Mapping WASH and COVID-19 in the Middle East and North Africa (2020-2021)


Since 2011, areas of the Middle East and North Africa, such as Syria, Libya and Yemen, have experienced acute conflict. Other parts of the region, such as Iraq, Palestine/Israel and Lebanon, have had protracted and intermittent conflict for decades. Populations have been dispersed with refugees flowing into neighboring countries, including Jordan and Egypt.

With the outbreak of COVID-19, the United Nations Secretary General called for a global ceasefire, recognizing that the spread of COVID-19 could have devastating health effects in conflict-affected countries with weakened public health systems and institutions.

The extent of the spread is unclear due to the difficulties of testing and reporting in the region. What is clear, however, is the lack of access to water, sanitation and hygiene (WASH) in the Middle East has exacerbated the pandemic, putting vulnerable populations, including refugees, at risk. In particular, in many refugee camps and urban settings, the possibility for social distancing and handwashing is difficult. More so, untreated sewage and the discharge of waste can further the spread of the virus.

For many populations in conflict-affected countries in the Middle East and North Africa, access to water and sanitation frequently depends upon assistance from nongovernmental organizations (NGOs) and humanitarian actors, or it may be contingent upon armed groups that control particular swatches of territory. Research is needed to understand how civilians are protected in situations where social distancing and frequent handwashing may not be possible as well as to understand the role of international humanitarian law in these contexts.

Project Description

This project team will examine how different communities and humanitarian actors in conflict-affected countries in the Middle East and North Africa are responding to the pandemic and expanding access to water and sanitation. Team members will map the spread of COVID-19 in the region and examine what lessons can be learned from the humanitarian sector as it seeks to halt the spread of the virus under conditions of duress and offer opportunities for peace-building.

The team will use an existing database on regional infrastructure (built through a collaboration between Duke and the University of New Hampshire) to illuminate the limitations of protections in international humanitarian law for keeping civilians safe when infrastructure is targeted. This work is expanding to examine the energy-health nexus in wars in the Middle East, given that the destruction of energy infrastructure in conflict produces numerous reverberating effects for human health (e.g., when an electrical power plant is destroyed, there can be indirect effects on the treatment of drinking water and wastewater along with affecting public health systems and hospitals).

This team will connect with different humanitarian organizations and local NGOs working in the region to understand how different populations are responding the pandemic. In particular, team members will examine the challenges faced by communities and organizations to provide clean water as part of the COVID-19 responses, particularly in situations where infrastructure access was already compromised and health services weakened.

Organizations with whom the team might interact range from U.N. organizations (e.g., UNICEF) to local NGOs (e.g., Ecopeace Middle East) to university counterparts in the Middle East (e.g., Al Quds University in Palestine).

Anticipated Outputs

Team website; database on how government and donor organizations in the Middle East and North Africa are addressing WASH in response to COVID-19


Fall 2020 – Spring 2021

  • Fall 2020: Break into subgroups; outline subgroup objectives; write short essays on methodological issues pertaining to WASH; begin doing online interviews and collecting data; build online knowledge platform
  • Spring 2021: Finish data collection and online knowledge platform; implement project deliverables

Team Outputs to Date

Project team website

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Team Leaders

  • Ekta Patel, Nicholas School of the Environment–Environmental Sciences and Policy–Ph.D. Student
  • Erika Weinthal, Nicholas School of the Environment-Environmental Sciences and Policy

/undergraduate Team Members

  • Ahmad Amireh, Biology (BS), Global Health (AB2)
  • Nora Benmamoun, Public Policy Studies (AB), Asian & Mid East Studies (AB2)
  • Sama Elmahdy
  • Mihret Gebru
  • Hadeel Hamoud, Political Science (AB), Int Comparative Studies (AB2)
  • Parmida Jamshidi, Biology (BS), Global Health (AB2)
  • Samantha Wind, Civil Engineering (BSE)
  • Miranda Wolford, Int Comparative Studies (AB)