North-west Syria

Situation Report

Highlights

  • Artillery shelling occurred daily and there was an increase in airstrikes at the end of April. OHCHR said at least four children were killed in shelling.
  • Improvised Explosive Devices (IEDs) and Unexploded Ordnances (UXOs) killed at least three civilians and injured at least five more, including a woman, in April.
  • The Humanitarian Needs Assessment Programme (HNAP) recorded 6,375 new displacements of people in April, primarily due to the deterioration of the economic situation.
  • COVID-19 cases decreased significantly in April: 284 new cases and 14 associated deaths were recorded, compared to more than 5,000 cases in March.
  • Strong winds and floods resulted in the destruction of at least 200 tents and damage to more than 700 tents.
Family during Ramadan in NWS
A mother prepares breakfast for her family after their Ramadan fasting in Al-Andalus camp for the displaced in east of Idleb. 10 April 2022. (Photo Credit: OCHA/Ali Haj Suleiman)

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North-west Syria

Situation Report

Key Figures

4.4M
Population in north-west Syria
4.1M
People in need in north-west Syria
3.1M
Food insecure people
2.8M
Internally displaced people (IDPs)
1.7M
IDPs living in camps

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Contacts

Sanjana Quazi

Head of Office

Madevi Sun-Suon

Public Information Officer

Ezgi Tutkal

Reporting Officer

North-west Syria

Situation Report
Background

Disclaimer

This Situation Report covers developments in north-west Syria and Ras Al Ain – Tell Abiad. OCHA Turkey prepares this report with the support of Cluster Coordinators and the Humanitarian Field Officers (HFO). The data/information collected come from both sources.

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North-west Syria

Situation Report
Trends
Families in camp in NWS
About 400 people live in Al-Faqia camp in north-west Idleb including children. 22 April 2022. (Photo Credit: OCHA/Mohanad Zayat)

Improving shelter for displaced people

Displaced communities continue to live in dismal conditions after more than a decade of conflict.

Out of the 2.8 million people displaced across Idleb and northern Aleppo, 1.7 million people live in 1,414 camps. Over 1,200 of these camps are unplanned. They often lack camp management systems. Most sites need improvement to basic services such as education, health, clean water, sanitation, and decent work. Chronic overcrowding is an issue as 85 per cent of displaced people live in sites with a critical level of population density.

It is estimated that 800,000 people are living in tents, most of which lack adequate durability, fire-retardancy and structural intergrity to withstand harsh weather conditions. Earlier this year, more than 10,000 tents were destroyed as a result of weather-related incidents, including snowstorms, strong winds and floods, and more than 200 fires were reported in displace sites resulting in deaths and injuries. Living conditions in tents raise significant protection risks especially for women and girls. The OCHA Community Voices Bulletin outlines women’s protection concerns with mental health implications due to limited privacy. While higher quality tents have been procured, they are still not suitable for long term use and need to be replaced after only a year.

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Media

Launch of Action Plan for Dignified Shelters and Living Conditions

In 2022, the UN and its humanitarian partners, through the Syria Cross-Border Shelter/Non-Food Items (SNFI) Cluster, drew up a new integrated Action Plan for Dignified Shelter and Living Conditions in North-west Syria as a response to an increasingly protracted displacement situation.

Until the end of 2023, the humanitarian community aims to move people from tents into dignified shelters. The Action Plan ensures people have access to drainage, sewage, water, roads, lighting, and electricity as well as education, health, and early recovery and livelihood opportunities. Dignified shelters are designed to last for at least 5 to 10 years and are expected to reduce the dependency of tented communities on annual winter support, which takes up about half of the SNFI partners’ annual budget. The Action Plan will require US$400 million to be completed.

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North-west Syria

Situation Report
Feature
Flooded tents in NWS
Heavy rain flooded tents of displaced families in Atmah camp in Idleb. 6 May 2022. (Photo Credit: OCHA/Anwar Abdulattif)

The need for change: dignified shelters in north-west Syria

In a short interview, Thomas Bamforth, Shelter/NFI Cluster Coordinator, explains why dignified shelters are not only necessary but cost-effective investments to meet the needs of displaced families.

Today, over 800,000 people are living in tents in north-west Syria. Could you briefly tell us the main challenges faced by families living in such conditions? 

Thomas: Tents are an emergency short-term intervention and they are designed to last about six months. Yet displaced families in north-west Syria have been living in them for more than two years. We need to remember that 58 per cent of people in displacement sites are children. They have been living in old and overcrowded tents with exposure to high risks of fire. In winter, it can get very cold with snow and temperatures as low as -10°C degrees. Numerous camps have also reported high levels of gender-based violence due to the fact that many tents do not lock properly and are easily see-through at night. This is not the kind of security needed to ensure the safety of women and children.

The term dignified shelter is widely used within the humanitarian community. To a non-technical audience, what makes a shelter “dignified”? 

Thomas: When people have been living in unplanned displacement sites for over a decade, we need a different type of shelter intervention that provides people with greater safety and protection. We are looking at dignified shelters that last five to ten years. They have doors that can be locked and windows that are secured, creating safer spaces for children, women and the wider families. They are also better suited to the environment with heating and insulation to accommodate the extremes of temperature conditions in north-west Syria.

The Action Plan highlights this need for change towards dignified shelters as “value for money”. Could you elaborate on this?

Thomas:There is a range of reasons to support investing in dignified shelters, from social to physical protection of people. But this is also a really effective use of humanitarian funding. Within the next year, we will have to replace 160,000 tents in north-west Syria which is an enormous investment. Tents are actually quite expensive if you need to replace them every six to 12 months. A decent tent can cost as much as US$850. A dignified shelter may cost up to US$2000 but it essentially lasts longer. For two tents which have to be replaced every six months, you can have a dignified shelter that lasts for five years. So there is a moment where we can invest in short-term humanitarian shelters or we can use those funds to look at medium-term options which will provide people with greater safety, security, and dignity. The real question is how can we afford not to do this ?

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For more information, click here to visit the website of the Shelter Cluster (Cross-border Operation – Turkey).

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North-west Syria

Situation Report
Trends
COVID-19 vaccine in NWS
COVID-19 vaccines were delivered to north-west Syria in 2021 through COVAX. 17 August 2021. (Photo Credit: OCHA/Bilal al-Hamoud)

Health

According to the 2022 Humanitarian Needs Overview (HNO), 3.1 million people out of a population of 4.4 million are in need of health assistance across north-west Syria.

More than 50 per cent of health care workers are estimated to have left Syria since the start of the crisis. In the north-west, there are about 10 health care workers per 10,000 people. The lack of trained health care workers, particularly specialists, has severely impacted the delivery of health assistance. Across the region, 422 out of 624 facilities remain fully or partially operational. 8 per cent of the health care facilities are fully or partially damaged.

The COVID-19 pandemic further strained health services since the first case was confirmed in the north-west in July 2020. Although the prevalence has decreased significantly by April 2022, the pandemic is still an area of concern for health partners. COVID-19 vaccination campaigns, which started in May 2021, are on-going today. However, vaccine hesitancy continues to hamper these efforts. As of the end of April 2022, only about 9 per cent of the population received one dose of the vaccine, while about 5 per cent received both doses. Vaccine coverage for other communicable diseases is also relatively low.

In the midst of these difficulties, the UN and humanitarian partners through the Syria Cross-border Health Cluster continue to provide essential health care services to communities in the north-west.

On average, over one million medical procedures have been completed including outpatient and mental health consultations, and referrals. In March this year alone, over 7,000 major surgeries were performed. However, much more funding is needed to continue these life-saving activities and reach all people in need. According to the latest OCHA Funding Gap Analysis (April – June 2022), the health cluster has only received 39 per cent of the required funding (US$19 million). Without sufficient and timely funding, an estimated 900,000 people are at risk of losing access to primary health care services, medicines, emergency obstetric care, neonatal care, and vaccines, among other health interventions.

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North-west Syria

Situation Report
Feature
Dr Najib at Hospital in Idleb
Dr Amina Najib and her family were displaced from Aleppo to Atma in 2012 due to the conflict in the country. She now works at the Al-Ikha'a Hospital in northern Idleb as a Medical Manager and a family medicine specialist. (Photo credit: SEMA)

From Aleppo to Atma: Defying the odds to save lives

“I had to be the doctor, gynecologist, midwife, and nurse because there was no other choice.”

Dr Amina Najib recalls the time when she helped women give birth in her own kitchen in north-west Syria. When she first arrived to Atma in northern Idleb in 2012, there were no female doctors nor midwives let alone a fully equipped medical center.

After graduating from medical school in 1997, Dr Najib resided in Aleppo to realize her childhood dream of becoming a health worker. When the conflict broke out in the country, she was forced to flee the city with her family and took refuge in Atma, a village whose population did not exceed 15,000 people at the time.

Today, Dr Najib is a Medical Manager and a family medicine specialist at the Al-Ikha'a Hospital in the same village. The four-story hospital treats more than 8,000 patients per month with the support of 115 staff including 72 health workers.

But the path to today has not been so easy.

“Many families who fled to northern Syria at the start of the crisis left their homes with nothing but spare clothes. We thought that things would deescalate and return to normalcy within weeks,” says Dr Najib.

Without adequate shelters, families resorted to sleeping on the floors. Massive inflows of people soon led to issues of overcrowding, creating an ideal environment for diseases to spread rapidly, particularly among children and pregnant women.

“When I first got to Atma, there was only one pediatrician. In cases of emergency, there was just no time to refer patients and we had to make the best of what we had,” she adds.

With the support of non-governmental organizations, she transformed her home into a makeshift clinic for pregnant women. Her kitchen became an operating theater. Tables, chairs and everyday items became supportive medical resources.

News of her health services soon spread to neighboring towns and over this period, Dr Najib shares that nearly 700 women were successfully supported in labor operations.

A silver lining came in September 2013 when the first medical center was established in the area. By April 2015, the center quickly grew into a full-fledge hospital in partnership with the Syrian Expatriate Medical Association (SEMA), a medical relief organization founded in 2011 as a response to the crisis in the country.

To this day, SEMA continues to support Dr Najib and her teams at the Al-Ikha'a Hospital through regular virtual consultations with health practitioners and specialists. When COVID-19 struck north-west Syria in 2020, SEMA rapidly provided awareness trainings, secured vaccines and established three isolation hopistals.

“We now even have an advanced Intensive Care Unit (ICU) at our hospital which is the first in the area. When I see all these developments, it makes me feel very proud,” tells Dr Najib.

“After all difficult moments, I have no regrets that I stayed in my country to help my people against all odds.”

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SEMA is among the humanitarian partners financially supported by the Syria Cross-border Humanitarian Fund (SCHF), a country-based pooled fund managed by OCHA Turkey. In 2021, the SCHF allocated over $167 million to fund life-saving and early recovery projects in north-west Syria.

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North-west Syria

Situation Report
Analysis
OCHA Funding Gap Analysis NWS

Funding Gap Analysis

There is a 51 per cent funding gap to provide aid to 4.1 million people in need in north-west Syria, according to the new OCHA Funding Gap Analysis (April to June 2022). Humanitarian partners require a total of US $460.2 million to carry out life-saving and early recovery activities.

To view the full analysis, click here.

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