WHO Humanitärt stöd till Syrien 2018-2019

Examples from the WHO Syria report 2019: In northwest Syria, the offensive that started in 2019,with escalations in April and December, significantly exacerbated humanitarian needs in one of the last opposition-held areas of the country. In December alone, following weeks of sustained air and ground assaults, approximately 300 000 people in the northwest were displaced, mostly to areas that were already heavily populated by people in urgent need themselves. Health systems were severely disruptedand hampered by fragmented governance, while the number of injuries due to military operationscontinued to rise. The heaviest burden on health was in northern Idleb, where overcrowded camps struggled to absorb the newly displaced as winter tightened its grip. Access to shelter, safe water and sanitation was and remains a major challenge. WHO and health partners stepped in to provide vital health care services to hundreds of thousands of people. In northeast Syria, humanitarian needs increased after the fall of ISIL’s last stronghold in March and the formation of one of the largest refugee and IDP camps in the country. The later withdrawal of US forces followed by a Turkish offensive in October once more triggered a mass displacement of more than 200 000 civilians, many of whom had previously been displaced many times during the conflict. At the time of this report, an estimated 70 000 of these people remain displaced. In southern Syria, the humanitarian situation remained highly fluid despite the signing of areconciliation agreement in July 2018. Armed attacks rose in the first months of the year. Tens of thousands of people displaced in 2018 returned to their villages to find fields and crops laid to waste, devastated infrastructure, acute shortages of electricity, clean water, sanitation and health care, and extensive contamination from the explosive remnants of war. The following are a few of the listings of results from the report of 2019: Primary Health Care (PHC)To enhance the coverage of affordable basic PHC services, WHO donated over 2.1 million treatment courses of life-saving medicines (including NCD kits) to health partners and delivered 406 pieces of equipment such as nebulizers, laboratory and ultrasound equipment, pulse oximeters, X-ray machines and generators to ministries, the Syrian Arab Red Crescent and NGOs. The Organization also supported over 5.2 million consultations in PHC centres throughout Syria. Among the PHC efforts most appreciated by beneficiaries during 2019 was WHO’s donation of27 mobile clinics to health responders across the country. WHO also provided 12 medical caravans to health partners working in the major IDP camps and informal settlements in the northeast. Each set of two caravans consisted of three clinics and a pharmacy. Among the mobile medical teams supported by WHO were four teams in Homs and Hama that were providing services for people from Rukban settlement and two teams deployed to schools in eastern Ghoutaas part of an oral health project. Trauma Care In northwest Syria, WHO’s office in Gaziantep delivered specialized trauma and surgical kits andmedicines to provide more than 180 000 treatments. In areas accessible from within Syria, WHO supported trauma care for 474 669 patients and delivered 2 354 029 courses of treatment and 108 pieces of medical equipment to health facilities providing trauma care services. A total of 2571 health care workers were trained on trauma care, treatment of patients with disabilities, first aid, prostheses, basic life support, mass casualty events, burns, war wounds and spinal cord injuries. WHO also supported 22 000 physiotherapy sessions and delivered nearly2300 disability devices. SGBV Syria is one of eight countries in the Eastern Mediterranean region in which WHO works on confronting genderbased violence (GBV) in emergencies. Since 2018, it has institutionalized the prevention of and response to GBV across the health sector. Health services can provide critical, time-sensitive interventions that prevent, mitigate or treat some of the health consequences of GBV and connect survivors to services that improve their health and well-being. Mental health and psychosocial support (MHPSS) services are a critical entry point for helping GBVsurvivors. WHO has sought to gradually introduce GBV services into health and community facilities rather than presenting them as isolated projects. This has increased policy makers’ awareness, built capacity and integrated GBV concepts into existing curricula and health andcommunity services. The year 2019 saw huge improvements in the response to GBV in Syria. The MoH endorsed its first ever training-of-trainers course in Aleppo, attended by health staff from eight governorates, and GBV was successfully integrated into MHPSS curricula, programmes and activities. Mental healthWHO and its partners have decentralized mental health care and increased community-based approaches. For example, trained and supervised doctors and health workers are providing integrated mental health care in over 540 PHC centres across the country. Two psychiatric wards in Lattakia and Damascus provide management for mental, neurological and substanceuse disorders. In the northeast, through close coordination with health partners, WHO continuedto transport patients in acute need of special care to Aleppo mental health hospital.In 2019, health partners across the country were provided with 121 202 treatment courses ofpsychotropic medicines, and 552 316 MHPSS services were delivered, often through local NGOs and innovative community-based methods. WHO trained psychosocial workers throughout Syria (including the northwest) on Problem Management Plus, a low-intensity psychological intervention that tackles depression, anxiety, problem-solving skills and resilience for adults. WHO’s office in Damascus supported training for 725 physicians on mhGAP. Hundreds of health care workers were trained on basic, family and group counselling, psychological first aid and first-line support for GBV survivors. The learn–work–learn method applied helped to ensure that learning was translated into practice and reinforced at further training sessions. Additionally, 26 journalists were trained on communications around suicide prevention and MHPSS. In sum, WHO’s office in Damascus supported 1 685 222 medical procedures and 8 555 792 treatment courses, 90% of which were delivered to areas classified as 3 and above on the severity scale. WHO’s office in Gaziantep, Turkey supported 4 556 341 medical procedures and 4 812 633 treatment courses. WHO continued to lead the health sector (from Damascus) and the health cluster (from Gaziantep), as well as the humanitarian programme cycle for the Whole of Syria health cluster (from Amman). WHO provided authoritative technical guidance and expertise, coordinated the work of over 180 health partners and trained more than 25 000 health staff. The Organization monitored and verified attacks on health care throughout Syria. On behalf of all health partners, WHO continued to voice its concern regarding these attacks and advocate for the protection of health care and respect for international humanitarian law.

Svenska: Tre mål har formulerats för insatsen: 1. Tillhandahålla livräddande humanitärt hälsostöd, med fokus på de mest utsatta och de allra mest behövande. 2. Stärka koordinering av hjälporganisationer och förbättra systemen för hälsoinformation, i syfte att höja effektiviteten i hälsoinsatserna och öka tillgången till sjukvård. 3. Stödja hälsosystemets möjligheter att tillhandahålla sjukvård samt stärka lokala samhällens förmåga att hjälpa flyktingar och förhindra utbrott av smittsamma sjukdomar. Syftet med WHOs program är att ge sjukvård till människor i behov i krigets Syrien. I WHOs mandat ingår också att koordinera de många hälsoaktörer i hälsosektorn och tillhandahålla information om hälsosituationen. Dessa funktioner är nödvändiga för en effektiv respons. Samordning av de olika hjälporganisationern bidrar till att identifiera gap och utarbeta gemensamma planer. Hälsoinformationen behövs för att snabbt kunna åtgärda akuta behov och utbrott. WHO arbetar också med att stärka de nationella hälsoinstitutionerna, för att de ska kunna fortsätta att tillhandahålla service. Det är Sidas bedömning att WHOs program i Syrien är i linje med organisationens mandat och att det i hög grad är relevant utifrån behoven.  Engelska: Objective 1: Provide life-saving and life-sustaining humanitarian health assistance with an emphasis on those most at risk and in need. Objective 2: Strengthen health sector coordination and health information systems to improve the effectiveness of life-saving health response for people in need, with an emphasis on enhancing protection and increasing access for health. Objective 3: Improve health system capacity for support of continuity of care and strengthen community resilience and response to IDP movements and disease outbreaks. The purpose of WHO’s program is to provide health care services for the duration of the conflict, to help coordinate the overall response and to strengthen and build capacity of local communities and the health care system to reduce the need for humanitarian support. It is here suggested that, based on the description above, these objectives seem highly relevant in relation to the situation in Syria and to the mandate of WHO.