WHO Syria: SITUATION REPORT Weeks 19-20; 10 – 24 May, 2019
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WHO Syria: SITUATION REPORT Weeks 19-20; 10 – 24 May, 2019 I. General Development, Political and Security Situation The security situation in Syria continues to worsen, especially in the Northwest, with the main hot spots being Aleppo, Hama, Idlib, Latakia, and Deir Ezzor Governorates. This has resulted in continued destruction of public infrastructures including health facilities, displacements of people from their traditional livelihoods, and attendant deaths and casualties. Between 1-16 May 2019, CCCM Cluster Gaziantep tracked 201,492 individuals moved to different communities in Aleppo and Idleb governorates alone (90,410 in camps and reception centers, and 111,082 outside camps). On 17 May 2019, the Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mark Lowcock, in a briefing to the Security Council on the humanitarian situation in northwest Syria; said: … I am most of all concerned about the number of attacks damaging or destroying medical facilities… ….… Since 28 April, WHO and health actors have identified at least 18 facilities that have been damaged or destroyed by air strikes, shelling or other fighting. All of them are inside the so-called de-escalation zone… … The trend has continued, day after day… There was a reported alleged chlorine attack in Northwest Syria on the morning of May 19, 2019 II. Key Health Issues 1. Between 01 January, through 20th May 2019, 31 confirmed attacks on health care facilities were reported to the SSA. These resulted in 27 deaths and 53 injuries of health care personnel, patients and co-patients. 2. As of 22nd of May 2019, the 16th group of 371 returnees from from Rukban arrived in Homs (105 males, 105 females, 125 children and 36 infants), bringing the total number of people who left Rukban to 13,153 people (31.5% out of 41,700 residents). They were all hosted in Abdul Rahman Shattoor shelter in Bayada. 0n the same day (22 May), 221 people ( 87 males, 69 females, 46 children and 19 infants) left the shelters (27 people left from Mahmoud Othman shelter and 194 people from the Arts Institute shelter). The total number of people who are still in the shelters is 1,023 people (652 from previous groups plus 371 from group 16). 3. Unfortunately, GoS has warned against the delivery of humanitarian assistance to Al Rukban, stressing that sending Humanitarian assistance to Al Rukban Camp will only serve the occupying power. This will further exacerbate the already bad health burden of those Syrian citizens. 4. With about 239,647 IDPs displaced from Northern Hama and Southern Idleb alone between 01 April – 16 May 2019, there is the enormous task of urgently providing humanitarian health assistance for these displaced population. 5. The Health sector is continuously updated on the impact of ongoing military campaign over 157 public health facilities and health personnel located in NSAG controlled areas and direct zones of ongoing violence, help keep the health sector plan up-to-date. 6. The Syria Health Minister, Nizar Yazigi, discussed with the WHO Director-General, Tedros Adhanom Ghebreyesus, during a meeting held on the sidelines of the international health association session in Geneva on 23 May 2019, Yazigi clarified that the Ministry has rehabilitated dozens of damaged medical centers and vital departments in hospitals in the safe areas. He called upon the WHO to exert more efforts to lift the economic measures imposed on Syria, which are hindering the import of some medicines and medical equipment. Page | 1 III. WHO Response 1) Coordination Conducted a health sector coordination meeting in Damascus on 21 May 2019 to review: a) Updates on Situation in north-west Syria; b) Health situation in Al Hol camp; c) scale up response in the southern Syria; d) enhancement of 4W health sector 2019 HRP; e) Bi-weekly mandatory health sector updates; f) health sector contact list; g) preparations for May Health Cluster Bulletin; h) MoH’s request to support reconstruction of hospitals and PHC centers and the need for standard specifications; i) overall operational challenges; and j) key priorities on Reproductive Health issues WHO conducted her quarterly WoS WHO meeting in Beirut, 13-14 May. Issues discussed and agreed include the current context and related strategic updates/changes by the hubs from an operational and health cluster/sector perspective, WHO’s internal position on the WoS structure vis-à-vis discussions held at OCHA and RHC level; WHO’s resource mobilization and communication strategy and prospective funding in 2019 and 2020; WHO’s response in Gaziantep vis-à-vis Turkey influence and WHO’s relation/interaction with the Turkish authorities; and WHO’s response to the anticipated returnees of IDPs and refugees. An updated draft of the health sector operational plan was prepared for Dara’a and Quneitra. Enhancement of 4W health sector 2019 HRP is under process. Health sector contact list is being updated. 2) Non-Communicable diseases/Primary health care In collaboration with UNPFA & UNICEF, adolescent Friendly Health centers were activated at PHC level, with 10 Adolescent friendly health centers established in 10 governorates (Damascus, rural Damascus, Homs, Hama, Aleppo, Qunitera, Daraa, Swayda & Tartous Lattakia). WHO supported the development of health indicators for adolescents for integration into Public Health Care Information system. These indicators will also feed into the standard WHO clinical guideline. A TOT workshop was conducted to develop multi-sectoral action plan aimed at enhancing adolescent health services (including preventive, therapeutic, referral, reactive sessions and consultative services at both PHC & community levels). Continued follow up on 2 MMTs deployed by the MoE to cover oral health project in Eastern Ghoota towns in rural Damascus. 3814 students were examined, and 3890 health promotion sessions for both teachers and students, and 15,896 preventive services were conducted. Dispatched the second shipment of dental supplies in favour of oral health project in EG. 6,848 medical consultations, 139 individual and 64 group PSS sessions, including 1629 medical prescriptions, were provided for returnees including those from Rukban camp recently returned to Homs governorate. Provided the following medical equipment to Jub Al Janadlai PHC in Homs DOH: 1 spectrophotometer, 1 Basic X-ray system, 2 portable Oxygen Concentrators, 6 examination beds, 2 blood pressure devices, 1 Water Bath. PHC programme delivered 19,568 treatments during the reporting period. 3) Trauma About 150 health workers were trained on trauma and disability in four governorates (Aleppo, Tartous, Damascus and Rural Damascus) – Annex 2. The following deliveries were made during the reporting period: o Equipment capable of providing 68,000 treatments and 400 trauma cases were delivered to Aleppo SARC and Damascus MOH central. Also included were 4 trauma kit A, 8 Basic kit, and 6 supplementary kit. Page | 2 o 3 Patient monitor devices were delivered to Qamishli National Hospital. o 118 wheel chairs were delivered to 10 NGO partner in Damascus, Daraa, Aleppo, Homs and Rural Damascus. o 13,417 medical treatments were delivered to MOH centrally warehouse in Damascus Updated the Trauma Referral and Medical Evacuation Plan for NWS according to the new development on the ground (the previous potential corridor "from Qalaat al Madiq to Suqaylabiyeh" is not available any more) Mission to Bambino Gesu Hospital in Rome (with the Deputy Minister of Higher Education and the Director of Damascus University Pediatric Hospital), to develop the cooperation between three Syrian University hospitals (Damascus University Pediatric Hospital, Damascus University Cardiac Surgery Hospital and Aleppo University Hospital) and the Bambino Gesu Children’s Hospital within the framework of the cooperation project between the Bambino Gesu Children’s Hospital and the WHO Country Office in Syria. 4) Immunization The following meetings were held under the immunization programme: o Meeting with head of National Certification Committee (NCC) for Polio in Syria o AFP case review meeting for final case classification. o Meeting with UNICEF to 1) follow up on the final updates on the new GAVI agreement proposed to the MOH and, 2) how to enhance EPI Routine activities in Aleppo in regards to the current challenges faced by the local teams (security, access and availability of PHC services related). The following monitoring visits were also conducted: o Aleppo governorate visit from 12-16 May 2019 to stand on the EPI/Polio program achievements, plan for remaining period in 2019, and agree the need to expand EPI to reach newly accessible populations. The Polio Surveillance activities were reviewed as well. o Dar'aa governorate visit on 19 May 2019, to stand on the EPI service capacities and the need for the coming months. o Sweeda governorate visit on 22 May 2019, to stand on the EPI service capacities. All Routine Immunization activities are progressing as planned. The final results of the National Immunization week of April 2019 in Syria shows that a total 225,090 children under the age of 5 years (91% of the estimated targets) were reached and given a relative routine vaccination dose to their entitlement. All accessible areas in the 14 governorates of Syria were covered. 5) Mental Health 13 capacity building activities took place across the country on different MH programs, and 325 health workers were trained (Annex 2). MHPSS capacity building agenda (till the end of 2019) was also developed for health and community workers across the country. Active family wellbeing centers beneficiary numbers from MHPSS activities: in DEZ Syrian Pulse NGO "1282 ", in HAMA, Al-Bir Hama NGO "1873". Following the finalization of the GBV plan for 2019, work commenced on the development of IEC and awareness campaign materials on GBV. Brief developed on MH interventions in the area of adolescents and youth for the WCO focal point in the Youth Task Force. Psychotropic procurement plan for 2019 finalized, and Mental health basic and equipment needs plan for 2019 finalized after wide consultation with MoH/MH department and all mental health facilities across the country.