Health response to the crisis in the Syrian Arab Republic and neighbouring countries, January 2013
WHO requires US$ 56 million to address the health needs of the populations affected by the crisis in the Syrian Arab Republic and neighbouring countries in 2013
The latest assessments estimate that over four million people have been affected within the Syrian Arab Republic, in all 14 governorates. In addition, UNHCR reports that over 500 000 refugees have fled to five of the neighbouring countries (Jordan 144 997, Lebanon 156 612, Turkey 137 756, Iraq 65 527 and Egypt 8858).
As the humanitarian situation continues to worsen, WHO has designated the crisis in the Syrian Arab Republic and neighbouring countries a Grade 3 emergency based on the criteria (scale, urgency, complexity and context) in its Emergency Response Framework (ERF). The Grade 3 emergency declaration allows WHO to scale‐up its response operations and provide substantial Organization‐wide support to its Country Offices to respond to the crisis. An Emergency Support Team has been established in Amman, Jordan, to provide technical back‐up to the WHO offices in the Syrian Arab Republic and neighbouring countries of Jordan, Lebanon, Turkey, Iraq, and Egypt.
Within the Syrian Arab Republic, insecurity and the breakdown of the health system in many areas have substantially reduced access to health services. Health professionals, staff and patients continue to face difficulties reaching hospitals and health centres due to insecurity. Reports from November and December 2012 indicate that almost 55% of public hospitals, approximately 10% of health centres and 58% of ambulances have been damaged or destroyed. At least 31% of public hospitals are out‐of‐service.
There is also a severe shortage of medicines and medical supplies particularly for anaesthesia, surgical and trauma care, burn ointments, antibiotics, as well as supplies and equipment for treatment for cardiovascular disease, orthopaedic conditions and haemodialysis.
The prolonged humanitarian situation has resulted in a growing unavailability of food, unhygienic and overcrowded living conditions, inaccessible or limited health care services and reduced immunization coverage for children under five. These combined factors increase the risk of communicable diseases and have serious implications on the nutritional status of children under five and pregnant and lactating women. Communicable diseases being reported through the Early Warning and Response System include influenza, acute diarrhoea and hepatitis.
The provision of mental healthcare remains a challenge, with a severe shortage of psychiatrists in the country and increased needs for referral to mental health treatment and care.
The number of refugees in neighbouring countries has put an immense strain on the hosting communities as well as on the infrastructure and resources of the countries concerned. The utilization of health services by Syrian refugees in neighbouring countries is steadily increasing, accelerated by the winter temperatures. Health centres are providing primary health care services including medications, vaccinations and diagnostic tests to Syrian refugees. As an example, a review of the utilization of health services among registered Syrian refugees in Lebanon indicated that over a six month period, for a population of 30 000, 7‐9% received primary health care services and 5‐7% were hospitalized.