A ‘children’s tragedy’: Hepatitis, diarrhea infect thousands of children stranded in Rukban amid summer heat


A Rukban toddler with “moderate” diarrhea symptoms on Monday, according to one nurse in the camp. Photo courtesy of Ruba Homsi.

AMMAN: Thousands of children in a remote desert displacement camp on the Syrian-Jordanian border have fallen sick with Hepatitis A and diarrhea amid an “intense” outbreak that local nurses are blaming on high summer temperatures and increasingly unsanitary conditions throughout the poorly serviced camp.

Medical workers in the Rukban camp along Syria’s southeastern border with Jordan started recording an uptick in hepatitis and diarrhea cases as early as May, two nurses living in the makeshift settlement told Syria Direct Sunday, although the number of infected patients shot up this month as summer temperatures began to soar.

The majority of patients are children. By one nurse’s estimate, as many as 500 children in Rukban are currently suffering from Hepatitis A, as temperatures reach close to 100 degrees F. However a statement posted to Facebook last week by the Tribal Council of Palmyra and Badia, which runs a network of media activists in the camp, placed the number at 900.

Meanwhile, as many as four thousand children in the camp have also contracted diarrhea, the statement said, calling the outbreak a “children’s tragedy.” Diarrhea can be deadly if untreated.

Rukban camp sits within a demilitarized no-man’s land between the Syrian and Jordanian borders known as the “berm.” There, a spate of bombing attacks in recent years claimed by the Islamic State mean a nearby border crossing into Jordan has been firmly closed to between 50,000 and 60,000 displaced Syrians estimated to live there. An unknown number of camp residents with dire medical needs are periodically allowed to cross into Jordan for treatment at a UN-run clinic, though multiple nurses and residents have told Syria Direct in recent weeks of a camp-wide waiting list for the clinic.

“We are living in a camp that doesn’t have the basic necessities of a normal life,” one Rukban nurse told Syria Direct via WhatsApp, requesting anonymity for security reasons. “There are no tools to diagnose patients and all we can provide to patients are antibiotics and sedatives.”

Though only deadly in rare cases, Hepatitis A can cause symptoms—including fever, diarrhea and jaundice—that are difficult to treat in Rukban, Ruba Homsi, a nurse who works in one of the camp’s handful of volunteer medical clinics, told Syria Direct via WhatsApp. The clinics are run by displaced camp residents who happened to receive medical training before fleeing their hometowns. Located in one corner of the camp, Homsi’s clinic consists of 14 nurses, though medical staff lack basic equipment for properly diagnosing hepatitis patients.

“We’re just trying to reduce the patients’ symptoms because we don’t have all the medicine we need,” Homsi said.

‘Nothing I can do’

Residents of Rukban, thousands of whom fled battles against the Islamic State in eastern Syria’s Deir e-Zor in recent years, are left stranded in the desert with scarce food and water supplies. They depend on rare international donations as well as goods smuggled from elsewhere in Syria to survive.

Soap, cleaning supplies and medicine are reportedly in desperately short supply more than six months after the last cross-border aid delivery arrived to Rukban in January.

With tens of thousands of displaced Syrians trapped at the border beside Rukban for several years, the camp has gradually morphed from rows of makeshift tents into a sprawling settlement of mud houses and cinder-block grocery stores. A UNICEF-run water pipe that supplies the camp from Jordan often cuts out and, when it does, rebel groups on the Syrian side of the border have been said to truck in water tanks, which they then sell to residents at prohibitive prices.

Living in Rukban, 33-year-old Umm Muneer only realized the water she was providing to her children was unsafe when her four-year-old son Mohammad began showing signs of jaundice—a key symptom of hepatitis. Her youngest child’s face and eyes turned “yellow as turmeric,” the mother of four told Syria Direct.

Nurses at a nearby clinic in the camp told Umm Muneer, who first arrived to Rukban two years ago from Palmyra in Homs province, that her son’s condition was likely contracted from drinking unclean water. However they couldn’t provide a proper diagnosis or any treatment, Umm Muneer added.

Umm Muneer considered taking Mohammad into Syrian government-held territory for treatment, but soon gave up on the idea—her husband defected from the Syrian army in the early years of the war, making any return a gamble with government authorities. And though she signed up on a waiting list to enter the UN-run medical clinic across the border in Jordan, Umm Muneer said on Monday she has yet to hear back from camp authorities reportedly in charge of the list.

Now, with advice from the underserved clinic inside Rukban itself, there is little Umm Muneer can do but try to sterilize her household’s water in the sunlight and simply wait for Mohammad’s symptoms to go away.

Nurses told her in recent days Mohammad had “stabilized,” she said, though the four-year-old is still vulnerable due to the continued border closure and shortages of medicine and clean water supplies.  

“God, there’s nothing I can do,” Umm Muneer told Syria Direct on Monday, while her son was still suffering from jaundice. “Living in this camp is like a slow death.”

Bahira al-Zarier

Bahira is from Damascus. She studied business and marketing before moving to Jordan in 2013. She did volunteer work in support of many refugee organizations before joining Syria Direct.

Madeline Edwards

Madeline Edwards graduated from the College of Charleston in 2016 and previously reported for The Daily Star in Beirut.