Syria

Recent Developments in Northwest Syria Flash Update - As of 24 April 2020

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HIGHLIGHTS

• While violence has significantly reduced in northwest Syria following the announcement of a ceasefire on 6 March, the humanitarian situation remains alarming as short-term needs are increasingly compounded by longer-term issues, such as malnutrition and lack of education.

• Moreover, some 135,000 people who were displaced since December went back to areas in Idleb and western Aleppo governorates from which they were displaced. This includes some 114,000 people who returned to their areas of origin and some 21,000 IDPs who returned to their previous location of displacement.

• The economic situation in northwest Syria further exacerbates humanitarian needs as the prices of basic items such as food, water and hygiene items have reached new highs every month since November 2019.

• While no cases of COVID-19 have been identified in northwest Syria, humanitarian response focuses on preparedness and response planning to minimise the potential impact of COVID-19 on communities and on humanitarian partners.

SITUATION OVERVIEW

The humanitarian situation remains alarming across northwest Syria. While active hostilities came to a halt in early March, the impact of recent military operations as well as multiple displacements, economic hardship and years of conflict continue to affect deeply the lives of civilians. The humanitarian needs of displaced people, returnees, and host communities remain extremely high.

Of the nearly 1 million people in the area who fled their homes to escape from hostilities between December and early March, some 846,000 people reportedly remain in displacement in northern parts of Idleb governorate and in northern Aleppo governorate. 60 percent of those who remain in displacement are estimated to be children and another twenty one percent women. The most urgent needs of the recently displaced individuals continue to be shelter, water, sanitation and hygiene, food and protection. At the same time, as the displaced population begins to settle in, needs with longer term impacts are increasing in prominence, such as health, nutrition and education services. In the last week, significant gaps in food assistance have been identified, due to challenges related to COVID-19 measures, funding, and re-programming.

Malnutrition is also becoming an increasing problem. For example, three in ten pregnant or lactating women are acutely malnourished, compared to 1 in 20 in the first half of 2019. Malnourished people have a compromised immune system and are therefore at elevated risk of mortality due to COVID-19. Large gaps in the provision of learning materials and education in camps exist as well.

Humanitarian needs are also increasing in some parts of western Aleppo governorate and southern Idleb governorate as thousands of families reportedly return to areas from which they fled, where many services and humanitarian activities were suspended or moved elsewhere as a result of recent hostilities. As of 24 April, an assessment conducted by a UN partner estimated that 114,000 people who were displaced since 1 December 2019 have voluntarily returned to their areas of origin in Idleb and western Aleppo governorates. An additional 21,000 people who had been previously displaced to these areas from other parts of northwest Syria due to hostilities prior to December 2019 also reportedly arrived back to their former place of displacement. The vast majority, - some 98,000 people – did so in April, while 37,000 people reportedly returned in March. 35 percent departed from Dana sub-district in Idleb governorate while 26 percent departed from A’zaz and Afrin sub-districts in Aleppo governorate. Atareb in western Aleppo governorate and Ariha in Idleb governorate each received around a quarter of all who returned, with most others returning to Daret Azza in western Aleppo governorate and Sarmin, Ehsem, Jisr-Ash-Shugur and Mhambal in Idleb governorate. Some 80 percent of the 135,000 people who returned to where they lived before the latest displacement are women and children, roughly corresponding with the proportion of women and children among the overall population of those recently displaced in northwest Syria.

The economic situation in northwest Syria further exacerbates humanitarian needs as the prices of basic items such as food, water and hygiene items that people need for their survival have been increasing consistently, reaching new highs every month since November 2019. The purchasing power in northwest Syria has been eroding since autumn 2019 as the Syrian Pound began to rapidly lose value against the US dollar. In addition, limited border movements linked to measures taken by authorities against COVID-19 have reportedly resulted in the reduced availability of staple items and price spikes of food commodities. Humanitarian actors are warning that vulnerable households are relying on negative and emergency coping strategies merely to meet their daily food needs, including the consumption of food items that have limited nutritional value.

Additional challenges have also arisen in light of the potential impact of the COVID-19 pandemic on people living in northwest Syria, on local health systems, and on the humanitarian actors delivering much needed assistance. As of 22 April, there are no known cases of COVID-19 in northwest Syria, while 42 cases have been confirmed in other parts of Syria, including three fatalities. Current impacts on the humanitarian situation in northwest Syria are due to countermeasures taken to mitigate the potential spread of COVID-19. Precautions introduced by local authorities reportedly include closure of schools and some markets, banning gatherings of people including for religious services, reducing operations of businesses including restaurants and grocery stores, and imposing curfews. At the Bab Al-Hawa and Bab AlSalam border crossings between Turkey and Syria, individuals are no longer permitted to cross except in medical emergencies, while humanitarian staff crossing is limited. Both crossings remain open for humanitarian and commercial shipments, with similar restrictions in place at crossing points between Idleb and northern Aleppo. At the border, infection prevention and control (IPC) measures are in place on the Turkish side and will be established on the Syrian side. IPC measures are also in place at two cross-line points.

The current humanitarian response to COVID-19 in northwest Syria is focused on two areas: prevention of, and preparedness for, potential cases, and ensuring that humanitarian assistance continues while mitigating the risk posed by COVID-19 to communities and humanitarian workers. An updated COVID-19 preparedness and response plan for northwest Syria was issued on 5 April, concentrating on scaling up capacities for prevention, early detection and rapid response to COVID-19 in Idleb and the Afrin and A’zaz to Jarablus area of northern Aleppo. Covering a minimum period of three months, from April to June 2020, the plan identifies a funding requirement of approximately US$ 35 million, primarily for IPC, case management, and risk communication and community engagement.

A laboratory in Idleb has been equipped to test for COVID-19 samples from the Idleb area since 24 March, while samples from the Afrin and A’zaz to Jarablus area of northern Aleppo are sent to laboratories in Turkey for testing. The laboratory in Idleb has a testing capacity of some 5,300 samples; of the 191 tests conducted as of 22 April, all have returned negative results. WHO and humanitarian partners have begun the process of capacitating additional laboratories in northwest Syria to test for COVID-19. The process is also ongoing to procure 90 ventilators, eight oxygen concentrators and three X-ray machines for hospitals in northwest Syria, in addition to the existing 203 ventilators. 21 ventilators have been repurposed for COVID-19 use.

To treat confirmed cases, three hospitals with ICUs supported by Health Cluster members are ready to receive patients in the coming weeks, and three additional health facilities are being established as COVID-19 isolation case management centres, in Idleb, Salqin and Daret Azza. Each of the latter three facilities will have a 70-bed capacity comprising 30 ICU beds for severe cases requiring ventilators, 30 beds for cases requiring close follow-up and treatment for underlying conditions, and 10 beds for patients pending discharge. One other hospital has been identified in northern Aleppo governorate as a referral hospital with 46 ICU beds and 200 bed capacity. As self-isolation is largely not feasible in the densely-populated northwest Syria, community-based isolation (CBI) centres are being planned to separate and limit the movement of people with low risk profiles presenting mild COVID-19 symptoms. Humanitarian partners have begun installing CBI centres with a total capacity of 1400 beds across 28 locations in Idleb and Aleppo governorates.

Humanitarian partners are updating existing plans to adjust for new service and delivery modalities to accommodate COVID-19 precautions while enabling operational continuity. Wherever possible, activities have been shifted to virtual platforms or phone-based engagement, including for coordination and for awareness raising, education, and case management services, and gatherings have been further reduced through scale-ups of door-to-door distributions and consolidating distributions. An extensive communication awareness campaign on individual precautionary measures against COVID-19 has also been implemented across northwest Syria, amplified through mosques, local communities, and social and traditional media.

UN Office for the Coordination of Humanitarian Affairs
To learn more about OCHA's activities, please visit https://www.unocha.org/.