Syria

Recent Developments in Northwest Syria - Situation Report No. 11 - As of 27 March 2020

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HIGHLIGHTS

  • The humanitarian situation remains dire across northwest Syria. Further scale up is required for preparedness for COVID-19 and to meet the needs of the current displacement crisis, which is the most severe situation in northwest Syria since the beginning of the conflict.

  • Humanitarian response remains high, with March on pace to be the month with the most UN shipments since the beginning of the cross-border operation. While the most severe emergency needs of recently displaced people continue to be shelter, water, sanitation and hygiene, food and protection, other needs such as health, education and nutrition are becoming more apparent.

  • There are no known cases of COVID-19 in northwest Syria. Preparedness and response planning is underway to ensure effective prevention and response to the virus, reduce transmission risk, and ensure the continued provision of humanitarian assistance amid COVID-19 countermeasures

SITUATION OVERVIEW

The humanitarian situation remains dire across northwest Syria. Nine years of crisis compounded by multiple displacements and economic hardship eroded the resilience of people and communities in Idleb and northern Aleppo governorates, rendering them more vulnerable in the latest wave of hostilities and displacement. Since 1 December, nearly 1 million people fled from their homes in northwest Syria to escape from hostilities. Those who are displaced are extremely vulnerable with 89% of communities in northern Aleppo and 99% in Idleb reporting vulnerable groups among the newly displaced, including female and elderly headed households, according to an assessment by an NGO partner. While displacement has reportedly stopped, the humanitarian needs of those who have been displaced as well as the pre-existing needs of the wider community remain as high or higher than at any other point in the conflict. Moreover, thousands of families are returning to areas such as Atareb and Ariha where their humanitarian needs will persist upon return as many services in these areas have been suspended or moved. The high level of needs is evidenced by the fact that March is on pace to be the month in which the highest number of shipments by the UN cross the border since the UN cross-border operation began in 2014.

The most urgent needs of the recently displaced individuals continue to be shelter, water, sanitation and hygiene, food and protection. At the same time, needs with longer term impacts are becoming more apparent such as health, nutrition and education. Three in every ten children under the age of five who are among the displaced population are stunted. Almost 400,000 school-age children have been recently displaced and need support to access education. Access to food is becoming a concern due to the diminishing availability in markets and rising prices, leading to more reliance on humanitarian assistance as reported by an NGO partner. Loss of access to 150,000 hectares of arable land by the newly displaced IDPs is likely to further limit the availability of food in the area.

The timely provision of humanitarian assistance remains essential in light of the potential impact of the COVID-19 pandemic in northwest Syria. The crowded living conditions, physical and mental stress and deprivation due to insufficient housing, food and clean water make people vulnerable to respiratory infections. Given the vulnerability of people in northwest Syria, avoiding the spread of the virus in northwest Syria is crucial. It is vital that humanitarian support to northwest Syria continues to scale up, not down, including emergency support from donors for both the COVID-19 preparedness and response and the previously existing emergency needs. A COVID-19 preparedness and response plan for northwest Syria has been developed by the Health Cluster, requiring an estimated funding of approximately USD 35 million. A task force has been established to ensure that preventative measures are taken and suspected and confirmed cases can be adequately followed up. The Early Warning and Alert Response Network (EWARN) system in northwest Syria has been revised for alert verification, investigation and sample collection, rapid response teams have been activated, and a triage system will be established at all health facilities in northwest Syria to limit transmissions in healthcare settings.

As part of the preparedness effort, laboratory technicians have been trained in COVID-19 testing to establish testing capability in Idleb governorate while laboratories in Turkey have been prepared and stocked to provide testing support.

Systematic testing for COVID-19 in northwest Syria started the evening of 24 March after a shipment of 300 tests arrived.

The first eight tests from suspected cases came back negative. Some 600 additional tests will reach the laboratory in Idleb shortly, and a shipment of 5,000 tests is scheduled to arrive in Idleb next week. In addition, a shipment containing 10,000 examination gloves, 1,200 gowns, 10,000 surgical masks, 500 respirator masks, 900 face shields and 200 protective goggles is expected to arrive in the coming days. The first COVID-19 case in Syria was confirmed on 22 March in Government of Syria areas, and four other cases were detected as of 25 March. There are no confirmed cases in northwest Syria as to date.

Facility-based and community-based isolation approaches will be used, given the dense population and overcrowded living conditions in northwest Syria. For hospital-based isolation in more severe cases, three hospitals in Idleb, Salqin and Daret Azza with intensive care units have been identified for potential use as COVID-19 isolation case management centres following modifications to their intensive care units (ICU). An additional 15 ICUs are also to be upgraded. In northern Aleppo governorate, two additional hospitals have been identified by the authorities, one is being upgraded to 40-bed capacity, with another still planned. Currently, WHO and its partners are training 540 health workers from 180 health facilities in the northwest on staff and patient safety and infection prevention and control. WHO is procuring additional personal protective equipment and 60 ventilators in addition to the 153 ventilators that are in use already. NGOs within the referral network will allocate ambulances, paramedics and nurses to contribute to the referral of COVID-19 cases.

Mitigating measures against the spread of COVID-19 have also been taken locally, including suspension of education services and of religious and social gatherings. Information about the symptoms and preventative measures are communicated to the wider public in northwest Syria as well as community-based health workers and responders. As part of the cluster response plan, a total of 1,000 community health workers have been mobilized.

Measures have also been taken to address the non-health impact of the pandemic to ensure the continued provision of humanitarian assistance to the estimated 2.8 million people who depend on it. While the full impact of COVID-19 on the cross-border humanitarian operation is difficult to predict, clusters are working with their members to identify how the measures against the virus will affect their operations, including regarding staffing, logistics, the import of supplies, etc. As the current health emergency is pushing humanitarian actors to identify new modalities to respond to the need on the ground, continued engagement from the international community and donors is of paramount importance to ensure that assistance reaches all those who are in need. Both the Bab Al-Hawa and Bab Al-Salama border crossings are now closed for individual crossings other than critical health cases, with permission required for humanitarian staff to cross. This has an impact on programmes that require NGO workers to cross into Syria regularly, monitoring and evaluation, and trainings.

Humanitarian and commercial transhipments have thus far not been impacted by COVID-19 countermeasures.
In addition to the health cluster plan on the health response to COVID-19 and the separate planning on the non-health impacts, efforts are being consolidated with Syria-wide, regional, and global planning, including a global appeal to be launched shortly in relation to COVID-19.

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