Newborns in encircled north Homs face malnutrition, emaciation as funding for baby formula falls through

AMMAN: Hundreds of newborns in a regime-blockaded north Homs town are going hungry after a more than three-week baby formula shortage due to a lack of funding, sources on the ground told Syria Direct this week.

One of the children affected by the shortage is six-month-old Shahad, who was born in May in a-Rastan, a town of 105,000 people, encircled by Syrian regime forces since 2012. Shahad has been hungry for most of her short life.

“She is emaciated and fatigued,” Shahad’s mother told Syria Direct.

Shahad is one of nearly 2,000 children in a-Rastan who depend upon canisters of powdered baby formula, that, when available, are distributed free of cost on a weekly basis by the Bureau of Motherhood, Childcare and Special Needs in Rastan.

The independent aid office is the only source of baby milk in the blockaded town because formula was not included in previous international aid convoys to the area. The last convoy to enter did so this past July.

The Bureau of Motherhood provides food, diapers, crutches, wheelchairs and medication at no cost for a-Rastan’s citizens. The Bureau used to receive funding from a Turkish organization, but aid stopped coming earlier this year, leaving the office reliant on monetary donations by individuals or small organizations.

Shahad at four months old this past August. Photo courtesy of Ahmad al-Beiruti.

When the money comes to the Bureau from local, regional and international donors, the office director Maha Ayyoub uses it to pay traders in a-Rastan, who bring in baby formula through the regime-held checkpoints that control what comes in and out of the blockaded area.

The milk itself is expensive—between 15 and 20 dollars a canister—and after the trader takes his fee and pays a bribe to regime personnel manning the checkpoint, who then buy it and bring it in, “the cost reduces how much we can buy,” Ayyoub told Syria Direct.

“Everything the Bureau brings in, we do personally, through bitter suffering and by paying huge sums of money,” she said.

Sometimes formula isn’t available in nearby towns. And sometimes, the money doesn’t come at all.

“Our milk crisis is constant,” Maha Ayyoub told Syria Direct. Due to a lack of funding, an estimated 1,000 children under six months old “have been without formula for the past three weeks” and do not have any healthy alternatives for nutrition.

The situation is slightly better for the roughly 885 infants over six months old in a-Rastan. The Bureau of Motherhood received a monetary donation last week and brought a seven-day supply of formula for older babies through the checkpoints, but the high cost meant “we could only pay for half of what we needed,” said Ayyoub. The purchase was the first in three months for that age group.

“It is inconceivable for an infant to receive a canister of milk only every two or three months,” said Ayyoub.

“This is an exhausting and tragic situation.”

 “We will not be able to distribute formula next week due to a lack of funds.” Photo courtesy of Bureau for Childcare, Motherhood and Special Needs in a-Rastan.

Why has baby formula not been included in previous international aid to a-Rastan? Ingy Sedky, the spokeswoman for the International Committee of the Red Cross (ICRC), which delivered July’s shipment, cited health and safety concerns in an August statement to Syria Direct.

“In general, the ICRC does not distribute baby milk, whether in Syria or any other country,” Sedky wrote in an email. Baby formula requires “adequate hygiene conditions for preparation” such as clean bottles and water, which may not be met in a conflict zone. The Syrian Arab Red Crescent (SARC), which also provides aid, has occasionally delivered baby milk on an “ad hoc basis” elsewhere in Syria, said Sedky.

While doctors and parents in blockaded, bombarded areas say that stress and chronic malnutrition can prevent mothers from nursing, the World Health Organization (WHO) maintains that breastfeeding is virtually always an option.

“We must quash the common misconception that mothers cannot breastfeed adequately in stressful settings or if they have poor nutrition,” WHO’s Director of Nutrition for Health and Development Francesco Branca and UNICEF’s Chief of Nutrition Werner Schultink, wrote in a WHO statement in May.

Maha Ayyoub disagrees on both accounts. If the ICRC “needs sterilized water, then they have brought in water purification tablets,” she told Syria Direct. As for “the justification of encouraging natural breastfeeding,” she said it “is not rational given the blockade and bombing.”

Shahad’s mother cannot breastfeed her infant daughter because she suffers from a neurological condition and takes medication that prevents her from nursing. But even if she were not taking medication, “my milk has completely dried up,” Umm Shahad told Syria Direct, “because of the lack of food and fear of bombardment.”

Without a stable, constant source of funding and baby formula for the Bureau, the parents of children who depend on it are forced to use unsafe alternatives.

Alternatives such as cow milk or goat’s milk mixed with water, cornstarch and water, tea and flower water have “caused great suffering” for young children, Rastan pediatrician Ahmad al-Beiruti told Syria Direct. Children suffer from malnutrition, severe intestinal inflammation, dehydration, cough and fever, he said, “due to ingesting these unhealthy alternatives.”

Al-Beiruti is currently treating Shahad, whom he described as “emaciated” this past August during a previous formula shortage. At the time, Shahad’s mother brought her to the hospital two or three times a week, he said, with “diarrhea, vomiting, dehydration from malabsorption and intestinal inflammation.”

Shahad’s condition improved after the Bureau was able to buy and bring in some formula, but today, three weeks into the newest shortage, she is six months old and her health is deteriorating, her mother told Syria Direct this week.

“I’ve gone into debt to buy goat’s milk to mix with water for my daughter,” Shahad’s mother told Syria Direct. “Now her health is as bad as it was” in August.

There are currently between 60 and 80 children six months old and younger who are suffering from malnutrition, pediatrician al-Beiruti told Syria Direct.

“I call on the world to break the blockade of a-Rastan before the children die,” Shahad’s mother told Syria Direct. “The children are blameless.”

Alaa Nassar

Alaa was forced to flee Damascus with her family because of the pressure from the Syrian regime in 2013. She was a student of Arabic Language & Literature at the University of Damascus. She came to Syria Direct because she hopes to find a new direction in her life and to show the world what is happening in her country.

Maria Nelson

Maria Nelson was a 2014-2015 fellow at the Center for Arabic Study Abroad program (CASA I) in Amman, Jordan. She holds a BA in Near Eastern Studies from Princeton University, with a certificate in Arabic Language and Culture.