Syrian Arab Republic: Flash Update – Madamiyet Elsham | 31 January 2016


  • An estimated 45,000 people are besieged in Madamiyet Elsham.
  • Residents have faced a sharp deterioration of the humanitarian situation over the last months due to increased access restrictions, particularly with regards to food and medical care.
  • Cases of malnutrition have been reported but no related deaths. However, eight deaths due to a lack of proper medical care have been reported in January.
  • The UN and ICRC have requested access to Madamiyet Elsham twice in January and are awaiting approval to deliver critical life-saving supplies inside the town.

Situation Overview

Madamiyet Elsham in rural Damascus is currently hosting approximately 45,000 people, of which an estimated 12,000 are IDPs mainly from neighboring Darayya. Since mid-2012, the area has been under the control of Non- State Armed Groups (NSAGs), and as of 2013, the city is surrounded by Government of Syria (GoS) forces. Following a local agreement that improved access conditions in mid-2014, the UN changed the status of the town from ‘besieged’ to ‘hard-to-reach’ in July 2014. Due to increased closures imposed on the town in December 2015, the UN re-classified Madamiyet Elsham as ‘besieged’ as of 27 January 2016. Madamiyet Elsham continues to be subject to sporadic shelling.
While government employees and women had previously been allowed to exit and enter the town, GoS forces reportedly closed down the only entry point into Madamiyet Elsham on 26 December, restricting free movement of all civilians. GoS employees were reportedly allowed to leave the town prior to the closure but were told that if they did so, they would have to stay outside the city until further notice. Between 50 and 100 GoS employees reportedly left Madamiyet Elsham and are now separated from their families who were not allowed to leave with them at the time. The remaining civilians were not forewarned of the closure. After closures in February 2015 and in August 2015, the closure in December is the third to occur within a period of ten months during 2015.
On 21 January 2016, fighting led to the displacement of an estimated 500 families from the southern part of the town towards the center of town.

Humanitarian Situation

Living conditions in Madamiyet Elsham were already dire previously but have deteriorated further since the recent closure reportedly led to severe shortages of food, medicines and other basic commodities. Due to the lack of regular supply of food or other commodities, prices have soared in recent months.
Until late December 2015, SARC has been delivering 3,000 bags of bread almost on a daily basis since August 2014 to the inside of Madamiyet Elsham. However, these quantities were insufficient to cover the needs of the community. Since August 2014, the Local Relief Committee (LRC) coordinated the entry of vegetables as well as six tons of foodstuffs and other basic goods (sugar, rice, bulgur, oil, biscuits, coffee and tissue paper) on a weekly basis. These regular deliveries improved the situation inside the town but failed to fully meet the needs of residents. When deliveries stopped in late December, many families resorted to negative coping mechanisms.
There is one remaining field hospital in the town which -although functional- is facing severe shortages or unavailability of medicines and medical supplies. Malnutrition has also been reported in the community, although reports on scale and severity vary. No death related to malnutrition has been reported to date. However, there have been reports of eight deaths (adults and children) since 1 January 2016 due to a lack of proper medical care. Local sources report that hundreds of children suffering from respiratory problems are unable to receive appropriate care, and that dialysis patients are increasingly at risk of renal failure due to a break in the supply of dialysis treatment. Reportedly, there are approximately 200 cases of disability in the town, of which several are amputees. There are eight doctors working at the hospital, of which three are dentists, plus an additional 20 other medical personnel. The hospital also faces challenges due to the lack of water and electricity as generators are only used for critical cases, such as during surgery.
Madamiyet Elsham has not had any electricity supply since November 2012. Small generators are available but citizens lack fuel to run them. When fuel was available, the price per liter amounted to SYP 8,000, a price beyond the means of most inhabitants. Shortage of electricity has also affected the availability and quality of water. On a positive note, limited quantities of water have been made available through the distribution network as of mid- January for the first time in six months, however, most residents continue having to fetch water manually from untreated wells due to the lack of electricity or fuel for generators.
Firewood is used for heating but is costly, with one ton costing SYP 100,000. The inability to bring wood from outside has led to the felling of most trees in the area. The shortage in water and difficulties with heating have led to poor hygiene and sanitation conditions, putting the community at risk of water-borne diseases. The lack of fuel has also resulted in the population resorting to burning plastic for heating, which is reportedly causing respiratory diseases and is polluting the environment.
There are seven schools functioning in Madamiyet Elsham out of an original 22 schools in 2012, with 6,000 students attending. The remaining functioning schools are damaged, often without doors or windows, and lack tables, heating, and education supplies. This is the second year that children are attending school after two years of interrupted education with unconfirmed reports that thousands of children are out of school.
Shelter conditions are also reportedly a concern, particularly due to the large displacement waves from both previous and more recent displacements. Some buildings where IDPs reside lack doors and windows, and there is a shortage in plastic sheeting, which is needed in particular during the cold winter months.
More than 50 per cent of those living in the besieged town are women and children. When supplies are available, men are reportedly often too afraid to pick them up. Therefore, women and children regularly have to walk long distances to reach checkpoints and are often subjected to harassment when collecting supplies. Arbitrary arrests at checkpoints have also been reported.
Madamiyet Elsham continues to face sporadic shelling, particularly in the last six months, leading to deaths and injuries. Access is also reportedly constrained by landmines and snipers.

Humanitarian Response

On 19 December, UNICEF delivered education kits, WASH, and nutrition supplies (including school bags, school stationery, HEB, water purification tablets, soap, shampoo, and winterization items) into Madamiyet Elsham.
SARC reported that the last time they distributed bread to the town was on 24 December 2015, when 3,000 bread bags were distributed. From August 2014 till December 2015, SARC, supported by ICRC and the Syria Humanitarian Pooled Fund (HPF), had delivered bread on a daily basis to Madamiyet Elsham. ICRC also last accessed the area on 11 November, mainly with medical supplies to the SARC clinic whilst the FAO delivered egg-laying hens in June 2015, and have plans to deliver additional items in 2016.
The UN submitted three formal requests throughout 2015 and two requests in January 2016 to conduct inter- agency humanitarian convoys to Madamiyet Elsham. One request was approved in principle in June 2015 but could not proceed as the necessary downstream permits were not obtained. One of the request made in January (made jointly with ICRC) was approved soon after it was made, although with the condition that delivery takes place outside the town. Discussions are ongoing, and UN agencies and partners are ready to proceed as soon as approval to deliver inside the town is granted.
WFP also requested a convoy to deliver food parcels to the town in December. However, the request has yet to be granted.

UN Office for the Coordination of Humanitarian Affairs:

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