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U.N. relief officials and aid organizations are bracing for what they fear could be a cataclysmic second phase of the pandemic: spreading in the close-quarters encampments of the world’s more than 25 million refugees and another 40 million internally displaced people.

More than 3 billion people lack access to hand-washing facilities, depriving them of one of the most effective first lines of defense against the spread of the coronavirus, according to UNICEF

the effort to ramp up an international aid response is being hampered by the quest to ensure the safety of international staff. Those concerns have been amplified by the announcement last week that David Beasley, the executive director of the Rome-based World Food Program, had been infected with the coronavirus. Some international relief agencies have recalled senior field officers, fearing they could be infected.

Konyndyk, who worked on the response to the Ebola epidemic in West Africa for the U.S. Agency for International Development, said that U.N. and relief agencies are having to balance ensuring the health of their own staff with delivering care to needy communities.

“You would have a hard time designing a more dangerous setting for the spread of this disease than an informal IDP settlement,” he said. “You have a crowded population, very poor sanitation … very poor disease surveillance, very poor health services. This could be extraordinarily dangerous … and I don’t think that’s getting enough global attention yet.”

In conflict-riven countries from Afghanistan to South Sudan to Yemen, dismal health care infrastructures are already overburdened after years of fighting

After five years of war, with millions of people on the brink of famine, Yemen’s population is more vulnerable to a coronavirus outbreak than those of most other countries. The conflict has left most of the country’s population effectively immunocompromised,

“For many population groups, living in overcrowded conditions, social distancing is a challenge or impossible,” according to the Assessment Capacities Project report. Many countries that host refugee camps, such as Afghanistan and Bangladesh, are likely to be overwhelmed by the health needs of their own citizens. Nations with weak health systems “may struggle to screen, test, and contain the epidemic for the host population let alone the refugees,”

In Gaza, the U.N. Relief and Works Agency (UNRWA), which provides primary care for about 70 percent of the territory’s more than 1.8 million people, is bracing for the likely arrival of the coronavirus in one of the most densely populated place in the world. The U.N. agency—which the Trump administration defunded last year and has sought to dismantle—has some 22 medical clinics in Gaza, putting it on the front lines of the defense of the coronavirus.

“I’m told that there are 60 ICU beds in the hospitals,” Matthias Schmale, the director of Gaza’s UNRWA operations, told Foreign Policy. “If there is a full-scale outbreak the hospital sector won’t cope.”

The leaders of major relief organizations are pressing donors to grant them greater flexibility to redirect funding from existing programs that are likely to be paralyzed by the pandemic and use that money for programs—including clean water and sanitation projects—that could help stem the crisis.

“As bad as it is now in the well-organized and affluent north, with health systems, good sanitation, and big infrastructure, imagine how it will be when it will hit crowded camps with refugees and displaced people,” said Egeland, who spoke by telephone from quarantine in Norway.

sweeping U.S. and U.N. economic sanctions imposed on governments in Iran, North Korea, and Venezuela are hampering relief efforts.

Egeland acknowledged that most U.N. sanctions regimes, including those for Iran and North Korea, include exemptions for the import of humanitarian goods. But the sanctions have scared financial institutions from providing vital financial services to relief agencies. “Not a single bank had the guts to transfer money, because they were all afraid to be sued by the U.S. government,”

The World Health Organization announced earlier this year that more than $675 million will be required through April—including $61 million for its own activities—to mount an international campaign against the virus. Though WHO’s Director-General Tedros Adhanom Ghebreyesus said recently that more money would be needed. On Feb. 17, UNICEF issued an urgent request for $42.3 million to support the coronavirus response. It will be used to reduce transmission of the virus by promoting distance learning for kids who can’t attend school and public information aimed at shooting down misinformation.

Guterres, meanwhile, expressed concern that the pandemic could claw back decades of efforts to raise international health standards and to scale back the most extreme levels of poverty, and undercut U.N. sustainable development goals, which are designed to improve the standard of living around the world by the year 2030.

“COVID-19 is killing people, as well as attacking the real economy at its core—trade, supply chains, businesses, jobs,” Guterres said. “Workers around the world could lose as much as $3.4 trillion.”

“We need to focus on people—the most vulnerable, low-wage workers, small and medium enterprises,” Guterres said. “That means wage support, insurance, social protection, preventing bankruptcies and job loss. That also means designing fiscal and monetary responses to ensure that the burden does not fall on those who can least afford it. The recovery must not come on the backs of the poorest—and we cannot create a legion of new poor. We need to get resources directly into the hands of people.”

armed Libyan groups are receiving payoffs to stop boats leaving Libya, in exchange for aid, aircraft hangars and money

Laura Thompson of the International Organisation for Migration told AFP on Wednesday that there “are somewhere around 31 or 32 detention centres, and around half are controlled by, or are in the areas controlled by, the government”. She said that nobody knew how many people were being kept in the facilities, where conditions were "extremely bad”.

illegal facilities, directly run by armed militias involved in human trafficking and fuel smuggling, often with the complicity of members of the coastguard service

Male captives are frequently beaten until they can somehow get relatives to send more money to Libya, or else set to work in factories or oil refineries. Women may end up being trafficked sexually.

a UNICEF report released in February, "detention centres run by militias are nothing but forced labour camps, armed robbery prisons. For thousands of migrant women and children, prison is a hell of rape, violence, sexual exploitation, hunger, and repeated abuses."

"Europeans think the problem in Libya is politics,” he says, “but we cannot build a government of national unity without a national army."

“When the centres are overflowing, migrants are taken out, there is no money to feed them all,” Ibrahim says. “Some guards are good people, but some of them are corrupt.”He hints at the tangled relationship which exists between centre personnel, smugglers, militia and human traffickers, which pass desperate migrants between themselves like a resaleable human commodity.The guards at detention centres may take money from the traffickers, then hand the migrants over.Or smugglers tip off the coastguard when their migrants are due to sail to Europe so that they will be captured and passed to militias.Or militias will seize migrants in the streets on the grounds that they do not carry the necessary documentation, a requirement in Libya. “They pretend to arrest illegal migrants and then keep them in their centres without food and water, take their money, exploit them, abuse women,” Ibrahim says.

The coastguard has repeatedly denied that its members are involved in the people-trafficking trade.But a UN report has found that:"Abuses against migrants were widely reported, including executions, torture and deprivation of food, water and access to sanitation. The International Organisation for Migration also reported enslavement of sub-Saharan migrants. Smugglers, as well as the Department to Counter Illegal Migration and the coastguard, are directly involved in such grave human rights violations."

Happiness and Bright's mother - I am never told her name - took all the money that their families could spare, then crossed the Sahara, reached the Libyan coast and paid smugglers to take them to Europe. It was then they were captured and brought to Surman.Happiness says that her friend became ill after Bright was born but received no medical aid. “Now her body is in the nearby hospital. It can’t be sent back to her family. She lost her documents at sea, and her family does not have the money to send the corpse.”

“They use us as slaves, and when we are no longer needed, they throw us away,” he says. "Humanitarian organisations do not come here. Sometimes some locals come to us with soap and bread. But no international."

She too crossed the Sahara, this time to escape Boko Haram. She was determined that her children would not grow up afraid, fearing every day that they would die."I do not care if they [the coastguards] have stopped me, I will try again," she says, looking at her newborn children. "I know it's dangerous. Nigeria is also dangerous. If war does not kill you, hunger will kill you, and here we are prisoners, the same hell. It's worth trying to cross the sea again.”Princess has yet to learn: she will be lucky to escape Libya.

80 percent of Yemenis are in now in debt, and more than half of all households have had to buy food on credit.

Up to 1.5 million households engaged in agriculture now lack access to critical agricultural inputs (including seeds, fertiliser, fuel for irrigation) and are in urgent need of emergency agricultural support. Of these, 860 000 households engaged in livestock production lack access to animal feed (fodder, concentrate, mineral blocks) and many livestock-dependent households have been forced to sell their herds to cater for other household needs

Over half of healthcare workers, including qualified mental health professionals, have left the country over the past decade.

Before the earthquake, the education system in Syria was already struggling. According to the UN, more than 7,000 schools had been damaged or destroyed. Some two million children were not attending school and 1.6 million were at risk of dropping out. The earthquake made the situation even worse, especially in northwest Syria, where 54 percent of schools were affected.

The UN humanitarian response plan was only 37.8 percent funded in 2023. Late last year, media reports indicated that the World Food Programme (WFP) will stop much of its main food assistance programme in the country this year due to a lack of funding.