1 As of December 2017, EWARS report 2 As of December 2017, 4W report

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Photo 1. In Rajo, Afrin, SARC Aleppo volunteers

continue distribution of UNFPA supplied dignity kits.

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Ministry of Health decree (2 January 2018)/REF: 4/176: It is not allowed to import or purchase the medicines which are manufactured in the Syrian local market. The issue of the MoH ban on importation of medicines and medical consumable locally manufactured has been ongoing throughout 2017. There were a series of different bilateral and joint meetings among the involved stakeholders. WHO international consultant has extensively worked to find alternatives and workable solution and a separate NV from RC/HC office was submitted to the MoFA. A way forward is at the levels of heads of UN agencies and ICRC (as being affected by this decision) to agree on the best way to proceed. This should be escalated to the level of UNCT and HCT while exploring other options to find a solution.

No convoy has been delivered since the last update to the HCT on 20 December 2017. The last UN inter-agency convoy was to Al-Houla and Harbanisfeh on 14 December 2017.

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The north-east Syria humanitarian situation continues to require emergency and more medium-long-term support. Continuous displacement from the conflict in Deir-ez-Zoir.

A need for short-, medium-term solutions for blood support for each of three governorates in NES (standard response should include 1) assistance with building rehabilitation; 2) provision of equipment and supplies; 3) staff capacity building). Treatment of patients with burn injuries remain a significant gap in NES, especially factored if these patients are refugees or without any documents. The referral outside of NES presents serious security concerns

There is need to provide more technical support to NES present partners on infectious disease control, notification procedures and referral pathway for patients.

There is a need for different types of assessment activities throughout Deir-ez-Zoir governorate. Access challenges in Deir-ez-Zor continue to limit understanding of humanitarian needs and population movements.

Continuous requests are being received. Health sector is enhancing data collection, information gathering throughout the governorate.

Need for hubs (Turkey and Jordan) to coordinate and be familiar of the details of cross-border convoys delivering health supplies.

Further clarity is required from OCHA on the notification mechanism by the UN to the Syrian authorities on all XB convoys as according to the UN Security Council Resolution and the use of XB crossing points from Iraq. Cautious approach about the start of cross-border operations from Yarobieh

Receiving timely approvals from the GoS to shit medical supplies to NES: There is no yet road access to Qamishli but approvals were received by WHO for airlifts.

The temporary ban of operations of national NGOs in NES decreased provision of health services in Hassakeh city, its rural area and camps while Ar Raqqa based services were continued.

DoH Al Hassakeh is prevented by the Self-Administration for technical supervisory visits to camps in Al Hassakeh

No medical evacuations have taken place since the small-scale evacuations on 26/28 December. The caseload of people requiring medical evacuation continues to grow.

Access to Afrin areas from Aleppo hub to roll out NGO supported activities (mobile medical teams, PHCs, referral system), NCD treatment, including dialysis, for patients in Afrin, future of mental health patients in Azzaz mental health hospital, medical evacuation.

To strengthen health sector response to the needs of 2.65 million people residing in north-western Syria. 1.16 million are IDPs and 1.73 million people are classified as people in need.

Ongoing violence in northern Hama: increased incidents of violence against health care.

Obstacles faced by INGOs to receive approvals to roll out response in parts of the country requiring immediate emergency response.

Building up advocacy efforts to highlight on the increased humanitarian needs and access requirement to the besieged and hard-to-reach areas.

Reduced access to southern governorates (Dara’a and Quneitra) due to increased violence/political influence.

Deterioration of health humanitarian situation (the Berm/Rukban area).

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National health working group meetings, Syria hub, are conducted (9 and 30 January).

HRP: Provided comments to the draft of “WoS Health Sector Protection Risk Analysis 2018”. Shared the WoS health team prepared document presenting the health objectives, activities and indicators proposed to be monitored and reported on during 2018, based on the agreements and participation of the hubs in 2017. HRP 2017 - draft of the annual PMR: Upon the request of WoS health provided initial feedback to the template for the 2017 End of Year Periodic Monitoring report. Organizations were requested to review and provide their feedback by 1 February 2018.

Eastern Ghouta: Working on inputs for OCHA developed non-paper: East Ghouta Planning Scenario, 7 January 2018. Reviewed and provided feedback to WoS health team on the agreement to facilitate monthly updating of preparedness and advocacy plans of besieged eastern Ghouta for a period of six months (January-June 2018), providing a simplified tool (EG reporting format) and the (EG reporting and updates plan) outlining the steps intended by WoS health sector to feed into the EG response effort. Updated health sector with the medical evacuation plan for eastern Ghouta and to further

enhance the technical knowledge and awareness on the required steps shared the most recent available triage guidance recommended by WHO: Report, WHO/ICRC Technical Meeting for Global Consensus on Triage 11-12 January 2017, WHO Headquarters – Geneva, Switzerland; The prehospital triage criteria in a chart. Both documents will be posted under Syria hub web page at the following site: www.humanitarianresponse.info.

Aleppo: To follow up with OCHA and health sector partners (national and sub-national levels) that HPF funding should be accessible on a priority basis to the organizations which participated in HRP 2018; To follow up with health sector UN agencies (WHO, UNICEF, UNFPA, UNHCR) on the requirement to review the joint programming in rural Aleppo governorate; To receive regular updates from Aleppo sub-national health sector on the implementation of projects that received funding for rehabilitation of health facilities during 2017; To recommend to OCHA and health sector partners that the modalities, funding of health sector response in north-east Syria be proportionately implemented also in north-west Syria (especially in rural areas of Aleppo governorate close to the borders of SDF controlled areas of the governorate and Ar Raqqa governorate).

Besieged locations: Follow up on the points from the internal technical meeting on access to besieged locations, including eastern Ghouta, including: To share the list of the members of the triage technical committee inside EG as received from health cluster to consider and their next steps and follow up actions inside EG. Health sector is to send the list of removed items in 2017 to XB partners as requested. To receive a formal request from health cluster GZT on utilization of expired medicines highlighting this issue and necessity of follow up actions. To follow up to have a sustained system of supply of hemodialysis treatment; solutions for thalassemia patients, NCD medicines. To follow up with WHO nutrition, SARC, UNICEF and nutrition sector on the practice of distributing therapeutic food with food baskets instead of targeting health facilities. To provide feedback on Damascus based response in routine vaccination in northern Homs. To share the bimonthly plan of IA convoys.

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HeRAMS reports http://www.emro.who.int/syr/information-resources/herams-reports.html EWARS reports: http://www.emro.who.int/syr/ewars-workshops/ewars-bulletins-2017.html