent clashes erupted in Paris on Saturday as tens of thousands took to the streets to protest against new security legislation, with tensions intensified by the police beating and racial abuse of a black man that shocked France. Several fires were started in Paris, sending acrid smoke into the air, as protesters vented their anger against the security law, which would restrict the publication of police officers’ faces. About 46,000 people marched in Paris and 133,000 in total nationwide, the French Ministry of the Interior said. Protest organizers said about 500,000 joined nationwide, including 200,000 in the capital. French President Emmanuel Macron late
Not enough beds and not enough doctors: a skyrocketing COVID-19 caseload is pushing hospitals in the Balkans to the cusp of collapse, in chaotic scenes reminding some medics of the region’s 1990s wars. After nearly a year of keeping outbreaks more or less under control, the nightmare scenario that the Balkans feared from the start of the COVID-19 pandemic is now starting to unfold. In hard-hit Bosnia-Herzegovina, one doctor described the distress of having to juggle the care of multiple patients whose lives were hanging by a thread. “The situation reminds me of the war, and I’m afraid it could get even worse
SIGNIFICANT RULING: That male prisoners are denied a choice as to their hair length suggests they are treated less favourably than female prisoners, the judges wrote Prison staff were wrong to cut the hair of a former Hong Kong legislator known for his long locks, the territory’s top court said yesterday, in the second significant ruling against authorities this month. The decision came as powerful establishment voices called for an overhaul of the judiciary — something opponents fear could muzzle the Hong Kong legal system’s vaunted independence as Beijing cracks down on its critics. The ruling by the Hong Kong Final Court of Appeal is the culmination of a long legal battle by former Hong Kong legislator Leung Kwok-hung (梁國雄), 64, who served a brief jail sentence in