AsIsraeli strikes continue in Lebanon, humanitarian workers are reporting grim and heartbreaking details about the toll on the civilian population.
The Lebanese Health Ministry said that, as of Sunday, at least 850 people have been killed, including 107 children and 66 women. Additionally, more than one in seven people, or at least 1 million are internally displaced as of Monday, according to official figures.
Aid workers spoke with ABC News about overcrowded conditions at shelters, women and children being disproportionately affected, and the need for psychosocial support.
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"Over the last few weeks, the situation has drastically deteriorated. We are currently going through catastrophic times, heartbreaking times," Cyril Bassil, communications coordinator at CARE International Lebanon and based in Beirut, told ABC News.
"The fear and anxiety is through the roof amongst the people living in Lebanon. Internally displaced people ... they don't know if tomorrow they're gonna be able to send their kids to school. They don't know if they're gonna eat tonight. They don't know if they're gonna have any form of future," Bassil said.
Displacement affecting women, children
Due to limited capacity at shelters,displaced people in Lebanon are shelteringin public spaces, open areas and other temporary locations, such as parking lots and restaurants.
Some humanitarian workers told ABC News they've seen families sleeping in their cars or on sidewalks with no mattresses, pillows or blankets.
Displacement has disrupted education, with around 120,000 people staying in collective shelters, most of them set up in public schools, according to theUnited Nations.
Bassil said that because classrooms are sheltering dozens of families, many children don't have access to school.
"Out of these [1 million] people, several hundreds, thousands of children that are out of school, right?" Bassil said. "You have among them people that need immediate medical assistance. ... We've met children that were dehydrated, that were laying down on the floor for hours because, if they got up, they would be dizzy and fall."
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Pregnant women in Lebanon are also facing risks because of the displacement crisis. According to theUnited Nations Population Fund, there are 11,600 pregnant women affected in Lebanon, 4,000 of whom are expected to give birth over the next three months.
Aid workers said many of these women cannot access a hospital or a clinic and some have been forced to give birth in dangerous conditions.
"I met a lady that gave birth in the middle of the street while stuck in traffic," Aline Kamakian, World Central Kitchen chef corps member based in Beirut, told ABC News. "Because she was stuck while fleeing the south, and traffic was around 12 to 14 hours. So, she gave birth in the middle of street, in the middle of traffic."
Similarly, Nour Kassab, gender and protection coordinator for CARE International in Lebanon, described a scene that will "stay with me for a long time."
"A woman who gave birth by Cesarean section just four days ago was lying on the sidewalk in Ain El Mraiseh with her newborn baby," Kassab said last week, referencing a neighborhood northwest of downtown Beirut.
"She should be resting, recovering and caring for her child in a safe place, but instead she is sleeping on the pavement. She told us she is still in pain and cannot properly take care of her surgical wounds. Watching a mother who just gave birth trying to protect her four-day-old baby while living on the street is heartbreaking. No woman should have to face such conditions at such a vulnerable moment in her life."
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Psychological impacts
Research has shown people living in war zones are atincreased risk of many mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD) and more.
At least 10% of those who experience traumatic events in armed conflict will have serious mental health problems and another 10% "will develop behavior that will hinder their ability to function effectively," according to the World Health Organizationin a review of research findings.
More recently, astudy published in The Lancetfound that in the first month of the Russian-Ukrainian war in March 2022, the first survey of Ukrainians' mental health showed 53% of Ukrainian adults were experiencing severe mental distress, 54% were experiencing anxiety, and 47% were experiencing depression. Six months into the war, 26% of parents still in Ukraine had post-traumatic stress disorder (PTSD), and 15% had developed complex PTSD.
Bassil said that CARE is providing psychological first aid and professional therapists for those in need of mental health care as well as safe spaces for people to "express their emotions."
In one instance, Bassil said he met a mother with three children ages 3, 5 and 8 who have been going through what he described as a "roller coaster of emotions."
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"They wake up in the morning, they start crying. And then they have hyperactivity, they start playing soccer, they start throwing things. They start picking fights," Bassil said. "They start doing anything to release their emotions, and then suddenly they switch to another emotion. So, it's a roller coaster of emotions that she was telling us she doesn't know how to handle this."
Another man Bassil said he met, whom he estimates is in his 70s, was distressed after losing the home he built by hand in southern Lebanon due to airstrikes and being forced to evacuate.
"He said he's spent the last 50 years enduring wars," Bassil said. "Fifty years, five decades, and he cannot take it anymore, and he has lost the desire to live. ... He meant it. He wasn't just saying like 'Okay, I cannot continue living like this. It's unbearable.' No, he was beyond depressed."
Kamakian, who was born and raised in Lebanon and has lived through several conflicts, said the mental health impacts among the civilian population are quickly becoming apparent.
"People are on the edge, mad, angry, depressed," Kamakian said. "Everyone is on the edge. [Someone] who lost their home and business doesn't have anything to lose. There is no hope. Like every day, it's getting worse and worse."
Reduced resources
Some of the aid workers said that funding cuts from global humanitarian organizations are making the crisis in Lebanon worse than the 2024 conflict.
In 2024, the U.S.provided nearly $157 millionin humanitarian assistance to support populations affected by the conflict in Lebanon, partly through the U.S. Agency for International Development (USAID).
President Donald Trump's administration made major cuts to USAID and, last year, Secretary of State Marco Rubio announced his department would be taking over programs previously run by USAID.
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Rubio announced at the time a post onSubstackthat USAID -- which oversaw foreign aid, disaster relief and international development programs -- would no longer be providing assistance to other countries.
Additionally, during the 2024 conflict, Kamakian added that countries in the Gulf Cooperation Council (GCC), including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates, provided significant assistance in Lebanon.
However, these countries are now being affected by the wider crisis in the Middle East and do not have the resources to help Lebanon similarly, she said.
"You had the GCC sending some aid [in 2024]. You had European countries," Kamakian said. "Today you don't have USAID. You don't have GCC countries."