Death’s waiting room: the ghost refugees trapped at the Syrian-Jordanian border

The situation at the berm, a makeshift refugee camp on the Jordan-Syria border, has reached crisis point. We revisit the site and find a no-man’s-land of starvation and disease.

Community leaders distribute paltry food and aid supplies at the Rukban refugee camp. AP Photo.

On the far east of the Jordan-Syria border, thousands of children are starting to starve. On Sunday, at least two children died – a boy and a girl, both cold, skinny and malnourished.

In the absence of adequate medical care, it’s hard to know exactly why. But in the hours afterwards, their grief-stricken parents lashed out for someone to blame: at the UN, for failing to provide much-needed food; at the militant groups controlling access to the scant medical aid here; and at Syrian president Bashar Al Assad, for his brutal assault on his own people.

“Unicef and the United Nations should be ashamed of themselves,” wailed the mother of the one-year-old boy, Abdel Aziz, in a video shared on Facebook.

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The UN issued no comment, but privately staffers described their sadness over the children’s deaths, and indicated more were likely to perish. “This is a terrible place, a terrible situation. It defies belief,” said one senior humanitarian.

“The berm is unique,” said another. “We have never seen anything like this.”

The berm, as it is known among aid workers, is a strip of demilitarised zone that runs along the border between Jordan and Syria. At an old crossing-point called Rukban, what was once a way station for would-be refugees has mushroomed into a ghastly sprawl of hopelessness.

In June, The National reported on the 60,000 refugees trapped in Rukban. As that story went to press, an ISIL suicide bomber's vehicle slipped through the border and detonated at a nearby military base housing US and Jordanian personnel. Seven Jordanian soldiers were killed. In an instant, everything changed. The border was declared a military zone, closed to civilians, and humanitarian aid ceased.

Five months on, the situation for the now-70,000 people trying to survive at Rukban has become untenable.

More than half are children. Shut away from the world’s media, they’ve been left to their own devices in a dry, inhospitable desert, surrounded by militants including ISIL, marauders and wartime profiteers.

Interviews with men and women living in Rukban depict a humanitarian crisis festering without aid or oversight. Imagine a sea of tattered, home-made tents as far as the eye can see. Barefoot children trudge through the rocky desert, hauling plastic containers of cloudy water from spigots and sellers, more than an hour’s walk away. Water collection, say residents, can occupy half the day. In the months without UN support, the water infrastructure has fallen apart. Queues at the few working spigots are hours-long. Those who can’t queue are forced to pay traders for water bought inside Syria, and then driven back to Rukban.

In the absence of proper sanitation facilities, human waste is everywhere. Hepatitis first broke out in late summer, and it hasn’t gone away. NGOs trying to monitor the situation remotely say that hepatitis is the leading cause of child mortality at Rukban.

Over the past five months, there has been little-to-no organised medical care. While several military field hospitals are nearby, they cater to militants first, civilians second.

German NGO Cap Anamour briefly ran a small medical facility in the settlement, and humanitarians in Amman say they are aware of a few tents where residents with some medical training are offering care.

In August, an infant boy was granted access to Jordan for emergency surgery after photos of his injury, circulated online, caused an outcry. Few others have been so lucky. Labouring women, in particular, can expect no special favours.

“There are no doctors to perform caesarean sections. There is nothing for those women. Most of us know a woman who has died giving birth,” said Nassma, 29, a primary schoolteacher who has been living at the berm for nine-and-a-half months. Faced with a lack of reproductive healthcare, clean water and safe housing, many women are forgoing having children altogether. Nassma’s 32-year-old sister arrived at Rukban with a son, and vowed not to conceive another child until she could give it a better life.

Hozaima, 30, a teacher from rural Homs, has been at Rukban for almost 11 months. In that time, she says, she has witnessed an uptick in early marriage.

“The girls are aged 13 and up, being married to men in their twenties. The primary reason is economic, but protection is part of it too,” she said.

The protection so many families seek is from the shame that would arise if their daughters were sexually assaulted. Women at Rukban say that following a spike this summer, instances of sexual violence have decreased as the camp has come under the control of the Free Tribes’ Army, a group that trains in Jordan and answers to a powerful Syrian Bedouin named Rakan Khdeir.

“There was no one to regulate things here, so sexual violence did happen,” said Hozaima.

“There was no authority, no order. This is going to happen,” said Nassma.

For girls married to men nearly double their age, such protection may be a double-edged sword. Women say child brides often miscarry, rarely carrying a healthy child to term. Poor nutrition may compound this: since the border closed on June 21, just a single shipment of food aid reached the berm’s inhabitants, in August and by crane.

Late last month, a dozen Rukban refugees were bussed down from the border for a multi-day training programme with United States NGO World Vision (the only NGO operating in the demilitarised zone.) Overwhelmed by the abundance of food, water and electricity, they described feeling a kind of survivors’ guilt.

The mothers in the group said they ached for their children 200km away, falling asleep with empty bellies. When an instructor rewarded participants with chocolates, the mothers slipped theirs into the folds of their dresses, to be taken back to Rukban and shared with sons and daughters. “Everyone goes to bed hungry. We eat one meal a day, zeit and zaatar. There is no bread,” said Nassma, whose hunger shows on her emaciated face. Her clavicle juts out sharply beneath layers of clothing.

“The prices are astronomical for any food. Since it’s so far from any city, the food prices reflect the cost of petrol, checkpoint bribes and the danger the drivers have to go through to get the food to Rukban,” said 39-year-old Badr al-Doud, who has been at the berm since February.

“To an extent, everything is available. But you can’t afford it,” said Hozaima.

Parents spoke of the anxiety of not being able to afford medication for their children.

“My daughter is four months old. She was born with severe asthma, and she suffers in the dust and the desert climate,” said Hussein Aboud, 26. He, like most others, can’t afford the medicine his family needs.

According to statistics collected by NGOs, respiratory illnesses are a common complaint at Rukban, followed by diarrhoea, malnutrition and jaundice. While parents say they regularly skip two meals a day to allow their children to eat more, after five months of severe deprivation, the little which children do get hasn’t been enough.

But this may be changing. In recent days, aid has begun to move again. Jordanian officials have worked out an approach with the UN and its partners to provide aid in a way that meets both Jordanian and US security concerns. This has involved relocating the aid distribution point from the Jordanian berm to the Syrian berm, 4 kilometres north. According to internal UN planning documents, the aim is to move refugees back from Jordan’s borders, so any threats – like the suicide bomber in June – can be spotted before they get close enough to cause damage.

World Vision is also working with Khdeir, head of the Free Tribes’ Army, to get hygiene kits, baby kits and children’s winter clothing to refugees. It’s an arrangement that doesn’t sit well with some other humanitarian groups, who argue that working with a militant group violates the humanitarian principle of impartiality.

“Humanitarian operations are getting more and more complex, which means making ethical choices more and more difficult. It’s not always clear who the good guys are and who the bad guys are,” said Luis Eguiluz, Médecins Sans Frontières’s head of mission in Jordan. MSF does not have a presence at Rukban.

Martijn Hekman, deputy director of World Vision’s Syria Response, said his group was doing its best “in tough circumstances” to get aid to those “who need it most”.

Aid distributions haven’t gone smoothly. Militants patrol aid hand-outs, ostensibly to enforce order, but in the last week staffers described rioting and gunfire.

“It’s impossible to distribute food, impossible to control the crowd,” said one UN employee at the Jordanian berm, after a particularly tough day.

A few days later, as aid staff remarked on a successful distribution, Nassma, back at the berm, put it in perspective. “Most of what they distributed recently was rice. This is an essential supply that should be in every house, but only about 1,000 families received these supplies,” she said. That’s just one-70th of the amount needed.

Days later, as aid workers fought to hand out more food, the two children died.

Was it hunger, exposure or illness? Or does it even matter? Even the lucky ones who survive the hunger and cold, said Hozaima, face another kind of death.

“Any tent you enter in the camp, you see people who have lost hope. It’s like we left our homes to go to our graves.”

Sara Elizabeth Williams is a freelance journalist based in Amman.