The scale, severity and complexity of humanitarian needs of people in Syria remain extensive. This is the result of continued hostilities in localized areas, new and protracted displacement, increased self-organized returns and the sustained erosion of communities’ resilience during close to eight years of crisis. Across Syria, an estimated 11.7 million people are in need of various forms of humanitarian assistance, with certain population groups facing particularly high levels of vulnerability. Whilst there has been a reduction in violence in many parts of the country over the past year, the impact of present and past hostilities on civilians remains the principal driver of humanitarian needs in Syria.
View the HNO online https://hno-syria.org/
1 Life-threatening Needs among the most vulnerable
With the crisis in its eighth year, staggering levels of need persist for people across Syria. An estimated 11.7 million people were in need of various forms of humanitarian assistance as of the end of 2018, representing a reduction since the beginning of the year. An estimated 6.2 million people remained internally displaced, with well over 1.6 million population movements recorded between January and December 2018. Close to 1.4 million displaced persons reportedly returned home spontaneously during the same period, with the majority estimated to have been displaced for relatively short durations.3 The UN estimates that 25 per cent of internally displaced persons (IDPs) are women of reproductive age, and 4 per cent are pregnant women that require sustained maternal health services, including emergency obstetric care.
Based on recent assessments, the Food Security and Agriculture sector estimates that a third of the population in Syria is food insecure, with pockets of acute and chronic malnutrition persisting in certain areas.4 Outbreaks of measles, acute bloody diarrhoea, typhoid fever and leishmaniasis were reported in various areas of the country throughout the year. Palestine refugees in Syria have remained particularly vulnerable, affected by displacement, loss of assets, and significant destruction of residential areas.
2 Protection Needs of Civilians
Syria remains a major protection crisis, with civilians exposed to multiple protection risks related to ongoing hostilities; the effects of new and protracted displacement; dire conditions in sites and collective shelters hosting IDPs; and the depletion of socioeconomic resources triggering harmful coping strategies (e.g. child labour and early marriages). Despite a reduction in hostilities in parts of the country, 2018 saw intense fighting in several locations, including East Ghouta in Rural Damascus Governorate, parts of southern Damascus, the southwest (particularly Dar’a and Quneitra), much of the north-west, including Idleb Governorate and Afrin District in Aleppo Governorate, and eastern Deir-ez-Zor Governorate. In many cases, hostilities had an immediate impact on the lives of civilians, causing death and injury, largescale displacement, damage to property and destruction of civilian infrastructure including schools, hospitals/health points and other services necessary to daily life.
Attacks on health care have remained a hallmark of the crisis. The UN estimates that almost half of health facilities in Syria are either partially functional or not functional as a direct result of hostilities. The protection of humanitarian and medical personnel has also continued to be a key concern. More than one in three schools are damaged or destroyed. Millions of people are exposed to explosive hazards, including in areas in which fighting has ceased and where multiple layers of contamination continue to threaten the lives of civilians.
Gender-based violence (GBV) continues to affect the lives of women and girls, with adolescent girls, women-headed households, especially those divorced and widowed, bearing the brunt of the crisis. Elderly people and persons living with disabilities are also among the most vulnerable requiring protection. In an evolving environment, protection issues are increasingly complex and often inter-linked. The lack or loss of civil documentation, common throughout areas affected by hostilities and displacement, represents a barrier to exercise housing, land and property (HLP) rights. It also triggers restrictions on freedom of movement and affects access to services.
3 Access to livelihoods and essential basic services
Close to eight years into the crisis, the resilience capacity of people in the most affected communities in Syria has been severely eroded. Essential basic services are widely lacking, including health, shelter, food, education, water and sanitation.
According to 2015 estimates, 83 per cent of Syrians lived below the poverty line. Recent indications suggest it has since worsened. A monthly food ration with staple items costs at least 80 per cent of an unskilled labourer’s monthly salary and 50-80 per cent of a public service employee’s monthly salary, demonstrating the existence of “working poor” in Syria. People in Syria are adopting reduced coping strategies due to the loss or lack of sustained livelihoods, and are increasingly vulnerable to displacement. Protracted displacement, the depletion of productive assets and savings, limited economic opportunities and the widespread destruction and contamination of agriculture-related infrastructures have had a profound socioeconomic impact on the population. In some cases, this has led to chronic levels of deprivation, contributing to people’s adoption of harmful coping strategies, such as reduced food consumption, deferment or delay in seeking necessary medical care; reduced hygiene practices, increasing public health risk; the spending of savings and the accumulation of debt. Such coping strategies are not only damaging and unsustainable but, once exhausted, may increase exposure to more harmful practices such as child labour, including in its worst forms, recruitment as fighters, early marriage and other exploitative practices. As hostilities have reduced in many areas, particularly those that have shifted control, and as selforganized return increases, needs relating to access to basic services and livelihood opportunities have grown. Consultations with communities have indicated that access to livelihood opportunities and basic services are among their primary concerns as affected people seek to rebuild their lives.
In 2019, the political and security landscape in Syria is likely to remain complex and dynamic. Hostilities and insecurity are expected to continue, most notably in the north-west and in parts of the north-east of the country, which will generate additional civilian displacement. Contingency plans are being put in place for up to 100,000 displacements per month (1.2 million in total for the year). A recent survey on the intentions of IDPs in Syria found that almost 70 per cent of households can be expected to remain at their current location. Twenty per cent of households expect to integrate into their place of displacement, and 44 per cent remain undecided about their future plans.9
Some areas are more likely to see increased stability and security, particularly as hostilities cease in many areas that witnessed changes of control in 2018. This situation may lead to an increase in the number of spontaneous returns by IDPs. Plans are under development to respond to the needs relating to up to 1.5 million potential spontaneous returns (from among the internally displaced population) in 2019. Existing monitoring and assessment methodologies in Syria cannot ascertain the voluntariness and sustainability of these returns, or whether they have been adequately informed and took place in safety and with dignity. Twenty per cent of returns in 2019 are expected to be in the governorate of Rural Damascus. The governorates of Aleppo, Homs and Dar’a may also receive high inflows of returnees.10 At present, the inter-agency community is not facilitating or promoting returns. It continues to support the displaced to make a voluntary and informed decision at the time of their choosing, including by contributing to efforts to overcome barriers to return for those who would like to do so, and by supporting the rights of IDPs to opt for their preferred durable solution.
Key concerns in 2019 will include conditions for people living in overcrowded IDP sites, particularly in the north-west and north-east of the country; the needs of host communities who share resources with the displaced; and natural hazards such as the impact of floods and drought from 2018 on food security and livelihoods. In the current situation, the impact of funding-related cuts to assistance to vulnerable Palestine refugees will threaten the lives and livelihoods of this disadvantaged population.