More than 12 million people in Syria are in need of humanitarian assistance

AFP Photo/Adem Altan

June 25, 2015

Highlights

The USG announces an additional $360 million in humanitarian assistance for the Syria crisis

Up to 150,000 people remained displaced in Idlib Governorate as of June 11 following increased conflict that began in late March

Attacks on medical facilities in Syria persist, resulting in the deaths of more than 600 health care personnel since the start of the conflict

Key Developments

On June 25, U.S. National Security Advisor Susan E. Rice announced more than $360 million in new USG funding to respond to urgent humanitarian needs, including for food assistance, health care, safe drinking water, and shelter support, in Syria and neighboring countries. The announcement—made at a White House commemoration ceremony for World Refugee Day— brings the total USG humanitarian funding for Syria to more than $4 billion since 2011.

Attacks on medical facilities continue to present significant security concerns for humanitarian organizations. On June 17, representatives of humanitarian organizations testified before the U.S. House Committee on Foreign Affairs highlighting the number of airstrikes on medical facilities across Syria, including 36 attacks targeting hospitals, health facilities, and aid convoys in May and June. In addition, in the Whole of Syria (WoS) June report, the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported 13 airstrikes on health facilities in Idlib since April 1. To avoid airstrikes, medical facilities in Syria are increasingly located underground, and many organizations are no longer posting international organization insignia on facilities.

The OCHA-led Kobane Working Group—comprising humanitarian and de-mining nongovernmental organizations (NGOs)—released its initial assessment of the conditions in Aleppo Governorate’s city of Kobane on May 6, following the February retreat of the Islamic State of Iraq and the Levant (ISIL) from the city. The group reported that fighting had destroyed nearly 50 percent of the city’s buildings and infrastructure and 80 percent of agricultural resources. Of the estimated 192,000 people who fled to Turkey during the fighting, approximately 62,500 people have returned to Kobane and neighboring areas, despite the extensive presence of unexploded ordnance and landmines in both rural and urban settings. Humanitarian organizations continue preparedness and response efforts to safely address identified needs, as security allows.

HUMANITARIAN ACCESS & POPULATION DISPLACEMENT

Between March 2011and April 2015, Physicians for Human Rights (PHR) documented 256 deliberate or indiscriminate attacks on nearly 200 medical facilities, with more than 600 health care personnel killed. While all combatants in the Syrian conflict have engaged in clashes that have killed civilians and damaged critical public infrastructure, Syrian Arab Republic Government (SARG) forces are responsible for 88 percent of the recorded hospital attacks and 97 percent of medical personnel killed during the past four years, according to PHR. On May 24, SARG airstrikes hit four hospitals—one in Hamah and three in Idlib—which together served approximately 11,000 patients per month. The persistent targeting of health facilities and personnel continues to prompt medical professionals to flee Syria.

Insecurity, shifting conflict lines, attacks on convoys, and deliberate interference with humanitarian operations, continue to impede humanitarian access to conflict-affected populations across Syria. Significant portions of northeastern Syria, rural areas of the capital city of Damascus, and multiple locations in central, northern, and southern Damascus remain inaccessible, according to the UN. In recent months, relief agencies also noted increased fighting along key access routes and densely populated urban areas in Damascus, as well as in Aleppo, Al Hasakah, Dar’a, Hamah, and Idlib governorates, and in some areas controlled by ISIL, further obstructing humanitarian operations.

In mid-May, ISIL commenced a major offensive against areas controlled by the SARG in eastern Homs Governorate, gaining control of the city of Palmyra on May 20. On May 25, the Syrian Observatory for Human Rights reported that ISIL forces had killed more than 200 civilians in Palmyra, including women and children, and at least 300 pro-government soldiers in the days prior to the city’s capture. Approximately 7,800 people had fled Palmyra’s surrounding areas to the town of Al Qaryatayn in southeastern Homs and toward the city of Homs as of May 21, according to the UN.

A volatile security situation in Idlib Governorate—particularly in the city of Idlib and surrounding rural areas—has resulted in continued large-scale population displacement since late March. The UN reports that SARG airstrikes on Idlib’s Ariha and Jisr al-Shugur towns killed at least 50 civilians during the week of June 1; more than 147,000 people in Idlib remained displaced as of June 11 due to recent fighting, according to the Camp Coordination and Camp Management (CCCM) Cluster—the coordinating body for humanitarian CCCM activities, comprising UN agencies, NGOs, and other stakeholders. Increasing numbers of people are migrating towards established IDP camp locations close to the Turkish border, including the Atmeh and Qah IDP camps in western Idlib, in addition to locations in neighboring governorates.

Fighting in southern Syria has resulted in large-scale displacement in Dar’a, Hamah, and Rif Damascus governorates. As a result of a major February offensive in southwestern Rif Damascus, more than 50,000 people were displaced, which was one of the largest displacements in southern Syria during the past two years, according to the UN. Additionally, the UN reports that in the last week of March, an estimated 18,500 people fled armed opposition groups in Dar’a, including 10,000 previously-displaced people. Escalated clashes in Dar’a’s Bisr al-Harir and Busra al Sham towns displaced approximately 40,000 people in April. The UN reports ongoing violence in Dar’a and Hamah displaced 4,000 people and 5,000 people in May, respectively. Most of the displaced from Hamah have since returned after SARG forces regained control of the contested village, according to the UN.

In early April, armed groups took control of the Nasib border crossing between Syria and Jordan, resulting in the disruption of humanitarian deliveries into southern Syria. Non-state armed groups continue to control the border crossing as of late June, hindering humanitarian activity. However, relief organizations have identified alternative routes for humanitarian shipments, including an increased reliance on Latakia Port and other border crossings.

Following a brief period in March when the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was able to access Damascus’ besieged Yarmouk neighborhood for the first time since December 2014, the area was again rendered inaccessible beginning April 1 as a result of an incursion by ISIL. Humanitarian organizations have been unable to provide aid inside Yarmouk since that date. To assist persons displaced from Yarmouk neighborhood to the adjacent neighborhoods of Babella, Beit Sahem, Tadamon, and Yalda, UNRWA conducted frequent deliveries of relief commodities between April 13 and June 7. In April, UNRWA provided approximately 5,000 UN World Food Program (WFP) food parcels, 13,200 bundles of bread, 50,000 liters of safe drinking water, and other emergency relief commodities, to displaced households.

Of the nearly $73 million in additional USAID/OFDA funding, approximately $70 million is supporting partner organizations to bolster agricultural resources, distribute emergency relief commodities, improve infrastructure in IDP camps and host communities, and provide psychosocial and health services, among other humanitarian activities. Since 2012, USAID/OFDA has contributed more than $684 million to support humanitarian assistance for the Syria response.

FOOD SECURITY

In April, USAID/FFP partner WFP provided an estimated 809,500 family food rations to benefit more than 4 million people in 12 of Syria’s 14 governorates. Included in this population are 5,000 besieged civilians in Rif Damascus’ Zakya town, whom WFP and the Syrian Arab Red Crescent (SARC) reached with emergency food assistance for the first time in more than one year. In addition, three UN interagency humanitarian missions delivered 16,000 food rations and humanitarian supplies to rural Homs’ city of Ar Rastan to assist approximately 81,500 civilians who have been under partial siege for approximately two years. WFP last gained access to Ar Rastan in May 2014.

On May 12, SARC, supported by the International Committee of the Red Cross (ICRC), began distributing more than 100 metric tons (MT) of food assistance to ISIL-besieged neighborhoods in the city of Dayr az Zawr, Dayr az Zawr Governorate, where nearly 240,000 people remain in SARG-controlled areas of the city. As of May 19, at least 13,000 households—nearly 70,000 people—had each received two kilograms of cooking oil and rice; however, the food security situation remains precarious, with two of the city’s main bakeries shutting down on May 16 due to fuel and yeast shortages. While SARC distributions represent measured progress towards meeting the needs of besieged populations in Dayr az Zawr, providing substantial assistance to approximately 230,000 people in need remains a significant challenge for humanitarian organizations. Although WFP recently received SARG clearance to airlift food commodities to Dayr az Zawr, the organization has not commenced the operations due to insecurity.

To date, USAID/FFP has provided $1.2 billion to WFP’s Syria operations for refugees in neighboring countries and vulnerable persons inside Syria, enabling WFP to reach approximately 2 million refugees and 4 million people inside Syria each month. Of the 4 million people WFP is assisting inside Syria, more than 2.2 million are located in UN-designated hard-to-reach areas.

In addition, USAID/FFP has provided more than $305 million to other partners working to address the acute food security needs of Syrians through the provision of emergency food commodities and food vouchers to conflict-affected populations. As of May 2015, USAID/FFP had funded programs that provided nearly 1 million food baskets and approximately 100,000 MT of flour to people inside Syria.

With the $46 million in additional funding, USAID/FFP is supporting partners to distribute food baskets, provide food vouchers to conflict-affected populations, and supply bakers with flour and yeast.

HEALTH AND WASH

During World Immunization Week from April 19–30, a SARG Ministry of Health vaccination campaign conducted in portions of Dar’a and Idlib immunized approximately 1.25 million children, according to the UN. Nearly 975,000 children younger than five years of age received measles, mumps, and rubella vaccinations, and nearly 110,000 children younger than one year of age received the measles vaccine. Campaign planners have been unable to conduct vaccination activities in Ar Raqqah Governorate due to ISIL attempts to exert control over the campaign in areas they hold.

Insecurity and conflict have destroyed significant portions of public infrastructure that facilitate water, sanitation, and hygiene (WASH) services throughout Syria, which has led to an increase in water-borne diseases and limited access to safe drinking water, according to the UN. USG partner the UN Children’s Fund (UNICEF) delivered WASH supplies to the SARG-controlled city of Qamishli in Al Hasakah, via the Nusaybin–Qamishli border crossing from Turkey to Syria, between April 27 and May 3. The delivery included 330 MT of water purification supplies, sufficient to support the needs of vulnerable populations in Al Hasakah, Ar Raqqah, and Dayr az Zawr for up to one year. In addition, UNICEF delivered household WASH kits to support nearly 8,000 people and hygiene kits for approximately 6,500 people. According to the UN, 11.6 million people across Syria require WASH assistance, including access to safe drinking water, improved sanitation and hygiene facilities, and the rehabilitation and development of water supply systems.

With nearly $21.5 million in FY 2015 support, USAID/OFDA partners are providing WASH services in at least 26 IDP camps, repairing damaged or insufficient WASH infrastructure in host communities, and conducting small-scale rehabilitation and maintenance of water systems. A USAID/OFDA partner is using newly committed funds to provide hygiene and WASH services to more than 22,500 people in Syria. The organization is distributing approximately 4,000 hygiene kits and training 50 community health workers to promote health education and behavioral change that increases knowledge of public health concerns and communicable diseases.

HUMANITARIAN COORDINATION

The WoS Strategic Steering Group, comprising senior humanitarian leadership from Jordan, Syria, and Turkey convened its first meeting in April. The group aims to bring coherence to humanitarian planning across Syria by supporting and leading a single humanitarian planning effort for the country. As part of the group’s collaborative effort, OCHA released the inaugural WoS Humanitarian Bulletin on May 7, which is an effort to consolidate information provided by NGOs and UN agencies across Jordan, Syria, and Turkey and provide a holistic picture of humanitarian needs and activities inside Syria. According to the report, humanitarian actors provided assistance to approximately 73 percent of Syria’s sub-districts in February. OCHA anticipates that WoS reporting will reduce gaps in humanitarian assistance and prevent duplication of response activities in Syria.

OCHA, through the Syria Information Management and Assessment Working Group, and a USAID/OFDA partner have initiated planning for the Needs Identification Framework to establish a common framework for identifying humanitarian needs across Syria. As part of the WoS effort to provide the humanitarian community with a more accurate and consistent picture of needs and assistance gaps in Syria, the working group will first revise population estimates and then identify a common methodology for calculating people in need and defining the severity of need.

To date in FY 2015, USAID/OFDA has provided more than $7 million to UN agencies and NGOs, including $3 million to OCHA, to strengthen the coordination of humanitarian activities, by enhancing information sharing and collective leadership amongst relief actors operating in Syria. In addition, with $1 million in USAID/OFDA funding, the UN Food and Agriculture Organization (FAO) is supporting the Food Security Cluster, which provides an inclusive common platform to humanitarian actors for the coordination of food security, livelihoods, and agriculture-related activities.

REFUGEE ASSISTANCE

Regional

State/PRM’s additional $241 million in funding supports international organizations, including ICRC, International Organization for Migration (IOM), UN Population Fund (UNFPA), UNHCR, UNICEF, and UNRWA to assist refugees from Syria in neighboring countries. With the additional funding, these organizations will provide access to education, health services, registration and legal assistance, shelter, programs to prevent and respond to gender-based violence, trauma support, among other activities. This new funding brings State/PRM’s humanitarian assistance in response to this conflict to nearly $1.9 billion.

Due to funding shortfalls, USAID/FFP partner WFP has reduced the value of food vouchers for Syrian refugees in neighboring countries. WFP plans to continue reducing voucher values while maintaining their beneficiary caseloads in June and July; however, the organization may need to reduce overall caseloads in August if new funding is unavailable. The reduction in assistance is affecting refugee households’ food security in addition to increasing negative coping mechanisms. Women may be at risk of sexual exploitation in exchange for needed food assistance, and children may increasingly be taken out of school to work or beg.

To date, USAID/FFP has provided nearly $1.2 billion to WFP’s Syria operations for refugees in neighboring countries— approximately as much as all other donors combined. Of the total funding, USAID/FFP has provided nearly $27 million in Iraq; more than $70 million in Turkey; approximately $224 million in Jordan; nearly $291 million in Lebanon; and more than $33 million for Egypt.

Iraq

In May, WFP distributed approximately 92,100 food vouchers and nearly 11,100 food parcels to more than 103,100 Syrians residing in refugee camps in Iraq. In an effort to ensure emergency food operations are reaching the most vulnerable populations, WFP staff, in coordination with UNHCR, is conducting a comprehensive tent-to-tent vulnerability assessment in all nine refugee camps, using 20,000 surveys to cover the entire camp population. WFP will use the survey results to define criteria for a tiered approach to emergency food assistance beginning in August.

A State/PRM-supported NGO continues to enhance health awareness among refugees and provide services in urban health facilities in Dohuk Governorate. To date, the NGO has provided 49 public health clinics with furniture and trained 53 community health volunteers to conduct health awareness sessions in public spaces in 43 areas of Dohuk. In addition, five health care worker outreach teams have conducted approximately 1,400 home visits to provide medical services.

Jordan

With USG support, UNICEF and 20 partner organizations have opened 145 Makani spaces in Jordan since January, which provide informal education, life skills training, and psychosocial support services for Syrian refugee children, as well as offer safe spaces for children and adolescents in the community. As of late May, an estimated 95,000 boys and girls had registered with Makani spaces and other child- and youth-friendly spaces in Jordan. UNICEF and its partners plan to establish an additional 96 centers and strengthen technological capacities to improve technical skill trainings and other educational programs in the coming months.

In addition, UNICEF is providing a monthly cash grant to approximately 71,900 children from the most vulnerable Syrian refugee families in Jordan, including households with unaccompanied minors or limited resources. The grants aim to reduce vulnerable families’ dependence on negative coping mechanisms, such as child labor and early marriage, by providing flexible funding for child-related expenses.

Frequent power outages in Jordan’s Za’atri refugee camp since mid-April have hindered operations in the camp’s obstetrical clinic, negatively affecting health care services for pregnant Syrian women in Za’atri, according to USG partner UNFPA. The UN agency is exploring alternative energy solutions, including solar energy, to operate medical equipment and maintain cool temperatures within the camp’s clinics. In May, UNFPA provided prenatal services to more than 3,200 women and delivered nearly 220 babies in the camp. In addition, UNFPA provided reproductive health services for nearly 10,000 individuals, primarily sheltering in Za’atri camp.

On May 19, a steering committee comprising NGOs, UN agencies, the European Commission’s Directorate-General for Humanitarian Aid and Civil Protection (ECHO), and State/PRM launched the Vulnerability Assessment Framework (VAF) baseline survey for Jordan. The VAF aims to target all humanitarian assistance for Syrian refugees based on a household’s vulnerability assessment. The survey results indicate that approximately 86 percent of Syrian refugees in urban areas live below the Jordanian poverty line, and over 80 percent of Syrian refugees are using crisis or emergency coping strategies, including begging, or engaging in degrading, high-risk, and illegal.

Lebanon

According to the UN, Lebanon now ranks first in the world in refugees per capita, hosting approximately 1.2 million registered Syrian refugees, which amounts to more than 20 percent of the country’s population. Of the 1.2 million refugees, nearly half of the population lives at or below the Lebanese poverty line of $4 per day, with one third of refugees surviving on $2–3 per day.

The Government of Lebanon recently mandated UNHCR to deregister more than 2,600 Syrian refugees who arrived in Lebanon after January 5; UNHCR has temporarily suspended all official refugee registration activities in Lebanon, which will have repercussions on access to some basic services and the legality of residence for refugees in Lebanon. In addition, UNFPA reports that birth registration for babies born to Syrian refugee mothers in Lebanon continues to be a challenge. UNFPA estimates 52,000 Syrian babies have been born in Lebanon since the beginning of the Syria crisis in 2012. Only an estimated 31 percent of these children have birth certificates, as many families lack the necessary documentation, such as marriage certificates, to apply for birth certificates for newborn babies.

A recent shelter survey conducted by UNHCR confirmed an increase in shelter vulnerabilities among Syrian refugees residing in Lebanon. An estimated 55 percent of refugees currently reside in insecure accommodations, including informal settlements, overcrowded apartments, unfinished buildings, and other sub-standard housing—a 15 percent increase from 2014. In response, with USG support, UN agencies and implementing partners have focused on providing more secure housing through shelter rehabilitation activities, such as prioritizing damaged infrastructure in urban areas, and legal support to protect the rights of tenants.

Through ongoing exercises to target vulnerable populations, WFP identified new eligibility criteria for refugee households to receive food assistance. Due to funding shortfalls, WFP has begun to transition less vulnerable households from its beneficiary caseload, including an estimated 35,000 households—or approximately 175,000 individuals—who received their final voucher in May, but remain eligible to request future support. More than 826,000 individuals will continue to receive monthly food voucher assistance in June. WFP will continue to monitor nutrition conditions to assess whether reductions in assistance result in elevated malnutrition levels for the Syrian refugee population.

Turkey

With support from State/PRM, from June 1 to June16, UNHCR has provided 8,000 blankets, 8,000 mattresses, and other assistance to the Government of Turkey Disaster and Emergency Management Directorate for distribution to newly arrived refugees in Turkey. UNHCR also constructed a pre-fabricated health facility in Sanliurfa Province’s city of Akcakale. Other State/PRM partners have provided medical supplies to Syrian refugees crossing into Turkey with injuries and disabilities and distributed 1,000 relief kits to benefit an estimated 2,100 civilians. With USG funding, the Turkish Red Crescent Society has also distributed an estimated 30,000 high-energy biscuit rations and approximately 27,400 bottles of water.

The Government of Turkey (GoT) has requested that WFP expand emergency food assistance to include Syrian refugees living in host communities—approximately 87 percent of all Syrian refugees in Turkey—in addition to the Syrians residing in refugee camps. To meet this request, WFP and the GoT are using vulnerability criteria to identify the most foodinsecure, vulnerable households in the provinces of Gaziantep, Hatay, Kilis, and Sanliurfa.

Egypt

WFP is conducting a biometrics verification exercise and vulnerability assessments in Alexandria, Cairo, and Damietta governorates to inform future beneficiary targeting. Following the conclusion of the biometric verification and vulnerability assessments in mid-July, WFP expects the overall caseload to reduce by approximately 20 percent.

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.