UNHCR/ J. Kohler

How technology is helping deliver aid to Syrian refugees in the Middle East

The Syrian refugee crisis has engulfed the Middle East, but technology is proving to be an essential tool to help aid organisations support displaced people

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The United Nations predicts there will be 4,270,000 Syrian refugees by the end of 2015. The majority of these displaced people will be hosted in Turkey, Lebanon, Jordan, Iraq and Egypt – with 88% living outside the region’s vast refugee camps.

The humanitarian aid effort is led by UN agencies working with the national governments and a multitude of non-governmental aid organisations (NGOs). The momentous task of registering and delivering aid such as food, healthcare and education relies on an array of often innovative information and communications technology (ICT).

It isn’t just the magnitude, the longevity or the geographical spread that makes the Syrian refugee crisis unique – compared with many recent humanitarian missions, such as Afghanistan, Pakistan, Sudan, Congo, Haiti and Nepal, the host countries and the Syrians themselves are, on the whole, more tech-savvy. Forget the stereotype of the aid worker with the clipboard, the Syrian aid effort is digital – registration with biometric verification, smartcard-based aid, smart device data collection, mobile communications and telemedicine.

“All these digital forms of aid have one underlying dependency – and that is robust networks. None of this will actually work unless people – both the aid workers and the beneficiaries – have access to communications. Where communications was a ‘nice to have’ at one point, now it is a ‘need to have’,” says Patrick Gordon, chair of the WGET Forum at the United Nations Office for the Co-ordination of Humanitarian Affairs (UNOCHA).

Digital registration

The first priority for a Syrian arriving in a host country is registration in the United Nations High Commissioner for Refugees (UNHCR) ProGres database. Until registered, they are not officially a refugee, thus not entitled to protection or eligible for aid – shelter, food, money, healthcare, education – from other UN agencies or the NGOs which fulfil day-to-day operations.

Registration creates a global digital record for every refugee, including the usual personal details, plus time of arrival, place of origin, occupation, education, family members, contact information and permission to share information. The operation has been speeded up by using barcode scanners to scan each refugee’s Syrian ID card.

Rather than using photos and fingerprints to verify a refugee’s identity, UNHCR has started to use iris scanning as verification. According to IrisGuard, the technology provider, 1.6 million Syrian refugees in the region have been registered in this way.

The Independent evaluation of UNHCR response report in January 2015 highlighted the positive impact of innovations including digital registration, barcode ID scanning and IrisGuard on the humanitarian response.

One of the report’s authors, Dorian LaGuardia, director of Third Reef Solutions, explains: “With UNHCR’s iris scans, the key was: accuracy – knowing absolutely who the person is, compared with paper-based data-entry systems where people might register multiple times under different names; convenience – the whole process takes only three to five minutes, compared with 20-30 minutes; and opportunities for better service, for example a record that could be integrated with other organisations’ programmes by capturing specific needs of a family, then linking this information with the relevant organisation.”

Digital delivery of aid

The traditional approach to aid is physical goods – tents, blankets, household goods and food – called “in-kind aid”. This is slowly being replaced by financial aid, allowing beneficiaries to purchase products at designated supermarkets, in town or camp, typically using paper or, increasingly, smartcard-based vouchers.

Digital payments are a more dignified way to provide aid and give greater choice to refugees. They also inject funds into the local economy and allow agencies to collect aggregate data, while reducing waste by not providing unneeded goods and cutting theft and fraud.

This move to cash is supported by the Report of the high level panel on humanitarian cash transfers (September 2015), which recommends: “Give more unconditional cash transfers. The questions should always be asked: ‘Why not cash?’ and ‘If not now, when?’”

The report estimates that only around 6% of aid worldwide is cash, but it is much higher in the Syrian region.

“All [World Food Programme] assistance to Syrian refugees today in the neighbouring countries – around 1.3 million people – is through vouchers and electronic cards. Inside Syria, we still use the traditional mode of delivering in-kind aid,” says Samer AbdelJaber, regional IT officer for Middle East and North Africa at the World Food Programme (WFP).

Digital aid programmes vary considerably between agencies and between the five host countries, depending on local conditions and regulatory environment. The largest implementation is in Lebanon, where more than one million refugees now use either WFP’s smartcard to buy goods at participating retailers, and/or UNHCR-backed ATM cards to withdraw money instead of receiving physical goods. In Egypt, WFP has adopted the store card of the supermarket Carrefour as a delivery mechanism.

WFP is working with other agencies and NGOs in Lebanon and Jordan to develop a single card that can be used for both commodity-based and cash-based assistance for the people jointly served. Common to all these methods, beneficiaries’ cards will be automatically re-credited each month, followed by an SMS notification.

Syrian refugees using ATMs
A Syrian woman in Mafraq, Jordan takes cash from an ATM after using iris scanning to identify herself

Jordan is home to the most sophisticated aid delivery methods. At branches of Cairo Amman Bank, refugees are able to withdraw their cash entitlement from UNHCR by placing their eye against an IrisGuard scanner – no card required. The success of this programme has encouraged WFP to pilot use of iris recognition technology to allow refugees to purchase food in participating supermarkets.

“The beneficiaries go to the partner retail shops, which are equipped with the iris scan at the point of sale (POS). The beneficiary just looks into the iris scanner, the system then contacts the WFP database and verifies that he is entitled to this amount of money or these commodities, then confirms to the POS that he is entitled to make the purchases,” says AbdelJaber.

Mobile data collection

Aid organisations are permanently evaluating and monitoring refugees. Rather than a clipboard, aid workers today enter data directly onto a mobile device.

“Most aid organisations do mobile data collection these days,” says Roger Dean, cash assistance project manager at the Middle East regional office of the Norwegian Refugee Council. “When you are conducting structured interviews with potential beneficiaries or key informant interviews, doing it on a smartphone rather than on paper cuts out the data-entry loop, which removes a lot of errors. Plus, it allows the whole thing to be a lot more structured, as a multiple choice question and answer gives you cleaner and quicker data.”

Data sharing and shared resources

The humanitarian mission in the Syria region is complex and involves at least 200 aid organisations across five countries. IT plays a valuable role in co-ordinating aid efforts and preventing needless duplication. These include the information systems provide by UNOCHA, such as the aptly named “Who does what where” contact management directory; and UNHCR’s Inter-agency Information Sharing Portal and Refugee Assistance Information System (RAIS), where partner agencies can update information on refugees.

There is a balance between the necessity of sharing information on refugees between agencies with the need to keep highly sensitive personal information secure – after all, UNHCR’s role includes protecting a refugee’s identity as much as their person. The use of biometrics should facilitate verification of refugee status/entitlement without sharing personal data.

Communications as aid

IT for humanitarian missions is provided by the Emergency Telecoms Cluster (ETC), which includes aid agencies and private organisations such as Ericsson and Cisco, led by WFP. Traditionally this has focused on the IT infrastructure needs of aid agencies, but the new vision enshrined in ETC 2020, adopted in April 2015, extends the remit to meeting the communications needs of the beneficiaries, giving them access to information, and the ability to communicate with agencies, governments and each other.

The aid sector and mobile trade body GSMA hope that all operators will join Axiata, Etisalat, Ooredoo and Smart Communications in signing the Humanitarian Mobile Connectivity Charter (HMCC), launched in March 2015, to guarantee to work together to provide/re-establish connectivity in emergencies.

“Article 19 of the Human Rights Convention indicates that communication is a human right. Providing it should be given the same priority as food, health or shelter. If people cannot communicate, then we don’t know where they are, what they need and if our aid has been appropriate. It is imperative that communities can communicate,” said UNOCHA’s Patrick Gordon.

The Human Rights Convention indicates that communication is a human right. Providing it should be given the same priority as food, health or shelter
Patrick GordonUNOCHA

A practical example of this is when refugees arrive at the Zaatari camp in Jordan, UNHCR gives them a SIM card from a local mobile network. This not only ensures that new arrivals are connected, but also that UNHCR has a database of contact numbers. However this is not yet common practice across the UNHCR response in the Syria region.

Information on needs and vulnerabilities, along with contact details, is collected from refugees during the registration process; communications media allows UNHCR to ensure details are up to date and to analyse and respond to refugees ongoing needs.

“While traditional communications and feedback mechanisms such as complaints desks, community outreach workers/volunteers, town hall meetings, flyers, posters and advertising remain essential, agencies are increasingly using technology for two-way communications with refugees and other beneficiaries,” says Ben Farrell, senior external relations officer, UNHCR Middle East and North Africa.

These include the use of the WhatsApp messaging application to send informative or anti-fraud messages, bulk SMS, modern and fully equipped callcentres/helplines, social media channels such as Facebook and dedicated information sites in Arabic, such as Refugees-Lebanon.org and help.unhcr.jo

Health aid

With millions of people fleeing from a war zone, then congregating in often close-knit environments, health is a major concern and is tackled by a multi-agency operation led by the World Health Organisation. ICT facilitates healthcare in numerous ways. SMS is commonly used to notify refugees to attend clinics for health checks or to receive vaccinations to help avoid outbreaks of diseases such polio.

Currently under consideration in Lebanon is a project to develop digital medical records for refugees or displaced people that can be downloaded to their personal devices to be taken with them if they leave the country.

WHO Lebanon and WHO Jordan are both working with the national governments to introduce a programme to monitor the health of refugees, maintain a database and improve early warning of disease outbreaks.

“At WHO Jordan, we are implementing a national programme of public health surveillance, in partnership with the Ministry of Health, to monitor the epidemiology of priority public health diseases, conditions and events. The programme uses mobile technology to enable reporting of information in real time from 267 primary and secondary care facilities across the country.

During the consultation health workers use mobile tablets to provide case-based reporting of disease and to introduce electronic modules for prescribing, using the WHO ‘model list of essential medicines’, and clinical diagnostic algorithms, including the integrated management of childhood illness and WHO Mental Health Gap Action Programme,” says John Haskew, technical officer at WHO Jordan.

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To help tackle the huge shortage of medical staff in overstretched intensive care units in war-torn Syria, the US-based Syrian American Medical Society (Sams) offers a three-pronged service of e-learning, telemedicine and telesurgery.

First, it offers medical courses, via e-learning, to supplement the training of physicians, medical staff and nurses. Second, Sams has recruited a global network of specialist physicians (often of Syrian origin) who volunteer to be on call, so Syrian physicians can initiate a consultation via video call when cases are complicated. Sams averages one remote consultation each hour. Third, Sams is now developing the capability to allow overseas specialists to supervise complex operations via web video links in the surgery.

Explaining the telemedicine consultation, Ahmad Tarakji, president of Sams, says: “We have cameras inside the hospital looking directly at each patient, so a physician in North America, for example, will be able to observe a patient through the webcam and view the monitor to read the vital signs. He will also be able to communicate with the patient, if he is awake, and/or his family, and with the local physician and nurses.”

Education aid

War in the Middle East and North Africa is keeping 13 million children out of school, according to a Unicef paper Education under fire (September 2015). Of these, 700,000 are Syrian refugee children in Jordan, Lebanon and Turkey, who are unable to attend school because the overburdened national education infrastructure cannot cope with the extra student load. One way to tackle this chronic educational shortage is online learning, where students access course materials on a mobile device or laptop.

Unicef is developing a programme called the “Virtual School for Education in Crises” (or Sahabati – My Cloud – in Arabic), which will offer courses, assessments and certification in Arabic, English, Maths and science.

Syrian refugee training
Public Health Surveillance Training in Aqaba Governorate, Jordan

The Norwegian Refugee Council (NRC) is piloting a distance learning programme with the British Council to teach English to young adult refugees in Jordan. Following an earlier English language pilot programme with the University of Geneva, 78% of students reported they would definitely do an online course – for all, this was their first experience of distance learning.

“We are also discussing with stakeholders the possibility of offering higher education from the [Zaatari] camp for youth through a distant learning programme,” says Amjad Yamin, project co-ordinator for information, media and communications at NRC.

The impact on fraud, waste, duplication, monitoring, transparency and accountability

The digitisation of the humanitarian process – registration, verification, data collection, digital cash, multimedia communications, data sharing and so on – makes the business activity considerably easier to monitor and evaluate than with the historical “analogue” version of paper forms and IDs, clipboards, meetings, convoys and food boxes. In an era where donors are demanding ever more transparency and accountability, ICT will continue to play a crucial role – including big data and analytics.

In Lebanon, WFP and UNHCR are working on a plan with the American University in Beirut to develop a targeting model that will use data from the vulnerability assessment of Syrian refugees and results of the local household census to deliver more evidence-based targeting to ensure aid reaches those who need it most.

As Dorian LaGuardia concludes: “There is an amazing congruence at the moment between technology and humanitarian services. I would like to see technology leveraged to get more and more accurate data from more sources so that humanitarian agencies don’t waste money – they don’t have enough money to be wasteful. They need to become nearly surgical in the way they use scarce funds so they can reach the needs of millions.”

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