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Whole of Syria Health Cluster Bulletin, 1 - 31 October 2018

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Syria
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Health Cluster
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HIGHLIGHTS (OCTOBER 2018)

  • Conflict remained intense around the last remaining ISIL stronghold in NE Deir-ez-Zor. On October 11th a raid occurred on the makeshift Hajin IDP camp, followed by the relocation of the inhabitants to ISILcontrolled areas. Regular coalition airstrikes continued, with frequent reports of civilians being affected. In Idleb, hostilities were reduced across the governorate during October, although an increase in kidnapping incidents of medical and humanitarian workers was reported.

  • The Outbreak and Response Assessment (OBRA) mission conducted in October concluded that the 2017 outbreak of vaccine-derived polio has now been contained. An outbreak of acute jaundice syndrome was reported in Afrin schools. Regular sand storms occurring across Syria have contributed to a marked increase in the burden of respiratory illnesses since September, while floods due to rains increased the risk of water-borne infections, especially in camps. The lack of access to TB diagnosis and treatment by populations in NSAG controlled areas is an oft-reported concern.

  • The situation of the population in Al Rukban camp on the border with Jordan remains dire, with only minimal humanitarian assistance provided since January 2018. The UN inter-agency convoy scheduled to take place in October to deliver assistance to over 50,000 inhabitants was delayed to November due to logistic and security reasons.

Situation update

Access to northern rural Homs improved in October with agreements being reached between the UN and the GoS. Access to E. Ghouta remains restricted, with the UN inter-agency humanitarian missions on hold since June 2018. The majority of the population has returned to their homes, and approximately 5,000 people, mostly males, remain in the IDP camps. Once Decree 18 issuing general amnesty for military deserters has been issued, most of these are also expected to return.

Conflict remained intense around the last remaining ISIL stronghold in NE Deir-ez-Zor. On October 11th a raid occurred on the makeshift Hajin IDP camp, followed by the relocation of the remaining inhabitants to ISILcontrolled areas.

Agencies working in this camp relocated their services to Al Busayra villages/IDP settlements. During October, regular coalition airstrikes continued, with frequent reports of civilians being affected.
Despite the continued hostilities, the number of newly displaced people from the ISILcontrolled Hajin enclave to surrounding SDF areas was relatively small (see map).

The demilitarized zone around Idleb officially took effect on October 15th, with the condition of removal of all heavy weaponry from the area by this date generally being met. With the ceasefire holding, hostilities were reduced across the governorate during October, allowing humanitarian actors working cross-border from Turkey to continue their activities, although this was constrained by restrictions on the use of the Bab Al Hawa border crossing for US and UK funded relief efforts. Insecurity continued, with reports indicating an increase in kidnapping incidents of medical and humanitarian workers in Idleb during October.

The critical humanitarian situation in Al Rukban camp at the border with Jordan received increasing media attention during October. Limited supplies reached the camp since January 18th and the one existing health facility is only able to provide basic first aid due to limited supplies of medicines and human resources. During October sandstorms and floods further compounded the dire situation of the camp’s inhabitants. A convoy from Damascus scheduled to provide food, non-food items, basic health kits, WASH and nutrition supplies to over 50,000 camp inhabitants was postponed to November due to logistic and security constraints.

In NE Syria, reports were received of disruption to education and health services in Ar-Raqqa and Al-Hasakeh governorates. On the 24th of October the Kurdish Self-Administration (KSA) reportedly closed four Primary Health Care Centres (PHCs) and immunization services centres supported by UNICEF and WHO. On the 25th of October a number of health and nutrition clinics treating cases of severe and acute malnutrition in Ar-Raqqa city were also closed. Conditions in many IDP sites have reportedly deteriorated, with harsh weather conditions (cold, floods and sandstorms) as well as decreasing assistance. An organised process of return continues from all IDP sites, with the overall trend of return slowing, likely due to the approaching winter season.