The Disasters Emergency Committee (DEC) says unaccounted deaths of people in Syria with diabetes, heart conditions and other chronic illnesses mean the true death toll of the war is far higher than the reported 70,000. Many more deaths are happening because the health service has collapsed with one third of hospitals and 90% of pharmaceutical factories out of action.
Some of the DEC member agencies say there are clinics where up to half the reported deaths have been from normally treatable chronic conditions. Insulin, oxygen, anaesthetics, and intravenous fluids are in desperately short supply, seriously compromising the ability of clinics to provide on-going treatment of chronic diseases. Aid agencies believe that factoring mortality from chronic diseases in would push official death tolls much higher.
Syria's pharmaceutical industry was concentrated in Aleppo and rural Damascus, areas that have been badly affected by the conflict. Drug production has stalled, and after more than two years of fighting supplies are running dangerously low. Drugs like insulin and specialist care like dialysis and chemotherapy are now unavailable for the majority of people who need them. Where they can be bought, prices on the black market have skyrocketed making them unaffordable for all but the wealthiest Syrians.
HelpAge International is currently collaborating with Handicap International on its response to the Syrian refugee crisis in Jordan.We are using our joint expertise to identify the needs of the most vulnerable groups affected by the conflict in Syria, including older people and people with disabilities, to ensure they can get essential relief services.
Older refugees disproportionately at risk
The main refugee camp in the north of Jordan, Zaatari camp, hosts more than 144,000 refugees. The camp is overcrowded and a lack of access to food has been reported.
People over the age of 60 make up around 3% of the Zaatari camp population - an increase from 2% since the beginning of the year. An older woman who arrived last week was 105 years old. UNHCR data from Zaatari camp shows that while refugees aged 60 and over constitute 3% of the residents, they account for 7% of the acute health conditions and 21% of chronic health conditions, such as diabetes and high blood pressure.
This indicates older refugees are disproportionately at risk and in need of greater humanitarian assistance. However medical facilities in Zaatari camp are becoming increasingly overburdened.
On dialysis and unable to chew his food
Mahbud, 69, arrived with his son Hisham, 52, two weeks ago. Mahbud is partially paralysed due to a stroke and cannot speak. He also needs dialysis twice a week. The two live together in the camp, but Hisham does not know what services are available for his father.
Mahbud cannot chew the food given to the residents of the camp. Hisham said: "He is my father - I will help him, no matter what. There has been no electricity in the camp for the last four days, so I have not been able to use the blender I bought to prepare his food and the lack of gas means I cannot cook. The priority should be to improve the bathrooms and kitchens as they are crowded and dirty."
Urban refugees less likely to receive help
Many Syrian refugees are leaving the camps to move to urban areas, joining thousands of other refugees who are already living in cities with relatives or contacts along the northern border between Syria and Jordan. This largely invisible population - estimated at about 75% of the refugee population - is relying heavily on the support of their Jordanian neighbours.
It is clear that many people are struggling to cover the cost of their basic essentials. The latest research shows that the average level of debt among these urban refugees is US$650 - a figure which represents about three months' rent. On top of this, the average shortfall in monthly income for this group is almost US$250.
HelpAge, in partnership with Handicap International, is planning to strengthen our assistance to older, disabled and other vulnerable refugees living in the urban areas of Jordan and Lebanon, notably in terms of access to housing, electricity and heating, clothing, food and healthcare.