Implications of simplified policy indicators on water security outcomes for vulnerable households in Irbid, Jordan

Chronic disease care crisis for Lebanon's Syrian refugees

In policy projects on refugees, the concept ‘vulnerable populations’ is treated as self-evident and any policy intervention about vulnerable refugees is seen as inherently positive. Before all else, such interest in ‘the most vulnerable of the vulnerable’ recalls the most virtuous aspects of heavily criticized humanitarianism. The category ‘vulnerable refugee’ has escaped from critical scrutiny by academic literature. The existing studies rely on preconceived notions of vulnerability in line with scholars’ normative predispositions, which makes us blind to already existing vulnerabilities on the ground. This article focuses on how the ‘vulnerable refugee’ category is constructed, appropriated and enacted by self-identified local humanitarian actors regarding Syrian refugees in Turkey. It argues, first, that various humanitarian actors’ notion of ‘vulnerable refugee’ is formed at the crosscurrents of various discourses (e.g. global securitization and global humanitarianism, and nationalism, Islamicism, secularism). Second, local humanitarian actors uniformly present Syrian ‘women and children’ as the most vulnerable; yet, their identification of particular ‘vulnerable women and children’ is informed by and enhances their own gendered, ethnonational, religious, political ideologies. This situation results in leaving out some refugees (as those whose vulnerabilities do not count) while exposing and binding the designated vulnerable into contradictory political ideologies and local faultlines. In the end, Syrian refugees may become not more resilient, but more vulnerable.

It is widely acknowledged that the world is currently experiencing an unprecedented water shortage, with agriculture being a crucial contributor. This paper presents a synthesis of available evidence, identify knowledge gaps, and make a state-of-the-art synthesis on green water management in Ethiopia. A systematic review methodology was implemented, encompassing the compilation and analysis of peer-reviewed and gray literature. The paper demonstrates that rainfed agriculture, which relies on “green water” (soil moisture from rainfall), accounts for 80% of cultivated land and 60-70% of global crop production. However, green water management has not received adequate attention in water policy and land rehabilitation programs in Ethiopia, where irrigation is limited. The analysis reveals a large yield gap and water productivity gap for major crops like maize, sorghum, and wheat in Ethiopia’s rainfed agriculture. Increasing crop yields through better soil, water, and crop management practices can significantly improve water productivity, offering “windows of opportunity” to enhance food and water security. Thus, a paradigm shift from the traditional narrow focus on soil erosion control towards an integrated green-blue water management approach in water and agricultural policies and programs is urgently required. Increased investments and expertise in green water management at the government level are crucial. Optimizing the use of green water resources in rainfed farming can also unlock Ethiopia’s export potential while improving domestic water and food security through strategic virtual water trade. In conclusion, the review highlights unlocking the potential of green water resources through targeted investments and policy support for rainfed agriculture can significantly contribute to Ethiopia’s water and food security objectives in a cost-effective and environmentally sustainable manner.

This paper analyzes impacts of water insecurity on men, women and children in Botswana, a middle income and semi-arid country. The paper contributes to the burgeoning literature on water security. Households in different settlement categories of Ngamiland, Botswana experience water insecurity. Men, women, girls and children living in water insecurity lifeworlds, play various roles in ensuring household water availability. Women and girls have the greatest agency in ensuring household water availability by spending considerable time transporting water containers loaded on their heads and engaging in rainwater harvesting. Water insecurity negatively affects personal hygiene and gives rise to household interpersonal conflicts. Countries facing water insecurity, e.g. Botswana need to promote research that can inform appropriate water policies, legal frameworks, technologies for water supply and financial mechanisms for enhancing household water security.

<p>Water security in Central Asia (CA) plays a vital role because of transboundary river systems and interconnected infrastructure assets. Each CA country has differently contextualized the water security notion to serve national priorities and needs. Various scholars have studied and interpreted the concept of water security in CA through economic, environmental, social, and technical perspectives. Yet however, there is very little information on the perceptions of policymakers and water professionals that are directly engaged with the water policy discourse in the CA region.</p><p>In this regard, we attempted to identify policy makers and water professionals' views on water management and security aspects in CA.  A Delphi method was introduced through a two-round survey to decision-makers and water professionals to assess the rate of agreement on different water security dimensions that have been identified through a thorough literature review.</p><p>Namely, the dimensions associated with urban & household facilities, economic activities, environmental aspects and natural hazards were assessed, whereas different attributes related to each dimension were also considered. The first survey round explored the rate of agreement in the following six different sections: the proposed water security dimensions (1) and attributes (2) in CA; historical trends and dynamics of each dimension (3) and the implications on a policy level (4); the national priorities for each country (5); and the effectiveness of mechanisms dealing with regional water security issues (6).  The second round synopsized the initial findings by exploring whether a higher agreement rate was attained in each of the sections mentioned above.</p><p> Clustering analysis was applied to better identify the agreement rate and assess decision-makers and water professionals' behavioral patterns within the two-survey rounds.  A number of clustering techniques were tested out. Methods such as K-Medoids, Spectral, Hierarchical, and Agglomerative clustering, as well as the Affinity Propagation, were applied. Hyperparameters were chosen based on the observations of how well the clusters are formed, i.e., how similar the responses are within the cluster and how much they differ from other clusters. The clustering was applied to the whole range of responses, as well as separately on different sections of the surveys.  </p><p>The findings indicate that the clustering of all six parts did not clearly define separation and distinctive agreement rates in the first survey round. However, when the clustering was performed within specific sections, e.g., the national priorities in each country, behavioral patterns were revealed among respondents. The clustering trends among sections became more apparent in the second survey round.  Our preliminary findings indicate that a set of socio-demographic and professional-related features of the participants are aligned with the patterns of the clustering outcomes on water security priorities in CA. The study findings could identify the major challenges that policymakers and water professionals face being mutually addressed by improving water security dialogue in the CA region.</p>

Emphasizes the importance of water security in the Middle East and North Africa (MENA) region in a global context, including impacts on human well-being and economic prosperity. Chronic scarcity, variable hydrology, poor governance, and soaring demand are causing overexploitation of the region’s scarce water resources. The surface water resources of the MENA region are not only the scarcest; they also constitute the most variable and unpredictable in the world. The MENA region, as well as Central Asia and parts of South and East Asia, stand out as areas in which water resources are being unsustainably exploited. Achieving water security involves actions across a range of elements related to water resources management and service delivery; without enhanced water security, achieving the Sustainable Development Goals (SDGs) will prove difficult, in particular SDG 6, the so-called water SDG, which seeks to ensure availability and sustainable management of water and sanitation for all.

Facing Global Environmental Change

The aim of the study was to establish how responsive the Water Policy (2010) is to ensure water security in the context of climate change. The objectives of the study were to establish if the water policy addresses water security and to determine whether the water policy addresses challenges in the climate change context and to examine national initiatives that address climate change response. Recognizing the broadness of the concept of water scarcity, the study limited the scope to establishing the relationship between water policy and water security in the changing climate. The study focused on water institutions mandated to deliver on water policies rather than the quantitative aspects of water scarcity. The study revealed that although there is some attention to water security in the water policy there is lack of commitment in terms of how climate change will be mitigated to ensure water security. The findings of the study also indicate that the water sector is managed among various ministries and this has resulted in overlapping competencies in ensuring water security with climate change impact. This indicates that there is need to have policy that has clear strategy in terms of a roadmap for mitigation of climate change impact on water security. In view of the findings of this study, it is recommended that the government should put in place a clear climate change policy to adequately address climate change and its impact on the water sector.Keywords: Climate change, Water security, Water policy, Water scarcity

Cairo—Mona Iraqi, an outspoken filmmaker turned television presenter, goes in for the kill. She had been staking out a Cairo bathhouse for some time. A hidden camera had recorded enough damning evidence to condemn the place. And now it’s time for action. Iraqi and a cameraman join Egyptian security forces as they raid the hammam. Dozens of bare-chested men, hands covering their faces, are herded out of the place while Iraqi and her crew record the sting operation’s climax for her show, “El-Mestakhabi” (“The Hidden”).Hours later, Iraqi takes to Facebook to promote her upcoming special. “With pictures, we reveal the biggest den of group perversion in the heart of Cairo,” reads the text accompanying five images. Iraqi can be seen in two pictures wearing a blue shirt and dark scarf, poker-faced, standing just to the side and pointing her iPhone camera at the men. Scott Long, a Cairo-based human rights blogger, and his friend save the pictures and text before Iraqi removes them two hours later. Building anticipation for her special, “The Dens for Spreading AIDS in Egypt,” Iraqi blurs none of the men’s faces, lives ruined almost instantly.Following the Egyptian military’s ouster of democratically-elected president Mohammad Morsi in the Summer of 2013, Egypt has embarked on a well-publicized witch hunt of men who have sex with men (who may or may not identify themselves as gay) and male-to-female transsexuals. A 2013 Valentine’s Day raid led to nine convictions for debauchery. The lawyer for one defendant explains the arrests were politically motivated. The military government had to prove to Egyptians it is at least as conservative as the now fallen Muslim Brotherhood. Just over a year after that raid, the arrests at the bathhouse show Egypt’s media nationalists are joining the security sector for a piece of the action—and, in Iraqi’s case, doing so in the name of fighting AIDS in Egypt.Publicly arresting and shaming members of one of the three groups most at-risk for contracting HIV goes against all established public health guidelines for curbing HIV transmission. The HIV virus thrives on stigma and discrimination, conditions that disincentivize any widespread testing, treatment, or simply engaging with state health officials or non-profits to learn about the virus and how to protect oneself. And in places like Egypt, where homosexuality—sometimes proven first by an HIV-positive test result—is criminalized, staying in the shadows is arguably the least risky way to live.Except that when it comes to HIV, the shadows can be quite dangerous.While the world rightfully applauds a global decrease in both new HIV infections and AIDS-related deaths, the Middle East and North Africa have seen quite the opposite. UNAIDS estimates that the region saw 25,000 new infections and 15,000 AIDS-related deaths in 2013, figures up 9 percent and 70 percent respectively, over 2005. The agency further estimates 230,000 persons are living with HIV in the Middle East and North Africa. The conclusion—governments will need to enact, change, and reinvigorate policies to circumvent a potentially serious situation, especially for most at-risk groups like men who have sex with men, sex workers, and intravenous drug users.Other vulnerable groups, like refugees, youth, women and girls, transsexuals, and prisoners, also stand to benefit from an effective response to the threat of HIV. With the political turmoil wrought by the Arab Spring, fighting the threat of HIV, or simply staying alive and healthy for those living with the virus, has become all the more challenging. Bureaucratic hurdles to receiving medicine in Egypt, vulnerable Syrian refugees arriving in countries like Lebanon and Jordan, a violent and fractured Libya, and loss of domestic and international funding, not to mention the limited access for foreign medical and nursing expertise, ensure the current situation will only get worse.Ahmed is a 52-year-old gay Egyptian man who has lived with HIV for over 30 years. He has dark hair, light eyes, and a kind face. In conservative Egypt, where sex education is not part of the school curriculum, Ahmed uses a popular gay web site to try to teach—or at least warn—men who have sex with men about the dangers of HIV. Months after Egypt’s revolution unseated former leader Hosni Mubarak, Egypt’s Islamists swept Egypt’s parliamentary elections and talk about HIV and AIDS began to decrease.Then, the Muslim Brotherhood’s Mohammad Morsi was elected president in the country’s most free and fair presidential elections ever. The new Egypt seemed to be finding its religious roots. Outward expressions of religion seemed to be gaining in popularity. Taboos against any discussion of sex, sexuality, and sexually transmitted infections removed those topics from public discourse. Apart from learning about the virus when friends test positive or from watching “Asmaa,” a groundbreaking UNAIDS-funded film about a woman with HIV, Egyptians have little awareness about the virus, says Ahmed.In the outdoor section of a nondescript café in Cairo’s Agouza neighborhood, Ahmed is joined by Hany, the 34-year-old leader of Friends of Life, an Alexandria-based NGO that supports Egyptians living with HIV. Hany and his wife both have the virus. It’s early afternoon, the café not yet filled with backgammon players and shisha smokers, so the men speak freely and openly—though not about ignorance and the need for sex ed. The men want to talk about the Egyptian Ministry of Health’s ineffectiveness at providing life-saving antiretrovirals and at monitoring the health of Egyptians living with HIV. The Ministry of Health, under Egypt’s National AIDS Program, ostensibly provides free medication to Egyptians living with HIV. Antiretrovirals stop the HIV virus from replicating. The medicine, when effectively administered, can allow the recipient to live almost as long as he would without HIV. It also counters further infections, as the person taking the antiretrovirals might see his viral load reach levels so low that his chances of infecting others are greatly decreased.But in Egypt the medicine is frequently unavailable at distribution centers. When that happens, according to Ahmed and Hany, health officials alter dosages, give expired drugs, use substitute medicines, or send Egyptians living with HIV home empty-handed. Some have gone five months without medication. All such scenarios create ticking time bombs, as the virus develops resistance to the drugs. Hany says the virus in his blood is now resistant to all but two medicines, neither available in the Middle East and North Africa. Ahmed says that Ministry of Health equipment to test for CD4 (a white blood cell) count, viral load, and viral resistance to drugs is inoperative. People are dying because of the Ministry of Health’s incompetence, both men say. And with Egypt having received over $8 million from 2008 to 2012 to fight HIV from the Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private initiative based in Geneva, the men suspect corruption. Even Hany’s NGO is not receiving the funds, yet the money must be going somewhere.Wessam El-Beih, former UNAIDS Egypt Country Coordinator, believes the funds aren’t going to sectors that would most effectively curb the HIV threat, such as targeting most at-risk population subsets, and that use of funds lacks transparency. But she cautions against charges of corruption. “I don’t think its right to accuse people of fraud without evidence to support that argument,” she continues. “Let’s acknowledge that healthcare in Egypt is compromised—no exception for HIV. It’s the general situation. We are the highest country in the world for prevalence of Hepatitis C since the ‘60s. And it has not been addressed.” Numerous attempts to reach Ihab Abdelrahman, former manager of the Ministry of Health’s National AIDS Program, go unanswered.Last year, two Egyptian journalists, Mohammad El-Garhey of the daily Al-Masry Al-Youm and Alyaa Abo Shahba of the online portal Masrawy, produced unprecedented investigative reports on HIV and AIDS in Egypt. Specifically, they highlighted incompetence at the state level—incompetence that was costing Egyptian lives. Both journalists documented AIDS-related deaths. The deceased had registered their status with the Ministry of Health, and the effective treatment they hoped to receive simply did not materialize. El-Garhey confirmed the health-monitoring equipment Ahmed had complained about almost two years earlier was in fact inoperable. A project addressing Egypt’s prison population had been abandoned, due to the violence at prisons during the revolution. Abo Shahba found that the Ministry of Health analysis kept imported medicine at customs—sometimes for up to a month—a direct cause of Egypt’s not providing appropriate antiretroviral medication to its citizens with HIV. Lack of adequate foresight and planning on the part of the Ministry of Health was the overarching culprit. Yet both articles are colored with the voices of health officials who either downplay the allegations or claim nothing is awry with Egypt’s HIV medicine distribution program.On December 2, 2014, ten months after El-Garhey’s and four months after Abo Shahba’s articles were published, the United Nations Information Centre (UNIC) and UNAIDS held a press conference in Cairo to commemorate World AIDS Day. Dr. Walid Kamal, the Ministry of Health’s National AIDS Program Manager, and Dr. Ahmed Khamis, UNAIDS Egypt Country Coordinator, presented Egypt’s new lofty goals to journalists: “Zero new HIV infections, Zero AIDS related deaths, and Zero Stigma and Discrimination by 2030,” according to UNIC’s website.Both Kamal and Khamis agreed to discuss which, if any, changes had been implemented to ensure that Egyptians with HIV receive proper medication and treatment. But neither was available on the scheduled day and time and neither responded to follow-up messages to reschedule or replied to questions sent by email. Ahmed has little faith in UN agencies and the Ministry of Health: “As far as they’re concerned, they hope we all die.”Syria has been engulfed in a bloody and destructive civil war since 2011 that has led to over 200,000 deaths. It is also home to the Islamic State. Many Syrians have fled the violence and gone to neighboring countries. In terms of HIV vulnerability, women and girls and displaced persons are particularly susceptible. About half of Syrian refugees are overlaps of those two categories. Some Syrians have entered a third category of vulnerability. To make ends meet in places like Lebanon and Jordan, some Syrian refugees are turning to sex work.Marieke Ridder is a program manager for vulnerable communities at Aids Fonds, an Amsterdam-based public-private enterprise whose mission is “towards a world without AIDS.” On the group’s website, superimposed on a picture of a woman, are the words “People with HIV are just like you and me” in large font. Ridder, 44 and blonde with light eyes like the woman in the picture, is a wife and mother of two who lives in Rotterdam. When Ridder is enjoying down time, her sense of humor and open nature ensure she is never alone. The kind of person with whom you let your guard down, she makes for good company. When Ridder is working, though, she is all business. And her business is empowering people living with HIV or vulnerable to HIV infection—generally various overlaps of youth, women and girls, sex workers, men who have sex with men, and transsexuals.Ridder spent the first week of February this year in Lebanon, where she worked with local NGOs attempting to address the influx of Syrian refugees, some of whom already held refugee status in Syria as they originated in Palestine. UNHCR counts nearly 1.2 million Syrian refugees in Lebanon, a country with a population of about 4.5 million, meaning one in five persons currently in Lebanon is a Syrian refugee. With increased demands on resources like jobs and housing, some Syrians—boys, girls, men, and women—are turning to sex work to survive. The dire economic conditions facing Syrian refugees in Lebanon have also led to early marriage for girls, increased risk of gender-based and sexual violence, and survival sex sometimes in exchange for food.Ridder says her local partners “all say that a lot of sex work takes place, but nobody wants to address it.” Although Lebanon is considered somewhat liberal, especially compared to its neighbors, sex work is still taboo and a source of shame.A week and a half before she left for Lebanon, Ridder explained that her travels would take her to 13 countries, including some in sub-Saharan Africa. The focus would be on youths under 18 who are either engaged in sex work or so vulnerable that they are at risk of being lured into the sex industry.Much of Ridder’s training and advocacy takes place in East Asia and sub-Saharan Africa. Addressing taboos is most challenging in the Middle East and North Africa. “You do walk on eggs, though, in all the countries,” she says. “There is the system that makes it difficult to work in. But no matter the country, there are people really ready to make the change.”Lebanon has already deliberately placed voluntary HIV testing and counseling centers in areas with Syrian, as well as Iraqi, refugees. The country has a total of 60 such centers. According to Lebanon’s 2014 progress report submitted to UNAIDS, the country’s dramatic new influx of refugees has created a burden on spending to combat the spread of HIV.Zaatari Refugee Camp in Jordan, one of the largest refugee camps in the world—certainly the largest camp housing Syrian refugees—has just under 84,000 inhabitants, according to UNHCR. And the population of Zaatari is only 14 percent of about 600,000 Syrian refugees in Jordan. Nearly one in ten people in Jordan is a Syrian refugee. As is the case in Lebanon, various vulnerable categories overlap that increase the risk of HIV infection. Dire economic conditions have led to early marriage and sexual exploitation of Syrian women, aid workers told The Guardian early last year. One woman’s husband forces her “to work in bars and in illegal activities,” she writes in a note. There are tales of men from Jordan and the Gulf who seek young Syrian wives, whose families might accept a dowry much lower than they would have in Syria.An official from Jordan’s Ministry of Health warns of an increase in HIV infections as a result of the influx of refugees. The HIV virus had been detected in eight Syrian refugees in the last two years, the official said, according to The Jordan Times. Jordan offers antiretrovirals to its citizens with HIV, but does not do so for non-Jordanians. While eight cases among a Syrian refugee population of over half a million is low, the number only represents those detected. According to Dareen Abu Lail, Y-PEER Network International Coordinator, actual numbers are unknown as Syrian refugees generally don’t get tested. She says that rape kits, with medication to prevent HIV infection and pregnancy, are offered to women in the camps who were victims of rape. As noted in Jordan’s UNAIDS-submitted progress report for January 2012-December 2013, “sexual violence is assumed to be underreported due to stigma and fear of retribution.” The report says that although there are no hard figures on survival sex and rape, there were 41 cases of post-abortion care in the months of February and March 2014 in Zaatari camp alone. The possibility that the unwanted pregnancies resulted from sexual violence or generally risky sexual behavior is clear.With sex work, sometimes connected to trafficking and exploitation, the number of HIV infections can easily grow among Jordanians as well as non-citizens. Because Jordan is classified as an “upper middle-income country,” it does not currently receive Global Fund grant monies to address HIV. Jordan is, according to the Ministry of Health official, working with international organizations to treat non-citizens with the virus. Sexual and reproductive health education, lacking across the region, is one area international organizations address to teach vulnerable Syrians about HIV and safe sex to prevent HIV transmission.The Y-PEER Network, spearheaded by UNFPA, is a network of youth leaders and advocates of youth health and rights. Y-PEERians offer comprehensive sexual and reproductive health education to young people, a vulnerable group, at Zaatari and other camps in Jordan. The group trains young Syrians who can then teach their own peers how to stay healthy. In 2013, 70 Y-PEER trainers some young Syrian refugees in in their own that vulnerable is the like in to offer training at refugee But most Syrian refugees in not live in it more challenging to reach them with empowering health the early violence of was a general sense of about the for a state under one while the country’s three years since the of leader for over four the country is in elected government is based in having fled violence from some of whose are to the group for the on the in that led to the of with political and is now in of has also become part of the against Islamic State. Egypt an on the of after a was Islamic Egyptian political violence, is facing an economic With on and other security now only from the of 200,000 to daily of the of the 2011 civil the country was some million a With the of only after its the state is both and to that the in and due to of and and the medical situation in is on the of of the HIV drug at the Ministry of Health’s for says the country has been to antiretrovirals for three months and to out of its current in March are working with on she says. be to the that with HIV who on her will go a or two without treatment before the situation is from did not to for political situation that has with from the who have HIV must across their violent country to receive their life-saving medication. Some make the others is not the first time this has the country’s 2011 months without HIV medication. As in Egypt, found their began to resistance to the drugs. There are of When a person living with HIV one of the treatment must be to stop the virus from replicating. With of resistance a is to AIDS and as there are for treatment. says that about 70 percent of with HIV can still use the first of drugs. The other 30 percent are on the One a is on the third of the she take her drugs, she will security situation some with HIV from medication. In Egypt, Egyptians found to have HIV medication have up in of Egypt’s security have HIV medicine as a for It is assumed that men with HIV have sex with other men, in Egypt charges of under the country’s a HIV medication is by a of a that with or the Islamic it may prove difficult to get the man with the to at HIV treatment a human rights than that the virus from he is the Y-PEER and a she of the work that Y-PEER does in of one with the current security situation, he he goes to to people on the and in the of this talk is about HIV, quite a in Libya, a conservative The week before had about HIV on To a new must show a health record to HIV-positive status generally an from being offered a to address this as well as stigma and in “I hands with people with HIV in of the camera to show that it’s not transmitted like to speak about HIV is new and a result of the 2011 revolution. we talk about HIV we can talk to the We can talk about the of says. not There is a in the people, in take care of people with HIV more because they She her right with its and nearly and a little It’s not a but it’s only the of the Arab Spring, is considered a Arab state when it comes to addressing the threat of HIV. of progress comes from an civil in groups can support the of living with HIV and those most at risk of including men who have sex with men, sex workers, and intravenous drug by communities will need to take in the Middle East and North Africa if are going to in the a gay human rights from Egypt, now a refugee camp in an In Egypt, he for the rights of refugees, including the right for those with HIV to in Egypt and not be to their countries. was in young Egyptians about their health including the right to to protect themselves from HIV. Because of his work, he violence and the difficult to from his In the years Egypt’s of Mubarak, on NGOs and the on the sense of As long as advocates like are out of countries, will be in access to effective antiretrovirals in the United public by with will need to more of on HIV. The official number of people living with HIV in Egypt is Ministry of Health UNAIDS estimates Egypt, with a population of million, has documented cases of HIV than Libya, reports cases in a population of with a population of million to has documented cases of HIV infection and estimates the to be at over When the numbers to are more to the threat of are or are at least In March 2014, the health from the of the Arab in Cairo to the Arab AIDS a United Nations political on the The that from that an in Arab is But the of some is The of the report for its in the new is a state on members of the three most at-risk groups for HIV infection can be not only with the but to the stigma and where HIV The this On the of health do for good in one country can be to the of is also an As El-Beih, of UNAIDS in Egypt, in conservative countries facing public funds to address HIV is a The of Arab health this The Arab AIDS for Arab to support other in the fight against HIV. countries not civil and political turmoil can support that have addressing the health of their especially in places with like Egypt, can be by a of the burden of fighting and of voices of persons living with HIV. “There is a the official and when we meet with people living with HIV and they go to get the the Egyptian in says. from UN agencies and the Egyptian government little sense that Egyptians who have registered with the Ministry of Health are like those in Al-Masry Al-Youm and may prove to and transparency. if the way funds are is charges of will be more difficult to a a all of the men in Iraqi’s television did Egyptians to the was one of the biggest says one “I there was an to In other cases there was no evidence offered and there were stigma and HIV and groups most at risk of infection is to curbing HIV and the lives of people living with the and people will not make them or HIV so only with state agencies and or of the HIV does not and easily into of not generally considered To curb the threat, and will need to effectively with public health Egypt’s of the men is a fair in that of the Middle East and North Africa in a state of with more than HIV at the of public and the changes to effectively address the threat of HIV and meet the of persons living with the virus will the region on to the lofty goals its health on in

Water security has emerged in the 21st century as a powerful construct to frame the water objectives and goals of human society and to support and guide local to global water policy and management. Water security can be described as the fundamental societal goal of water policy and management. This article reviews the concept of water security, explaining the differences between water security and other approaches used to conceptualize the water-related challenges facing society and ecosystems and describing some of the actions needed to achieve water security. Achieving water security requires addressing two fundamental challenges at all scales: enhancing water’s productive contributions to human and ecosystems’ well-being, livelihoods and development, and minimizing water’s destructive impacts on societies, economies, and ecosystems resulting, for example, from too much (flood), too little (drought) or poor quality (polluted) water.

The impact of cash transfers on Syrian refugees in Lebanon: Evidence from a multidimensional regression discontinuity design

Exploring the impact of multidimensional refugee vulnerability on distancing as a protective measure against COVID-19: The case of Syrian refugees in Lebanon and Turkey

The Origins of the Syrian Conflict: Climate Change and Human Security

This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon's rank-sum test, t-test, and Pearson's chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; p = 0.004). Greater household water (p = 0.028) and food insecurity (p < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water (p < 0.001) and food insecurity (p < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.

While dynamic water security models related to food and livelihood security have advanced significantly in recent decades, the inclusion of demographic variables in these models is often limited to merely population growth. As many countries have either completed or are in the process of completing the demographic transition, population growth alone may no longer be the predominant demographic variable influencing water security models. Therefore, there is a discernible need for more comprehensive water security models to consider the simultaneous impact of various demographic variables on different aspects of water security. Inspired by the contemporary environmental demography perspectives, we introduce a generic integrated framework for integrated water-population interactions (IWPI) which explores the overlooked impacts of demographic transitions on different aspects of water security. Demographic shifts can impact food and water consumption and agricultural employment. Recognizing these dynamics is essential as countries advance through demographic transitions and face mounting pressures on water resources. The Integrated Water-Population Interaction (IWPI) framework was implemented in Iran through the Water-Population System Dynamics (WPSD) model. The model shows that population size, household composition and urbanization significantly affect domestic water consumption. It also reveals how changes in educational and occupational structures impact livelihood security and food self-sufficiency under water constraints. We introduce a novel population metric for water security assessment in Iran, offering policy-makers a tool to assess and address water insecurities that can affect the population in different ways. Our findings recommend realistic food self-sufficiency targets, flexible water resource planning and policies that integrate population dynamics with water, food and livelihood security to ensure sustainable outcomes in Iran.