World Health Organization Syrian Arab Republic Donor Update 2016 (Q3) World Health Organization Syrian Arab Republic Donor Update, 2016 (Q3) Contents

8 Foreword 12 Overview 18 WHO’s Response Technical leadership and coordination Trauma care Primary health care including vaccination Contact Details Secondary health care WHO Country Office (, Syrian Arab Republic) Elizabeth Hoff, WHO Representative Mental health [email protected] Disease surveillance WHO Country Office (Damascus, Syrian Arab Republic) Health information system Noha Alarabi, Donor and Reporting Officer [email protected] Partnerships with NGOs WHO Headquarters (Geneva, Switzerland) Nutrition Cintia Diaz-Herrera, Team Leader, Resource Mobilization for Appeals Emergency Risk Management and Humanitarian Response WASH [email protected] 26 Capacity building Cover photo credit: WHO/Mohammed Badra 30 Financial overview for Q3, 2016 Printed in the Syrian Arab Republic 31 Humanitarian Response Plan for 2017 © World Health Organization 2016. All rights reserved. 32 WHO web stories and media updates Photo credit: Ashweh WHO/Khalil

“AT LEAST TWICE A WEEK FOR THE PAST FEW MONTHS, WE HAVE HAD TO CONDEMN ATTACKS ON HOSPITALS AND CLINICS IN SEVERAL COUNTRIES OF THE REGION”

- DR ALA ALWAN, WHO REGIONAL DIRECTOR FOR THE EASTERN MEDITERRANEAN Foreword THE THIRD QUARTER (Q3) OF classified as besieged and three 2016 saw a dramatic escalation are classified as hard-to-reach. of military activities, especially Together, they are home to over 5 around . The city has million people. Attempts to deliver become the most visible face of aid to these areas have been ’s suffering. As of the end of deliberately obstructed or delayed, September 2016, around and many medical and surgical 250 000 people were estimated supplies have been routinely to be trapped in the eastern part removed from aid convoys. of the city. East Aleppo has just Despite these challenges, and over 30 doctors. Almost 80% thanks to sustained funding from of its hospitals have either been its humanitarian donors, WHO destroyed or are functioning only has continued to implement the partially. Supplies of food, water, emergency health programmes medicine and fuel are dwindling set out in the Humanitarian rapidly. According to local health Response Plan for Syria for 2016. WHO IS CALLING FOR authorities, in the last week of This report describes the main September 2016 alone hundreds achievements of WHO’s country A PAUSE FOR MEDICAL of people in East Aleppo were office in Damascus and its hubs EVACUATIONS killed and more than one thousand in Gaziantep () and Amman were injured. These numbers (Jordan) during the third quarter of WHICH ARE CRITICAL were reported from functioning 2016 TO MAKE SURE health facilities; the real figures are probably much higher. SERIOUSLY WOUNDED WHO has called for the HAVE THE RIGHT TO immediate and safe evacuation of the sick and wounded out of east OBTAIN HEALTH CARE Aleppo, and the safe passage of Elizabeth Hoff AND ALSO PEOPLE medicine and medical supplies WHO Representative to the WITH CHRONIC into the area. At the time of writing, Syrian Arab Republic WHO has been forced to abandon DISEASES NEEDING its meticulously negotiated plans Thirteen-year old Luma has suffered from kidney failure for more than two years. REGULAR CARE. to evacuate wounded and critically ill patients. WHO continues to As haemodialysis treatment was not available in her home town of Afrin, her work with the International Syria family brought her to the Al-Ihsen charity centre in northern Aleppo. With support Support Group (ISSG) to negotiate from WHO, Al-Ihsen is managing five health centres in Aleppo and surrounding a ceasefire that will be honoured by areas. all parties and allow it to implement its evacuation plans. Over half of Syria’s public hospitals and almost half of its public health care centres are either closed or are only partially functioning. Health needs throughout Syria remain acute. Photo credit: WHO/Aleksander Nordahl Photo credit: Eighteen locations in Syria are WHO/Bassam Khabieh Photo credit:

8 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 9 Q3, 2016 Highlights

In the third quarter of 2016, WHO:

Delivered more than 73 tons of essential Facilitated the evacuation of 39 people from medicine, medical and laboratory equipment the besieged towns of Madaya, Foah, and and supplies and emergency kits to all eastern Ghouta, and from . besieged locations across Syria. Just under half of these supplies were delivered through Vaccinated over 600 000 children under five cross-border operations to northern Syria. years of age in hard-to-reach and besieged locations. Delivered 1 468 632 treatments from within Syria, of which 38% went to people in Improved timely response to diseases besieged and hard-to-reach areas. surveillance from 72% in Q2 to 85% in Q3.

Delivered 296 700 treatment courses through Assessed the status of functionality of all cross-border operations from WHO’s hub in public hospitals and health care centres in Gaziantep. Syria.

Participated in 21 inter-agency convoys, and Screened more than 160 000 children under undertook nine cross-border missions to five years of age for malnutrition. hard-to-reach locations. Trained over 3800 health workers on Worked with the World Food Programme to health assessments, trauma care, the case organize airdrops of medical supplies to the management of specific diseases, mental besieged city of Deir-ez-Zor, as a result, health, nutrition and other topics. 22 800 medical treatments and 500

Photo credit: WHO/Bassam Khabieh Photo credit: treatments for trauma cases were delivered.

10 Donor Update Q3, 2016 Overview

As of September 2016, according to WHO’s Health Resource Availability Mapping System (HeRAMS), over half of Syria’s public hospitals and half its public health care centres were either closed or functioning only partially.

STATUS OF HEALTH CARE FACILITIES IN patients and their families in hard-to-reach evacuation and treatment that provide a into east Aleppo would require a sufficiently SYRIA and besieged locations. This includes framework for coordinated action by local long ceasefire window (at least 48 hours). It As of September 2016, according to WHO’s guaranteeing their safe return following health care providers, authorities and cross- also depends on the availability of sufficient Health Resource Availability Mapping System treatment. border partners. The framework sets out numbers of ambulances, drivers and health (HeRAMS), over half of Syria’s public hospitals WHO’s efforts have met with some success. the conditions and approvals that must be care staff to transport approximately 200 and around half of its public health care In August, following an urgent appeal by obtained to allow critically ill patients to be patients and their families out of east Aleppo. centres were either closed or only partially Staffan de Mistura, the United Nations evacuated or treated in situ: Lastly, in order to succeed, these operations functioning. WHO regularly assesses the Special Envoy for Syria, up to 36 people were require that all parties guarantee the safe status of health care facilities in the country, evacuated from the besieged towns of Foah 1. Approvals for east Aleppo health authorities, passage of patients out of east Aleppo and and continuously monitors the numbers of and Madaya. WHO was also involved in the ambulances and medical teams (with support the safe delivery of supplies into the area. people ill and injured, including those requiring evacuation of conjoined twins from eastern from the Syrian Arab Red Crescent (SARC) At the time of writing, the Organization is medical evacuation and/or specialist health Ghouta to Damascus, and the evacuation of to facilitate the safe transport of patients and still awaiting the removal of all obstacles that care. a severely burned three-year old boy from their families through government-controlled would allow it to implement these plans. Homs. areas to Idleb for medical care. ACCESS TO PEOPLE IN NEED In the last week of September 2016, well 2. Approval for SARC ambulances and medical REMOVAL OF MEDICAL ITEMS FROM INTER- Beyond its immediate objective of delivering over a thousand people in besieged East teams to evacuate patients and their families AGENCY CONVOYS life-saving medical supplies, WHO has Aleppo were reported to have been injured from east to west Aleppo. Government security forces continue to continued to advocate at the highest levels following the intensified shelling of the 3. Approval to dispatch medical teams to east remove life-saving treatments and medical of government for the lifting of the siege on city. Establishing humanitarian corridors to Aleppo to treat patients in situ. items from inter-agency convoys. In Q3 of all affected areas across Syria. WHO has evacuate the wounded and critically ill is 2016, national security forces removed large consistently advocated for the immediate imperative. Working with all partners, WHO The medical evacuation of patients and their quantities of medicine and medical supplies

evacuation of wounded and critically ill has painstakingly negotiated plans for medical Aleksander Nordahl WHO/ Photo credit: families and the delivery of medical supplies from 18 of the 21 convoys transporting

12 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 13 “It has been a long time since anyone came to visit me. I don’t know anything about my family”, said tearful Nadia. Sitting in Ibn Khaldoun mental health hospital (the only such facility in northern Syria ), 32-year old Nadia recalls memories of neighbours in her hometown of Idleb. Ibn Khaldoun hospital has been severely damaged in the conflict, and patients have had to relocate several times.

medicine and medical supplies. Over 25 tons items removed from inter-agency convoys. It of supplies - sufficient to provide 49 188 informs the Ministry of Foreign Affairs(MoFA) treatments - never reached their destination. and the Ministry of Health (MoH) of all rejected Items removed included trauma, surgical items, and includes this information in its supplies including blood and blood products, contribution to the UN Secretary-General’s anaesthetics, antibiotics and analgesics. monthly report to the Security Council. WHO Increasingly, security forces are removing life- continues to advocate for the importance saving medical equipment such as incubators, of ensuring the safe delivery of all medical supplies, including specialized medical Deliveries through Inter-Agency Convoys over 2016 equipment.

ATTACKS ON HEALTH CARE FACILITIES 49,188 Q3 AND HEALTH PERSONNEL 692,318 The number of attacks on hospitals and health care centres continues to rise despite intense 71,713 Q2 international attention and media reports. Syria 774,271 is now the most dangerous country in the world for health workers. Hundreds have been 25,345 Q1 killed. Thousands more have courageously 979,217 chosen to stay behind and fulfil their oath to save lives. Some have literally gone Number of treatments delivered underground to keep providing care. Number of treatments removed A SARC convoy with UN supplies headed for Orem Al-Kubra in Aleppo was destroyed hemodialysis machines and ventilators. while offloading 31 UN-contracted commercial The delivery of medicine and supplies trucks carrying flour, medicine and supplies, fluctuates from one quarter to another nutritional supplements, winter clothes and depending on approvals received, the blankets for 78 000 people. The SARC security situation, and operational challenges. warehouse and most of the trucks were Whenever government approval is given for destroyed. At least 18 people including the inter-agency convoys, WHO works with health head of the SARC in Orem Al-Kubra were

*this map is generated based on UNOCHA's information on hard-to-reach and besieged areas. on hard-to-reach information *this map is generated based on UNOCHA's partners to assemble and deliver enough killed. WHO alone lost nine tons of emergency 2016* WHO, January - September by Treatment Courses Provided Number of medicine and supplies to cover basic needs medicine and supplies destined for hospitals for three months in each area of delivery. and health care centres in Aleppo and Orem

WHO maintains detailed information on all Al-Kubra WHO/Delil Souleiman Photo credit:

14 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 15 EAST ALEPPO.ALMOST ARE WORKINGIN 80% OFHOSPITALS ONLY 30 DOCTORS PARTIALLY FUNCTIONING ONLY DESTROYED OR ARE HAVE EITHERBEEN Photo credit: WHO/Khalil Ashawe

2.1 TECHNICAL LEADERSHIP AND • Assessed health needs during convoy COORDINATION missions; reviewed requests submitted by medical staff or health care facilities. Strategic and Policy Coordination: • Consolidated the lists of health sector supplies to be included in inter-agency • Provided regular updates to the Special convoys, based on priority needs and convoy Advisor to the United Nations Special Envoy capacities. on the status of health care facilities and the delivery of medical assistance and care 2.2 TRAUMA CARE across conflict lines. These updates, including operational solutions for sustained access to In Q3 of 2016, WHO: Aleppo and other besieged locations, were shared with the International Syria Support • Distributed 135 474 trauma care treatments Group. to Aleppo, Damascus, Dar'a, Deir-ez-Zor • Monitored attacks on health care facilities (via air drops), , Homs, Lattakia, Rural and personnel. Damascus and Sweida. • Prepared monthly reports to the Secretary- • Prepared a contingency plan for chemical General on the implementation of Security weapons for , and updated Council resolutions 2139 (2014), 2165 (2014), the training course on dealing with exposure to 2191 (2014) and 2258 (2015). chemical and hazardous materials. WHO’s • Led the work of the health sector in preparing • Donated anaesthesia and electrocardiograph for the Humanitarian Needs Overview (HNO) machines, monitoring devices, portable and Humanitarian Response Plan (HRP) for ventilators, suction machines, X ray machines, Response Syria for 2017. defibrillators, beds for intensive care units, • In the aftermath of attacks on health care oxygen concentrators, incubators, sterilizers, facilities in Quneitra and Dar'a, coordinated the stretchers and examination tables to hospitals health sector response to ensure the continuity in Damascus, Hama, Homs, Idleb, Rural of health care services in these locations. Damascus, and Tartous. • Donated supplies and accessories to Working in hard-to-reach and besieged the Disability and Physical Rehabilitation locations: directorate in Damascus. As a result, 150 patients from all over Syria were fitted with • Monitored the status of health care facilities artificial limbs. in the 21 hard-to-reach and besieged locations. • Assessed surgery and trauma management • Advocated at the highest levels of capacity of around 50 hospitals and 30 primary government for sustained access for delivery health care facilities in northern Syria. of medical supplies, medical teams and mobile • Supported 800 surgeries and trauma

Photo credit: WHO/Christopher Black Photo credit: clinics to these areas. treatments in northern Syria.

18 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 19 • Distributed 49 surgical supply kits and training for northern Syria. to-reach areas. Over 157 000 children under sessions to NGOs and health care facilities in materials to 25 health care facilities in Dar’a • Developed an interactive map to allow mobile five were vaccinated, of whom 24 309 also Aleppo, Damascus, Homs and Rural Damascus. and Quneitra. clinics in northern Syria to coordinate services received Vitamin A supplements. In addition, • Donated and installed a generator at the for communities in need. 12 492 women of reproductive age were Kidney Hospital in Damascus (supported by 2.3 PRIMARY HEALTH CARE INCLUDING • Procured and equipped six ambulances for vaccinated against tetanus. Vaccination teams UNOCHA). VACCINATION northern Syria; donated supplies and equipment were able to totally reach only four of 14 • Provided critical medical equipment such as to 19 others, and supported their operating governorates (Dar'a, Lattakia, Quneitra, and anaesthesia machines, C-Arm X-ray, ventilators, WHO implemented the following activities in Q3 costs. These ambulances transported over Sweida). and incubators to hospitals in Aleppo, of 2016: 2500 patients to hospitals and specialized The campaign was complemented by a routine Damascus, Hama, Homs, Idleb, Lattakia, Rural facilities. immunization campaign in accessible areas Damascus and Tartous. • Supported 2 716 536 consultations in health • Donated supplies to and supported the of northern Syria in July-August 2016. Over • Prepared an assessment of cancer care care centres across the country. operating costs of four emergency health 450 000 children were vaccinated against management in Syria to determine current • Distributed over 900 000 treatments to health facilities in northern Syria. These facilities poliomyelitis, diphtheria, pertussis, tetanus, status, challenges and priorities for support care centres throughout Syria. treated more than 7200 patients. haemophilus influenza, hepatitis B, measles and within the current context. • Supported NGOs providing health care • Continued rolling out the essential package of rubella. services in Aleppo, Damascus, Dar'a, Hama, primary health care services in southern Syria. WHO is coordinating the work of the Expanded 2.5 MENTAL HEALTH Homs, Lattakia and Rural Damascus. These Programme for Immunization task force in NGOs provided 67 600 outpatient consultations. WHO supported the following vaccination southern Syria. The task force is currently In Q3 of 2016, WHO: • Delivered 177 815 treatments for diabetes campaigns: strengthening cold chain and staffing capacity including 134 800 insulin injections to Aleppo, to implement vaccination campaigns in southern • Trained 240 health professionals including Damascus, Hama, Homs, Lattakia, Rural The second round of a multi-antigen vaccination Syria. 65 doctors from northern Syria on the mhGAP Damascus and Tartous. campaign against diphtheria, pertussis, tetanus, WHO Syria continues to support routine intervention guide. Currently, mental health • Distributed more than 1000 vials of insulin to poliomyelitis, haemophilus influenza, hepatitis immunization in health care facilities in services are being offered in 214 primary northern Syria. B, measles, mumps and rubella was conducted accessible areas. In July 2016, 68 347 dropout health care centres across Syria. • Finalized an essential health service package from 24 to 28 July 2016 in besieged and hard- children were vaccinated through routine • Trained 17 mental health professionals vaccination programmes. on how to train community and health care providers on the implementation of Self-help +, 2.4 SECONDARY HEALTH CARE which is designed for adult Syrians in hard-to- reach areas. A total of 23 doctors and nurses in In Q3 of 2016, WHO: PHC centres were trained on using the self-

1 927 242 Deliveries through Inter-Agency Convoys over 2016 • Delivered supplies to support 11 850 dialysis help book. An audio guide is being recorded and will be piloted in the coming months. • Trained 131 health care providers and nurses on psychological first aid and psychiatric Local/Central Health Authorities nursing as well as 68 community workers on

440 757 647 404 HTR Areas identifying and helping people suffering from Besieged Areas substance abuse problems, and referring them Cross-Border Deliveries 430 626 for treatment when needed.

418 000

314 724 • Donated equipment to two newly rehabilitated

307 771 343 901 psychiatric wards in hospitals in Hama and

243 998 Lattakia. The wards will begin receiving Secondary Health Secondary Care Equipment Delivered by Governorate Machines X-Ray Adults/Infants for Ventilators Defibrillators Multi-6 Channel ECG Infant incubators Haemodialysis Machine Sterilizers OB/GYN ExaminationTable ICU Beds OperatingTable Anaesthesia Machine

238 972 292 645 219 163 patients in November 2016. 226 646

212 152 199 454

185 815 Aleppo 5 7 2 3 5 3 - - - - - • Donated mental health medicines to Ibn

183 800 154 800

143 021 Damascus 6 - - 2 5 4 3 1 - - - Khaldoun hospital in Aleppo to cover the needs 133 059

170 164 156 000 110 921 Homs - - - - - 5 - - - - - of around 150 patients who are expected to be 167 151 115 674 medically evacuated.

75 505 Lattakia 1 ------4 1 - 60 807

97 434 49 598 • Donated mental health medicines and

72 682 91 200

1500 28 568 46 784 Rural - 1 - - - 2 - - - - 1 supplies to cover the basic needs of 450 500 4 000 Damascus patients in Ibn Sina hospital in Rural Damascus. Tartous 1 - - - 3 ------January Feruary March April May June July August September • Prepositioned psychotropic medicines to

20 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 21 Aleppo’s water supply comes from the river to the east of the city. The water is treated at pumping stations before it reaches the city’s water network. If the pumps stop working, the water is instead channelled to the river that flows through the city, raising it to dangerously high levels. “We don’t have water at home”, says 14-year old Tarek. I have to fill jerry cans from the river and take them home.”

be provided to different PHC facilities and sixteen suspected cases of meningitis were to treat patients in northern Syria. on the Syrian market. hospitals in northern Syria. reported from the besieged town of Madaya. • Completed the field work for a study • Launched a template for monitoring attacks • Supported a workshop for 33 UN staff in WHO supported the evacuation of 11 patients, estimating the sero-prevalence of Hepatitis B against health care [health facilities and staff]. northern Syria on self-care/staff-care. nine of whom were admitted to a Damascus and C among selected population groups in • For the first time since March 2015, assessed hospital for investigation and treatment and two Syria. health care facilities in southern Syria that are 2.6 DISEASE SURVEILLANCE of whom were referred to facilities in Idleb. accessible from Jordan. 2.7 HEALTH INFORMATION SYSTEM • Harmonized reporting from health care In Q3 of 2016, a number of disease outbreaks WHO also: facilities in southern Syria. were reported through WHO’s Early Warning In Q3 of 2016, WHO: Alert and Response System/Network: • Maintained regular reporting from 1635 2.8 PARTNERSHIPS WITH NGOS • A total of 123 cases of Guillain-Barrée sentinel sites. • Assessed the status of all public hospitals Syndrome were reported from Damascus, • Prepared for the winter season by securing and health care facilities in Syria, and published In Q3 of 2016, WHO: Lattakia, and Rural Damascus governorates. influenza vaccines, updating its winterization regular overviews. The information was used to WHO coordinated the collection of samples for plans, printing awareness-raising materials and identify and fill gaps. • Supported national NGOs that provided testing, and procured apheresis devices and donating laboratory tests for influenza to the • Maintained oversight of the Drug Information over 370 000 treatments, 67 600 outpatient immunoglobulin. Identification of the causative public health laboratory. Management System project, which aims to consultations, 39 597 surgical interventions agent is ongoing. • Donated 45 000 vial of leishmaniasis track all medicines for Syria that are procured and 1827 deliveries, focusing on vulnerable

• Between 2 August and 25 September 2016, medicine (glucantime) to the MENTOR initiative WHO/Bassam Khabieh Photo credit: either locally or globally and that are available groups and internally displaced people (IDPs)

22 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 23 in Aleppo, Damascus, Dar'a, Hama, Homs, • Donated nutrition supplies to 20 nutritional Lattakia and Rural Damascus. stabilization centres, and provided technical • Trained over 170 staff from 58 NGOs on support. A total of 141 patients with severe disease surveillance, primary and secondary acute malnutrition were treated. health care, mental health, nutrition, trauma • Revitalized the Baby-Friendly Hospital care and health information. Initiative (BFHI), which aims to promote and • Contracted three NGOs to support patients in support breastfeeding in maternity hospitals. Ibn Khaldoun mental health hospital in Aleppo To date, BFHI has been integrated in 21 and Ibn Sina mental health hospital in Rural hospitals. Damascus. • Expanded early child development activities in stabilization centres in 10 governorates to 2.9 NUTRITION help malnourished children recover, grow and reach their full potential. In Q3 of 2016, WHO: • Screened 161 054 children under five years 2.10 WASH of age for malnutrition. • Supported 444 nutrition surveillance centres. In Q3 of 2016, WHO: • Delivered emergency nutrition supplies to • Completed the rehabilitation of five existing besieged locations to treat over 400 severely groundwater wells in Aleppo. The water malnourished children requiring hospital care. supplies now conform to WHO’s standards for Hospitals with integrated BFHI by Governoarte drinking water quality. The wells are providing safe water to five public hospitals in Aleppo (Al Tawlid, Ibn Rushd, Al Razi, University and Heart Surgery hospitals). Rehabilitation works

Aleppo included the provision of submersible pumps, water purification units, electrical generators The recent escalation of violence in and around Aleppo has forced Hasna and Lattakia and solar panels, and the installation of her three children to flee to a shelter close to the Turkish border. “We barely drinking water fountains and special outlets for have food to eat. We have been eating bread for the past two weeks”, she said. Hama water tankers. As a result of this work, 35 000 Increasing numbers of people are in need of humanitarian aid. Civilians trapped people now have enough safe water to meet Tartous in conflict areas face acute shortages of food, medicine, water and other basic Homs their daily needs. • Launched a second initiative to improve life essentials. Those who are trying to flee are in urgent need of assistance and the water supply system for Aleppo Kidney protection. Damascus Hospital, including the provision of a double Rural Damascus reverse osmosis water purification unit, water Quneitra Sweida storage tanks, and a 150 kVA electric power generator to support the functioning of 60 Dar’a dialysis machines Photo credit: Ashweh WHO/Khalil

24 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 25 3.0 Capacity Building

In Q3 of 2016, WHO trained 3841 health workers across the country on the following topics:

TRAINING TOPIC TRAINING COURSE PEOPLE TRAINED Trauma First aid and basic life support 715 Major incident medical management Burn management Hospital major incident medical management Dealing with hazardous materials Upper limb amputation and rehabilitation TRAINING TOPIC TRAINING COURSE PEOPLE TRAINED Primary health care Management of NCDs 992 Disease surveillance EWARS web application 761 PHC information systems, infection control and response Laboratory safety procedures practices EWARS implementation and expansion Noncommunicable disease interventions for Polymerase chain reaction techniques northern Syria (training of trainers) Laboratory diagnosis of cholera, HIV, malaria, Polio and routine immunization leishmaniasis, TB, brucellosis, medium Secondary care Rational use of medicine (with focus on cancer 334 preparation, virus cul-ture, food poisoning medicines); improving patient safety; infection Management of communicable diseases control practices (leprosy, TB, leishmaniasis) Infection control HIS Data gathering, analysis and reporting 430 Mental health mhGAP 983 Nutrition Expanded reporting on early detection of 287 Psychological first aid malnutrition Psychiatric nursing Nutrition surveillance and severe acute Self-care/staff care for humanitarian health malnutrition workers in northern Syria Early child development programme Substance abuse infant and young child feeding Self-Help Plus programme Treating severe acute malnutrition Photo credit: WHO/ Omar Sanadiki Photo credit:

26 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 27 Photo credit: WHO/Omar Sanadiki Photo credit:

38% OF WHO’S DELIVERIES WENT TO PEOPLE IN BESIEGED AND HARD-TO-REACH AREAS 28 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 29 4.0 Financial Overview for Q3, 2016

In the Humanitarian Response Plan for 2016, WHO appealed for US$ 155 271 474 to implement its emergency health response. As of the end of September 2016, WHO had received just under 25% of the required amount.

Overview of funding requested/ received in 2016

US$ 155 271 474 requested (US$ 117 101 161) US$ 38 170 313 funding gap received

Funding per donor 5.0 HUMANITARIAN RESPONSE PLAN FOR 2017

Donor Amount received WHO has led the health sector’s contribution to the Humanitarian Needs Overview and the ECHO (pledge) 6 659 268 Humanitarian Response Plan for Syria for 2017. WHO aims to address immediate health needs in 2017 as well as longer-term, more sustainable approaches to strengthen the health system and Norway 6 135 722 health care delivery. WHO’s priority activities in the 2017 Humanitarian Response plan include UNOCHA 5 861 180 interventions under the Health, WASH and Nutrition Sectors, as well as priority actions under the UN DFID 1 578 947 Strategic Framework. USAID 17 500 000 Spain 335 196 Japan 100 000

Total 38 170 313 WHO/ Omar Sanadiki Photo credit:

30 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 31 6.0 WHO WEB STORIES AND MEDIA UPDATES

WHO condemns multiple attacks on Syrian hospitals

Health care increasingly out of reach for Syrians in eastern Aleppo City

Hospitals turned into graveyards: child and maternity hospital in Aleppo hit

ProtectHealthWorkers: stop the attacks on health care in Syria

Conjoined twins evacuated to Damascus, among 20 urgent cases

Regional Director's statement: Stop the war on hospitals!

Humanitarian Airdrop No 100 in Deir Ez-zor

Almost daily, health care is targeted in Syria Like many children, 12-year-old Hiba, suffers from severe injuries and loss in both legs. Three months ago, a mortar felt on her house in Aleppo, and since, she has Bi-monthly Health Emergencies Update been receiving treatments at the Aleppo University Hospital. WHO is providing WHO calls for immediate safe evacuation of the sick and wounded from conflict areas the needed medicines and medical supplies for her recovery. Despite the continuous migration of doctors and qualified nurses, those how remain strive to GENEVA / SYRIA MEDICAL EVACUATION deliver quality health care for victims like Hiba.

Medical supplies airlifted to Al-, Syria

Syria: Reaching besieged populations

Health workers and patients between life and death in eastern Aleppo city WHO/Aleksander Nordahl Photo credit:

32 Donor Update Q3, 2016 World Health Organization - Syrian Arab Republic 33 “My neighbour told me about a group of doctors who are vaccinating children in our camp”, said Hasna. She immediately took her one-year old son to be vaccinated. Every day, vaccination teams immunize around one hundred children in camps and shelters. They aim to cover all children in an area that hosts some 5000 families. Photo credit: Ashweh WHO/Khalil World Health Organization- Syrian Arab Republic P.O. Box 3946 Damascus, Syrian Arab Republic http://www.emro.who.int/countries/syr/