OXFAM RESEARCH REPORT MARCH 2018 A CLEAN AND DECENT LIFE WITHOUT WaSH? An analysis of impacts and risks of reduced and limited WaSH funding on Syrian refugees in Informal Tented Settlements in Bekaa, Lebanon. www.oxfam.org ACRONYMS ACH Acción contra el Hambre AJEM Association Justice et Miséricorde CHV Community Hygiene Volunteer CISP Comitato Internazionale per lo Sviluppo dei Popoli CTV Community Technical Volunteer ECHO European Civil protection and Humanitarian aid Operations FSL Food security and livelihoods GAC Global Affairs Canada IAMP Inter-Agency Mapping Platform IMC International Medical Corps ITS Informal tented settlement MEAL Monitoring, evaluation, accountability and learning NRC Norwegian Refugee Council Sawa Sawa for Development and Aid UNHCR United Nations Commissioner for Refugees UNICEF United Nations Children's Fund VASyR 2017 Vulnerability Assessment of Syrian Refugees in Lebanon 2017 WaSH Water, sanitation and hygiene WVI World Vision International WFP World Food Programme CONTENTS EXECUTIVE SUMMARY .............................................................................................................................. i INTRODUCTION .................................................................................................................................... i METHODOLOGY .................................................................................................................................... i FINDINGS AND CONCLUSIONS ............................................................................................................ ii RECOMMENDATIONS ......................................................................................................................... iv 1. INTRODUCTION ...............................................................................................................................1 1.1 BACKGROUND TO THE STUDY .................................................................................................1 1.2 PROBLEM STATEMENT ............................................................................................................1 1.3 AIM AND OBJECTIVES OF THE STUDY ......................................................................................2 1.4 DESCRIPTION OF WASH SERVICES TO ITS ................................................................................2 1.5 PRESENTATION OF THE STUDY REPORT ..................................................................................3 2. METHODOLOGY ...............................................................................................................................4 2.1 RESEARCH FOCUS ....................................................................................................................4 2.2 RESEARCH APPROACH AND METHODS ...................................................................................4 2.3 SAMPLING................................................................................................................................5 2.4 CHALLENGES AND LIMITATIONS .............................................................................................7 3. THE SITUATION OF ITS HOUSEHOLDS AND COMMUNITIES AS IT RELATES TO WaSH SERVICE REDUCTION .............................................................................................................................................8 3.1 INTRODUCTION .......................................................................................................................8 3.2 GEOGRAPHY OF THE BEKAA VALLEY .......................................................................................8 3.3 LIVING CONDITIONS FOR ITS RESIDENTS ................................................................................9 3.3.1 Sites and shelter .............................................................................................................. 9 3.3.2 Water, sanitation and hygiene infrastructure and services .......................................... 10 3.3.3 Public health .................................................................................................................. 11 3.4 THE POLITICAL AND SOCIAL CONTEXT FOR SYRIAN REFUGEES IN THE BEKAA .................... 12 3.4.1 Introduction ................................................................................................................... 12 3.4.2 The legal status of Syrian refugees and its consequences ............................................ 12 3.4.3 Interactions with Lebanese society ............................................................................... 13 3.5 SOCIAL STRUCTURES AND DYNAMICS IN THE ITS ................................................................ 16 3.5.1 Introduction ................................................................................................................... 16 3.5.2 Social cohesion and solidarity ....................................................................................... 16 3.5.3 Social tensions and conflict ........................................................................................... 17 3.6 REFUGEES’ PERCEPTIONS AND FEELINGS ABOUT THEIR SITUATION ................................... 18 3.6.1 Introduction ................................................................................................................... 18 3.6.2 Representations of the past in Syria ............................................................................. 18 3.6.3 Representations of the present ..................................................................................... 19 3.6.4 Representations of the future ....................................................................................... 20 3.7 REFUGEES’ LIVELIHOODS STRATEGIES ................................................................................. 20 4. CONSEQUENCES OF WaSH SERVICE REDUCTION TO ITS............................................................. 22 4.1 INTRODUCTION .................................................................................................................... 22 4.2 COPING STRATEGIES FOR MANAGING REDUCED WaSH SERVICES, AND THEIR DIRECT CONSEQUENCES ............................................................................................................................... 23 4.2.1 Introduction ................................................................................................................... 23 4.2.2 Water supply ................................................................................................................. 23 4.2.3 Latrines .......................................................................................................................... 24 4.2.4 Solid-waste management .............................................................................................. 25 4.2.5 Hygiene supplies ............................................................................................................ 27 4.3 IMPACTS OF REDUCTION OF WaSH SERVICES ..................................................................... 27 4.3.1 Introduction ................................................................................................................... 27 4.3.2 Communicable-disease impacts .................................................................................... 27 4.3.3 Psychosocial impacts ..................................................................................................... 28 4.3.4 Impacts on livelihoods ................................................................................................... 30 4.3.5 Protection risks .............................................................................................................. 33 4.3.6 Impacts on social stability ............................................................................................. 34 4.3.7 Other potential impacts of WaSH service reduction ..................................................... 36 5. CONCLUSIONS .............................................................................................................................. 38 6. RECOMMENDATIONS ................................................................................................................... 40 ENDNOTES ............................................................................................................................................ 41 ANNEX 1. SUMMARY OF STRATEGIES TO COPE WITH REDUCED WASH SERVICES, AND THEIR POTENTIAL DIRECT AND INDIRECT CONSEQUENCES ....................................................................... 44 ANNEX 2. BIBLIOGRAPHY .............................................................................................................. 45 ANNEX 3. LIST OF KEY INFORMANTS ............................................................................................ 46 EXECUTIVE SUMMARY INTRODUCTION Lebanon hosts approximately 1.5 million Syrians who have fled the war in their country since 2011. Funding for assistance for refugees and refugee-affected populations in Lebanon is declining sharply across all sectors. In 2017, the WaSH sector, which is the focus of this study, received just 60 million US$ of a total appeal for 280 million US$, to serve refugees and Lebanese people in need, compared with 90 million US$ received against an appeal for 391 million US$ in 2016. As of January 2018, only 9 percent of the year’s WaSH sector appeal had been secured. Unless more funding is secured there will be substantial