“Putting a Band-Aid on a jugular vein”

Iran’s rapidly expanding coronavirus outbreak threatens not only Iranians but also a uniquely vulnerable population—the Middle East’s millions of refugees.

By early March Iran’s coronavirus death toll was the second highest outside China. A surge in cases across the Middle East—including Iraq, Lebanon, Egypt, and the Gulf states—traces back to Iran. Neighboring states quickly moved to close borders and cut off travel to the country, while aid workers turned their attention to protecting the region’s victims of war and displacement.

At least 12 million refugees and internally displaced people (IDPs) live between Iraq, Syria, Lebanon, and Turkey—countries with ties to Iran via shared borders, military alliances, common religious observances, and frequent travel. Iran itself hosts nearly 1 million refugees, mostly from Afghanistan.

Within the last six months, new fighting between Turkey and Syrian forces has forced more than 1 million from their homes. Of 900,000 people displaced since December due to fighting in Idlib, more than half are children. The border with Turkey has been closed to them, and with the departure of most large relief groups, organized help is lacking.

Subzero temperatures and snow this winter made a difficult situation worse. Skeleton aid crews worked with locals to secure wind-whipped, non-winterized tents. They delivered food staples to families without cookstoves or heat, and children in flip-flops trudged through snow. At least seven children died due to the cold. Another 35 children, at least, died in airstrikes and ground attacks.

“We took in some sleeping bags and supplies,” reported Steve Gumaer, president of Michigan-based Partners Relief and Development, “but everything in this crisis feels like putting a Band-Aid on a jugular vein.”

Enter COVID-19, the respiratory disease that the novel coronavirus causes.

Following basic advice to protect against the disease—avoiding people who may be infected, stepping up hand-washing and personal hygiene, seeking medical care if symptoms occur—becomes difficult to impossible in the substandard conditions of a tent camp. “If coronavirus gets into these weakened populations, the death toll among the hungry and diminished people is going to be high,” said Gumaer.

Other obstacles await aid groups and world health officials. Besides open warfare and border closings, government upheaval and months of street protests have hampered banking in Lebanon and Iraq, the two main areas for staging relief work in Syria.

Limits on deposits and withdrawals mean workers sometimes must backpack cash into the region to purchase supplies. Lebanon this month faces key deadlines to repay billions of dollars in Eurobonds. A default, which seems likely, could lead to the collapse of its banking system.

Small, agile relief groups persist despite recent obstacles and the looming threat of COVID-19.

Partners Relief’s Gumaer was in Lebanon in March and sent a team into Syria’s Idlib province on March 12, along with equipment and supplies to outfit a “hospitainer,” a container-built mobile hospital designed to treat trauma and diseases in the war-torn region. Working with a church-based NGO in Syria, the hospitainer medical team will include surgeons and other specialists, all prepped (with approval from the Ministry of Health) to deal with COVID-19.

“We have good people and seasoned doctors because they are all out of employment as their hospitals have been destroyed in Syria,” said Gumaer.

Other groups also continue. “We have not changed our ministry process,” said Tom Atema, co-founder of Heart for Lebanon, a group working among Syrian refugees. The North Carolina–based group works through local churches to administer aid and services, and “we always have had a level of health and security and safety measures in place” to avoid the spread of diseases like COVID-19, he said.

By early March two cases had been diagnosed in Bekaa Valley camps in Lebanon, but Atema said work there continues: “We believe Heart for Lebanon was born in a crisis to help the people in crisis unconditionally. It’s during these crises that we have the unprecedented opportunity to share and show the love of Jesus Christ.” 

WORLD has updated this report since its original posting.