This Situation Report covers developments in north-west Syria and Ras Al Ain – Tell Abiad. OCHA Türkiye prepares this report with the support of Cluster Coordinators and the Humanitarian Field Officers (HFO). The data/information collected come from both sources.
Nearly 200 camps at risk of losing WASH support due to underfunding
Temperatures in Syria have climbed as high as over 40 degrees this summer, with above-average temperatures foreseen from July to September, according to the World Meteorological Organization. In north-west Syria, the adverse impacts of heat are heavily felt in camps and informal settlements where 2 million people live. Nearly 80 per cent of the camp residents are women and children, many of whom live in overcrowded conditions without adequate ventilation and cooling, let alone privacy of space. According to the Education Cluster, over 80 temporary learning centers in camps have closed this summer due to shortages in water supply.
Today, as many as 660 camps (44 per cent of over 1,500 camps) across Idleb and northern Aleppo do not have water, sanitation and hygiene (WASH) support, affecting over 907,000 people. Half of them are children, reported the WASH Cluster. Families are surviving off intermittent water support provided by local authorities or costly water supplies from private companies, which are not always regulated for drinking and safety. Camps that lack sanitation support, such as waste collection and desludging of septic tanks, are seeing piles of trash accruing over time.
More than halfway through 2024, the cross-border response continues to face serious funding gaps amid a scaling down of the operation. UN agencies and partners have significantly reduced human resources to cut costs, resulting in reduced humanitarian activities. This year, the UN and its partners are reaching some 1 million people in north-west Syria per month with aid and critical services – more than half of the 2.5 million people reached in 2023. As of 29 July, over 400 trucks with UN aid have crossed from Türkiye to north-west Syria. During the same period last year, over 3,700 trucks have crossed.
Without increased funding, at least 192 additional camps (111 in Idleb and 81 in northern Aleppo) will be deprived of WASH support by this September, affecting nearly 250,000 people. Many of these camps are already in precarious conditions. According to the Camp Coordination and Camp Management (CCCM) Cluster, over 40 per cent of camps are over five years old and urgently need rehabilitation of properties, roads and communal facilities. 372 camps are located in remote and volatile locations with limited humanitarian assistance coverage.
As of 29 July, the Humanitarian Response Plan for Syria is only some 21 per cent funded, with $871 million secured out of the $4.07 billion needed. The WASH Cluster has been among the worst-funded sectors, having secured only 12 per cent of the funding needed, as of June 2024.
Scabies response targets 71 camps and seven communities
The absence of sanitation services, compounded by limited water supply and overcrowding, creates the ideal conditions for infectious diseases to spread. Scabies are among the diseases of concern in north-west Syria, particularly in dense camps, given that it is transmitted person-to-person through close skin contact.
On 16 July, Health and WASH Cluster partners launched a large-scale permethrin-based mass drug administration against scabies with the support of the World Health Organization (WHO). The campaign will last for 21 days, targeting over 180,000 people in 71 camps and seven communities with financial support from the European Union. Complementing this effort, partners have also distributed UNICEF-procured hygiene kits and provided training to community workers and hygiene promoters to treat the disease and prevent its further spread.
According to the WHO, north-west Syria has a high prevalence of scabies that surpassed the WHO-recommended 10 per cent community transmission threshold, with higher rates in camps, based on a community-based study conducted last December. Individuals living in camps were found to be seven times more likely to contract scabies lesions than those in communities. Children and the elderly living in resource-poor areas, and people with compromised immune systems, face a higher risk of contraction.
Closure of hospitals, safe spaces for women and girls, schools – among others
The humanitarian community remains alarmed over a 79 per cent gap between needs and resources for Syria. While funding for the response has increased over the past two months - from $227 million in May to $871 million in July - the uncertainty and scarcity of resources continue to affect operational planning, coordination and programming. There is a shock among communities and aid workers that results from this year’s downsizing of operations contrasting last year’s demand for a scale-up response due to the earthquakes.
Many health facilities are forced to downsize operations, close departments or reduce working hours due to funding shortfalls. Over 110 health facilities, including 34 hospitals, have already suspended operations as of the end of July. If this funding trajectory continues, the Health Cluster warned that 50 per cent of all functional health facilities in north-west Syria will fully or partially cease operations by December 2024.
Women and children are bearing the brunt of the consequences. As of June, 51 essential spaces that served as gender-based violence delivery points to an average of 450 women and girls each month have already closed down, according to the Protection Cluster. This included 18 mobile clinics integrated with protection services, 17 women and girls safe spaces, 10 integrated spaces within health facilities and five community centers. The absence of integrated services would leave countless survivors without assistance.
According to the Education Cluster, 1 million children are at risk of dropping out of school without increased support to education resources including textbooks and teacher incentives. Nearly 700 schools in greater Idleb lack essential support while 100 schools already lost assistance by July, affecting over 110,000 students and nearly 6,500 teachers.
Amid the funding crisis, a priority of the cross-border response has been early recovery and livelihood support to address the root causes of vulnerabilities and strengthen community resilience. The Early Recovery Strategy and Action Plan for north-west Syria, created in late 2022 and updated last summer following the earthquakes, noted that all sectors “must integrate early recovery” into their respective strategies. This July, the Inter-Cluster Coordination Group (ICCG) completed the second review of this plan, taking into account the Centrality of Protection Strategy which was endorsed in May 2024 by the humanitarian leadership.
Early recovery interventions are not only necessary but also cost-effective. Among the efforts has been to move the 800,000 people out of tents in north-west Syria. For the cost of two tents, which need replacement every six months, a dignified shelter can last more than five years and offer better privacy, durability, and structural integrity. Since the launch of the Action Plan for Dignified Shelters and Living Conditions in March 2022, over 34,000 families have been moved from tents into dignified shelters as of the end of June 2024. Over 6,800 additional shelters are in construction, reported the Shelter/NFI Cluster. However, this is still only 40 per cent of the target with valid Housing, Land and Property Rights.
Other examples include rehabilitation and agricultural projects that shift people’s dependency away from emergency aid. On 14 May, the Deputy Regional Humanitarian Coordinator, David Carden, led a UN interagency mission to Idleb, accompanied by OCHA, UNICEF and WFP. They visited a project that treats wastewater from 16 camps and communities, enabling over 250,000 people regular access to safe water rather than depending on water trucking. The delegation also visited a farmer in Maaret Tamsrin who was provided with seeds, fertilizers and training on climate change adaptation and sustainable farming, enabling him to grow vegetables and earn a regular income. Both of these projects are supported by the Syria Cross-border Humanitarian Fund (SCHF).
More recently, on 23 July, a UN delegation led by OCHA, and comprised of WHO and IOM, crossed to northern Aleppo to assess the impacts of funding shortfalls. They spoke with families living in a dignified shelter camp in Afrin, as well as health workers and patients at a maternity hospital in Raju. The camp has been cut off from food and sanitation support while the hospital, which serves nearly 50,000 people, has secured funding only up until the end of July. In the face of these challenges, a common message was shared with the UN delegation: above all else, the people in north-west Syria want peace, jobs and livelihood opportunities.
North-west Syria has seen a significant rise in malnutrition rates, with the Global Acute Malnutrition (GAM) prevalence surging to nearly five per cent in 2023, a threefold increase since 2019. Today, 9 out of 10 Syrian children are not eating minimally acceptable diets, resulting in cases of stunting and wasting. As many as 506,530 children under five across Idleb and northern Aleppo urgently need treatment for acute malnutrition, with nearly 108,000 experiencing severe wasting. The situation is further exacerbated by disease outbreaks, limited sanitation services and food shortages. In a short interview, Dr Rajia Sharhan, Interim Nutrition Cluster Coordinator and UNICEF’s Health and Nutrition Specialist, spoke to OCHA about the implications of underfunding, particularly on women and children, and the shift toward a more sustainable response.
What is the nutrition situation in north-west Syria like today and who is most affected?
Dr Sharhan: The Nutrition Cluster is currently facing severe challenges worsened by the ongoing conflict, economic instability, and disasters. We are facing a significant funding gap this year, having secured less than a quarter of the $32.9 million needed for 2024, which affects the provision of curative nutrition services, cash and voucher assistance, and the maintenance of primary healthcare infrastructure. This also hinders our ability to plan strategically for the longer term which has implications on the sustainability of programmes. All sub-districts in north-west Syria are classified as being under "severe" and "extremely severe" conditions. Due to the funding cuts, all children under five and pregnant and lactating women are at significant risk. 20 per cent of children are already stunted in north-west Syria. About half the children and women in northern Aleppo are anemic.
With the available funding this year, the UN and its partners could only target 625,000 out of 3.6 million food-insecure people. Are there already nutrition implications? What are your biggest concerns?
Dr Sharhan: The possible implications are increased malnutrition rates, worsening health outcomes and disruption to our nutrition programmes. Without regular food assistance, Syrian households are struggling to meet their daily nutrient intake. It also has implications for our ongoing nutrition activities, such as supplementary feeding programmes, which rely on a stable food supply to be effective. The immediate concern is the potential for a sharp increase in both moderate and severe acute malnutrition cases among children and pregnant and lactating women. But there are also potential long-term consequences. Chronic malnutrition during early childhood can have disastrous effects on physical and cognitive development, affecting children's ability to learn and thrive in the future. Some of these cases are irreversible which is why it’s important to invest in early childhood nutrition.
How has the Nutrition Cluster adapted to reduced funding?
Dr Sharhan: Since the start of 2024, there has been a reduction in both Nutrition Rapid Response Teams and therapeutic feeding programmes due to underfunding. To adapt to these challenges, the Nutrition Cluster has adopted a new strategy aimed at creating a more sustainable and resilient system through integration with the health sector. The response is now guided by the catchment areas of primary healthcare facilities, ensuring that nutrition services, like routine screenings, referrals and malnutrition treatment, are integrated with primary healthcare. UNICEF has secured all the necessary curative supplies, ensuring no gaps in the availability of therapeutic foods and other essential nutrition supplies. This strategic shift, away from relying on Rapid Response Teams that have been in place for over 11 years, represents a move toward a more resilient and self-sufficient healthcare system. This more integrated approach addresses not only immediate needs but also lays the foundation for long-term health improvements in north-west Syria.
Communities in north-west Syria are coping with severe heat during these summer months. Has the heat impacted the nutrition response?
Dr Sharhan: While severe heat can exacerbate the overall humanitarian situation, its direct impact on the nutrition response has been relatively low. However, the effect on water supply and sanitation conditions can indirectly influence nutrition by increasing the risk of waterborne diseases and dehydration. Together with the Health and WASH Clusters, we are working together on community-based mapping and integration efforts to mitigate these risks. The WASH team prioritizes nutrition in its plans, while the Nutrition Cluster prioritizes health, ensuring a coordinated approach to address the impacts of heatwaves. Severe heat does pose challenges such as increased needs for hydration and safe food storage, but the main strategies to combat malnutrition—provision of cash and voucher assistance, social behavior change activities, and integration with health services—remain effective even during periods of extreme weather.
One tent for himself, his wife and four children.
The harsh winters were the worst part of it, he recalls.
“Every year, we had to put stones around the tent to prevent it from flying.” Each morning was an arduous trek to refill their water tank.
Today, Khaled’s family now lives in a new dignified shelter unit, offering some respite amidst life in displacement.
“It has made a huge difference – a big psychological relief,” Khaled expresses.
The dignified shelter is a prefabricated shelter unit composed of a steel frame, lockable entrance and solar-powered lighting system. Each unit has a kitchen, living area and hygiene facilities.
“We used to have a common space for toilets, which was not good for women and girls. Now, we have private toilets.”
Khaled is also thrilled to have a kitchen for the first time in years. He remembers having to cook outside their tent – their only choice despite the risk of fire. Khaled’s community is one of three sites where IOM and the International Humanitarian Relief Association (IYD), with the support of the European Union, are installing dignified shelters.
“We are all happy and relieved here. We no longer have this tense situation due to our hard living conditions.”
As another summer approaches, Khaled feels fortunate that he will spend this one with electricity to power a fan. In total, since 2022, IOM has installed over 8,100 dignified shelter units in the Aleppo and Idleb Governorates.
“This offers a significant improvement in living conditions for families displaced for years. It is also cost-effective and sustainable, as we continue to face steep funding cuts for the humanitarian response in Northwest Syria,” says Claudia Natali, IOM Türkiye Deputy Chief of Mission.
For the cost of two tents, which need to be replaced every six months, a dignified shelter can last up to ten years, with better privacy and durability. IOM and IYD are further rehabilitating and expanding the water network and linking each household to it, ensuring that families have continuous access to clean water. Previously, they had to rely on refilling water tanks or organizations conducting water trucking.
As part of a multisectoral response, Khaled’s family also received six rounds of multipurpose cash assistance. “It was very helpful in letting us meet our basic needs.”
Despite collective efforts, conditions remain dire for 4.2 million people in Northwest Syria still in need of humanitarian assistance. Over 800,000 continue to live in flimsy tents.
Although Khaled and his family now go to sleep better at night, his next target is to find a job. He has been relying on his son who works in seasonal agriculture. With no solution in sight to the conflict, Khaled’s memories of peace and safety fade more and more each day.
“It’s great to have a new home, but it will never be better than my old home. I hope one day everything will be resolved, so that I can go back and rebuild my home.”
IOM’s work to install dignified shelters in Northwest Syria is made possible by the European Union, German Federal Foreign Office, Syria Cross-border Humanitarian Fund and UN Central Emergency Response Fund.
Written by Miko Alazas, IOM Türkiye Media and Communications Officer
Security incidents and hostilities have increased over the past month. On 1 July, demonstrations marked by violence and road blockades took place in northern Aleppo, particularly in the towns of Afrin Azaz, Al-Bab and Al Ra’ee, following unrest in the region. This led to the temporary closure of border crossings into north-west Syria including Bab Al-Hawa, Bab Al-Salam and Al Ra’ee. By 4 July, the UN resumed its operation through Bab Al-Hawa. By 9 July, all three border crossings became operational.
The disruption has led to the suspension of humanitarian activities of at least 34 NGOs in Afrin on 1 July well as activities in primary health centers and mobile teams. Travel restrictions coupled with additional checkpoints affected the movement of aid workers, including as many as 150 staff from one NGO who cross daily from Türkiye to Azaz. The Health Cluster reported that internet connectivity issues hindered the flow of data from hospitals, many of which relied on online systems for patient and operational data. By 5 July, all NGOs who reported suspension had resumed their operations.
All PTT (Posta ve Telgraf Teşkilatı) centers in northern Aleppo, which provide mail, banking, and logistics services, were closed on 1 July, according to Cash Working Group. This resulted in a rise in the price of gas, food, and non-food items. The centers started reopening on 10 July, with all being fully opened by 15 July.
The month of July also saw an increase in hostility incidents in Idleb affecting residential villages and camps without casualties. Since the beginning of 2024, at least 17 people, including six children, were killed by hostilities and 75 others were injured, including 27 children and 10 women, according to local health authorities as of 26 July.
As of the end of July, the SCHF received over $34 million in paid contributions with the support of 11 donors. But this is a significant drop compared to the $131 million it received during the same period in 2023, and $84 million in 2022. Unless donor appetite changes, it is estimated that SCHF contributions will decrease by approximately 60 per cent this year.
Last year, the SCHF received some $150 million in total with the generous support of donors and allocated $140 million to assist 2.8 million people in north-west Syria. 55 per cent of the people assisted were women and girls. 158 projects were implemented through 53 partners, of which 66 per cent of the fund went directly and indirectly to local partners.
The use of the Bab Al-Hawa border crossing for UN aid delivery and personnel movement to north-west Syria was extended for an additional six months until 13 January 2025. So far in 2024, over 90 per cent of trucks and 70 per cent of missions by UN personnel used this border crossing to reach north-west Syria, complementing Bab Al-Salam and Al Ra’ee.
As of 28 July, the UN has completed 539 cross-border missions to north-west Syria since the first interagency visit to Idleb on February 14, 2023 – 222 of these missions were conducted in 2024.
On 6 June, WHO conducted a cross-border mission to the Bab Al-Salama hospital in Azaz, northern Aleppo, to hold the first Health Cluster Coordination meeting inside north-west Syria, bringing the coordination of the health sector closer to field partners and communities. These coordination meetings have previously been held in Gaziantep.
Since the beginning of 2024, a total of 415 trucks carrying aid by seven UN agencies crossed from Türkiye to north-west Syria, as of 29 July.
As of 29 July, the 2024 Humanitarian Response Plan for Syria, which asks for $4.07 billion, is some 21 per cent funded.