Syria: crisis update - October 2017

MSF supports more than 70 medical structures – from hospitals to small health posts – located across Syria, including in Aleppo, Idlib, Homs, and Dara’a governorates.

Northern Syria

Raqqa governorate

Tabqa
Tabqa, a city located near the dam on the Euphrates river, was taken from Islamic State (IS) group by the Syrian Democratic Forces (SDF) in May 2017. Most of the people who fled the city and were living in Ain Issa camp have returned to their homes, despite the lack of public services and the many remaining landmines. In October 2017, MSF opened a clinic with an emergency room, stabilisation beds and an outpatient department. Patients requiring a higher level of care will be referred to Kobanê/Ain al-Arab.

Ain Issa camp
Ain Issa camp, to the north of Raqqa, is an official transit camp for people displaced by the conflict.

With the SDF/US-led coalition frontline moving towards Raqqa, and the Syrian government frontline moving towards Deir Ezzor, people are arriving in the camp daily. As some people are just transiting, the number of arrivals matches the number of departures, and the camp population of around 8,000 remains stable.

MSF supports a team in the camp in giving the WHO-recommended package of vaccinations to children under five. An MSF team is now managing the outpatient department, which provides primary care and chronic disease consultations, and refers patients to Kobanê/Ain al-Arab or Tal Abyad hospitals if necessary. Children in the camp are screened for malnutrition, and formula milk is distributed to babies under six months whose mothers are unable to breastfeed. MSF also distributes non-food items and provides water and sanitation services in the camp.

Tal Abyad
Tal Abyad, in Raqqa governorate, recently came out of conflict. The hospital was badly damaged and most of its medical equipment was either destroyed or looted. MSF worked with the Kurdish health authority to support the hospital in preparation for the Raqqa offensive. In recent months, MSF has supported the paediatric, maternity and surgical wards, as well as vaccination activities. Patients come from a radius of 120 kilometres.

Since the Raqqa offensive began in June, medical teams have admitted 339 patients, many of whom received emergency/lifesaving surgery. In the last two weeks, 54 injured patients have been admitted, including 34 war-wounded. A team is vaccinating almost 100 children under five per day in each location that they visit.

Idlib governorate

Atmeh
In Atmeh, northwest Syria, MSF runs a surgical burn hospital staffed by Syrian nationals and supported by a team of Syrian and international staff based in southern Turkey. Patients at the centre, which has a capacity of between 15 and 19 beds, receive surgery, skin grafts, dressings, and physiotherapy. The facility also treats emergency cases, and provides mental health support and outpatient consultations. In addition, MSF runs health education, and disease surveillance activities in camps and villages hosting displaced people around Atmeh.

Mobile clinics
Displaced people in 10 camps benefit from a mobile clinic, which provides basic healthcare and immunisation. These services are also open to the resident host population in the area.

Two other mobile clinics in Idlib governorate focus on non-communicable diseases and needs assessment.

Partnerships
MSF has scaled up its co-management partnership with an important referral hospital in Qunaya and provides fully comprehensive support to all services, as well as maternity services and vaccination activities. The hospital recently boosted its capacity to conduct specialised consultations such as urology and ophthalmology.

Aleppo governorate

In Azaz District, MSF runs the 34-bed Al Salamah hospital. Services include outpatient and inpatient consultations, emergency room, surgical care and maternity and additional support services (pharmacy, laboratory, X-ray, etc.). Patients who can’t be treated there are referred to facilities in Azaz District or Turkey.

In the first half of 2017, teams vaccinated more than 26,000 women of childbearing age and children in three districts. Over the same period, MSF vaccinated 44,000 children aged between six weeks and 59 months in a multi-antigen campaign in the countryside of western and northern Aleppo.

MSF’s ad hoc logistic donations and regular donation programme of medicines and medical consumables has benefitted three hospitals in the area. MSF finished handing over the donation programme to other health providers in June 2017.

Contextual changes and access to a broader area resulted in more medical and logistic donation support to other health facilities between January and June 2017 in north Aleppo governorate.

Menbij
Menbij city was taken over by the Kurdish authorities after several months of fighting. MSF started working in partnership with the Kurdish health authorities in Menbij hospital to support the emergency room, operating theatre, paediatric, inpatient and outpatient wards and the thalassemia unit.

The conflict has displaced many people to Menbij, where MSF is operating mobile clinics in a camp.

Kobanê/Ain al-Arab area
In the Kobanê/Ain al-Arab area, MSF has worked alongside the local health administration since March 2015 to re-establish basic health facilities. It provides assistance to outpatient health services and vaccination services and helps implement psychological support programmes. In 2017, more than 101,680 outpatient consultations and 138 surgeries have so far been carried out in MSF-supported structures throughout the district.

Since June, a team has supported the emergency room, intensive care unit, operating theatre and nursing activities at the General hospital. Most of the trauma cases received in Kobanê are due to landmine injuries.

MSF supports all activities including surgery in the IKOR maternity and the general hospitals in Kobanê/Ain al-Arab, covering the Serin, Menbij and Tal Abyad districts.

MSF also supports a network of counsellors giving individual and group counselling, and psychosocial sessions in one of the supported primary healthcare units in Kobanê/Ain al-Arab.

Hasakah governorate

Since July 2017, MSF has been active in several locations across Hasakah governorate, as the healthcare system further deteriorates and people continue to be displaced. Teams are working in several camps, providing medical care and supporting the maintenance and cleaning of sanitation facilities.

Vaccinations

Five MSF vaccination teams are deployed in 21 different locations in northeast Syria to provide the WHO-recommended package of vaccines to children under the age of five and to screen for malnutrition.

Southern Syria

Dara’a and Quneitra governorates

MSF provides medical and logistical support to seven hospitals in Dara’a and Quneitra governorates through consistent and sustained contact with Syrian medical professionals. Support includes medical and logistical consumables, vascular surgery items, staff incentives, and fuel for generators.

MSF also manages an emergency stock of medical supplies for treating war-wounded patients. In the first half of 2017, 1,573 war-wounded were received and treated by MSF-supported hospitals in southern Syria.

Three field hospitals in southern Syria receive medical and logistical support from MSF. This includes medical supplies and equipment, medicines, and consumables, such as bandages, gauzes, feeding tubes, intravenous fluid drops, and syringes.

MSF supports one southern Syrian hospital with donations of hygiene products (surgical instruments and dressing sets), weekly medical and technical support, incentives, running costs, and training. Two blood banks in southern Syria receive transfusion kits and training from MSF.

Dara’a
In February 2017, when increased hostilities between armed opposition groups and government of Syria forces in Dara’a City, MSF distributed 893 relief kits to displaced populations in Neimeh and the Dara’a farmlands.

In May 2017, 196 tents were distributed to the displaced in the farmland areas near Dara’a city and four tents to a partially destroyed field hospital.

Ad hoc support

MSF also gives ad hoc support to other facilities. It gives material or financial support to cover emergency needs arising from changes in the context (such as bombing of health structures and movements of internally displaced people), or to cover gaps caused by the loss of other NGOs or donor support, which leave facilities unable to respond to the needs or vulnerable to closure.

Teams work in Syria’s neighbouring countries – Jordan, Lebanon and Iraq – to give medical and humanitarian assistance to refugees and host communities. In Turkey, MSF provides assistance to refugees through partner organisations.