Syria/Iraq: Polio Outbreak - Oct 2013
On 28 Oct 2013, the Minister of Health of the Syrian Arab Republic announced that, after a 15-year absence, polio had returned to the Middle East. Thirteen cases were confirmed from Syria's Deir Al Zour province. The occurrence of an outbreak reflects declining immunization rates due to the severe interruption of public health services and to the conditions in which the people are living. A comprehensive outbreak response will need to be implemented across the region, with seven countries and territories to conduct mass polio vaccination campaigns targeting more than 22 million children aged under 5 years. (Strategic Plan for Polio Outbreak Response in the Middle East)
As of 8 Feb 2014, 17 confirmed polio cases had been reported from Syria's Deir ez-Zour Governorate, three from Aleppo Governorate, one from Al. Hasakeh Governorate and two from Idleb Governorate (WHO/UNICEF, 8 Feb 2014).
By 20 Mar, a total of 37 cases had been reported: 25 cases by the Syrian Arab Republic Ministry of Health, and 12 cases from contested areas (Aleppo, Edleb and Deir Al Zour) not yet reflected in official figures. The most recent case had onset of paralysis on 17 Dec 2013. Further evidence of regional spread was confirmed by notification of a case from Iraq, the first polio case in the country since 2000. The case, a six-month old boy from Baghdad who had not been immunized, developed paralysis on 10 Feb 2014. Genetic sequencing indicates the virus is most closely related to virus detected in the Syrian Arab Republic. (WHO, 21 Mar 2014)
By 8 Oct, three cases had been reported in the Middle East with onset of paralysis in 2014 - two in Iraq and one in Syria. The most recent case reported from Iraq occurred in Mada'in district, Baghdad-Resafa province, with onset of paralysis on 7 Apr. Syria’s most recent case had onset of paralysis on 21 Jan. The fact that six months had passed with no new cases being reported indicates that transmission of the virus has been interrupted. (Global Polio Eradication Initiative, 8 Oct 2014)
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Pakistan: Water, sanitation, and health services are urgent needs among the 780,000 registered displaced from North Waziristan (government figures). The data is being cleaned to check for duplication.
Iraq: Access to areas within the governorates of Anbar, Babylon, Diyala, Salah al Din, Kirkuk, and Ninevah remains difficult due to ongoing violence clashes, disruption of communication and transportation routes, and a widespread shortage of fuel.
Iraq: The Islamic State of Iraq and the Levant and its allies have overrun non-Kurdish controlled areas Ninevah and significant areas of neighbouring Salah al Din and Kirkuk governorates, as well as part of northern Diyala. Access is severely limited, and hundreds of thousands of displaced persons are in need of humanitarian assistance.
Iraq: An estimated 500,000 Iraqis have fled Mosul following the city’s takeover by the Islamic State of Iraq and the Levant. The IDPs are fleeing from the west to the east of the city, to other parts of Ninevah governorate, and to the Kurdistan region. Indiscriminate shelling is reportedly continuing. In Anbar governorate, armed violence has displaced close to half a million people so far this year.
CAR: The security situation in Bangui has reportedly deteriorated; 25 have been killed in renewed clashes. Violence has disrupted the April–May planting season, which will likely lead to below-average 2014–2015 harvests.
Syria: 241,000 people are estimated to be living under siege, 196,000 besieged by government forces, and 45,000 by opposition forces. Nearly 2,000 civilians are reported to have been killed in air strikes on Aleppo this year. Humanitarian access to both government and opposition controlled areas dropped significantly in May.
Balkans: On 13 May, cyclone Tamara hit the Balkans. Heavy rainfall resulted in extensive flooding in Serbia, Bosnia and Herzegovina, and Croatia; 1.6 million, 1.5 million, and 38,000 people have been affected, respectively. In total, 81,879 people have been evacuated. Relief efforts are being hampered by landslides, damaged infrastructure, blocked roads, and blackouts.
South Sudan: A cholera outbreak was reported in Juba, with 43 suspected cases and two deaths recorded. Displacement figures have climbed to 1,005,000 IDPs and 310,000 refugees in neighbouring countries. Juba and the South Sudan Democratic Movement/Army – Cobra Faction signed a peace agreement over conflict in the Greater Pibor area.
Iraq: 6,000 people fled the Iraqi military’s shelling of Fallujah over 6–16 May. The Iraqi Government has denied using barrel bombs, but residents keep describing what appear to be such devices.
South Sudan: Peace negotiations in Addis Ababa have resulted in a ceasefire agreement between South Sudan’s president and the head of the opposition. The number of IDPs in South Sudan stands at 983,000. Following fighting in Upper Nile state, at least 11,000 new South Sudanese refugees have crossed into Ethiopia, bringing the total to 120,000. Altogether, 341,000 South Sudanese refugees are in neighbouring countries.
Syria: The security situation had deteriorated with escalating violence in the West of the country resulting in population displacement and hampering the delivery of humanitarian assistance. Large numbers of newly displaced are heading to the calmer regions of Idleb governorate, which hosts over 500,000 IDPs. In the East, Iraqi helicopters hit an opposition convoy in the first strike claimed by Iraq inside Syria since the conflict began.