‘The human toll is staggering’: aid groups triage yet another Middle East crisis

Christina Lu

Foreign Policy  /  October 9, 2024

Israel’s invasion of Lebanon has triggered a new wave of displaced people in a region already under record strain.

As Israel expands its military campaign in Lebanon, aid groups and humanitarian organizations are racing to help as many as 1.2 million people—or nearly a quarter of the country’s population—who have been forced from their homes by the conflict.

Israel invaded southern Lebanon on Sept. 30 in a bid to push Hezbollah forces back from the two countries’ shared border and enable the return to northern Israel of tens of thousands of Israelis who have also been displaced by the fighting over the past year.

Israel and the Iran-backed militant group have traded near-daily tit-for-tat strikes since Oct. 8, 2023, when Hezbollah began targeting Israel with missiles, rockets, and drones in solidarity with Hamas following the Palestinian militant group’s Oct. 7 attack on Israel. In recent weeks, though, Israel has intensified its offensive, including by deploying thousands of troops into Lebanon as well as bombing Beirut and other parts of the country to assassinate senior Hezbollah leaders and destroy the group’s weapons and military infrastructure.

The dramatic uptick in fighting, and especially the Israeli invasion, triggered a sudden mass exodus from southern Lebanon, with people fleeing to Beirut and beyond to try to avoid being caught in the crossfire. Lebanon is now facing the one of the biggest displacements of people in its history, further compounding pressures on a country that has long been mired in economic and political instability. The country’s caretaker prime minister, Najib Mikati, estimates that 1.2 million people have been displaced; the United Nations puts the number slightly lower, at over 900,000.

That is putting additional strain on aid organizations that had already been working to support the nearly 800,000 Syrian refugees in Lebanon, the bulk of whom face extreme poverty and depend on aid.

Recent weeks “have been the deadliest and the most devastating for Lebanon in decades,” said Lisa Abou Khaled, a Beirut-based spokesperson for the U.N. Refugee Agency in Lebanon. “The human toll is staggering.”

Beyond the many displaced, more than 2,000 people have been killed by Israeli attacks in the last year, according to the Lebanese health ministry, whose figures do not differentiate between civilians and combatants. That death toll includes 127 children and 261 women. Nearly 10,000 people have been wounded, according to official figures.

Israel issues evacuation orders ahead of its strikes, but its warnings can include muddled, confusing messaging that offers little clarity as to the locations that civilians should avoid. Airstrikes can take place just hours after the initial evacuation orders are given. And in Gaza, where human rights groups have accused Israel of conducting indiscriminate attacks, the Israeli military has previously ordered Palestinians to relocate to areas deemed “safer” only for Israeli forces to continue to bomb those same areas.

As Israel expands its offensive into Lebanon, civilians have sought refuge in nearly 900 buildings—most of which are schools but may also include hotels and even nightclubs—that the Lebanese government has designated as collective shelters. Most of those shelters are now full, forcing people to sleep in outdoor spaces such as public parks and streets, according to U.N. officials.

Bachir Ayoub, the Lebanon director for Oxfam who has worked in the humanitarian aid sector for nearly two decades, told Foreign Policy that what is happening in the country is unlike anything he has witnessed before. “The scale of devastation is frightening,” he said. “Nothing is like what I’m seeing right now. Absolutely nothing.”

Around 250,000 peoplemostly Syrians and Lebanese, have now left Lebanon for Syria, according to the United Nations. Kenneth Roth, the former executive director of Human Rights Watch, said the return of refugees who originally fled the regime of Syrian President Bashar al-Assad “reflects the complete desperation that they feel” under Israel’s campaign. “It kind of is a window into the fear that people have at this stage, not knowing where Israel’s going to be targeting,” he said.

For those who remain in Lebanon, aid agencies and humanitarian organizations are scrambling to scale up their operations to cope with the growing displacement crisis. Their most immediate focus, aid workers and representatives told Foreign Policy, is meeting civilians’ most essential needs by supplying drinking water, hygiene supplies, food, mattresses, blankets, sanitation items, basic medication, and cash assistance.

The United Nations issued a $426 million humanitarian aid appeal for Lebanon last week as officials warned of “further displacement.” As part of that broader effort, the U.N. Refugee Agency has put out an appeal for $111 million. And the World Food Program (WFP), which has launched an emergency operation in Lebanon, needs $105 million in order to reach 1 million people daily through the end of the year, said Shaza Moghraby, a WFP spokesperson.

Médecins Sans Frontières (MSF) has expanded its emergency operation response in Lebanon and has conducted more than 1,780 medical consultations, according to the charity group. Oxfam has similarly ramped up its efforts to distribute bottles of water, menstrual health management kits, hygiene kits, and mattresses as the conflict has intensified.

“The needs are huge,” said Luna Hammad, MSF’s medical coordinator in Lebanon, who said the group has been providing primary health care and mental health support as well as focusing on other essential needs, including hygiene kits, shelter items, and drinking water. “Of course, as much as we try to scale up, it’s still going to be not enough,” she added.

The widening war has also been dangerous for aid and health care workers themselves, particularly as Israeli bombardments have struck hospitals in Lebanon, forcing some to close down. At least 50 paramedics have been killed by Israeli attacks in the country in just the last few weeks, while 37 facilities have shuttered, according to the World Health Organization.

“There’s a very disturbing history of that in Gaza, and now the fear is that that will be replicated in Lebanon at a moment of acute need,” said Roth, referring to the large number of health care workers who have been killed. In April, an Israeli strike on a World Central Kitchen convoy killed seven workers in Gaza and prompted the organization to temporarily halt its operations there. Israel later said the attack was “in serious violation” of its own military procedures.

The growing crisis in Lebanon comes as international humanitarian efforts are facing an enormous funding gap. According to the United Nations’ 2024 Global Humanitarian Overview, $49 billion was needed this year to support 187.6 million of the people worldwide across 43 different response plans. Yet only around one-third of that has been received so far, leaving a funding shortfall of $32 billion. Total reported humanitarian funding this year, which currently stands at $22.5 billion, is down by around 7 percent compared with this time last year, according to the U.N. report.

“The workload of the global humanitarian community continues to increase, but the funding to support the response needed just isn’t there,” said Ciarán Donnelly, the senior vice president of international programs at the International Rescue Committee.

In recent weeks, many governments—including in France, Canada, Jordan, the United Arab Emirates, Turkey, Egypt, Saudi Arabia, and the European Union—have pledged or provided humanitarian support to Lebanon.

The United States has pledged nearly $157 million in new humanitarian assistance to the country, money that will be channelled through the State Department and the U.S. Agency for International Development. But the United States has also sent Israel at least $17.9 billion in military aid over the past year, according to Brown University’s Costs of War project—the most military aid Washington is ever recorded to have sent the country in a single year.

Meanwhile, conditions remain dire in the besieged Gaza Strip, where the death toll has now exceeded 42,000 people, according to the Gaza Health Ministry. Nearly 17,000 of the dead are believed to be children.

“As the humanitarian community, we will continue to do our level best to respond, but the most urgent solution remains a political solution,” Khaled said. “This remains the priority to really end this suffering.”

Christina Lu is an energy and environment reporter at Foreign Policy