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World Health Organization Donor Update 2014 (Q2)

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World Health Organization Donor Update 2014 (Q2) Photo credit: WHO WHO credit: Photo World Health Organization Syrian Arab Republic Donor Update 2014 (Q2) World Health Organization Syrian Arab Republic Donor Update 2014 (Q2) Contact Details WHO Country Office (Damascus, Syrian Arab Republic) Ms Elizabeth Hoff, WHO Representative [email protected] WHO Emergency Support Team (Amman, Jordan) Ms Louise Kleberg, External Relations [email protected] WHO Headquarters (Geneva, Switzerland) Ms Cintia Diaz-Herrera, Coordinator External Relations, Emergency Risk Management and Humanitarian Response [email protected] Cover photo credit: WHO/B.Khabbieh Content 6 The Situation in Syria in Q2 of 2014 8 WHO in Syria: Responding to Needs 17 Challenges and Mitigation Measures 20 Financial Overview for Q2 of 2014 22 WHO Strategic Interventions Under SHARP 2014 23 Glossary Photo credit: WHO/O.Sanadiki credit: Photo The Situation in Syria in Q2 of 2014 1. People in need of humanitarian assistance The violence in the Syrian Arab Republic has continued to escalate during Q2. The past three months have been marked by continuing conflict, with pockets of sustained high-intensity fighting. There have been no major changes in the balance of power in the central and southern regions, in spite of government gains in these areas. Opposition groups continued to fight the Syrian Armed Forces (SAF) along the main highway linking Syria‟s major urban centres, from Aleppo to Dar‟a, while combat between armed opposition groups including The Islamic State of Iraq and Levant and Kurdish forces continued in the east and north. Clashes in frontline areas (including Dar‟a, Deir ez-Zor, Rural Damascus, Homs and Aleppo) have led to new large-scale displacements and a worsening humanitarian situation. The number of people in need has therefore increased significantly due to barriers accessing humanitarian assistance, reduced agricultural production, scarce employment opportunities, decreased purchasing power, and exhausted coping mechanisms.1 . People in Need (PiN): 10.8 M (compared to 6.8 M in Q2 2013 and 9.3 M in Q1 of 2014); . Internally Displaced People (IDPs) 6.5 M (compared to 4.25 M in Q2 2013; the UN has not yet released updated figures for the number of IDPs for Q2); . People killed: 160,000 (compared to 93,000 in Q2 2013 and 150,000 in Q1) . People injured: 750,000 (compared to 465,000 in Q2 2013 (same figure as in Q1 of 2014)). Al_Qunaytirah Graph 1. Updated figures of estimated population in governorates, PiN and IDPs (OCHA, May 2014) As_Suweida PiN SHARP Revision IDPs SHARP Revision Pop_Est_2011 Lattakia Tartous Raqqa Dara Hama Hassakeh Dayr_Az_Zor Homs City_Damascus Idleb Rural Damascus Aleppo Rural City_Da Dayr_Az As_Suwe Al_Quna Aleppo Damascu Idleb Homs Hassakeh Hama Dara Raqqa Tartous Lattakia mascus _Zor ida ytirah s PiN SHARP Revision 2,575,00 1,654,00 1,117,00 820,000 748,000 711,000 582,000 533,000 517,000 490,000 472,500 363,500 133,500 87,000 IDPs SHARP Revision 1,787,00 770,000 708,000 410,000 560,000 441,000 197,500 245,500 266,000 177,000 452,000 300,000 69,000 72,000 Pop_Est_2011 4,868,00 2,836,00 1,501,00 1,754,00 1,803,00 1,239,00 1,512,00 1,628,00 1,027,00 944,000 797,000 1,008,00 370,000 90,000 1 Source: Syria Needs Analysis Project (SNAP), ACAPS, May 2014 6 2. Disintegration of the public health system The crisis has disrupted health care services and led to dire shortages of essential medicines, supplies and health care workers, especially those trained in emergency care. Despite the challenges faced in reaching contested/remote areas, WHO managed to reach 2,519,270 people in Q2 (making a cumulative total of 5,071,776 people reached between January and June 2014). For the first time in three years, WHO was able to deliver noncommunicable disease medicines to Douma in the besieged area of East Ghouta in Rural Damascus. Even when people in need were able to access health services, positive health outcomes were undermined by the effects of protracted stress, suffering and increased vulnerability. Graph 2. Overview of functionality of As of June 2014, hospitals and health care facilities have been hospitals (June 2014) damaged in 11 of Syria‟s 14 governorates. The most heavily affected governorates are Aleppo, Rural Damascus, Homs, Dar‟a and Deir ez- 23% Zor. 47% Hospitals fully . Functionality of hospitals2 (see Graph 2): Just under half functioning of the 97 MH hospitals are fully functioning. The remainder are Hospitals partially either only partially functioning, or have ceased to function functioning altogether. Hospitals not functioning . Access of patients to hospitals (see Graph 3): 69 of the 30% 97 MoH hospitals are accessible, and 20 are not accessible. The status of accessibility of the remaining 8 hospitals is unknown. Almost two thirds of ambulances have been damaged. Graph 3. Overview of access of patients to hospitals (June 2014) Mortar and artillery attacks, including barrel bombing and airstrikes, car bombs, hijackings and kidnappings are some of the daily 8% challenges faced by health care workers. Many health professionals have left the country3, creating severe shortages in many areas 21% Hospitals fully including trauma care, anaesthesiology and laboratory diagnosis. accessible Hospitals not Graph 5. Percentage of health staff estimated to be accessible present in the country by category (March 2014) Access status not Emergency available 71% Physicians Specialists 0.20% Others 11% 22% Graph 4. Number of people per medical doctor by governorate Resident doctor (March 2014) Pharmacists 10% 0.50% 441 Tartous 718 1,077 Lattakia 1,111 1,336 Hama 2,103 5,040 Aleppo 6,040 7,984 Rural Damascus 9,298 Nurses and 10,480 midwives Homs 21,464 36% Technicians 21% 2 Percentages have changed compared to previous quarterly reports, as the Ministry of Health previously reported all hospitals located in opposition-controlled areas as 'not functioning'. Thanks to the expansion of the HeRAMs and the increased number of health workers trained in reporting on functionality and accessibility, WHO is now able to provide a more comprehensive picture of the situation on the ground. 3 Unfortunately no updated data is available from the MoH 7 3 WHO in Syria: Responding to Needs Photo credit: WHO/O.Sanadiki credit: Photo Achievements in Q2 2,519,270 people (for a total of 5,071,776 1.2 million aquatab tablets were distributed in between January and June 2014) directly Aleppo city. Each tablet is sufficient to disinfect benefited from the distribution of medicines and the daily drinking water supply of a single family. equipment as well as from health care. 137,975 people (for a total of 447,875 between 6 river water purification units were distributed January and June 2014) to Al-Boukamal Town in the Governorate of Deir benefited from the delivery and distribution of ez-Zor, where the local water filtration plant was health kits. damaged in the fighting. 2,913,640 children under 5 years of age were 35 HIS sentinel sites were established across vaccinated against polio in all governorates. Syria and 90% of health care facilities were assessed for damage and functionality across the Over 3,660 health care workers were trained on country. first aid, infection control, HeRAMs reporting, chemical hazards and water testing, early detection The lives of over 45 children under 5 years of of malnutrition, etc. age were saved in Hama, Deir ez-Zor, Homs, Aleppo, Lattakia and Damascus, thanks to the 62 new EWARS sentinel sites WHO-supported programme to establish were established throughout Syria in Q2, including therapeutic feeding centres in hospitals. over 21 sites in opposition-controlled areas (reaching a total of 528) after WHO successfully A plan to establish an in-patient psychiatric advocated with the Government for the expansion unit for 20 people was prepared in collaboration of EWARS and the distribution of essential with Al-Mouwasat hospital. medicines and medical supplies in opposition- controlled areas. Despite serious obstacles in delivering humanitarian aid to contested areas, the medicines, medical supplies and equipment delivered to opposition areas by WHO accounted for over 28% of all items delivered in Q2 of 2014. A total of 705,396 people benefited from these efforts. B.Khabbieh Photo credit: WHO/ credit: Photo 9 Graph 6. Overview of beneficiaries reached by end of Q2 of 2014 by distribution hub (including week 26) Graph 7. Comparison of beneficiaries reached throughout 2013 and beneficiaries reached by Q2 of 2014 (including week 26) 4,742,103 4.6 mio 2,913,640 Overall Beneficiaries 2013 2.2 mio 1.5 mio Beneficiaries Jan - May 2014 447,875 Treatments IEHK and other kits Polio campaign 10 Overall goal: to reduce morbidity and Inter-agency needs mapping – In Q2, WHO mortality in the Syrian population provided consolidated health information each month to OCHA‟s „Dashboard‟ – a multi-sector WHO‟s regional strategy for the Syria crisis, falling monitoring tool that displays the number of within the WHO Emergency Response beneficiaries reached by each sector. WHO also Framework, focuses on five priorities: provided consolidated health sector information to OCHA‟s bi-weekly Humanitarian Bulletin. 1. Leading and coordinating the health Working with local NGOs and focal persons - sector; WHO has increased the number of local NGO 2. Providing health information to partners from 36 (in December 2013) to 454. provide evidence for the emergency These NGOs - located in all 14 governorates of response; Syria - provide primary and secondary level 3. Enhancing access to quality and medical care, including trauma care5, through fixed priority preventive and curative health and mobile clinics. Via these networks, vulnerable services; and hard-to-reach populations are able to access 4.
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