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Situation Report: WHO Syria, Week 19-20, 2019

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WHO Syria: SITUATION REPORT Weeks 28 – 29 (5 – 18 July), 2019 I. General Development, Political and Security Situation (22 June - 4July), 2019 The security situation within the country remains volatile and unstable. The main hot spots remain Daraa, Al- Hassakah, Deir Ezzor, Latakia, Hama, Aleppo and Idlib governorates. The Turkish military preparations along the Syrian /Turkish borders escalated the tension in the Euphrates region ushering in an imminent military operation against the Kurds. The Eastern governorates are still witnessing a high level of asymmetric attacks against SDF personnel in the form of of IEDs and VBIEDs explosions. The security situation in North rural Hama remained tense; SAA regained control over a town that was seized by NSAGs a week ago . Military operations are still taking place against NSAGs held towns in Idlib, Hama, Latakia and Aleppo Governorates. An increase in the number of Indirect Artillery Fire attack (AIF) has been noted in Aleppo city in comparison with the previous week. At least five Syrian soldiers were killed after being attacked in the governorate of Daraa, 90 km south of the capital Damascus. Military sources asserted that the terrorists ambushed a military vehicle between Yadouda and Dahya, leaving five soldiers dead and 16 injured. Air strikes targeted rebel-held cities in northwest Syria on Friday, a war monitor reported, widening bombardment of the last major insurgent enclave to areas that had mostly escaped it. The strikes killed three people in Idlib and three in Maarat al-Numan, two of the largest cities in the region, the Britain-based Syrian Observatory for Human Rights said according to a Reuters report. The United Nations is close to agreement with Syria on setting up a constitutional committee, a long-awaited step in a stalled peace process, the U.N. Syria envoy said on 10 July. “I believe we have made a very solid progress and we are very close to have agreement on establishing the constitutional committee,” Gerd Pedersen told reporters after meeting the Syrian Foreign Minister Walid al-Moualem. Thousands of Syrian refugees have returned to their country in the last 24 hours from Jordan and Lebanon, the Lebanese immigration authorities reported A new batch of displaced Syrians arrived in Jlaighem corridor in Homs eastern countryside coming from al- Rukban Camp as the displaced were held against their will for years in the camp due to terrorism and the US occupation forces. SANA reporter said that tens of families on 10 July arrived with their belongings at Jlaighem corridor by buses coming from al-Rukban Camp in al-Tanf area II. Key Health Issues With the displacement of approximately 330,000 individuals, there is an increasing demand for health services in northern Idleb and a pressing need to reach every person with much needed healthcare. Health Cluster partners have deployed more than ten mobile clinics to provide primary healthcare services for displaced people in the arrival areas. Each mobile clinic, consisting of a doctor, a midwife, a nurse and a community health worker, offers services for child health, nutrition, communicable and non-communicable diseases, maternal and newborn health, and is equipped with essential medicines and medical devices. Mobile units rotate across several communities for internally displaced people, ensuring the provision of basic health care services and coordinating the referral and transportation of patients to other health facilities whenever this is required. Each of these mobile clinics provides between 1,500 and 1,800 consultations per month. Page | 1 In Al Hol Camp the: Twelve static medical points, 18 medical mobile teams, two vaccination teams, a leishmaniasis team and three maternity clinics are providing daily health care services to the camp inhabitants. 11 health points were reporting to Early Warning And Response System (EWARS) during the reporting period. Common morbidity cases are related to influenza-like illnesses, acute diarrhoea, tuberculosis, leishmaniasis, measles, wormborne diseases and lice. Most of the water tanks are still without covering causing a water contamination. The result of random 56 water samples shows that most of the water sources are non-drinkable due to the bacterial contamination. III. WHO Response 1) Non-Communicable diseases & Primary health care: Represented WHO at the Strategic Framework meeting. Participated with the joint meeting between MOH & UN Agencies to discuss the new updated list of health centers for minor rehabilitation process. Participated in WebEx discussion concerning WHO/UNICEF joint cooperation to improve PHC health care with a focus on community level, the objectives were as follows: o Background information - joint letter from both RDs , o Briefing from UNICEF and WHO representatives on the current activities related to strengthening PHC. o Suggested mechanism for approaching the MOH by the two organizations jointly. o Suggestions for developing a joint Work-plan - October 2019. Communicating officially with MoH concerning the need of a national consultant expert to follow up on the Primary Health Care Measurement and Improvement Initiative /PHCMI initiative relevant data collection and PHC improvement at MOH level. Coordination with EMRO & MOH counterparts is in place. Submitted Donor Report under PHC/NCD programs for the 1st half of 2019. Continued follow up with PICC for SDGs ; Syria profile, the health & sectors’ indicators are under updating process. A total of 280 NCD kits under ECHO were received and under distribution process to NES, NWS, SW & Rural Damascus. Dispatching life-saving medicines to SACSN NGO in Lattakia, 62 NCD kits to SARC Aleppo and 11 NGOs in several governorates: Homs (Shabab Al Khair , Odad Alfuqara NGO & Al Bir NGO), Draa ( Al Birr Association) , Aleppo ( Health promotion NGO - Al-Ihsan NGO & Al –Taalouf NGO ) , Rural Damascus (YOUTH CHARITY /EG & Circassian Charity Association /EG) and Damascus ( Nour Foundation For Relief And Development /EG (YBB)) , ALBIR Hama NGO. A total number of PHC/NCD treatments was provided 252,155 during the reporting period. 2) Trauma About 150 health workers were trained on trauma and disability in three governorates (Aleppo, Lattakia, Tartous and Damascus). The following deliveries of (8,000 treatments and 500 trauma cases of trauma medicines and medical kits) were provided during the reporting period: 2 Trauma kits (200 trauma cases) and 1 IEHK Basic kit ( 1000 treatment) were delivered to Bab Al Sebaa NGO in Homs. 1 surgical supplies kit (100 trauma cases) was delivered to Mar Afram NGO in Al –Hassakeh. 3,000 treatments of medical supplies were delivered to Bab Al Sebaa NGO in Homs. Delivered 15,000 bags of Sodium chloride 0.9% to SARC as part of the response to the urgent need in the North West Syria health facilities. 40 first aid kits were delivered to UNICEF in Damascus. Participated in PSEA meeting, prevention of sexual exploitation and abuse, with focal points from UN agencies and discussed the challenges, trainings materials, gaps in the PSEA area in preparation for the upcoming UNCT meeting this month that is dedicated for PSEA discussions and decision making. Page | 2 3) Immunization The WR a.i. has highlighted the main strategic directions for the coming period in order to support the MOH achieve its planned Goals. Respect, quality of the performance, high accountability and decentralization are the main benchmarks that will be followed by WHO in relation to our set objectives. WR a.i. met with the EPI/Polio program staff to examine the organogram, program update and future plans. He emphasized the duly update of the Polio risk assessment (finalized and sent to EMRO for review) and the stages reached in the routine immunization acceleration plan for Syria (to be discussed with the MOH and partners). The comprehensive field EPI review and data quality assessment of the different components of the EPI is completed by the international/national experts; currently the team is compiling the findings for final report to the MOH on 21st of July 2019. This will pave the way for the GAVI project implementation in coordination with EPI program in Syria. The VPD Regional adviser, in person, have reviewed the EPI infrastructure at the central level and met with essential partners (UNRWA, UNICEF and SARC) as well in Damascus. Meeting of the EPI Regional advisor with H.E. the deputy minister of health; the strong commitment of central and governorate level health staff was elicited during the completion of the EPI review and the Data Quality Assessment (DQSA), hence H.E. was thanked for the hospitality and good cooperation. The GAVI proposal was also discussed ; the regional advisor urged his excellency for the rapid finalization of the draft proposal to expedite the process and reduce the risk of stock-out of vaccine in 2020; it was agreed to finalize the document within this week to enable the start of the process of drafting the proposal before the end of the year since the September deadline was already missed. Conducting a workshop for the development of The EPI Improvement plan, the workshop was facilitated by experts from EMRO office . It took place in Damascus and was attended by EPI mangers of all 13 governorates. The objective is to critically review the main points for improvement of the Program and endorse it by the MOH and ensure its implementation at the grass root level. The Polio Expert Review Committee Meeting (16 July 2019) at central EPI department
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