1. SITUATION IN 2016
Intense hostilities continued across many parts of Syria in 2016. The situation remained characterized by widespread violence, indiscriminate attacks on civilian populations, serious human rights violations and mass population displacements. As a result, an already catastrophic humanitarian situation deteriorated yet further. By the end of 2016, more than 300 000 people had been killed and over 1.5 million had been injured since the crisis began. A total of 13.5 million people were in need of humanitarian assistance, 6.5 million people had been forced from their homes, and around 4.8 million had sought refuge in other countries. Almost one million people remained trapped in besieged areas, and almost four million were living in hard-to-reach areas, including one million who were militarily encircled. More than 80% of the population is living below the poverty line. Many children have known nothing but conflict.
In February 2016, the situation offered a glimmer of hope with the International Syria Support Group’s adoption of the Munich Declaration setting out the terms of a cessation of hostilities. UN Security Council resolution 2268, adopted later that month, endorsed the Munich Declaration and also demanded a cessation of hostilities. These initiatives resulted in a short-lived reprieve, but the violence soon resumed, with devastating impacts on civilian populations. In the absence of a political solution, the conflict looks set to continue in 2017.
Thanks to sustained diplomatic pressure, access to besieged and hard-to-reach areas improved significantly in 2016 compared to the previous year.
By the end of the year, WHO and its UN partners were able to reach all besieged locations with desperately needed humanitarian assistance. However, government forces continued to systematically remove life-saving medical and surgical supplies from cross-line inter-agency convoys, and medical evacuations continued to be obstructed by the parties to the conflict.
Impact of crisis on health care delivery The destruction of hospitals and health care facilities has deprived millions of people of access to even basic health care. Around half of Syria’s public hospitals and health care centres are either closed or only partially functional. Those that remain operational have suffered daily power cuts, and only 12% of them have back-up generators. In some areas, the prevailing insecurity remains a major obstacle to accessing health care. As a result of lack of access to timely trauma care, up to one third of those injured in the conflict will suffer life-changing disabilities and will require long-term care. Many pregnant women have no access to life-saving obstetric care or essential reproductive health care. Patients with untreated chronic diseases face the prospect of death or disabilities. The mass exodus of health care professionals and the collapse of the national health information system have compounded the dire health situation.
• Over 11 million treatments delivered across Syria, of which over 1.7 million were delivered through cross-border operations.
• Essential medical equipment and ambulances distributed to hospitals and health care facilities.
• Children in besieged and hard-to-reach areas vaccinated against childhood diseases.
• All 18 besieged areas reached with humanitarian health assistance.
• 34 cross-border missions conducted to besieged and hard-to-reach locations.
• 1618 sentinel sites across the country reporting to the disease early warning and response system/ network.
• Nutritional surveillance services for children under five expanded to 445 health care centres.
• Health care facilities across the country continually assessed.
• More than 41 000 health care staff trained on a wide range of topics including trauma care, first aid, primary health care, reproductive health, and the management of noncommunicable diseases.
• Over US$ 43 million mobilized in funding support.