The conflict in Syria is probably one of the worst humanitarian crises since the Second World War. It has claimed over a quarter of a million lives and displaced over 11 million people in only six years. It has seen a dramatic increase in sectarian violence. The rebellion was sparked in Daraa (Syria’s southern governorate) and spread to Damascus, Aleppo, and eventually the entire country. Over the course of the crisis, nine million people have fled their homes, 6.5 million of whom have been internally displaced, and 1.3 million in 2015 alone (OCHA HNO, 2016). Millions more are being further displaced or trying to flee out of the country, moving through Daraa towards Syria´s southern border to escape violence in conflict zones around the region.
Traversing this path to relative safety is not easy. The Syrian conflict has divided the country into a patchwork of territories controlled by three main actors. The Islamic State of Iraq and the Levant (ISIS) controls large areas in north and central Syria. Opposition forces have consolidated control in two main areas, one in the northwest and one in the south. The one in the south mainly comprises the Quneitra and Daraa governorates, with the exception of a small strip of land that includes the road from Daraa to Damascus and is part of the city of Daraa. These latter two areas are under the control of government forces, which control most of the western border and northern territories (ISW Rus Mil Act, 2016).
Control over these areas is anything but stable, as battles rage around important strategic locations and cities such as Damascus and Daraa. These and many other urban centres continue to suffer from heavy aerial bombardment and other types of violence (ISW Syria Sitrep, April 2016). In fact, western Daraa, Daraa city and other areas in the north remain conflict zones, or areas where government, ISIS and opposition forces conduct regular offensives. Furthermore, international involvement by Russian or Coalition forces, have done little to improve the health of the population. The compound impact of these military actions is reflected in the significant displacement of the local population to “safer” or more stable zones to the east of Daraa city, and further south, into Jordan.
As a consequence, the health system in Daraa is now completely dependent on external support. MSF OCBA is extensively supporting some health facilities in the eastern part of Daraa governorate. In September 2015, MSF’s support to Busra Hospital was increased to include medication, consumables, financing of human resources, and fuel. MSF’s support increased gradually from simple donations to a full supply of medications, consumables, human resources financing, logistical support, medical protocols and very ambitious plans for vaccination (for children less than one year old and pregnant women), physiotherapy, trauma surgery and development of the healthcare system. Nevertheless, apart from data collected at MSF facilities, nothing or very little is known of the highly fluid population living in the area where MSF operates.
In order to deliver clear and actionable data from the catchment area, and to have a better idea of the population’s health needs, MSF conducted a baseline assessment of the health and essential service needs of the the crisis-affected population in eastern Daraa governorate. The assessment was conducted in July 2016 by MSF OCBA’s regional Health Surveillance Programme (HSP) team and the South Syria project team from the Jordan-Syria mission. Primary findings were available in real-time via web link to a live streaming dashboard. Access to the ‘MSF-HSP Dashboard’ is possible via MSF-HSP administrators (see contact information below). Multi-stage cluster sampling of a well-dispersed sample from throughout the area of interest allowed investigators to draw inferences about to all persons of concern living in eastern Daraa governorate.