Overview of MSF’s Syria Crisis related activities

December 4, 2013

Overview of MSF’s Syria Crisis related activities © Baozhu Wei

After more than two and a half years of extremely violent conflict in Syria, the situation is becoming increasingly dire for millions of people. Aid is falling drastically short of what is needed. The previously well functioning health system has collapsed leaving many without access to basic health care services, and the routine vaccination programme has been disrupted leaving thousands of children unprotected. People are suffering, not only from the direct consequences of war - bombs and bullet wounds - but also from having to leave their homes and belongings, and having their regular lives and medical treatments interrupted. The displaced people are living in makeshift camps or overcrowded accommodation where sanitary conditions are poor. Food shortages are commonplace, and water and electricity supply is disrupted.

=> Inside Syria

MSF is operating 6 makeshift hospitals and 2 health centres inside Syria. From June 2012 to date, these teams have performed 102,828 medical consultations (more than 40,000 of these as Emergency Room consultations), 4,899 surgeries and 1,516 safe maternity deliveries. The teams are also running mobile clinic programmes in some areas when security conditions allow, and we are running comprehensive routine vaccination programmes for children in the areas where we are operating. As well as war wounded, we see a lot of patients with chronic diseases such as diabetes or hypertension, patients who can no longer access their regular treatment and who rely on MSF's medical services to avoid falling dangerously sick.

In areas where MSF is not able to work directly, we have an extensive programme of remote support for Syrian medical networks, both in opposition-controlled and in government-controlled areas. Through this programme we are supporting 30 hospitals and 60 medical posts in 7 governorates. On average around 3 tons of medical supplies or basic relief items such as blankets, mattresses, soap or cooking sets are supplied per day through this programme.

Syria statistics (from June 2012 to end October 2013):

ER consultations – 40,052

Out-patient consultations – 62,776

Surgical procedures – 4,899

Maternity deliveries – 1,516

Emergency measles vaccination campaign – 75,000 children (April to June 2013)

Currently 718 international and Syrian MSF staff working inside Syria

Syrian Refugees in neighbouring countries

According to official estimates, more than 2 million Syrian refugees are registered or awaiting registration in Syria’s neighbouring countries, but the actual number could be much higher. Compared to Syria, there is much better access and security in the surrounding countries, yet the humanitarian response to the refugee crisis remains inadequate.

Today the resources of these countries are stretched to the limit. Jordan and Lebanon have almost reached their limits for meeting the basic needs of the increasing number of refugees. Gaps in health services continue to expand while funding diminishes.

MSF is carrying out medical consultations (primary health care, vaccination as well as mental health care) and distributing relief items to refugees in Iraq, Jordan and Lebanon.

In Iraq there are more than 200,000 Syrian refugees. Most of the refugees arriving in the north of Iraq have come from the traditionally Kurdish areas of Syria in search of safety in Iraqi Kurdistan. The main border crossing into Iraqi Kurdistan was closed since last May and reopened on 15 August. Since then, over 60,000 refugees have crossed the border into the Kurdish region of Iraq. On the day it reopened, an estimated 7,000 Syrians crossed the border. Since mid-September the border has been substantially closed, with short windows of opportunity for refugees to cross from time to time.

MSF is providing out-patient health services, mental health consultations and water and sanitation engineering in several locations for refugees in Iraq, notably in Domeez and Kawargosk camps, and also in transit and refugee camps in Dohuk, Erbil and Sulaymaniya governorates.

Iraq statistics (to end October 2013):

Total consultations, including mental health sessions – 152,831

Currently 145 international and Iraqi MSF staff working on refugee activities

In Jordan there are more than 550,000 Syrian refugees. The majority of the refugees are living outside of the refugee camps putting pressure on the existing services and increasing prices (food, housing) for both Jordanian citizens as well as refugees. The Jordanian health system is becoming increasingly overburdened with the continuous influx of refugees and wounded from Syria.

MSF has closed its paediatric hospital project in the Zataari refugee camp as other health actors are currently able to meet the health needs in the camp. MSF will, however, maintain some presence in the camp to assess the health needs in order to respond to any future gaps. In September, MSF started an emergency surgical project inside the Ministry of Health hospital in Ramtha, next to the Syrian border. MSF has conducted more than 230 life-saving surgeries on more than 125 war wounded coming from Syria, including multiple amputations and patients with severe abdominal, chest and orthopaedic injuries. In Amman, MSF’s reconstructive surgery hospital continues to see a high proportion of Syrian wounded. The team provides orthopedic, maxillofacial and plastic surgeries for victims of violence, and physiotherapy, psychosocial support and post-operative care are also provided as necessary. In Irbid, MSF has just started to provide mother healthcare for refugees that are living among the Jordanian community rather than in a refugee camp.

Jordan statistics (to end October 2013):

ER consultations – 4,564

Out-patient consultations – 15,814

Surgical procedures – 700

Currently 188 international and Jordanian MSF staff working on refugee activities

In Lebanon there are more than 800,000 Syrian refugees. This has overwhelmed the response capacity of the local authorities and significant assistance in needed from aid organisations. Tensions are high in some parts of Lebanon, reflecting pro-opposition or pro-government views among refugees and Lebanese communities.

Living conditions are worsening as more and more refugees are staying in unsuitable shelters. Informal tended settlements, mostly scattered throughout the bordering regions of Beeka Valley and North of Lebanon are widespread and present worrying water and sanitation conditions. Growing medical gaps for refugees include access to secondary health care, safe deliveries in the hospital and chronic diseases medications that are increasingly difficult for many refugees to access.

MSF is assisting refugees through general medical consultations including treatment of acute and chronic diseases, immunization, reproductive health care and mental health care, as well as distributing relief items. MSF’s main activities are in the Bekaa valley, main crossing point for people fleeing Syria; in Tripoli, North Lebanon, where most of Syrian refugees are staying; and in Saida and Shatila, where the majority of Palestinians from Syria have gathered.

Lebanon statistics (to end October 2013):

Total consultations, including mental health sessions – 91,046

Currently 172 international and Lebanese MSF staff working on refugee activities

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