UPDATE SYRIA CONFLICT - DISASTER NEEDS ANALYSIS - 21 June 2012
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DISASTER NEEDS ANALYSIS – 21 June 2012
UPDATE SYRIA
CONFLICT
Crisis Overview
Internal conflict has escalated over 16 months
into a situation that, according to the ICRC, Conflict affected areas
amounts to a non-international armed conflict in
some areas. There are daily armed clashes Clashes and casualties have been
between the military, pro-government militias, reported in the provinces of Idleb,
and a loosely organised opposition in civilian Homs, Hama, the country side of
centres. Civilians believed to support the op- Damascus, and Dara, and to a
position have been trapped in towns and cities lesser extent in Aleppo, Damascus
under heavy bombardment. In recent weeks city, Lattakia and Dayr Az Zor.
protection concerns and humanitarian needs The northern provinces of Al- Has-
have increased. There have been over 16,000 sakeh, Raqqa, the southern prov-
reported killings since March 2011. The inces of As Suweida, Al Qunayti-
UNHCR has registered around 77,000 people rah and the eastern provinces of
who have fled Syria. However, the actual num- Tartous have seen modest dem-
ber of refugees is estimated to be much higher. onstrations but have had little vio-
Estimates for the number of IDPs range be- lence.
tween 300,000 to 500,000.
Priority concerns
The impact of economic, finance and trade sanctions on Syria has increased as had
been projected in the ACAPS scenario in February, crippling the economy and reducing Poor access to basic commodities and essential services for the civilian population in
access to food and basic services. The deepening economic crisis is expected to further besieged areas.
erode livelihood opportunities and reduce access to basic goods.
Insecurity and economic sanctions have contributed to inflation and high food and
Concerns that pre-existing regional tensions will be aggravated by the conflict in Syria commodity prices, impacting food security nationwide.
are increasing. Cross border incidents, abductions of nationals and foreigners, and
Restricted humanitarian access in conflict affected areas.
refugee flows to neighbouring states have grown proportionally with the increasing vio-
lence. In Lebanon, simmering tension fuelled by the revolt in Syria has led to clashes in Lack of access to health care in conflict affected areas. Medical personnel and
the northeast. patients have been subjected to torture and arrest.
The Joint Special Envoy of the UN, Kofi Annan, and the League of Arab States intro- Violence against children, indiscriminate attacks on populated centres, torture, sexual
duced a six point peace plan, which includes a ceasefire that should have taken effect abuse and extra judicial killings are major protection concerns.
on April 12 but did not take hold. In April, the UN Security Council established a UN Refugees and IDPs lack access to livelihood opportunities and are dependent on
supervision mission with 300 observers. Due to the intensification of armed violence, humanitarian aid. Shelter is a pressing issue for the displaced Syrians.
the observer mission was suspended on the 16th of June. An international intervention
remains a valid option, although a disputed one. More support has been voiced over the Limitations on information on humanitarian needs.
creation of a buffer zone or humanitarian corridors.
1
UN vehicles are frequently shot at. At least two roadside bombs have targeted UN
Information Gaps and Needs convoys (UN 2012/06/07).
On January 25, the SARC Secretary General was killed while traveling in a vehicle
Information on the specific areas under attack and neighbourhoods under siege as
clearly marked with the Red Crescent emblem (SARC, 2012/01/25).
well as information on the distribution of control over the different areas.
Numbers of IDPs, their priority needs and their locations.
Logistical constraints
Information on level of food insecurity, particularly for areas affected by conflict.
Aid workers have questioned whether the UN would have the capacity to deliver if full
Data on refugee numbers and location within Iraq, Jordan, Lebanon and Turkey. access to affected areas was granted; they point to challenges recruiting the right
Data on needs of separated and unaccompanied children and other vulnerable people, a lack of aid infrastructure in Syria, and heavy restrictions imposed by UN se-
groups. curity rules (IRIN 2012/06/08).
Information on the extent of sexual and gender-based violence. Delays in receiving GoS approvals and tax exemptions for receiving food and non-
food items have previously occurred (LogCluster 2012/01/17). However, the GoS has
Capacity and coverage of existing health facilities. promised to lift bureaucratic blockages to aid, delays in issuing visas, and to improve
Information on use and availability of water sources. clearing of shipments at customs (IRIN 2012/06/08).
Within the conflict affected areas, movement for civilians is limited and obtaining relief
supplies can be dangerous due to shelling and the presence of snipers.
Humanitarian framework During military operations, electricity and communications are cut off for days at a time
disrupting communication and operations in health centers (IRIN 26/09).
Humanitarian Access Means of telecommunication are limited (PI 2012/06/20).
The ICRC and Syrian Red Crescent (SARC) recently reported access to "almost
everywhere" in Syria (AJ 2012/06/11).The SARC is coordinator and exclusive channel for
all humanitarian assistance in Syria. (IFRC 2012/06/14). On-going and Planned Assessment
The Government of Syria (GoS) has recently granted nine UN agencies and seven
international NGOs access to conflict areas. GoS also allowed the UN to set up field WFP and FAO are currently conducting a food security assessment in several gover-
offices in four locations: Dara, Dayr Az Zor, Homs (also covering Hama) and ldlib. norates (PI 212/06/18).
Reconnaissance missions for the establishment of these presences were deployed on
June 3 (IRIN 2012/06/08, UNOCHA 2012/06/05). UN teams will work together with SARC to assess needs in Dara, Dayr Az Zor, Homs)
and ldlib (UNOCHA 2012/06/05).
However, new international NGOs have not yet been allowed to enter Syria to scale
up aid. NGOs like Save the Children and Médecins sans Frontières, which have
repeatedly tried to gain access to Syria, remain outside the country (IRIN 2012/06/08).
Recommendations for Further Assessments
44 specific projects have been allowed, with the GoS maintaining a strong level of
control in all relief operations (IRIN 2012/06/08).
Rapid multi-sectoral assessment in accessible conflict affected areas. Displaced
populations can function as key informants on the situation in non-accessible areas.
Safety of humanitarian workers Mapping of on-going and planned assessments (Survey of Surveys)
Humanitarian workers in Syria face threats to their lives (UN, 2011/10/2). IDP profiling
Medical personnal are deliberatly targeted and subject to arrest and torture by the Sex and age disaggregated data is needed to improve the analysis of specific needs
security forces (Amnesty 2012/06/14). of sub-groups of the population.
2Displacement Profile April. This can be attributed to increasing smuggler fees and tightened security control
over the Syrian border with Iraq (MAG 2012/06/13, UNHCR 2012/06/18).
IDPs
The main concerns of the population in Domiz camp are the lack of employment and
Estimates of IDPs displaced by the current unrest range between 300,000 and livelihood opportunities, leaving them fully dependent on humanitarian aid. The few
500,000 (UN 2012/05/29, Syrian Arab Red Crescent 2012/05/30). However, there is a lack of that have access to informal jobs are exploited by the employers and often denied
information on the exact number, location and needs of the IDPs in Syria. It is likely salaries (UNHCR 2012/06/5).
that displacement follows sectarian lines, with Alawites and Christians fleeing to the
relatively safe provinces of Tartous and Lattakia on the west coast. No major health concerns were reported amongst refugees in Iraq, except for some
cases of diarrhoea, skin diseases, and respiratory problems (UNHCR 2012/06/5).
A lack of adequate water and sanitation services has been reported in the Domiz
Regional camp (IOM 2012/06/12).
Since the start of the Demography all registered refugees The medical unit providing aid to refugees in Domiz camp reports that maternal care
uprising in March remains a major need (UNHCR 2012/06/5).
2011, more than
77,000 refugees have
been registered in Jordan
Turkey, Jordan,
Lebanon and Iraq There are around 25,000 refugees registered in Jordan. However, it is estimated that
(UNHCR 2012/06/18). between 30,000 and 50,000 Syrians have crossed into Jordan since March 2011
(UNHCR 2012/06/05, PI 2012/06/20).
The numbers
depicted in this There are currently three official transit sites operating in the north of Jordan: Bashab-
chapter reflect the she, Cyber City and the King Hussein Stadium. A fourth site is close to completion in
number of refugees Source : UNHCR 2012/06/12 King Abdullah Park (OCHA 2012/06/01).
officially registered by
UNHCR. The actual There is little information on the food security status of refugees in Jordan. They have
number is believed to be much higher. In addition, many refugees have assets and do limited livelihoods opportunities and are dependent on aid.
not require assistance at this time. As assets are depleted, more refugees will likely The MoH has pledged to provide free access to public healthcare centres to registered
register (RI 2012/06/05, PI 2012/06/21). Syrian refugees (UNHCR 2012/05/24).
Of the host countries, only Turkey has ratified the 1951 Geneva Convention relating to There are no reports of major health concerns.
the Status of Refugees and its 1967 protocol. Hence, refugees in Jordan, Iraq and
Lebanon do not receive refugee status. Syrian refugees are accused of draining Jordan’s meagre water resources, which is
one of the world's 10 driest countries. The majority of Syrian refugees live in the
The Syria Regional Response Plan, launched in March 2012, stipulates the response northern cities of Mafraq, Irbid, Ramtha, Jerash and Ajlun. All areas already suffer
and coordination structures for these refugees (UNHCR 2012/03/23). from water shortage. Increased populations put additional strains on already scarce
resources, particularly in relation to water availability and consumption, waste man-
agement, sewage systems, energy, health and education (AFP 2012/06/01).
Iraq
Shelter has been reported as a concern, including for those that currently reside in
Around 5,000 Syrian refugees, primarily Kurds, have been registered in Iraq (UNHCR rented accommodation, as it becomes more difficult to access resources needed to
2012/06/05).
pay the rent (PI 2012/06/20).
Most refugees are in the Dohuk governorate, the Kurdistan region of Iraq. Some have
found temporary shelter with host families and in mosques, but the majority reside in
the Domez refugee camp about 40 miles inside the Iraq border (Reuters 2012/06/13).
According to local authorities, an estimated 15 to 30 people cross the border per day.
The overall number of arrivals in June remains low in comparison with the month of
3Lebanon Overview map
There are around 27,000 Syrian refugees in Lebanon (19,000 registered individuals,
an additional 3,000 Syrian refugees in Tripoli, and 5,000 in Bekaa pending registra-
tion) (RI 2012/06/05, UNHCR 12/06/08).
The refugees primarily reside in the north of Lebanon, including Tripoli, and Bekaa
Valley in the East (UNHCR 12/06/08).
Refugees in Lebanon do not receive formal refugee status (which allows for the issu-
ance of work permits), cannot travel freely and do not have access to Lebanese social
services. The Lebanese Government recognises incoming Syrians not as "refugees"
but as "displaced Syrians" (AJ 2012/04/19).
Refugees live in a mix of host families, rented accommodation and public buildings.
There are no refugee camps for Syrian refugees. Inadequate shelter conditions and
overcrowding is a concern and host family capacity is reaching saturation point (UN
2012/03/01).
Syrian migrants in Lebanon, work primarily in construction. If the Lebanese economy
continues its downturn, these migrants may register as refugees which could possibly
overwhelm current assistance structures (PI 2012/06/18).
78% of refugees depend on humanitarian assistance, ad hoc charity, sharing host
families resources and using credit to meet basic needs. Many live with host families
who themselves struggle to make ends meet (WFP 2012/04/24).
Preliminary findings from a gaps assessment in the north of Lebanon suggest an
above normal occurrence of diarrhoea among children, linked to unsanitary conditions
and water contamination (UNICEF 2012/06/07).
A WASH assessment among Syrian refugees and host communities in North Lebanon
discovered alarmingly poor levels of water quality (ACTED 2012/05/24).
Recent assessments in Bekaa Valley point to the need for family planning and pre-
natal care, including nutrition (UN 2012/06/16).
Turkey
The number of registered refugees stands at 27,400 (UNHCR 2012/06/12).
The refugees are accommodated in Turkish Red Crescent camps in the south eastern
provinces of Hatay, Gaziantep, Sanliurfa and Kilis (AFP 2012/06/13).
Similar to Jordan, there is no specific data available on the food security situation.
Refugees have limited access to livelihood opportunities and it can be assumed that
they will be dependent on humanitarian aid for their food needs.
There are no reports of major health concerns.
4Humanitarian Profile
Affected
Non-Displaced Displaced
1,000,000 ≈ 1,322,000 -
(UN 2012/06/05) 2,479,000
IDPs Refugees and
≈ 505,000 - asylum seekers
1,158,000 ≈ 1,321,000
IDPs displaced by current Registered Syrian refugees Registered refugees and asylum
unrest Protracted IDPs fleeing current unrest (UNHCR, seekers in Syria in 2011 (UNHCR,
≈ 300,000 - 500,000 ≈205,000-658,000 2012/06/18) 2012/06/01)
(UN 2012/05/29, Syrian Arab 77,199 757,340
Red Crescent 2012/05/30) 1982 Hama
≈10,000-20,000 Turkey: 27,405 Iraq: 750,900
(IDMC 11/11)
Kurds 1965-1976 Afghanistan:
≈60,000-140,000 Lebanon: 20,702 1,970
(IDMC 11/11)
Golan 1967 Somalia: 2,640
Jordan: 24,151
≈70,000-433,000
(IDMC 11/11)
Drought Induced Iraq: 4,941 Sudan: 870
2007/8 and 2008/9
≈65,000
(ODI 12/2011) Yemen: 110
Humanitarian Profile
The humanitarian profile attempts to account for the number of people having humanitarian needs arising from a given emer-
Various: 850
gency. It is a count of the number of “affected” people in the emergency. Different groups are identified within the humanitarian
profile, such as displaced, non-displaced, IDPs and refugees and asylum seekers. Source: IASC 2011
Palestinian:
Estimated figures are represented as ≈. The lower ranges presented are based on conservative estimates. 486,946
Available figures did not allow for the displacement figures to be mutually exclusive. For example, population displaced due to
2011 protests may consist of people that also belong to a protracted IDP group (e.g. drought induced displaced). Secondary
and tertiary displacement is not represented.
5Scenarios Challenges in assessing needs of IDPs and refugees in diverse urban environ-
ments.
Probability level Impact level Emergency food distribution, targeted food assistance to the most vulnerable
groups such as Iraqi refugees, women and children, and IDPs as well as targeted
Highly unlikely No impact assistance to affected rural populations and livelihoods support.
Unlikely Impact does not exceed local capacities Priority needs Provision of impartial and safe access to medical care, including providing access
Likely Impact is likely to exceed local capacities to essential emergency medical services.
Very likely Humanitarian intervention needed
Registration and needs profiling of IDPs and refugees
Almost certain Large scale humanitarian intervention needed
Guerrilla warfare in urban areas Probability level X
The scenarios developed for this update can be simultaneous, and are not mutually Scenario
exclusive. Some of the assumptions have already proven to be certain and are cur- Impact level X
rently realised. The objective of the scenarios is to project the probable development Timeframe: 6 months up to protracted crisis
and humanitarian impact of these assumptions in the upcoming months. Opposition forces (FSA) establish better command and organisation lines and
increasingly gain pockets of control focusing on strategic urban areas through guer-
Increasing Impact of Economic Probability level X rilla attacks.
Sanctions Scenario X Regime forces are unable to suppress the opposition which successfully asserts its
Impact level position (CSIS 08/02).
Timeframe: 3 months Heavy bombardment in cities, sniper-fire and gun battles cause a high number of
Finance and trade sanctions coupled with strong depreciation of currency and lack non-combatant casualties.
of credit facilities negatively affect Syria’s ability to import food and non-food items, Assumptions Increased mutual mistrust and resentment between members of opposing camps.
reducing access to and availability of food. Pressure on international partners to Frequent clashes induce resettlement of groups in like-minded areas, confirming a
implement sanctions further contributes to reduced access to food, fuel and medi- worrying pattern of sectarian segregation (Iraq scenario) (Economist 28/01).
cine (Alertnet 19/06, Economist 18/02, BBC 11/2011, GIEWS 2012/04/12). In line with the international pressure on the regime, sanctions, punitive measures
There is a sharp drop in consumption, massive cash withdrawals, capital outflow, and official condemnation of violence there will be an increasing number of interna-
unpaid loans, failing currency, a tumbling stock market, negative growth, inflation as tional actors willing to support the opposition (Reuters 16/02).
high as 50%, a sharp decline in Government revenues, and high unemployment Neighbouring countries and/or allies facilitate supply of weapons to opposition
(ICG 7/2011). forces. Communications are strategically disrupted.
Assumptions
Reduced access products to control pathogens, including certain viruses, bacteria The impact of conflict concentrated in urban centres is twofold:
and toxins further impact the health sector (Alertnet 15/06/2012). Displacement in villages and cities before and during clashes. Destruction of
Sharply increasing prices of cooking and heating oil and gas will reduce access to houses and property causing long term displacement.
these commodities, impacting severely not only transport but also the means for Population trapped between the conflict lines, unable to flee and access basic
cooking and heating. services or humanitarian assistance during the clashes. Where power struggles
Cross-border trade is hit hard by transport delays caused by security-related road persist, whole neighbourhoods face ghettoization along the lines of affiliation
closures and increased costs of petrol and oil (FT 04/2011).Loss of Government with either of the conflict parties and ultimately along sectarian lines. Limiting
control over price of key agricultural products and lack of means to maintain current access to food, water and basic services in specific areas could be used as a
food subsidies. strategic element of warfare and demoralisation.
The overall economic crisis severely impacts food security, which is already af- A potential implication of the struggle for power could be the break-up of the country
fected by high food prices. into areas of influence (Yemen scenario).
GoS is unable to import food to cover the needs and to sustain provision of basic Impact Internal displacement increases rapidly including urban to rural displacement, urban
Impact services. to urban displacement and displacement along sectarian lines.
Lack of trading and livelihood opportunities in urban centres and rural areas are Looting and the grabbing of property increases in urban areas and further fuels
affected by closed shops and markets limits the availability of food and basic sur- tensions among affected civilians.
vival items. Security services and proxies are subject to ever-increasing attacks. Regime forces
Escalating violence inhibits humanitarian organizations to deliver food and medical progressively lose mobility and control over portions of the country, forcing retreat.
assistance in conflict centres and bordering areas affected by tensions and insecu- There no longer is a permanent loyalist military presence in parts of Idleb, Hama
Operational rity. and Homs governorates, enabling the armed opposition to further regroup and or-
ganise. Governorates of Dayr Az Zor and Dera’a follow a similar path.
constraints Limited space for humanitarian operations, including emergency cash transfers.
Challenges in maintaining food and medicine stocks and keeping them safe from
As defections mount and the army is under ever greater stress, the regime cannot
muster sufficient military resources to reverse the trend.
raids.
Cross border movements into Lebanon, Turkey and Jordan increase, with long-term
6displacement of refugees in camps and host families. Population trapped in conflict areas and cities with violent clashes face major food
shortages and gaps in medical service provision.
Insecurity increases inaccessibility for humanitarian actors. Protection for affected population.
Operational
Challenges to monitor urban areas create lack of awareness of needs. Emergency health care and secondary surgical care for the injured.
constraints Priority needs
Humanitarian actors prone to attacks by armed militia groups. WASH and food assistance.
Emergency assistance to displaced population in the border regions.
Populations trapped in conflict areas with heavy fighting face protection risks, espe-
cially women and children. Registration and needs profiling of IDPs and refugees.
Emergency health and surgical care for the injured.
Priority needs Emergency assistance to displaced and conflict affected populations, including food
assistance.
Registration and needs profiling of IDPs and refugees.
Spill-Over Scenario Probability level X
Impact level X
Timeframe: protracted crisis
Sectarian allegiances mirroring the conflict lines within Syria will intensify cross
boarder fighting, opening space for groups not directly involved in the conflict to use
violence to remedy existing grievances (Alertnet 19/06/2012).
Political groups affiliated with either side of the conflict will increase domestic ten-
sions and trigger protests, which erupt in violent clashes. This could contribute to a
shock to fragile domestic power balances in Lebanon and at the stake of re-fuelling
Assumptions internal uprisings.
Establishment of safe havens for opposition forces in neighbouring countries inten-
sifies tensions in the region and between countries.
Opposition forces regroup in neighbouring countries recruiting allies along sectarian
lines and allegiances.
Fundamentalist fighters and proxies report directly to foreign parties. The regime
grows weaker and more violent, involving neighbouring countries as diversions.
Increased measures of border security will impede the flow of displaced persons
from Syria into neighbouring countries exposing the fleeing population to the risk of
being targeted by the Syrian security forces. This could result in a high number of
people trapped in border regions with no access to humanitarian assistance.
Regime retains considerable manpower and that support base is radicalised even
as it narrows. Reorganised around a hard-core elite composed of ruling family
members and loyalists whose determination to fight has only heightened as their in-
Impact volvement in months of repression has grown.
Humanitarian supply chains are disrupted as well as the provision of humanitarian
assistance to populations in refugee-hosting countries and from neighbouring coun-
tries into Syria.
The continued smuggling of diesel and weapons from neighbouring countries into
Syria - needed by armoured vehicles as well as by industry and farmers - could
hamper efforts to isolate fighting and prevent spill-over to more areas.
Inaccessibility for humanitarian actors
Logistical constraints
Operational Selective procedures at the borders restrict most vulnerable groups from entering
constraints and accessing essential services.
Water and electricity can be cut off, disrupting communication channels and supply
chains.
7Livelihoods and Food Security In February 2012, the Government doubled customs duties and imposed an addi-
tional 30% tax on goods imported from Turkey, which has put further pressure on
domestic prices (GIEWS 2012/04/12).
Priority Concerns Syria's two most vital sectors - tourism and oil – have been hard hit by the unrest
and economic sanctions. A continued decline in economic activity is expected for
Most affected areas the duration of 2012 (BBC 2012/04/09).
An estimated one million people need humanitarian assistance, including food
assistance, due to the impact of the prolonged social unrest on household The value of the Syrian pound has crashed to its lowest level in black-market trad-
economies and food distribution channels across markets. Even before the vio- ing. Even against official exchange rates, the Syrian pound has plummeted by more
lence broke out in Syria, 1.4 million people struggled to meet their daily food than 60% against the US dollar (BBC 2012/04/09).
needs.
In 2008, food subsidies were 2.1% of total GDP in Syria, the highest of the region.
In conflict-affected areas, insecurity has disrupted trade networks and basic food Syria's deficit has increased due to declining Government revenues and loss of oil
items are scarce. Of particular concern are the besieged areas, such as Homs, exports hit by sanctions. This deterioration of the Government’s fiscal position can
where movement is highly restricted, food supplies are running low and humani- have implications for these subsidies (WB 2009).
tarian access is limited.
Unemployment is estimated to have risen to more than 20% since the uprising Livelihoods and food insecurity
began. This has been coupled with soaring food prices across the country and
high inflation. Even before the violence broke out, 1.4 million people struggled to meet their food
needs. Many are now living in areas which have become conflict hotspots such as
Homs, Hama, rural Damascus, Dara and Idleb and the concern is that they have
Key characteristics become even more vulnerable (GIEWS 2012/04/12).
Since the unrest began, livelihoods across the country have been impacted.
Economy and Consumer Price Index - bread and cereals Central Bureau of Statistics
Food prices o An estimated 300,000 small farmers and herders in the north-eastern prov-
inces are affected by the loss of opportunities from seasonal labour migration
Inflation is in-
to the south and east (GIEWS 2012/04/12).
creasing rapidly
o The continuing instability and the volatile security situation have rendered
and is currently at
breadwinners unemployed (WFP 2012).
30%, mainly due
o Civil insecurity prevents farmers from accessing their farmland during the
to sharp increases
harvest. There is limited availability and access to fertilizer and seeds (GIEWS
in food prices and
2012/04/12).
fuel shortages.
(GIEWS 2012/04/12, o The unrest is affecting pastoralists by restricting mobility of herds, with nega-
Reuters 2012/06/13). tive effects on access to water and pasture, and reducing the access to vet-
erinary drugs and other supplies (GIEWS 2012/04/12).
The joint UN-OIC o Increasing insecurity and criminality is affecting livelihoods and trade, as
analysis of the people are unwilling to carry the large amounts of cash needed to obtain
Government-led commodities (PI 2012/06/18).
assessment mis-
sion found that
food prices had
risen by between 30% to 60% in most localities visited, and by up to 80% in some
localities, such as Hama (PI 2012/06/18). This will further reduce access to food for
poorer households.
8Food Availability Health and Nutrition
Basic food, such as bread, is becoming scarce in affected areas (BBC 2012/06/08, IRIN
2012/03/27). In the besieged city of Homs, people are reportedly running low on food Priority Concerns
supplies (AFP 2012/05/24).
There is a lack of access to health care in conflict-affected areas. Medical facili-
The outlook for the 2012 winter cereal crops and for harvest from May is uncertain ties and personnel are directly targeted and the distribution of medicines is dis-
given disruptions in overall agricultural activities (GIEWS 2012/04/12). rupted.
Normally, Syria relies on food imports for almost half of its total domestic use. FAO Medical personnel and patients have been subject to torture and arrest in hands
estimates that the Government has to raise cereal imports by a third (from 3 to 4 of the security services. Patients refrain from visiting official medical facilities.
million) to offset a loss in output due to the current unrest. The main barley-
producing areas are Homs, Hama, Aleppo and Idleb, all areas where fighting has Areas that host IDPs, such as Tartous and rural Damascus, face an increased
been heavy (Reuters 2012/06/13, WFP 2012/03/15). burden on their health services.
Although there are no sanctions in place against food commodities, economic and
trade sanctions imposed by the international community together with the strong
depreciation of the local currency and lack of credit facilities are negatively affecting Key characteristics
the country’s ability to import food commercially.
Access and coverage
A lack of payment mechanisms and growing issues with discharging at Syrian ports In some conflict affected areas, basic health services are completely disrupted.
limit the possibilities to import large quantities of food commodities (Reuters 2012/05/17, Limited access to health services also results from difficulties for both health per-
FAO 2012/06). sonnel and patients in safely reaching hospitals and health centres (WHO 2012/03/14).
Supply and distribution of medicine, medical supplies and equipment is disrupted
due to limited access and the effect of sanctions on international procurement
Poverty Incidence per Governorate (2004) (UNDP 2004) (WHO 2012/03/14).
There is a large increase in weapon-related injuries (WHO 2012/05/06).
There is an increase in complicated and delayed obstetric emergencies (WHO
2012/05/06).
The influx of populations moving from affected areas to rural Damascus, Tartous
and Damascus has increased the burden on health services, while facilities in af-
fected areas are underutilized due to security concerns (WHO 2012/05/06).
The interruption of all preventive services including vaccination has been reported.
The vaccination coverage rate has decreased in affected areas (RI 2012/03/14, WHO
2012/03/14).
Stakeholders including the MoH, local NGOs and SARC report a need for:
o Strengthening/restoring the trauma management capacity and referral
system in affected areas.
o Addressing the lack of medicines and supplies, especially in relation to
trauma care and chronic diseases.
o Ensuring the ongoing provision of basic health services, with particular
emphasis on child health, maternal health, and chronic diseases.
9o Strengthening health workforce with mobile clinics and fixed health posts Protection
(WHO 2012/03/09).
A number of detainees’ relatives have raised concerns regarding the ability of their
family members to obtain adequate medical treatment in detention (HRW 2012/05/13). Priority Concerns
Targeted attacks Violence against children is widespread and a major protection concern.
Physicians are required by law to immediately notify security services of the arrival Torture, extrajudicial killings, and indiscriminate violence have impacted both
of any wounded person at a health facility, regardless of the severity of injuries (IFRC adults and children, with men and boys being predominately targeted and vul-
2011/10/24).
nerable to violence and sexual abuse in detention. Impunity for such violations
Doctors and wounded patients are directly targeted and risk torture and arrest at the remains widespread.
hands of the security services. Injured people taken to military hospitals are being
A lack of information on GBV makes timely and appropriate emergency medical
tortured and beaten during interrogation (UN Cte Torture 2012/05/06).
and psychological response to victims of sexual violence and abuse difficult.
Even if the resources and infrastructure are there, the fear and risks of capture are
so great that doctors hesitate to treat patients or only provide basic first aid. Doctors
reported that 'being caught with a patient is worse than being caught with a weapon' Child Protection
(MSF 2012/05/17). Violence involving children
Medical facilities have been directly targeted (UN Cte Torture 16/05/2012). Children, aged 8-13 years, have been forcibly taken from their homes and used by
soldiers and militia members as human shields, illustratively, children are placed in
front of the windows of buses carrying military personnel to raid villages (Alertnet
Communicable diseases 12/06/2012, Economist 12/06/2012, UNGA 2012).
At the start of May 2012, there were no reports of communicable disease out-
breaks. As the unrest continues into the summer and temperatures rise, the inter- Children are victims of military aggression by Government forces, the Syrian Army,
ruption of water and sanitation services results in an increased possibility of disease the intelligence forces, and the Shabbiha militia. Children have been killed by sniper
outbreaks. There is a need to strengthen Syria’s early warning surveillance system fire in residential areas, and some have been maimed while taking shelter in their
(WHO 2012/05/06). own homes. Among the violations are the recent summary executions of children in
Houla and Taftanaz (HRW 11/06/2012, UNGA 2012).
Lessons Learned Government forces continue to use violence against children in areas where mem-
As a result of impaired access to healthcare, conflict affected populations face bers of FSA or other armed opposition groups are present, where deserters are al-
higher risk of disease and are more likely to be severely affected if they fall ill (ICRC legedly hiding, or if they are seen fleeing the country to seek refuge (UNGA 2012).
2004). Deserting army officers have reported that they were ordered to attack protesters
Individual immunity decreases due to malnourishment, inadequate shelter and ex- regardless of their age (HRW 11/06/2012).
haustion (MSF 1997). Schools have been regularly raided and used as military bases and detention cen-
Malnutrition increases the susceptibility of individuals–particularly children–to respi- tres (HRW 11/06/2012, UNGA 2012).
ratory infections, malaria, diarrhoeal diseases and measles and is an important According to the Syrian Revolution Martyr database between the start of the upris-
cause of death (HSRP 2009). ing and 10 June 2012, 1226 children aged 16 years or younger have been reported
killed. Of these 76% (933) were boys, and 24% (293) were girls (SRMD 14/06/12).
Child Recruitment
There are credible reports of children being recruited by the Free Syrian Army to
help with frontline medical duties and act as messengers, increasing their risk of at-
tack by Government forces (Economist 12/06/2012, UNOHCHR 07/06/2012).
10Psychosocial Needs Women and Gender-Based Violence
As of 20 June 2012, 77,199 people have fled the violence in Syria and registered According to the Syrian Revolution Martyr database, around 16,000 persons have
with UNHCR in neighbouring Jordan, Lebanon, Turkey and Iraq. Around 25% of all been killed between the start of the uprising and 11 June 2012 (SRMD 15/06/12). Of
displaced Syrians are children and adolescents who face interruption of schooling, these 93% (15,300) were men and 7% (1,160) women (SRMD 15/06/12).
limited access to basic services, and psychosocial distress caused by witnessing
violence and displacement (UNICEF 04/06/2012, 11/05/2012). Syrian Government forces and pro-Government armed militias have used sexual
violence to torture men, women, and boys detained. Soldiers and pro-Government
armed militias have sexually abused women and girls as young as 12 during home
Torture and Detention raids and military sweeps of residential areas and in detention facilities (HRW
Children as young as ten years have been tortured while in detention. The 15/06/2012).
Shabbiha militia was reportedly involved in the detention and torture of children dur- Methods of torture include: sexual abuse, forced witnessing of sexual abuse in de-
ing military operations and using makeshift detention cells in schools. Most child tention, rape, penetration with objects, sexual groping, prolonged forced nudity, and
victims of torture describe being beaten, blindfolded, subjected to stress positions, electroshocks and beatings to the genitals (HRW 15/06/2012).
and whipped with heavy electrical cables (UNGA 2012, Economist 12/06/2012).
The stigma in Syria surrounding sexual violence makes victims reluctant to report
Detainee children have been kept in solitary confinement and denied medical abuse. Even when they wish to seek help, survivors of sexual assault have limited
treatment, adequate food, and water (HRW 11/06/2012). access to emergency medical care, psychological services, legal assistance, and
Detainees – overwhelmingly men and boys – are routinely tortured and forced to social support. Survivors who have fled to neighboring countries also face obstacles
make incriminating and false confessions – such as possession of weapons or in- in seeking treatment, including limited service options and inability to access ser-
volvement with the armed opposition (AI 14/06/2012). vices that are available due to the stigmatization of sexual abuse, families restricting
their movement, and the fear of being subjected to so-called “honour” crimes (HRW
Men and boys report sexual torture and rape during detention, including beatings of 15/06/2012).
genitals, forced oral sex, electroshock treatment, being burned by cigarettes (UN Cte
Torture 16/05/2012, UNOHCHR 07/06/2012). Detention facilities where male and female detainees have reported sexual torture
include Military Intelligence Branches (known as “Palestine Branch”) in Damascus;
Detention facilities are overcrowded, forcing detainees to take turns to sleep (UN Cte the Military Intelligence facilities in Jisr al-Shughur, Idleb, and Homs; the Political
Torture 16/05/2012, UNOHCHR 07/06/2012). Security branch in Latakia; the Air Force Intelligence branches in Mezze, Latakia,
Injured people taken to military hospitals were tortured and beaten during interroga- and Homs; and the Idleb Central Prison. The majority of cases however has been
tion. Numerous methods of torture have been identified. Those methods included reported from Homs (HRW 15/06/2012).
severe beating with batons and cables, forcing detainees into stress positions for
hours or even days in a row, electroshocks, and deprivation of food, water and Human Rights Violations
sleep (UN Cte Torture 16/05/2012, UNOHCHR 07/06/2012). Although men and boys have been the primary targets of extrajudicial executions,
Obstruction and denial of medical assistance to the injured and sick, and the sys- hundreds of bystanders not directly involved in the conflict have been killed and in-
tematic arrest and torture of wounded patients in State hospitals is a grave concern. jured from indiscriminate shooting and shelling by Syrian armed forces (AI
Individuals suspected by the GoS of setting up and operating alternative medical 14/06/2012).
care or providing medical supplies were also subjected to arrest and torture by the
security forces (UN Cte Torture 16/05/2012, UNOHCHR 07/06/2012).
Blockades and Urban Insecurity
Security force members, government supporters, former members of the Syrian Blockades and curfews have been imposed on cities such as Homs, Hama, Dara
armed forces, and those identified as members of pro-government militias are sub- and Idleb. During blockades, residents have been unable to obtain water, food and
ject to kidnapping, detention, torture and execution by armed opposition groups medical supplies. National security forces reportedly have targeted residential wa-
(HRW 20/05/2012). ter supply systems, and the blockades have made it difficult to get the injured to
hospitals (UNSG 22/05/2012).
11 The use of explosive weapons in populated areas, as in Homs and Idleb, has had WASH
profound humanitarian consequences, including damage to buildings and essential
infrastructure and threats posed by explosive remnants of war (UNSG 22/05/2012).
WASH for the affected population in Syria has not been stated as a priority need.
Bomb attacks reportedly carried out by armed opposition groups in Damascus and However, National Security Forces have reportedly targeted water supply systems,
Idleb have also claimed civilian lives (UNSG 22/05/2012). which, if continued, will affect the basic water needs of the population. Water avail-
ability in Syria has been further affected by power cuts. (UNSG 22/05/2012).
Criminality is on the rise, with increasing reports of widespread looting and theft
(IRIN 2012/06/19). WASH needs are highest among the Syrian refugee populations in neighbouring
countries.
Two oil pipelines have been attacked by the opposition forces: one of them linking
Homs and Damascus and one in the eastern province of Dayr az Zor. Pumping is The irrigation canal flowing through fields, connecting the Homs district to the reser-
expected to resume in the next few days, although the same pipeline had been tar- voir sited 12km south-west of Homs is largely dried up. Temperatures in Syria can
geted twice in the last two weeks (Alertnet 19/06/2012). exceed 40C (104F) in summer, and locals accuse the Syrian army of deliberately
shelling and rocketing vulnerable water tanks on rooftops to deprive residents of
drinking water. The situation has been exacerbated by rumours that the remaining
Security in the border areas water supply has been contaminated, leading to a rush on bottled water. The dis-
Government forces have reportedly prevented civilians from leaving the country at tricts of Al-Qusoor, Baba Amr, Bayada and Asherah have had no water or electricity
Lebanese and Turkish borders. All men aged 18-42 are banned from traveling out- service for two months now (BBC 2012/06/08).
side Syria without prior authorization (AFP 27/03/2012).
An opposition activist reported that there was no electricity in the besieged town
To reach northern Lebanon, Syrians must navigate heavily mined areas and avoid Rastan, central Homs province, and a shortage of food and water (AFP 2012/05/24).
being shot by Syrian soldiers (RI 14/03/2012, Alertnet 2/03/2012). Refugees trying to cross
into Lebanon have reported Syrian border police confiscating their belongings, ar- In several areas, waste removal has been hampered by the insecurity, creating
rested them, or shooting them (RI 05/06/2012). hygiene problems and an increase in water borne and skin diseases (PI 2012/06/18).
Armed cross-border clashes erupted at the northeastern Lebanese-Syrian border.
The Lebanese Army has since deployed its troops in the area and is monitoring the
situation (UNHCR 08/06/2012).
Syrian forces are laying mines near the Turkish border, especially in the southern
Idleb region, in an attempt to block the flow of refugees out and supplies for insur-
gents (Reuters 06/04/2012, Alertnet 13/06/2012).
Lessons Learned
Exposure to armed conflict is a principal risk factor for the development of mental
disorders and Post Traumatic Stress Disorder (PTSD) in particular.
Children are the most vulnerable group to develop PTSD and related mental disor-
ders (ICRC 1996).
Among women, rape is the assault that has the highest probability to lead to PTSD
(Resnick et al 1993).
12Timeline
Source : Al Jazeera 2012/06/18
13Key background documents
Amnesty, Deadly Reprisals: Deliberate Killings and Other Abuses by Syria’s Armed Forces, 14th of June 2012, http://www.amnestyusa.org/research/reports/deadly-reprisals-
deliberate-killings-and-other-abuses-by-syria-s-armed-forces
FAO, GIEWS -Special Alert 331 - Civil unrest raises grave concern for food security, 14th of March 2012 http://reliefweb.int/node/482868
HRW, Syria: Stop Grave Abuses of Children, 11th of June 2012, http://www.hrw.org/news/2012/06/11/syria-stop-grave-abuses-children
HRW, Syria: Activists Arrested, Held Despite Pledge to Annan, 13th of May, http://www.hrw.org/news/2012/05/13/syria-activists-arrested-held-despite-pledge-annan
UN, Syria Regional Response Plan, March 2012, http://data.unhcr.org/syrianrefugees/uploads/SyriaRRP.pdf
UN Committee against Torture, Committee against Torture considers situation in Syria in the absence of a report, 16th of May 2012, http://reliefweb.int/node/497095
UNGA, Children and armed conflict, Report of the Secretary-General, 26th of April 2012, http://reliefweb.int/sites/reliefweb.int/files/resources/Full_Report_4118.pdf
UNHCR, Syria Regional Refugee Response Information Sharing Portal, http://data.unhcr.org/syrianrefugees/regional.php
WHO, The Syrian Arab Republic crisis – Meeting humanitarian Health Needs, 13th of March 2012.
http://reliefweb.int/sites/reliefweb.int/files/resources/syria_donor_alert_13march2012.pdf
WHO, Syrian Arab Republic unrest, Situation report #6, 8th of May 2012, http://reliefweb.int/sites/reliefweb.int/files/resources/Syria_sitrep_6.pdf
Methodology – This desk study presents estimations of scale, severity and likely impact of a disaster. It
aims to inform decision making for preparedness and emergency response and intents to complement and
integrate assessment-related data from other agencies. Feedback to improve the DNA is welcome
(dna@acaps.org). ECB and ACAPS thank agencies and NGOs who have shared data and analysis.
Update: This DNA is an update of two earlier DNAs (December 2011 and February 2012) and the informa-
tion within this report should be seen in light of the information provided in these earlier DNAs. The previous
versions of the Syria DNA can be found here.
Disclaimer – Information provided is provisional as it has not been possible to independently verify field
reports. As this report covers highly dynamic subject, utility of the information may decrease with time.
References – Please note that all sources are hyperlinked (in brackets) and that an accompanying glos-
sary is available here. Information sourced as PI refers to personal interviews with experts in the field.
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