New report on WHO/Europe health emergency response to the crisis in the Syrian Arab Republic in 2017

The WHO Country Office in Turkey has released a comprehensive report on the activities conducted by the WHO Health Emergencies team in 2017 and the outcomes achieved for the Syrian population in northwest Syrian Arab Republic and Turkey. As health needs escalated throughout the year, the team continued working to mitigate the suffering of millions through cross-border operations in northwestern Syria and the Refugee Health programme in Turkey.

Seven years into the Syrian conflict, millions of people are still in need of humanitarian assistance. By the end of 2017, some 13.5 million people needed life-saving assistance in the Syrian Arab Republic, 4.5 million of whom were located in hard-to-reach areas, including 540 000 people in 11 besieged areas. Despite some reduction in the level of hostilities in certain regions, humanitarian access to people in need remained constrained by sustained conflict, shifting frontlines, slow administrative and bureaucratic processes and general safety and security concerns.

The health situation continued to deteriorate, with 11.3 million Syrians in need of health care. In the north-western Syrian Arab Republic, the large numbers of displaced persons continued driving health needs and posing further challenges to an already overstretched health system. Owing to the continuous disruption of immunization services, a new polio outbreak hit the Syrian Arab Republic in 2017, leaving 74 confirmed cases in the governorates of Deir Ez-Zor, Raqqa and Homs. Widespread attacks on health facilities and health personnel continued throughout the year, despite international condemnation.

In Turkey, hosting 3.4 million refugees posed serious challenges to the national health system, in terms of shaping policy, organizing services and mobilizing resources. This was especially true for those provinces with the largest numbers of refugees: Sanliurfa, Gaziantep, Hatay, Istannbul, Mersin and Adana. In addition to overstretched health capacities, language and cultural barriers were significant obstacles to refugees’ access to health service, as patients were often unable to describe their symptoms or understand instructions for treatment.  Mental health needs among Syrians continued rising as the constant exposure to violence and experiences of exile left consequences such as depression, anxiety or post-traumatic stress disorder.

WHO Health Emergencies programme: A stronger operational response to the Syrian crisis

Owing to the complexity of the crisis and the increasing needs in the Syrian Arab Republic, in 2014 humanitarian partners agreed to work from three hubs in Turkey, Jordan and the Syrian Arab Republic under the ‘“Whole of Syria” approach. This initiative set up a coordination platform and a common plan seeking to bring coherence in the humanitarian response to the Syrian crisis. Within this scope, the new global WHO Health Emergencies programme - established in 2016 with the aim to add a stronger operational response to WHO’s traditional technical and normative role- an emergency operations team was set up in Turkey. This team operates both from the Country Office in Ankara and the Emergency Office in the border city of Gaziantep. The team’s two main lines of work aim at ensuring one coordinated response to the Syrian crisis: through cross-border operations in the northern Syrian Arab Republic from Gaziantep and through the refugee health response in Turkey.

Reaching those most in need

In the northern Arab Republic, WHO worked with local NGOs that brought health care to those women, men and children most in need, even in hard-to-reach areas and besieged zones. In particular, 465 tonnes of medical supplies and medicaments were delivered to health facilities. Owing to the lack of health professionals, WHO also committed to ensuring continuous and updated training for those remaining, on a broad range of medical interventions, such as chemical exposure treatment, burn treatment or mental health and psychosocial support. This enabled doctors, nurses and other health workers to respond in a timely and proper manner to the health needs of their compatriots. WHO also supported efforts to conduct disease surveillance in the country while working to increase immunization coverage for children under 5 in the governorates of Idleb, Aleppo, Hama and Homs, both at health facilities and through supplementary campaigns.

In Turkey, WHO remained a close ally of the Ministry of Health in the design and implementation of the health response to the needs of Syrian refugees. The Refugee Health programme looked to provide access to care for all in a manner sensitive to refugees’ needs, while helping to ease the pressure on the overstretched Turkish health system. More than 433 000 free, culturally and linguistically-sensitive health consultations were provided in WHO-supported Refugee Health Training Centres, with more than 1 200 Syrian health workers trained and certified to serve in the Turkish health care system. WHO also supported the training of over 550 Turkish and Syrian doctors in mental health and psychosocial support and the training of more than 450 Turkish-Arabic interpreters in medical terminology.

Reporting on one year of health emergency response

The report follows the standardized WHO Health Emergencies programme structure, defined as the incident management system. The six critical functions (Leadership, Partner coordination, Information and planning, Health operations and technical expertise, Operations support and logistics and Finance and administration) are followed for each programme, presenting the outcomes achieved for 2017. It also provides an overview of the gaps and challenges to the programmes, building on an action plan response for 2018 and beyond.