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SYRIA CRISIS Whole-Of-Syria Update

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SYRIA CRISIS Whole-Of-Syria Update SYRIA CRISIS Whole-of-Syria update Situation report # 4 JUNE 2018 WHO supported partners in southern Syria, including the Syrian Arab Red Crescent, by providing them with 189,000 numbers of treatments since 17 June. Photo: WHO 11.3 M 6.6 M 8,100 PEOPLE 5.6 M 9 ATTACKS ON IN NEED OF INTERNALLY LIVING IN REFUGEES HEALTH CARE HEALTH CARE DISPLACED BESEIGED AREAS KEY FIGURES HIGHLIGHTS 130 WHO STAFF IN WOS WHO responded to multiple dynamic emergency situations across HEALTH CLUSTER PARTNERS Syria, including in Afrin (Tal Refaat, Nabul, Zahraa, and Fafin), eastern 121 IN DAMASCUS, GAZIENTEP Ghouta, and northern rural Homs. The humanitarian situation in Idleb AND AMMAN remained particularly dire, which is linked into massive new displacements since the end of 2017. TARGET POPULATION FOR In southern Syria, violence escalated with heavy artillery and aerial 11.2 M HEALTH RESPONSE IN 2018 shelling. By end June, an estimated 66,000 people were displaced due to the fighting, mostly from eastern Dar’a governorate to areas near HEALTH FACILITIES the Jordanian border and the Golan Heights. There were registered cases of measles and leishmaniosis in northern TOTAL NUMBER OF HOSPITALS 111 Syria and acute diarrhoea in northeast Syria. At the end of June, of the 111 assessed public hospitals (MoH and HOSPITALS FUNCTIONING MoHE), 55 (50%) were reported fully functioning, with 27 (24%) (55 FULLY AND 27 82 hospitals reported partially functioning (i.e., shortage of staff, PARTIALLY) equipment, medicines, or damage to the building), while 29 (26%) WHO FUNDING were non-functioning. US$ REQUESTED AS PART OF 141 M SYRIA HUMANIATRAIN RESPONSE PLAN 22 M US$ RECEIVED BY WHO (16.2%) PAGE 1 Whole of Syria Situation overview The escalation of hostilities in southern Syria created huge humanitarian needs in Dar’a, Quneitra, and Sweida governorates, with up to 66,000 people displaced by the end of June. UN agencies discussed new mechanisms for access as more areas that have recently experienced change in lines of control. In total, WHO delivered 166,863 treatments to southern Syria from Damascus by the end of June. The interagency cross-border convoy scheduled to depart Ramtha, Jordan, on 27 June was placed on hold and remained on standby at the end of the month. Throughout the country, there continues to be a need for increased humanitarian access to areas that have recently experienced change in lines of control, which are highly vulnerable to disease outbreaks due to recent population movements within the country and lack of access to basic services, including poor water and sanitation. Across Syria, new measles cases continued to be reported with the highest disease burden occurring in northern Syria. Additional pockets of leishmaniosis and acute diarrhoea were reported in northern Syria and northeast Syria respectively. Nine attacks on health care were reported through the country in the month of June, killing three health workers, injuring five, and reinforcing the need for the protection of patients, health workers, and health facilities, particularly during transitional phases. From 24-27 June alone, eight health facilities were attacked and either partially or fully destroyed during hostilities in eastern Dar’a, leading to the loss of critical health services in the area, including outpatient consultations, inpatient admissions, emergency obstetric care, trauma and surgical care, dialysis, mental health services, physical rehabilitation and blood banks. In northeast Syria, there are concerns over displaced populations who are returning to their homes facing the threat of landmines, unexploded ordnances, and explosive remnants of war. June also saw continued high transmission of communicable diseases including measles, acute diarrhoea, and cutaneous leishmaniosis In total during the month of June, WHO and its implementing partners delivered 326,109 medical treatments1 to eight governorates during the month of June. WHO conducted no cross border deliveries from Jordan or Turkey this month; however, there was one cross-border convoy from Iraq. SITUATION OVERVIEW Northwest Syria (Idleb, Aleppo, Afrin, Hama, Latakia, Tartus) 136,000 people were estimated to remain in Afrin district, with 134,000 people remaining displaced to the Tall Refaat sub-district, Nabul and Zahraa towns, and surrounding communities. In Afrin and across northwest Syria, there was a shortage of essential medicines, medical staff, and specialized services. Leishmaniosis remained a pressing concern in Aleppo and Idleb governorates, especially in camps and remote areas of the region. The only NGO in Idleb Governorate providing leishmaniosis treatment has insufficient funding to assure a comprehensive response. Tuberculosis treatment was also reportedly unavailable in some non-government controlled areas of rural Aleppo and Idleb Governorate, and the referral system for tuberculosis and thalassemia is suboptimal and requires strengthening. The measles epidemic remains a concern, particularly in Idleb, which reported 3611 positive cases during the first two weeks of June, and Aleppo, which reported 2060 in the same period.2 Mental health remained a point of concern due to the weak referral system, lack of integration of 1 One standard treatment course (e.g. a course of antibiotics for 8 days) is considered as treatment for one person. Treatment courses are determined for each medicine distribution based on international WHO standards. 2 Data from April 30, 2018 to June 16, 2018 (epidemiological weeks 18 -24)for all EWARN-covered areas in Syria PAGE 2 mental health services at the primary health care level, and dearth of professionals properly trained and qualified to respond to the needs of the affected population. The destruction of Kafr Zeita hospital created a large gap in northern Hama countryside for health services to women and children, as it was the major provider of maternity and child health services in the area. For IDPs displaced from Afrin, WHO supported 13 mobile medical teams (MMTs) and one primary- health-care centre in providing essential health care services. MHPSS services are integrated with 13 medical teams, and nutrition surveillance services are integrated with 10 MMTs. Coordination is in place, including with SARC and DoH, on the effective mechanism to transport critical emergency patients to Aleppo city facilities. Northeast Syria (Ar-Raqqa, Hasakeh, Deir Ez-Zor) There are reports of a deteriorating humanitarian situation in the Dashisha area in Al-Hasakeh Governorate following an escalation of hostilities since 1 May. Reportedly, limited groups of IDPs from these areas managed to reach IDP sites in Al-Hasakeh Governorate and are being hosted in the existing IDP sites. An estimated 138,000 individuals returned to Ar-Raqqa city since October 2017 and 188,000 to Deir-ez Zor governorate since November 2017, although conditions for returns remain unsafe due to high levels of contamination of explosive hazards. A flash flood in Ein Essa in week 23 significantly damaged the IDP camp; an estimated 40% of the camp’s tents were destroyed, and 10% of the health and medical centres were damaged. From 18-31 June, WHO led a joint WHO-UNICEF field investigation of acute diarrhoea cases along the Euphrates river in Dier Ezzor Governorate .As of 24 June, 578 cases, including 12 deaths, of acute diarrhoea were reported in Deir Ez-Zor. To date, the distribution of symptoms includes acute diarrhoea (100%), bloody diarrhoea (94%), abdominal pain (93%), fever (80%), vomiting (15%) and dehydration (8%). WHO’s ongoing partners in Northeast Syria include GOPA, 11 medical mobile teams, and Al-Hikmah Private Hospital. In coordination with UNHCR, WHO evacuated two TB cases from Al Roj camp to Al-Hikmah private hospital for advanced care and follow up. Damascus, Rural Damascus, East Ghouta By the end of June, 18,543 people remained housed across seven shelters across eastern Ghouta in Rural Damascus. As of 30 June, 21,450 have returned to communities across East Ghouta. One IDP shelter in Adra was closed. Fixed/mobile teams providing emergency referrals and outpatient services including reproductive health, nutrition screening, mental health services, EWARS and WASH cover the other seven shelters. The provision of health services in eastern Ghouta communities remains disrupted with only five public health centres now partially functional in Duma, Saqba, Hazzeh, Ein Tarma and Arbin. UN agencies still have no regular access granted into communities in eastern Ghouta. In South Damascus following the end of hostilities in Yarmouk Camp, increased service coverage is required in Yalda, Babila and Beit Sahm. A lack of medicines (especially chronic diseases, anemia, skin diseases); treatment for injuries resulting from trauma; oral health/dentistry; and nutrition surveillance was reported. Mobile teams necessary as conditions to receive and distribute health supplies are not currently in place. From March until the end of June, WHO provided the following support: o 16 shipments containing 772,543 medical treatments were delivered, accounting for 56.5 tons of health supplies o 48 EWARS sentinel sites reported surveillance information, with 309 reports produced and 28 alerts investigated and responded to. o 13 WHO-supported NGOs deployed for the response. o Nine MHPSS mobile teams deployed, with three operating in the past week, and 71 static medical points provide integrated MHPSS services. 7,018 basic psychological interventions PAGE 3 have been provided to people. o
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