2020 Humanitarian Needs Overview: Syrian Arab Republic (April 2020)

Summary

The humanitarian consequences for people suffering the crisis in Syria are wide-ranging and profound. Overall, 11.06 million people are in need of some form of humanitarian assistance in 2020. This includes 4.65 million people estimated to be in acute need.1 As the crisis enters its tenth year, 6.1 million people remain internally displaced.2 5.6 million people have fled their homes, the vast majority to neighbouring countries, with limited prospects for return due to ongoing hostilities in some locations, concerns regarding safety, and the lack of adequate housing, basic services and employment opportunities.3 In 2019, over 1.8 million population movements inside Syria were reported.4 Crucial civilian infrastructure such as schools, water supply systems, health facilities, and housing infrastructure has sustained extensive damage and much of it remains unrestored or in disrepair. In areas where hostilities have subsided, life remains a daily struggle due to limited access to basic services and livelihood opportunities, increasing financial hardship and an eroding capacity to cope. Around ninety per cent of the population is estimated to live under the poverty line.5 Recent economic shocks stand to further set back the recovery of the Syrian people and render many more vulnerable. Millions of women, children and men continue to rely on humanitarian assistance as a vital life-line and to meet their basic needs.
Humanitarian Consequences related to Physical and Mental Wellbeing People in Syria continue to suffer from increasingly localized, intensified hostilities which uproot families from their homes, claim civilian lives, damage and destroy basic infrastructure, and limit freedom of movement. Almost 40 per cent of internally displaced families have been displaced more than three times, with every displacement further eroding coping capacity. Repeat displacement numbers are particularly high for internally displaced persons (IDPs) in north-west and north east Syria, where the majority of the 1.8 million displacement movements were recorded in 2019.6 More than 400,000 people were displaced in the north-west between May and August 2019, many of these multiple times. Some of those displaced were again uprooted a few months later, forming part of the over 950,000 people who fled escalating hostilities in southern Idleb and moved mostly northwards the Turkish-Syrian border during the period 1 December 2019 and 29 February 2020.7 In the north-east, more than 250,000 people were forced to flee their home during a two-week period in October 2019, with over 75,000 people remaining displaced after that two-week period.
An additional 15,750 Syrians sought shelter and international protection in Iraq.8

Many of those displaced sought refuge in and added to an already high number of IDPs living in last resort sites, i.e. mainly informal settlements and collective centres in which shelter and WASH facilities are sub-standard, and health and protection risks are elevated. In total, the number of IDPs in last resort sites and camps increased by 42 per cent in 2019 compared to 2018, and as of February 2020 stands at over 1.4 million.9

Based on available data, as many as 11.5 million people live in areas contaminated by explosive hazards, exposing them to significant risks.10 57 per cent of those who have survived contact with explosive hazards in 2019 have sustained lifelong impairment.11 3.07 million are estimated to be living with a disability.12 The crisis continues to impact the mental wellbeing of those affected by new and prolonged displacement, exposure to violence, loss of income and reduced access to basic services, touching the youngest in particular: 42 per cent of surveyed households report signs of psychosocial distress in children – nightmares, lasting sadness and anxiety, amongst others – in the last 30 days, suggesting that many girls and boys are in a situation of prolonged distress.13 Half a million children are chronically malnourished and an additional 137,000 children under five years of age are suffering from acute malnutrition, heightening their exposure to preventable morbidity and mortality.14 Maternal malnutrition rates have increased five-fold compared to 2019, particularly in north-west Syria where acute malnutrition was prevalent in 21 per cent of displaced pregnant and breastfeeding women at the time of publication.15 Anemia is also on the rise. One out of every three pregnant and lactating women is anemic, leading to poor intrauterine growth, high-risk pregnancies, and childbirth complications. One out of every four children 6-59 months are anemic, and the youngest are most affected with 42 per cent of children 6-23 months suffering from anemia.16 In 2020, the number of food insecure people has increased by 22 per cent, from 6.5 million in 2019 to 7.9 million people in 2020.17 Humanitarian Consequences related to Protection Multiple grave and often inter-connected protection risks persist. These include actions leading to civilian casualties (death and injuries) which point to violations of International Humanitarian Law (IHL), specifically a disregard for the principles of proportionality, distinction and precaution. Attacks on civilian infrastructure such as health, water supply and education facilities and personnel continue unabated and reduce population’s access to critical services. In 2019, 85 attacks on healthcare facilities18 and personnel and 157 attacks on schools19 were recorded.
An estimated 2.45 million children aged five to seventeen are out of school20 and face elevated protection risks related to, among others, child marriage and engagement in child labour including in its worst forms such as recruitment and use by parties to the conflict.21 One in three school children are displaced, with the physical and mental impact of displacement affecting individual growth and learning. In 2019, 23 per cent of victims of explosive hazards accidents were children, of whom 42 per cent were injured or killed while playing.22 Missing or absent civilian documentation frequently represents a barrier to exercising housing, land and property rights, and freedom of movement and is referenced by affected populations as the top concern for accessing assistance and services.
Insecure shelter/housing tenure due to the loss or lack of civil documentation generates additional physical and mental consequences for communities, often leaving them with little choice but to reside in unsafe, sub-standard buildings prone to collapse or in other sites of last resort. Fueled also by increasing economic hardship and a dramatic loss of purchasing power due to the devaluation of the Syrian pound, affected population have little choice but to increasingly resort to harmful coping mechanisms, many of which disproportionately affect women and girls, including child / forced marriage and various forms of gender-based violence.
Meanwhile, 95 per cent of the 438,000 Palestinian refugees in Syria continue to be disproportionally affected by the above factors and will continue to experience extreme vulnerability in 2020.

Humanitarian Consequences related to Living Standards Years of crisis have exacerbated living conditions for most Syrians due to significant reductions in the availability of, and access to essential services, destructions of housing infrastructure, loss of livelihoods and reduced purchasing power as a result of economic decline. Amongst others, only 53 per cent of hospitals and 51 per cent of primary healthcare centres (PHCs) across Syria are estimated to be fully functional.23 Over eight million people have to rely on alternative and often unsafe water sources to meet or complement their water needs, increasing public health risk, with indicators on water availabity and quality being worst for IDPs in north-west and north-east Syria.24 The number of people requiring shelter assistance has increased by 20 per cent, from 4.7 million in 2019 to over 5.5 million in 2020. This rise is driven by loss of capital, the destruction of housing infrastructure and the deterioriation of shelter conditions in 238 out of 272 sub-districts, and compounded by the scale of new displacement in 2019, protracted displacement, return movements and a very limited shelter response.25 Over half of all IDPs have now been displaced for over five years,26 many requiring sustained basic service delivery and livelihood support. A deteriorating economic situation, caused chiefly by the protracted crisis and hostility-induced loss of economic assets, underinvestment, pressure resulting from unilateral coercive measures, and exacerbated by the fiscal crisis in neighbouring Lebanon, has contributed to the continued loss of livelihoods and reduction in household purchasing power.27 The ongoing devaluation of the Syrian Pound (SYP), which since October 2019 has lost over half of its value on the informal market and reached a low of 1,250 SYP per US dollar (US$) in January 2020, has further reduced families’ purchasing power. These factors combined have contributed, amongst others, to the increase in the number of food insecure people and are likely to lead to further increases in poverty, inflation and price levels for basic food and non-food items in 2020.28