June 24, 2019

Highlights

Attacks in northwestern Syria displace at least 310,000 people in May, damage and destroy health care centers

Relief organizations respond to shelter, health care needs at Al Hol camp

Food security conditions worsen in hard-to-reach areas of Syria

Rukban departures continue through May

Key Developments

Ongoing Syrian Arab Republic Government (SARG) and Government of the Russian Federation (GoRF) airstrikes and shelling in northwestern Syria continue to kill, injure, and displace civilians; destroy health facilities; and result in the suspension of relief operations in many armed opposition group (AOG)-controlled areas of Idlib and northern Hamah governorates, the UN reports. Between April 28 and May 29, SARG and GoRF-led hostilities killed at least 300 people and damaged more than 20 hospitals and primary health care centers in northwestern Syria, according to the UN. Since May 1, airstrikes and shelling have displaced at least 310,000 people.

An estimated 73,000 people were residing at Al Hasakah Governorate’s Al Hol camp as of June 19, the UN reports. Relief organizations continue to respond to emergency food, health, nutrition, shelter, and water, sanitation, and hygiene (WASH) needs among the camp population—nearly 65,000 of whom arrived at the site between early December and late May.

Since late March, approximately 14,300 people have departed the informal Rukban settlement—located along the Syria–Jordan border berm—and arrived at five collective shelters in Homs Governorate, the UN reports. With support from the UN, the Syrian Arab Red Crescent and local health agencies are responding to the emergency needs of populations departing Rukban.

INSECURITY, DISPLACEMENT

Northwestern Syria

Ongoing violence in northwestern Syria continues to endanger and displace civilians, with SARG and GoRF artillery shelling continuing across northern Hamah and Idlib in early June. Between April 28 and May 29, conflict killed at least 300 civilians and injured more than 700 people, according to the UN. From May 16–22, SARG and GoRF hostilities displaced approximately 30,000 people, contributing to a total of more than 310,000 people displaced from northern Hamah and southern Idlib since May 1, the UN reports. As of May 22, nearly 104,000 internally displaced persons (IDPs) arrived at displacement sites and reception centers, while more than 203,000 people remained displaced outside of formal camp sites, relief organizations report. More than half of the new displacements fled to Idlib’s Dana sub-district, further exacerbating humanitarian needs in the area, which is densely populated and is receiving the highest number of displacements in northwestern Syria.

Northeastern Syria

Relief organizations continued to expand humanitarian operations in Al Hol camp during May in response to growing health and shelter needs, including the establishment of additional field hospitals and three new phases of the camp. As of June 19, Al Hol hosted approximately 73,000 people; women and children comprise approximately 90 percent of the camp’s population, the UN reports.

Southern Syria

Between March 24 and June 17, nearly 14,300 people departed the informal Rukban settlement for five collective shelters in Homs, the UN reports. The majority of individuals spend approximately 24 hours at the shelters before relocating to other areas in the governorate; however, an estimated 500 people remained at the shelters as of mid-June. The number of weekly departures from Rukban has reportedly decreased in recent weeks due to a lack of vehicles and the high cost of transportation from the settlement to the edge of the 55 kilometer de-confliction zone, according to the UN. However, relief organizations expect departures to continue due to persistent adverse humanitarian conditions at the camp, relief actors report. In May, a USAID/OFDA partner rehabilitated two collective shelters in Homs to support protection, shelter, and WASH needs of IDPs departing Rukban.

HEALTH AND WASH

Airstrikes in AOG-controlled areas of Hamah and Idlib continued to damage critical health facilities and disrupt health operations in northwestern Syria throughout May. As of May 29, an estimated 30 health facilities and 18 vaccination centers had suspended operations in the two governorates, the UN reports. Five surgical units and 13 ambulances continued operations in northern Hamah and Idlib to provide emergency services in the area. USAID/OFDA partner the UN World Health Organization (WHO) reported no gaps in health care services at Idlib’s Atmeh camp, which hosts more than 100,000 IDPs; however, the organization identified health care needs in communities near the camp. Response organizations plan to operate three mobile clinics in the area during June to support up to 18 communities per week.

Health organizations continue to respond to ongoing health care needs among residents at Al Hol camp. From May 12–24, WHO-supported health centers provided nearly 3,000 health consultations, 1,090 first aid and emergency health care interventions, and more than 1,300 psychosocial support sessions to camp residents, the UN agency reports. As of late May, health actors had also reached approximately 5,000 children with measles vaccinations and more than 15,000 children with polio vaccinations. Relief organizations report the need for additional static health facilities at Al Hol, as well as limited capacity at a hospital in nearby Qamishli city to receive patients referred by health care actors at the camp, WHO reports.

As of May 29, approximately 35 relief organizations continued to provide humanitarian assistance—including malnutrition screening for nearly 21,000 children, monthly hygiene kits, and WASH services—throughout Al Hol. Additionally, relief organizations planned to commence operations of three field hospitals—containing up to 100 beds—during June. The expansion of health services will improve camp residents’ access to life-saving health care and reduce the number of referral cases to neighboring hospitals, with only the most critical cases transferred.

PROTECTION

Relief organizations continue to identify protection needs at Al Hol, including services for unaccompanied children, referral services, adequate lighting, and improved WASH facilities, including latrines and showers, the UN reports. As of May 29, the camp hosted approximately 480 unaccompanied and separated children, including nearly 90 children who remain in interim care units waiting for family reunification, according to the UN. Additionally, populations lacking civil documentation face challenges returning to areas of origin, and movement restrictions limit the ability of IDPs to reach civil registrars in Al Hasakah city to obtain proper documentation.

15 relief organizations had suspended protection services—including child-friendly spaces, community centers, and safe spaces for women and girls—in Aleppo, Hamah, and Idlib governorates as of May 31, the UN reports. The Protection Cluster—the coordinating body for humanitarian protection activities, comprising UN agencies, non-governmental organizations (NGOs), and other stakeholders—expects further service disruptions if hostilities continue in northwestern Syria; protection actors also report challenges providing psychological first aid and psychosocial support referrals when interventions are not accompanied by other basic services to meet IDPs’ needs. Despite ongoing hostilities, Protection Cluster members reached nearly 5,430 individuals with protection services in 45 communities within 15 sub-districts in Aleppo and Idlib from May 21–May 27. Additionally, cluster members referred individuals for other services including health and specialized protection services.

SHELTER AND RELIEF COMMODITIES

As of May 29, State/PRM partner the Office of the UN High Commissioner for Refugees (UNHCR) and State/PRM-funded camp management continued expansion efforts in Al Hol camp; upon completion, the expanded camp phases will potentially accommodate up to 13,000 people, the UN reports. As of June 19, Al Hol hosted approximately 73,000 people, more than 90 percent of whom are women and children, according to the UN.

During the second half of May, a fire at Al Hol killed one person and destroyed three tents as a result of congested tent spacing, the UN reports. As of May 29, camp management continued to address the establishment of a fire extinguishing system to prevent further fires.

Idlib’s Dana sub-district continues to host the largest number of newly displaced IDPs fleeing SARG and GoRF-led hostilities in northwestern Syria. Shelter Cluster members report relief commodities as an urgent need among IDPs, as well as authorization from land owners to utilize land to host newly displaced people, according to the UN. Relief organizations have distributed available relief commodity stocks and requested relief supplies and tents from contingency stocks. Large populations continue to shelter in open areas as IDP camps reach capacity, negatively affecting humanitarian conditions and access to emergency services in northwestern Syria, the UN reports.

FOOD SECURITY AND NUTRITION

Relief organizations continue to respond to food and nutrition needs among IDPs and other affected populations in northwestern Syria. With support from five Nutrition Cluster members, including USAID/OFDA partner WHO, approximately 30 rapid response teams distributed High Energy Biscuits and nutritional supplements to nearly 3,500 children ages five years and younger and pregnant and lactating women in Aleppo’s Atareb sub-district and Idlib’s Dana, Kafr Takharim, and Maaret Tamsrin sub-districts, the UN reports. Additionally, rapid response teams provided more than 400 pregnant and lactating women with information about optimal infant feeding practices and continued to screen populations for malnutrition.

In May, USAID/FFP partner the UN World Food Program (WFP) provided ready-to-eat (RTE) rations—easy-to-carry rations designed to feed a five-person household for one week without needing to be cooked—to meet the immediate needs of 200,000 people displaced by fighting in northern Hamah and southern Idlib. WFP has pre-positioned sufficient RTE rations in Aleppo and Idlib, as well as contingency stocks in Turkey, to feed additional displaced people should hostilities in northwestern Syria further escalate. The UN agency is also planning to increase general food distribution caseloads in Idlib from nearly 700,000 people in May to more than 823,000 people during June to meet the medium-term food needs of displaced persons.

More than 40 percent of surveyed residents in northern Hamah and southern Idlib report lack of access to markets due to SARG and GoRF-led hostilities, the REACH Initiative reports; nearly one-quarter of communities also report the displacement of food vendors due to airstrikes. Surveyed residents report that limited availability of transportation and nearby vendors has negatively affected access to food in local markets. Nearly 80 percent of people surveyed by the REACH Initiative reported using negative coping mechanisms, such as eating fewer meals, in response to the limited accessibility of food; access to meat and fresh vegetables were the most widely reported food needs among surveyed populations.

Between March and April, food security conditions deteriorated in Al Hasakah and hard-to-reach areas of Hamah and Homs, according to a recent WFP assessment. Conditions worsened particularly in Al Hasakah, with nearly 40 percent of surveyed households reporting either poor or borderline food consumption levels—based on a three-tier classification system determined by the frequency, diversity, and nutritional value of consumed foods—compared to nearly 30 percent of surveyed populations reporting similar food consumption levels in March. In remote areas of Hamah and Homs, nearly 40 percent of households reported poor or borderline food consumption scores, a 3 percent increase compared to March. In addition, surveyed households reported frequent reliance on negative coping mechanisms—including limiting meals, portion sizes, and adult food consumption—to meet food needs, WFP reports.

Relief organizations continue to identify nutrition needs at Al Hol camp, WHO reports. From May 12–24, humanitarian actors referred 17 children experiencing severe acute malnutrition to a stabilization center in nearby Qamishli city for treatment, according to the UN agency. During the same period, malnutrition at the camp resulted in three deaths, WHO reports. USAID/FFP partner WFP continues to reach all Al Hol residents with emergency food assistance.

With USAID/FFP support, WFP delivered emergency food assistance to approximately 3.2 million people throughout Syria’s 14 governorates—including approximately 261,000 people in 24 hard-to-reach areas in Dayr az Zawr, Homs, Ar Raqqah, and Rif Damascus—in April. Countrywide assistance included more than 43,000 metric tons of in-kind food and approximately $3 million in cash-based transfers.

PUBLIC DONATION INFORMATION

The most effective way people can assist relief efforts is by making cash contributions to humanitarian organizations that are conducting relief operations. A list of humanitarian organizations that are accepting cash donations for disaster responses around the world can be found at www.usaid.gov/crisis/syria.

The USG encourages cash donations because they allow aid professionals to procure the exact items needed (often in the affected region); reduce the burden on scarce resources (such as transportation routes, staff time, and warehouse space); can be transferred very quickly and without transportation costs; support the economy of the disaster-stricken region; and ensure culturally, dietary, and environmentally appropriate assistance.