Syria Programme

Syria Programme



CONTEXT

Syria remains one of the most challenging humanitarian emergencies in the world, with persistent hostilities that have resulted in hundreds of thousands of deaths and triggered one of the worst displacement crises in modern times. In 2023, 15.3 million people were in dire need of lifesaving health assistance: a 3.2 million increase from 2022. In Idlib and Aleppo where DDD works, on average 79% of residents are internally displaced people (IDP) living in rented accommodation or tents.

The humanitarian situation in Syria was further exacerbated by the devastating February earthquakes in 2023. An estimated 2.9 million people were affected by the February earthquakes, and more than 300.000 people had to leave their homes.

The ongoing war in Syria has claimed thousands of lives, displaced over 10 million people and fueled the worst refugee crisis since World War II. The socio-economic impact of war, including the depletion of economic resources, the continuation of forced displacement movements, and the destruction of livelihoods, has had a profound effect on local communities to access and use vital/essential services such as health care.

By the end of 2022, 5.6 million people in northwestern Syria were in need for humanitarian support. Epidemics such as measles, acute bloody diarrhea, typhoid fever, and cutaneous leishmaniasis continued to be serious health issues due to certain health risks accompanied by overpopulated refugee camps, poor living and sanitation conditions, and lack of access to necessary vaccination services in unregistered settlements.

Attacks against civilians stuck in the middle of protracted conflict environment also result in disability injuries, trauma, and war-related psychological problems. Around 27% of Syrian population above 13 years of age have a disability, while 50% of them needs mental health and psychosocial services. The humanitarian situation in northwest Syria worsened after the escalation in violence between 2019 and 2020. According to the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA), nearly 1 million people -81% of them women and children - have been displaced in the region since 1st December 2019. Dana, Salqin and Azaz, three sub-districts in Idlib and Aleppo host 56% of recent internally displaced people. Although the severity of internal displacements has decreased following the ceasefire on March 6, 2022, the needs have increase as northwest Syria becomes increasingly isolated and dependent on foreign aid.

In the northern part of the Aleppo Governorate, internally displaced people have had to settle in informal camps, unfinished buildings, and open spaces due to lack of appropriate places for new settlements. Furthermore, the lack of access to clean, palatable water and adetation, bad weather conditions, and the fuel shortage resulting in price hike have led to the deterioration of the living conditions of internally displaced people and the host community.

A cholera outbreak started in Syria in September 2022, particularly in the northern part of the war-torn country, adding a new layer to the suffering of the people of Syria. The cholera outbreak erupted due to a contaminated water wells in the region was another reminder of how crucial it is to continuously support and sustain critical infrastructure that allows humanitarian corridors for
the delivery of essential services.

The ongoing conflicts lasting for 13 years have seriously damaged the water and channel networks and decreased supply by 40%, while only 52% of the hospitals are operational under harsh conditions. The outbreak came amid a repeatedly reported water crisis, scarce funding for urgent humanitarian needs and ongoing armed conflict with threats of further attacks.

The 2022-2023 Humanitarian Response Plan for Syria had only 27% of the necessary resources. Health financing represented barely 16.7% of the aid provided and with a gap of 484 million dollars, while nutrition financing reached 10.7% with a gap of 11 million.



EARTHQUAKE RESPONSE IN SYRIA

Jandairis and Afrin in Western Aleppo and Harim districts in Idlib where DDD works, have the highest density of internally displaced people (IDP) in the country living in rented accommodation or tents with on average 79% of the population. These areas were the most affected by the earthquake. Much of the town of Jandairis was reduced to rubble. Over 8,000 people were confirmed dead in these three locations, with many more buried under rubble as the necessary excavation equipment was stuck at borders. A further 12,000 earthquake-related injuries were reported.

DDD provided medical services to beneficiaries affected by the earthquake through the mobilisation of MMUs and 9 primary health care centres (PHCC) in the Aleppo and Idlib regions.

DDD provided beneficiaries with PHC, SRHR, and MHPSS services, as well as nursing and free medication in PHCCs, offering more than 367,000 consultations to around (unique) 136,000 IDPs
because of the earthquake. As a preventive measure to decrease the spread of hygiene-related diseases, DDD distributed 30,000 kits in affected areas of Aleppo and Idlib. Additionally, within its emergency response to increased needs in the region, DDD has reopened its PHCC in Idlib staffed by doctors, nurses, midwives, pharmacists, community health workers, psychosocial workers and pharmacists, among others. DDD's medical staff were able to directly provide primary healthcare
services directly to vulnerable beneficiaries inside and outside the
camps.



There is an increased number of people who now live in tents as a result of the earthquakes. There are no containers for people to live in Syria. Poor and open living conditions in tents expose children and adults to freezing temperatures in winter and heat waves in summer, combined with poor ventilation of chimneys in the tents and inadequate sanitation in the camps, are just some of the determinants negatively impacting health trends. Women, children, the elderly, and People with Disabilities (PwDs) who have integrated health needs are the most vulnerable to these conditions. These conditions aggravated the cholera outbreak in the region by increasing the transmission and mortality rates.

Ongoing needs

The demand for integrated medical and protection services continues to be enormous in NWS, particularly affecting vulnerable groups such as children, women, the elderly, and people with chronic diseases and PwD. New camps established post-earthquake to house displaced people were full by September 2023.

Displaced people who lived in Jandairis town in Afrin region have returned from rural areas but often lived in new camps established in the city as their homes were damaged. In addition, people from other places in the Afrin region are now moving to Jandairis because new camps are set up in and around the town with the anticipation of new services.

In Idlib, IDP camp populations have also increased as people sought safer ground. Moreover, problems with access to basic needs such as safe water and sanitation facilities has resulted in the spread of communicable diseases such as scabies, lice, and cholera in the region, as well as in many individuals suffering from physical and mental health issues.

GBV is endemic and has been further exacerbated by the earthquake due to the increased displacement; disproportionately affecting women and children.

Domestic violence, sexual violence, rape, sexual exploitation, abuse and harassment, unaccompanied minors, child abandonment, child labor and early marriage have all increased in NWS where MdM Türkiye works. Sociocultural factors and particularly the lack of civilian security services in the area undermines efforts to support survivors and improve the protection context.