تم إثبات أول حالة إصابة بمرض كوفيد-19 في شمال غرب سوريا في 9 تموز 2020، وهذا يعتبر يوماً حاسماً وبداية تحدٍّ حقيقي أمام عمليات الإغاثة في سوريا. تعاني منطقة شمال غرب سوريا من نظام صحي منهك، وبنية تحتية مدمرة، وتمثل أحد أكثر المناطق اكتظاظاً بالسكان حول العالم، مع وجود 1.2 مليون شخص يعيشون في مخيمات النزوح
كعضو فاعل في فريق العمل الصحي المختص بمواجهة كوفيد19 في شمال غرب سوريا، انضمت منظمة خبراء الإغاثة إلى عدد من المنظمات الأخرى للتحضير لهذا اليوم منذ شهر آذار 2020. قامت خبراء الإغاثة بتطوير أدلة عمل إرشادية، وتدريب أكثر من 890 عاملاً وقائد مجتمع، وتوظيف عدد إضافي من عمال الصحة المجتمعية، وتركيب خيم لفرز الحالات في المراكز الصحية لتخفيف المخاطر التي يواجهها المرضى والكادر الطبي
اعتباراً من شهر تموز 2020، تقوم خبراء الإغاثة بإطلاق 750 عامل صحة مجتمعية حول مناطق شمال غرب سوريا المختلفة، ليعملوا مع عمال الإغاثة وأفراد وقادة المجتمع لتوحيد الجهود في سبيل إنقاذ حياة 4.2 مليون إنسان
The first COVID-19 case was confirmed in northwest Syria (NWS) on 9 July 2020. This marks a critical day and a real challenge to aid operations in Syria. NWS already has an exhausted health system, destroyed infrastructure, and one of the most condensed locations in the world with over 1.2 million living in displacement camps. Relief Experts Association (UDER) as an active member of the NWS COVID-19 health taskforce, has joined other organizations in preparing for this day since March 2020. UDER developed prevention guides, trained over 890 workers and community leaders, recruited additional CHWs, and installed triage tents in health centers to reduce risks to patients and staff. As of July 2020, UDER is dispatching 750 CHWs across northwest Syria to work with aid workers, community members and leaders to ensure that we are all working together to save the lives of 4.2 million people in NWS.
An IDP patient referred from Termanin PHC to a referral hospital due a chest injury during the displacement
In December, Relief Experts Association (UDER) scaled up its health services in Sarmada, Termanin, and Atareb communities in Idleb and Aleppo governorates. UDER’s Sarmada and Termanin PHCs are located in Dana, which is the subdistrict that received the highest number of IDPs from southern Idleb and Maaret Annuman, according to CCCM Cluster in Gaziantep, while Atareb PHC is located in Atareb subdistrict, which is the second highest IDP arrival subdistrict.
Among the communities where Relief Experts is operating, Termanin witnessed the most significant burden, as 3 new IDP shelters were established to host the IDPs coming from southern Idleb. A referral pathway was established between Rehana IDP shelter and Termanin PHC with support from SRD’s referral network to transfer patients from Rehana and other IDP shelters to Termanin PHC. The referral cars transfer around 15-20 IDP patients at a time to Termanin PHC to receive health services in pediatric, internal medicine and gynecology clinics. The number of new IDP visits to Termanin PHC reached more than 50 per day starting mid-December, which increased the IDP visits to the facility by 30%. In Atareb and Sarmada, the health facilities have already reached their full capacity due to the large number of IDPs who arrived to these two communities during previous displacements, however, the percentage of IDP patients visiting the facilities slightly increased in December.
Although UDER’s facilities do not provide 24-hour services, the
staff volunteered to respond to urgent cases after working hours, which may
require an expansion in staff if the population numbers remain high for the
next 2 months. The three health facilities are also providing referrals to
higher level facilities in coordination with different referral networks and ambulance
systems in the area.
Relief Experts as a main speaker from NW Syria hub
Relief Experts participated as a speaker at the Humanitarian Senior Officials Meeting on Syria, which was hosted by the Government of Denmark in Copenhagen between 19 and 20 November 2019. The focus of the meeting was to address challenges in the Syrian humanitarian context, fostering a solution-oriented dialogue and discussing possible step forwards. The meeting represented a follow up of previous discussions held since 2018 in Oslo, Berlin and Geneva, and it was attended by donors, members of the Humanitarian Task Force and of the International Syria Support Group, all the members of the Strategic Steering Group and representatives of all humanitarian hubs.
During the two-day meeting, Relief Expert’s CEO, Dr. Hani Taleb, was part of the panel on NW Syria, represented the perspective of humanitarian health-focused NGOs, presented the main challenges in northwest Syria, and outlined solutions to preserve and improve the impact of health aid provided to the displaced population in Syria and the refugees in Turkey.
Relief Experts’ CEO as part of the panel on NW Syria
“We are rallying efforts in order to reach the widest range of Syrian and Arab refugees in Turkey”, Dr. Hani Taleb, UDER’s CEO.
Reaching the maximum number of refugees in Turkey with health education and advice on utilizing healthcare services is a challenge. Turkey hosts the largest number of Syrian refugees in the world, and they reside across the country in large cities and urban areas. The government of Turkey is providing a full range of health services to Syrian and Arab refugees, but these services are affected by barriers such as language, culture and social norms.
To maximize the impact of this project, UDER established a number of partnerships with local NGOs in Turkey to provide channels of communication with the wide refugee community, starting in Gaziantep and Istanbul. This effort is still far from reaching the maximum number of NGOs and civil society actors, but the network is growing every day.
Emerging from the needs of the refugee community in Turkey, UDER started this project in order to deliver health education at the community level, and to raise the awareness of the Syrian and Arab refugees about the best way of utilizing health services in Turkey.
When an elder refugee spends hours at a hospital because he or she doesn’t know how to book an appointment, when a mother leaves her children at home to visit a migrant health center without knowing what services this center provides, and when a worker takes few hours from his job to take his child to a health center only to find out that what he needs is not offered at this level; all of these are forms of knowledge barriers facing refugees everyday. Such barriers and challenges can easily be addressed with community health programs.
Building on its experience in community health programming in Syria, UDER started this project in Gaziantep and Istanbul in 2019. The project requires a close coordination with different levels of services providers, civil society actors, and above all the large refugee community in Turkey, and UDER decided to take this challenge with the aim of reaching the best utilization of refugee-focused health services in Turkey.
After school supplementary educational session, 1st group
UDER started its supplementary education program in Gaziantep with a select group of 5th grade students. The program aims at providing the critical support needed for these children to ensure that they can keep up with the demands of the Turkish education system despite that the have been exposed to this system for the first time in their educational life.
The groups are limited in size to ensure an deficient teacher/student interaction
Student interviews for 5th grade supplementary education program
It was a joyful day. UDER’s team with Homs Abroad staff met with 5th grade students who were selected to receive supplementary education for better integration in the Turkish educational system. The children showed a huge passion for learning and an outstanding aspiration to becoming leaders of their communities. They showed a remarkable understanding of the challenge that lies ahead, yet an enormous amount of confidence.
Student interviews for 5th grade supplementary education program
The Health Cluster in Gaziantep produces a monthly bulletin which provides an overall update on the main activities reported by health actors in northwestern Syria. The report talks about the recent developments in northwestern Syria, challenges and risks facing healthcare, progress towards the planned health targets and a brief from different NGOs on their conducted activities. Relief experts was part of this report which talks about its recent improvements in PHC and community health and some of the health trends picked up by UDER’s field teams.
In partnership with Homs League Abroad, Relief Experts Association launches a new program for supporting the integration of Syrian students in Turkish public schools. The program will provide supplemental lessons for Syrian students who are already enrolled in public Turkish schools, but are facing difficulties in keeping up with their Turkish peers. The program will rely on Turkish and Syrian teachers to provide daily supplementary sessions covering the full curriculum applied at Turkish schools. The program will also provide transportation for the students to ensure the participation of student living in underserved neighborhoods.
UDER’s community workers visiting an IDP site in Idleb
The humanitarian situation for people in northwest Syria continues to deteriorate as the latest escalation in hostilities is now in its fourth month. Hundreds of civilians have been killed or injured due to airstrikes and shelling since 1 May while almost 630,000 displacements took place as people have fled their homes to escape from violence and to reach essential services that they need to survive. The overwhelming majority of the displaced people are moving to densely-populated areas close to the Turkish border in northern Idleb governorate, where humanitarian assistance is overstretched.
Relief Experts Association has scaled-up its support to the newly displaced IDPs who arrived to Dana and Atareb through its primary healthcare centers and outreach community health teams. While the humanitarian response is ongoing to address the pressing needs of the newly displaced individuals as well as host communities, additional funding is urgently required to maintain and scale-up the current levels of emergency response in the coming weeks and months.
Local sources reported an accelerated movement of civilians northward away from the hostilities as the frontlines shifted. While the exact number of displaced individuals is difficult to ascertain at this stage, local sources are reporting that entire communities fled from the violence and in anticipation of hostilities affecting their villages and towns. Between 1 and 27 August, more than 130,000 displacements have been recorded from northern Hama and southern Idleb governorates. Many of these individuals and families have been displaced before, some of them multiple times, which makes them extremely vulnerable to additional shocks. The most recent wave of displacement adds increasing vulnerability for people in already dire humanitarian situation in northwest Syria. From 1 May to 27 August, some 630,000 individual displacements, which include secondary displacements2, have been recorded from northern Hama and southern Idleb governorates. Displacement within GoS-controlled areas is estimated currently at some 10,585 individuals, primarily in frontline villages in northern rural Hama and northern rural Latakia governorates.
Since late April, hundreds of civilians, many of whom are women and children, have lost their lives while countless others have suffered severe injuries, often leaving them with permanent disabilities. From 19 April to 29 August, the Office of the UN High Commissioner for Human Rights (OHCHR) documented that 1,089 civilians, including 572 men, 213 women and 304 children, were killed due to airstrikes and shelling carried out by parties to the conflict. The suffering of women, men, boys and girls is exacerbated by the widespread destruction of civilian infrastructure crucial for survival. Since late April, 51 health care facilities have reported receiving damage by violence in northwest Syria, as reported by WHO. Over the course of only two days, 28 to 30 August, seven medical facilities were reportedly damaged by airstrikes according to WHO. Six of these facilities – four hospitals and two primary health care centres – were functional at the time of the incidents. At least two of the health facilities damaged by airstrikes in August were paediatrics and maternity hospitals, yet another example of the heavy toll that the violence is taking on women and children. Similarly, the devastating effect of the hostilities on educational facilities will become more acute as the new school year is due to start in late September. While UNICEF reported 87 incidents that affected schools due the hostilities, education cluster members reported that 59 individual schools have been damaged by the violence since late April. Moreover, at least 94 schools are reportedly being used as shelter by IDPs across northwest Syria. According to one report, out of an estimated 650,000 school-aged children in northwest Syria, less than half can be accommodated at the remaining functional schools.
The humanitarian situation in northwest Syria continues to deteriorate as the most recent upscale in violence is set to enter its fourth month. Hostilities between Government of Syria (GoS) forces and their allies and non-state armed groups (NSAGs) across Idleb, northern Hama and western Aleppo governorates has dire humanitarian consequences for an estimated three million people, of whom 76% are estimated to be women and children. After a brief lull in airstrikes from 2 to 4 August, as a result of a conditional ceasefire, airstrikes resumed on 5 August. There was renewed violence on 7 August when fighting between ground forces resumed. This resulted in GoS forces gaining control of several towns and villages including Skik, Hbit, Abdin, Arbain, Zakat, Um Zaytuna and, eventually, Khan Shaykun on the M5 highway – the major road running north-south in northwest Syria. These areas as well as Kafr Zeita, Latmana and Latmin in northern Hama are not accessible to humanitarian organizations, meaning that any civilians who remain in these areas cannot receive assistance and services that they may depend prior to the latest fighting. Military activity in northern Hama and southern Idleb that led to shifting frontlines has a drastic impact on the people living in these areas. Since the collapse of the conditional ceasefire on 5 August, local sources are reporting that civilians are fleeing en masse towards the north. While the exact number of displaced individuals is difficult to ascertain at this stage, local sources are reporting that entire communities are fleeing from the hostilities. Between 1 and 18 August, more than 72,000 displacements have been recorded from northern Hama and southern Idleb. Local sources are reporting that population movements are continuing. Many of these individuals and families have been displaced before, some of them multiple times, which makes them extremely vulnerable to this additional shock. The most recent wave of displacement adds to an already dire humanitarian situation in northwest Syria. From 1 May to 18 August, some 576,000 individual displacements, which includes secondary displacements have been recorded. Overall, it is estimated that well over 400,000 people have fled from their communities in northern Hama and southern Idleb to look for safety. Reports from the ground suggest that the patterns of displacement largely remain the same, with most people moving north close to the border with Turkey to areas that are already densely-populated in northern Idleb and a small number of individuals moving to northern Aleppo governorate. Many displaced individuals move to overcrowded displacement sites or makeshift shelters, placing additional strain on overstretched humanitarian assistance available in these areas. While displaced individuals, as well as receiving communities, have immediate humanitarian needs across all sectors, finding shelter remains one of the most pressing needs. Large scale and frequent population movements pose a particular challenge to humanitarian partners. Humanitarian partners in northern Idleb are increasingly reporting on the shortage of shelter options, increases in rents and a number of displaced people staying out in the open. Since late April, hundreds of civilians, many of whom are women and children, have lost their lives while countless others have suffered severe injuries, often leaving them with permanent disabilities. Since late April, the Office of the UN High Commissioner for Human Rights (OHCHR) has documented the deaths of more than 500 civilians while information provided by local sources indicates that as of August 23, more than 870 civilians may have been killed, including some 180 children and 145 women. Since the resumption of airstrikes on 5 August, these continue to take a heavy toll on civilian lives. On 14 August, a series of airstrikes in the Ma’arrat Humeh area in southern Idleb resulted in the death of two humanitarian workers, a paramedic and an ambulance driver. Their ambulance was completely destroyed, and a rescue worker coming to their aid was also killed. On 16 August, airstrikes reportedly hit residential buildings that were constructed to house IDPs and supported by a humanitarian organization in the city of Has, killing 20 people, including seven children and eight women, and injuring more than 50 civilians. The widespread destruction of civilian infrastructure, such as people’s homes, IDP settlements, bakeries, markets, hospitals, schools and water stations, adds to the suffering of civilians in northwest Syria. Since late April, at least 43 incidents impacting health facilities or personnel in northwest Syria have been confirmed by the World Health Organization, killing and injuring patients, and damaging or destroying vital health facilities. In addition, a total of 87 incidents damaging or destroying educational facilities have been verified by the United Nations Children’s Fund during this same period. Moreover, several water stations were reportedly damaged or destroyed by airstrikes or shelling, disrupting access to clean water and education for hundreds of thousands of people.
Read more about the latest updates on the humanitarian response here.
