North-west Syria

Situation Report

Highlights

  • Artillery shelling occurred on most days, while there was a significant decrease in airstrikes. OHCHR said shelling injured at least 6 civilians in March, including a child.
  • The Humanitarian Needs Assessment Programme (HNAP) recorded 7,982 new displacements of people, primarily due to the deterioration of the economic situation.
  • COVID-19 cases increased for a second consecutive month. In March, 5,386 new cases and 49 associated deaths were recorded, compared to 4,147 cases that were recorded in February.
  • As of March, 4.4% of the population have been fully vaccinated against COVID-19, while 8.7% of the population received one dose.
  • Floods affected 19 displacement sites and strong winds affected 217 sites in March. Six sites received heavy snowfall. Over 3,000 tents were damaged and 2,400 tents were destroyed.
Children in NWS
Children in Deir-Hassan camp. 7 year-old Naseem (middle) had her feet amputated after playing with an unexploded ordnance five years ago. 2 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

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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North-west Syria

Situation Report
Feature
Quote1

43 year-old Muhammad and his family of five have been displaced more than once.

He lives in Dana city and works as a labourer in constructions, earning 55 TRY per day. He was able to look after his family with this wage, but the inflation in March has rendered food increasingly unaffordable.

Muhammad fears that he will have to ask his 14 year-old son to drop out of school and work so that his family can eat.

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North-west Syria

Situation Report
Trends

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 ($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

The case for 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
Feature

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 Najeeb 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 2012, Dr Najeeb never thought that her career would kick start in the midst of a conflict. It was this same year that she fled Aleppo with her family and took refuge in Atma, a village whose population did not exceed 15,000 people at the time.

Today, Dr Najeeb 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 Najeeb.

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 delivery room 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 Najeeb 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 Najeeb 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 Najeeb.

“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
Feature
Quote2

More than a year ago, Basem was forced to take his son, Rashid, out of the third grade to work.

Basem’s daily wage of 40 TRY was not enough to meet his family’s needs. Rashid came back home every day exhausted from work, hoping to return to school one day.

When an NGO started a cash-for-work program in the Atma camps, Basem got an opportunity to earn more income. Rashid was able to return to school shortly after his father started this work.

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