COVID-19 IN AREAS OF KURDISH SELF ADMINISTRATION CONTROL

SITUATION REPORT 20 MAY 2020

1 / 16 SUMMARY

 As of 18 May, there have been six confirmed cases of COVID-19 in Kurdish self-administration (KSA)-held areas of northeast , four of whom have recovered.

 The actual number of COVID-19 cases is likely to be significantly higher, as a lack of sufficient testing and the low surveillance capacity is impeding the KSA from accurately assessing the spread of the virus in its territories.

 The KSA’s COVID-19 related movement restrictions had a significant negative impact on small-scale commercial businesses and daily wage workers, while price inflation and the continuing devaluation of the Syrian pound further reduced residents’ purchasing power.

 Poor and vulnerable residents who could not work enlisted in unprecedented numbers into the Syrian

Democratic Forces (SDF) as a coping strategy to mitigate the financial burdens of COVID-19.

 A continued decrease in the demand for fuel following the implementation of movement restrictions is

likely to have a disastrous impact on the KSA’s annual budget which is heavily dependent on oil revenues.

 Restrictions imposed by the Government of Syria (GoS) and the Regional Government (KRG) are

hindering COVID-19 prevention and treatment supplies from reaching the northeast.

 The KSA has been inconsistent in implementing preventive measures across IDP camps in its territories, leaving humanitarian organizations to act independently

2 / 16 INTRODUCTION

On 17 April, the KSA announced its first COVID-19 related death, a 53-year old man who passed away on 2 April in Quamishli National Hospital in Al-Hasakeh governorate with no recent history of travel. Two additional cases were confirmed on 29 April – a married couple from Al-Hasakeh city related to the northeast’s ‘patient zero’ (the KSA announced on 11 May that the husband had recovered, however the wife 1,2 remains in quarantine), and following this, three more cases have since been confirmed.

This report highlights the impact of COVID-19 on the local economy of northeast Syria, with a particular focus on livelihoods. It will also assess the KSA’s attempts to mitigate both the spread of the virus and the ensuing economic shocks on poor and vulnerable households, and investigate their effect on social tensions. In addition, the report will analyze the KSA’s COVID-19 response in IDP camps, focusing on Al- Hole camp in Al-Hasakeh governorate as a study. It will also discuss concerns regarding the KSA’s testing capability and the low number of confirmed cases in its territories, as well as ongoing impediments to the

delivery of health supplies to northeast Syria.

The research methodology used for this report includes both primary and secondary sources. To ensure a broad and accurate analysis, the Syria Humanitarian Access Team (HAT) collected data in all four

governorates under the KSA’s control: Al-Hasakeh, Ar-, Deir-ez-Zor, and . The report also relies on information from UN operational partners, international NGOs, and local sources.

CURRENT SITUATION

1. Precautionary Measures The KSA began implementing COVID-19 precautionary measures as early as 29 February when it announced the partial closure of the Semalka border crossing separating Al-Hasakeh governorate and Iraqi Kurdistan. On 12 March, the KSA announced additional precautionary measures, including the closure of all civilian crossings with opposition-held areas and Iraqi Kurdistan, the indefinite suspension of all public gatherings and educational institutions, and the extension of the partial closure of the Semalka border crossing. On 15 March, humanitarian agencies were mandated to suspend training activities that required gatherings and

enclosed spaces. On 16 March, non-essential activities of the KSA’s public agencies were suspended and cafes, restaurants, gathering centers, cafeterias and gyms across northeast Syria were closed the following

3 day. The KSA also banned religious institutions from holding in-person mass prayers and large gatherings.

3 / 16 Additional measures were announced on 19 March including a travel ban on movement between main cities in KSA territories and the closure of commercial markets, among other restrictions. The KSA did make exemptions for public and private hospitals and health centers, international humanitarian organizations and the Syrian Arab Red Crescent (SARC), pharmacies, bakeries, and grocery shops, as well as trucks transporting food products, infant formula, and fuel. The lockdown was initially expected to only last for 15 days, however it has been continuously extended since then, and is now set to expire at the end of Eid al Fitr. By 29 March, all arrivals passing through KSA's border crossings were forced to undergo a 14-day quarantine at designated quarantine facilities. The KSA also announced the suspension of military 4,5 conscription from 5 April to 5 July, 2020.

As a way of deterring violations to its lockdown and enhancing the effectiveness of COVID-19 mitigation measures, on 6 April the KSA announced penalties for violations. While these fines were being strictly implemented by the KSA’s security agencies at the time of their announcements, as of 18 May local sources 6 report that this was no longer the case.

2. Prevalence of COVID-19

O n 17 April, the KSA announced its first COVID-19 related death, a 53-year old man who passed away on 2

April in Quamishli National Hospital in Al-Hasakeh governorate with no recent history of travel. Two additional cases were confirmed on 29 April – a married couple from Al-Hasakeh city related to the

northeast’s ‘patient zero’ (the KSA announced on 11 May that the husband had recovered, however the wife remains in quarantine), and following this, three more cases have since been confirmed. 5,6

3. Testing Facilities

Despite the donation of four polymerase chain reaction (PCR) testing devices to detect COVID-19 by the KRG to KSA-held territories, the low number of confirmed COVID-19 cases in the northeast is partially due to the KSA not properly utilizing all of their available testing facilities. This is likely to be due to the lack of technical expertise among local health staff, despite KRG-affiliated doctors travelling to the northeast to implement training on the operation of the devices. In addition, testing is only conducted in Quamishli

(1) https://www.facebook.com/smensyria/photos/a.955507237972547/1294877357368865/?type=3&theater (2) Three additional cases were confirmed using antibody tests which indicated that they had previously contracted COVID-19, however were no longer active. It should be noted that these cases were reportedly from the same cluster in Al-Hasakeh city as the previous three. (3) Exceptions were allowed for residents seeking urgent medical treatment, and cross-border travel by aid workers on Tuesdays.

(4) Depending on the sighting of the new moon, Eid Al-Fitr is likely to begin on 23 or 24 May and will be celebrated until 27 or 28 May.

(5) On 19 March, public gardens, private medical clinics, concert halls, and condolence tents were also closed and hospital visitations banned.

4 / 16 city and the PCR machine is reportedly only operational for two days per week. The lack of sufficient testing in the northeast is preventing the KSA from accurately assessing the spread of COVID-19 amongst residents, and the actual number of cases is likely to be significantly higher than those reported, particularly given that the apparent patient zero is likely to have contracted the virus locally (due to a lack of recent travel history).

Previous to the procurement of PCR devices, testing in KSA-held areas was carried out by sending suspected patient tests to Damascus, a practice which has continued. The number of tests which have been sent are limited however; by 25 April only 48 samples (24 from Al-Hasakeh, 22 Deir-ez-Zor, and 2 from Ar-Raqqa) had reached the capital. Further indications of limited testing can be seen across the whole of Syria; as of 6 May, the Central Public Health Laboratory (CPHL) in Damascus had conducted approximately 2,000 COVID- 19 tests in total, including the northeast. Additionally, the Rojava Information Center reported that Damascus was refusing to collect COVID-19 test samples from the northeast, assumed to be due to tensions 7,8,9,10 between the two administrations, which is likely to further delay accurate assessments of the outbreak.

4. Low Surveillance Capacity

Low surveillance capacity poses another significant hindrance to determining an accurate count of COVID-

19 cases. In a context such as this one, having a unified surveillance system in place that is able to not only accurately detect suspected COVID-19 cases, including through a contact tracing mechanism, but also alert

the appropriate testing authorities in a timely manner is even more crucial. In the northeast, there are currently three separate surveillance mechanisms with three separate alert pathways, which is making

timely coordination considerably challenging for both the KSA and health sector humanitarian

organizations. The fact that all of the six confirmed cases in KSA territories to date have no history of recent travel and all originate from the same cluster suggests that there has been at least some level of undetected 11 community transmission.

(6) First-time curfew violators would be fined 5,000 SYP, second-time violators would be fined 10,000 SYP, and third-time violators 15,000 SYP. After three violations, perpetrators would be fined triple the amount of their last violation’s fine. Also, vehicles were held for one day for first-time violations, for three days for second-time violations, and for a week for third-time violations which included a fine of 25,000 SYP. (7) UNOCHA, UNOCHA & WHO Syrian Arab Republic COVID-19 Response Update No.02’, May 2020 (8) ibid (9) Human Rights Watch, ‘Syria: Aid Restrictions Hinder Covid-19 Response’ April 2020 (10) Rojava Information Center, ‘The Coronavirus Crisis in North and East Syria’ April 2020 (11) Samples that are collected through the Early Warning Alert and Response System (EWARS) are transferred to the Central Public Health Laboratory (CPHL) in Damascus for testing. Samples collected through the Early Warning and Response Network (EWARN) are transferred to Idleb for testing. Samples collected by the KSA are transferred to Quamishli for testing.

5 / 16 IMPACT ON LOCAL ECONOMY

1. Local Markets The closure of non-essential shops and the travel ban between cities and governorates, coupled with consumers’ avoidance of market hubs out of fear of COVID-19 infection, led to a negative impact on local markets across KSA territories. It was reported that in Al-Hasakeh city, COVID-19-related measures greatly impacted small-scale commercial businesses, such as those selling clothes, shoes, and stationery. This was because most business owners incurred debt when purchasing their products from wholesalers and were unable to repay them given the stagnation in market activities and lack of customers.

Table 1: Price Changes from January to May in Al-Hasakeh city

Item Prices (SYP/kg) on Jan 14 Prices (SYP/kg) on May 13 % Price Change

Goat Meat 700 9000 1186 %

Chicken 1400 1800 29%

Tea 6000 10000 67%

Sugar 550 1000 82%

Eggs 1750 2300 31%

Tomatoes 600 900 50%

Potatoes 300 550 83%

Cucumber 400 500 25%

Onion 350 400 14%

Lemon 800 2400 200%

2. Price Inflation This pattern coincided with price inflation of basic goods across KSA territories (Table 1). While local sources state that civilian stockpiling of goods following lockdown announcements led to price inflation, the continuing devaluation of the Syrian pound played a more determining factor on market prices (Figure 1). The exchange rate of the Syrian pound in Al-Hasakeh on 27 February, prior to implementation of COVID-19 related restrictions, stood at 1,060 SYP per USD. By 12 May, the Syrian pound devalued by 56%, reaching 1,650 SYP per USD in the same city – a new record low in Syria. This has in turn been attributed to the

financial crisis in Syria’s neighboring country, Lebanon, as well as other structural issues within the country’s economy and secondary impacts of COVID-19.

6 / 16 Figure 1: Syrian Pound to USD Exchange Rate in Al-Hasakeh city

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Increased demand was noticed across KSA-held areas in early April among hygiene vendors, pharmacists,

and food shops. Some shops across Al-Hasakeh, Deir-ez-Zor and Ar-Raqqa governorates reported that the supply for hygiene items and vegetables could not meet market demand. Additionally, the main challenge 12 vendors faced with maintaining sufficient supply of goods was price inflation.

The average retail price of face masks, gloves and disinfection materials also increased during this period. In

Al-Hasakeh city, local sources reported that the cost of a face mask (consisting of three layers) increased from 50 to 450 SYP from the end of February to April. Higher quality reusable facial masks increased from 800 to 1200 SYP from March to April. Price increases are attributed to both a dramatic increase in demand due to panic buying, as well as traders artificially inflating prices as a way of increasing profits; demand for cleaning supplies such as Dettol and chlorine and soap increased in Al-Hasakeh city as fears of the virus

spread. Local sources state that while local suppliers are taking advantage of the increased demand for these supplies by inflating their prices, their quality does not match required standards, making it very difficult for northeast-based humanitarian organizations to locally procure them. For example, many locally procured hand sanitizers are not meeting the required 70% ethanol concentration.

(12) REACH, Impact Of Covid-19 On Markets In Northern Syria ‘ April 2020

7 / 16 3. Agricultural Sector

There has been a minimal impact on the agriculture sector. Given their importance to food security, the KSA has made allowances for farmers and agriculture workers (as described below).

4. Fuel Economy One of the most important economic impacts resulting from the COVID-19 pandemic is the decreased demand for fuel (especially diesel) due to the movement restrictions imposed by the KSA, who banned travel between major cities on 19 March. According to a study conducted by REACH, out of 466 assessed communities in the northeast, 84% (392 communities) reported that staying at home as much as possible was a protective measure implemented by residents. Oil revenues are the KSA’s main source of income. In 13,14 2019, oil and fuel sales made up approximately 78.8% of the KSA’s revenues.

If restrictions continue, a decrease in demand for fuel would have a disastrous impact on the KSA’s annual

budget, which would in turn decrease its capacity to properly respond to the pandemic and continue providing vital services. Total revenues for the KSA in 2019 were estimated to have reached SYP 197.7

billion ($120 million), for a population of 2.4 million (approximately $50 per person). The KSA has already been facing criticism regarding its lack of adequate service delivery amongst local residents, a further

decrease in the quality or quantity of services delivered would only further ignite these underlying social

tensions. In addition, the KSA spent approximately 34.3% of its annual budget on funding for the SDF. While the Islamic State (ISIS) no longer controls territory in Syria, its sleeper cells still pose a significant security

threat, and the pandemic has witnessed a ramp up in prison riots and attempted jail breaks in SDF prisons that are known to house alleged ISIS fighters. A reduction in the KSA’s revenues is therefore likely to result

in increased insecurity in northeast Syria as it would severely decrease the SDF’s capacity to properly secure 15,16 its prisons and combat ISIS sleeper cells.

(13) REACH, ‘Northeast Syria: COVID-10 Multi-Sectoral Rapid Needs Assessment’, April 2020 (14) According to official figures acquired from the KSA’s Department of Finance, fuel and oil revenues in 2019 amounted to 155.9 billion SYP. The KSA’s total revenues in 2019 were 197.7 billion SYP. (15) Based on the current black market exchange rate of 1,650 SYP per USD, 15 May 2020. (16) According to official figures acquired from the KSA’s Department of Finance, in 2019, the KSA spent SYP 67 billion on the SDF. Its annual expenditure in 2019 amounted to SYP 195.6 billion.

8 / 16 IMPACT ON LIVELIHOODS

The KSA’s lockdown measures have had a significant negative impacts on local residents’ livelihoods; the movement restrictions have impeded civilian’s ability to travel to their places of work, while the mandated closure of non-essential shops, businesses, and government agencies have resulted in loss of wages to workers at a time of a record devaluation of the Syrian pound. In communities in northeast Syria recently assessed by REACH, 70% reported that COVID-19 has had a partial or total negative impact on livelihoods; with 57% of communities reporting a high negative impact on both skilled and unskilled wage employment; 54% reporting a high negative impact on manufacturing jobs; and 34% reporting a high

17 negative effect on trading livelihoods.

1. Daily Wage Laborers In addition, it has been reported that daily-wage labor – which is the third primary livelihood activity in northeast Syria, and accounts for approximately 19% of households’ source of income – has been the most negatively impacted by the lockdown measures. As daily-wage laborers are amongst the poorest and most

vulnerable members of Syrian society, losing their primary source of income has made many of them destitute and has forced some of them to carry out their work activities in secret in order to survive.

However, local sources stressed that prior to the easing of the KSA’s restrictions on 21 April, most daily

wage workers were not able to make such accommodations. According to UN operational partners, households in Syria that depend primarily on daily-wage labor have an average monthly income of 83,041

SYP (January 2020), which is the lowest income strata in the country. Even prior to the onset of the global pandemic, 52% of households in northeast Syria reported that their income was insufficient to meet their

18 basic needs. The loss of purchasing power of the Syrian pound will only exacerbate this issue.

2. Enlistment into security forces Local sources also report that many daily-wage laborers and other local out-of-work residents have enlisted in the (SDF) and other KSA security agencies as a coping strategy. Al-Hasakeh governorate alone reportedly witnessed approximately 6,000 SDF enlistment applications over the last two months – the largest number of applications since its founding in 2015. This is in spite of the suspension of military conscription by the KSA from 5 April to 5 July, 2020.

(17) REACH, ‘Northeast Syria: COVID-10 Multi-Sectoral Rapid Needs Assessment’, April 2020 (18) According to UN operational partners.

9 / 16 3. Public sector employees Despite the closing of non-essential government institutions since 16 March and all education establishments since 14 March, public sector employees’ and teachers’ livelihoods in northeast Syria have not been negatively impacted by the lockdown measures as both the KSA and the GoS have continued to pay their salaries. The public sector is the largest primary livelihood activity in northeast Syria, and is the 19 main source of employment for approximately 29% of households.

SOCIAL TENSIONS

Across KSA-held territories there have not been any significant protests or demonstrations against movement restrictions. Local sources state that there was a potential for protest amongst poorer residents at the beginning of the lockdown, due to economic grievances. This has since been tempered following the easing of restrictions and the partial reopening of shops and businesses on 30 April.

There have however been several incidents of civil disobedience throughout the lockdown period. Friday prayers continued to take place in mosques across Deir-ez-Zor governorate, with little resistance by the

SDF and the KSA’s Internal Security Forces (Asayish). It should be noted that movement restrictions have been enforced much more stringently by the SDF and the Asayish in Al-Hasakeh and Ar-Raqqa governorates

than in Deir-ez-Zor governorate. Approximately 160 people were arrested by the SDF and the Asayish in Ar- for violating the KSA’s curfew and lockdown on 26 March. Local sources indicate that

this is likely to be due to the greater prevalence of the KSA’s security agencies in the latter governorates,

and the sensitivities associated with interrupting Friday prayers in the more conservative Deir-ez-Zor communities, where there has been a growing resistance to Kurdish governance since the spring of 2019.20

The sensitivities associated with the holy month of Ramadan has further weakened the KSA’s security agencies’ willingness to disrupt cultural and religious traditions – on the first night of Ramadan, residents of Ar-Raqqa city flooded city streets in celebration with a minimal response from the SDF and Asayish, while mosques in Ar-Raqqa city have been holding Friday and Tarawih prayer services. Furthermore, residents in Ar-Raqqa city also reportedly believed that the KSA’s movement restrictions were not 21 justifiable given the extremely low number of confirmed cases.

(19) According to UN operational partners. (20) For additional information, please refer to HAT’s report on ‘Tribal Protests against Kurdish Governance in Deir-ez-Zor Governorate’, June 2019. (21) The holy month of Ramadan began in Syria on 24 April, 2020.

10 / 16 AID DELIVERY AND MEDICAL SUPPLIES

Human Rights Watch (HRW) stated on 28 April that restrictions imposed by the GoS and the KRG were hindering COVID-19 prevention and treatment supplies from reaching the northeast, and urged the UN Security Council to reverse its 10 January Resolution 2165 (2014) which ceased cross-border aid delivery through the Ya'robiyah border crossing with Iraq. Ya'robiyah – located in eastern Al-Hasakeh governorate – was an important source for the supply of medical equipment and medicines, with the UN estimating that 40% of all medical, surgical and health supplies to the northeast entered via the crossing. INGOs had estimated that the amended resolution would affect 1.4 million civilians in the northeast from receiving 22,23,24,25,26 medical aid.

During a Security Council meeting on 29 April, Mark Lowcock, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, called for the reopening of Ya'robiyah to enable the transfer of critical medical supplies. In response, Vassily Nebenzia, Permanent Representative of Russia

to the UN, warned members from wasting time in their efforts to advocate the reopening of the crossing and instead “focus on engaging humanitarian agencies in a constructive dialogue with Syrian authorities.”

More recently, a number of US house representatives and senators sent a letter on 12 May to Michael

Pompeo, US Secretary of State, to increase diplomatic efforts for the reopening of Ya’roubiyah for at least 27,28,29 one year.

While advocacy groups continue to push for the reopening of the crossing, restrictions from the KRG have

also impacted aid supply into the northeast. A letter sent by Dr. Dindar Zebari, the KRG’s International Advocacy Coordinator, to HRW on 27 April, stated that “the [humanitarian] agencies are currently not able

to buy Coronavirus-related medical aid in Kurdistan Region markets; they should import them. This

measure is in place as the Kurdistan Region is having a shortage in terms of medical supplies due to the current outbreak.” HRW’s report also indicated that the organization of cross-border aid transfers between

KRG and KSA areas have been ill-defined which have led to delays. This is in addition to Damascus’ 30,31 bureaucratic obstacles which have been hindering humanitarian aid from reaching the northeast.

(22) Human Rights Watch, ‘Syria: Aid Restrictions Hinder Covid-19 Response’, April 2020

(23) The UN resolution, which has been annually renewed since 2014, was vetoed by China and Russia on December 20, 2019 and amended by Russia to exclude authorization for Al-Ramtha border crossing with Jordan and Ya'robiyah in Iraq. The duration of the authorization was also reduced from twelve months to six. It is important to note that the resolution is only legally applicable to United Nations agencies and the partners they are supporting. (24) The Guardian, ‘Cross-border aid to Syria at risk amid UN security council split’, December 2019 (25) Refugees International, UN Security Council Vote to Halt Cross-Border Aid from Iraq ‘Chokes off a Critical Lifeline’ to Syria - Syrian Arab Republic’, January 2020 (26) UN, ‘Avoiding Midnight Deadline, Security Council Extends Authorization of Cross-Border Aid Delivery to Syria, Adopting Resolution 2504 (2020) by Recorded Vote | Meetings Coverage and Press Releases’, January 2020

11 / 16 MITIGATION METHODS

Kurdish Self-Administration Mitigation To mitigate the negative primary and secondary impacts of COVID-19 preventative measures, the KSA has enacted several policies in recent weeks.

1. Exemptions for Utility Bills On 6 April, it was announced that residents of KSA territories would now be exempt from paying water, electricity, and municipality taxes for the months of May and June. Although dependent on consumption, the average monthly amounts paid by residents for these bills ranged between 3,000 to 5,000 SYP in Al- Hasakeh city and 2,000 to 4,000 SYP in Ar-Raqqa city. These exemptions are unlikely to have a major impact on spending for average households given the continued price inflation. Even prior to the record devaluation of the Syrian currency, households spent on average 46% of their income on food in northeast

Syria.32,33

2. Agriculture and Construction Since 6 April, farm supply stores, veterinarians, and shops selling parts for agricultural machinery were allowed to operate between 17:00 and 01:00 (outside curfew). Additional exceptions were made to the

construction and industrial sectors on 21 April, whose workers were allowed to continue operations throughout the lockdown. Specifically, the movement of farm and manual workers to and from their work

sites was permitted provided they did not travel with more than ten individuals per vehicle.

3. Business, Labor and Trade The KSA further eased restrictions on 30 April as commercial shops, businesses and markets were allowed

to open between 06:00 and 15:00, followed by curfew (15:00–06:00). The curfew was then further

shortened (19:00–06:00) on 11 May. The KSA extended the lockdown until the upcoming end of Eid Al-Fitr but allowed private and public mass transportation across its territories to resume. Many daily wage workers, including taxi and motorcycle delivery drivers were then able to resume work. Additionally, on 17 May, the KSA announced the reopening of its crossing points in Tayha, Menbij subdistrict and in Al-

Thawrah (Tabaqa), Al-Thawrah subdistrict connecting its territories with GoS-held areas from 19 to 26 May. This is likely aimed to alleviate the impact of COVID-19 movement restrictions for traders in KSA areas who

34 source their supplies from GoS-held areas, especially in preparation for Eid Al Fitr.

(27) UN, ‘Tragedy Beckons in Syria as War-Ravaged Health‑Care System Is Ill-Equipped to Cope with COVID-19 Spread, Humanitarian Chief Warns Security Council | Meetings Coverage and Press Releases,’ April 2020 (28) Russia UN, ‘Permanent Mission of the Russian Federation to the United Nations,’ April 2020

12 / 16 4. Livestock exports The KSA also allowed the export of livestock from its territories to Iraq on 7 May, reversing its 16 January decision taken in response to the low availability of meat in local markets. While the resumption of livestock exports could alleviate the financial burden on livestock traders, it has raised concerns among the local population regarding the potential increase of the price of meat domestically.

5. Bonuses for KSA employees On 17 May, the KSA announced that it will be releasing bonuses to its employees, including to the Asayish, amounting to 25,000 SYP for the occasion of Eid Al-Fitr. The decision could help to reinforce the KSA's base supporters, particularly during such tough economic conditions.

Community Level Mitigation In an effort to alleviate the financial and economic burden of COVID-19, local councils have launched initiatives to help communities in their areas. On 25 April, Ar-Raqqa city’s local council launched ‘Ramadan’s Table’ a food aid campaign with the aim of distributing food baskets to approximately 5,000

low-income families across the city and its countryside. Other grass-root initiatives supported by residents of Ar-Raqqa city were launched on 7 May to distribute food baskets to poor families in the city. Similar

initiatives such as ‘Iksa’ Yatim’ (clothes for orphans) and ‘Ta’awano’ (cooperate) were also supported by the

Religious Affairs Office of Ar-Raqqa civil council.

Response in IDP camps The KSA’s response to COVID-19 across IDP camps in its territories has been delayed compared to its urban centers. Mobility restrictions within the camps were imposed late, on 26 March, and local sources reported

there were noticeable variations in their consistency. In Al Hole camp, Hole subdistrict, a medical and

quarantine center was built, non-essential commercial shops were closed and movement of aid staff within tents was reduced, however there was little to no implementation of the curfew and social distancing measures. Informal camps, such as Tal Al-Bi’a, Al-Miqas, and Hazimah in Ar-Raqqa governorate, received

little attention from KSA authorities and did not have to abide by KSA’s COVID-19 mitigation measures. In other camps, such as Al- Camp, local sources reported that disinfection campaigns were carried out while residents were prevented from gathering in crowds.

(29) US Foreign Affairs Committee,’McCaul, Risch, Menendez, Engel, Call on Administration to Intensify Efforts to Restore Cross-Border Humanitarian Operations at Syrian Border’, May 2020 (30) Human Rights Watch, ‘Supporting resource response, Letter’, April 2020 (31) ibid (32) The mean household income in northeast Syria is estimated to be 122,000 SYP per month. (33) According to UN operational partners.

13 / 16 The KSA’s inconsistency in implementing preventive measures across camps could indicate a degree of negligence among KSA-affiliated camp authorities with regards to the potential ramifications of a COVID- 19 outbreak, however it should be noted that it is much more challenging to implement social distancing measures in IDP camps given their often densely populated setup. One local source explained that KSA- affiliated authorities wanted to avoid raising tensions among camp residents, some of whom would find movement restrictions as infringing on their daily activities, particularly within overcrowded camps such as Al Hole. Regardless, it appears that (I)NGOs have had to introduce their own COVID-19 preventive measures, such as relocating many of their activities and meetings online. Within IDP camps, humanitarian organizations put guidelines in place, which included the following;

 building fencing to avoid overcrowding;  installing additional handwashing points;  providing extra protective equipment for triage staff;  banning relatives from to accompanying suspected patients; 35  screening before entry in the event of suspected cases.

Case Study: Al-Hole Camp

As of May 2020, Al Hole Camp’s population is approximately 68,000 people, including 24,000 children. This case study provides a snapshot of attempted efforts to implement measures to prevent COVID-19.36

INGOs have reported that the population density of Al Hole is approximately 37,570 people per square

kilometer, and that a potential COVID-19 outbreak inside the camp is likely to have devastating results given the lack of adequate healthcare or testing facilities relative to population size.,, According to the UN

Office for the Coordination of Humanitarian Affairs (UNOCHA), there are approximately 15 fixed medical

points, eight mobile medical teams and three field hospitals across the camp, while testing for residents follows the same process as for the rest of KSA-controlled areas. Local sources reported on 11 May that the

World Health Organization (WHO) is in the process of preparing quarantine centers in the camp which would encompass four large tents, each of which would house 20 beds. These would still be extremely limited given the large camp population. As it stands, while there may have been reports of suspected cases – on 5 April a female IDP displaying COVID-19 symptoms was escorted out of the camp to be 37,38,39,40,41 quarantined for 14 days – as of 11 May, there have been no confirmed cases of COVID-19.

(34) Cafes, restaurants, places of worship, schools, universities, and official KSA institutions remained closed with the exception of institutions that provide essential healthcare and services (35) ICRC, ‘Syria: Al Hol field hospital introduces COVID-19 preventative measures’ April 2020 (36) Save the Children, ‘Syria: Thousands Of Foreign Children In Al Hol Camp Must Be Repatriated Given Coronavirus Fears’, May 2020

14 / 16 Following the first confirmed case of COVID-19 in KSA-held areas on 17 April, outreach and awareness efforts were amped up, and included dissemination of posters in public facilities and spoken messages through loudspeakers. Efforts to address and protect most vulnerable people (such as the elderly) from COVID-19 are still in the initiation phase.

CONCLUSION The KSA’s efforts to reduce restrictions and open up the economy as much as possible have provided the opportunity for increased income-generation in communities. The alleviation efforts however are likely to increase the risk of COVID-19 transmission, particularly given the lack of clarification on social distancing and the seemingly relaxed implementation of the movement restrictions by security agencies. With movement returning between governorates and cities, the KSA has also failed to define the appropriate social distancing measures, increasing potential for misinterpretation and disregard for official guidelines.

However, given the lack of financial resources available for the KSA to design and implement an adequate

social protection response to compensate residents for their lost wages, improved testing and surveillance capacities, along with the continued implementation of social distancing measures are key to reopening

the local economy safely. While the KSA and community level measures have gone some way to alleviate the primary and secondary impacts of COVID-19, the dual shocks of an unprecedented currency

devaluation and a severely restricted workforce could also be devastating.

(39) Save the Children, ‘A Children's Crisis: Update on Al Hol camp and COVID-19 concerns - Syrian Arab Republic,’ May 2020 (40) UN OCHA, North East Syria: Al Hol camp, January 2019 (41) The woman tested negative for COVID-19.

15 / 16 CONTACT

Nicholas Bodanac Humanitarian Access Team [email protected]

The Humanitarian Access Team (HAT) was established in Beirut in March 2015 in response to the collective challenges facing the remote humanitarian response in

Syria. Successful humanitarian and development interventions require a nuanced and objective

understanding of the human ecosystems in which these

interventions occur. To this end, the HAT’s most important function is to collect, triangulate, synthesize, analyze and

operationalize disparate data and information. Since 2015, HAT analysis has provided a forward-looking template for

international interventions in Syria, and facilitated an increasingly nimble, adaptive, integrated, and ultimately impactful international response to the Syrian conflict.

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