Syria Complex Emergency - Fact Sheet #6 FY18

Speeches Shim

April 6, 2018

The UN conducts humanitarian assessment mission to Ar Raqqah city for the first time since October 2017

Conflict in Eastern Ghouta kills more than 1,600 people and displaces 133,000 others since mid-February

Operation Olive Branch displaces more than 137,000 people since January 20

WFP resumes operations in northeastern Syria following a one-month suspension

The Syrian Arab Republic Government (SARG) continues its military offensive in Rif Damascus Governorate’s Eastern Ghouta region. As of April 6, the SARG had retaken the marjority of the region from armed groups Ahrar al-Sham (AAS) and Faylaq ar-Rahman (FAR). Eastern Ghouta’s Douma town and surrounding areas—controlled by armed group Jaish al-Islam (JAI)—remains the last opposition-held area, international media report.

Since March 9, more than 133,000 people—including an estimated 50,000 opposition fighters and family members—have fled Eastern Ghouta, including through evacuations coordinated between AAS, FAR, the SARG, and the Government of the Russian Federation (GoRF). Of the evacuees, more than 60 percent arrived at eight collective shelters in Rif Damascus, where relief organizations are providing emergency assistance, including food, medical, nutrition, and water, sanitation, and hygiene (WASH) assistanc.

Operation Olive Branch—the Government of Turkey (GoT)-led military offensive in northwestern Syria—has displaced more than 137,000 people from Aleppo Governorate’s Afrin District to nearby areas of the governorate since January 20, the UN reports. Despite access constraints due to insecurity, humanitarian agencies are providing basic assistance to displaced populations. In March, two interagency humanitarian convoys reached Aleppo’s Tell Refaat sub-district, providing food commodities, emergency relief items, and health and nutrition supplies to at least 50,000 internally displaced persons (IDPs) from Afrin. The UN continues to advocate for sustained access to Afrin and neighboring areas hosting populations affected by the offensive and for freedom of movement for people to return to their homes or move onward to their desired final destinations.

Numbers At A Glance

13.1 million

People in Need of Humanitarian Assistance in Syria

6.1 million

IDPs in Syria

4 million

People Reached per Month by USG Assistance in Syria

5.6 million

Syrian Refugees in Neighboring Countries

3.6 million

Syrian Refugees in Turkey


Syrian Refugees in Lebanon


Syrian Refugees in Jordan


Syrian Refugees in Iraq


Palestinian Refugees in Syria

Humanitarian Funding

To Syria Humanitarian Response
FY 2012 - FY 2018

USAID/OFDA $1,467,232,578
USAID/FFP $2,495,220,280
State/PRM $3,736,575,196
TOTAL $7,699,028,054


Central and Southern Syria

SARG and GoRF airstrikes in Eastern Ghouta continued to kill and displace civilians through early April, relief organizations report. Since an escalation of conflict on February 18, airstrikes and bombardments, as well as ground clashes between the SARG and opposition groups, have killed more than 1,600 people, according to international media. As of March 25, AAS and FAR had entered into agreements to surrender and evacuate Eastern Ghouta; evacuations from Eastern Ghouta’s Harasta neighborhood and surrounding areas previously controlled by AAS and from southern areas of Eastern Ghouta previously controlled by FAR were completed as of March 27, the UN reports.

As of early April, Eastern Ghouta’s Douma town and surrounding neighborhoods—controlled by JAI—constituted the last opposition-held enclave in the region and remained besieged by the SARG, international media report. SARG and GoRF shelling and airstrikes have largely ceased in the besieged area since March 24; however, local sources reported sporadic SARG bombardments and shelling in Douma from March 26–28. In preparation for a resumption of military operations in the area, international media report that SARG forces have recently mobilized towards Douma, where at least 70,000 people remain, according to the UN.

More than 133,000 people have fled Eastern Ghouta since March 9, including 50,000 opposition fighters and family members through organized evacuations to Aleppo and Idlib governorate. The remaining 83,000 evacuees fled through SARG-established corridors to eight collective centers—including schools, warehouses, and other buildings—in Rif Damascus and other areas of northern Syria, according to the UN. As of April 2, more than 44,000 people were sheltering at the centers, while the SARG has permitted approximately 39,000 IDPs to leave the sites upon completing a screening process and identifying a host family member, the UN reports.

From March 12–14, SARG airstrikes hit opposition-held towns in eastern areas of Dar’a Governorate, according to international media. The airstrikes represent the first aerial attacks in Dar’a since a July 2017 ceasefire agreement and subsequent de-escalation of conflict throughout the governorate. The attacks have displaced an estimated 7,000 people, more than 6,200 of whom fled northeastern Dar’a, the UN reports.

Northern Syria

Operation Olive Branch, which began on January 20, continues to prompt population displacement and increase humanitarian needs. GoT forces and GoT-affiliated groups had seized control of approximately 90 percent of Afrin District, including Afrin town, as of March 19, the UN reports. The GoT has indicated that the next phase of Operation Olive Branch will expand east of Afrin and involve a military offensive to capture Tell Refaat, according to international media. Humanitarian organizations have expressed concern that hostilities in Tell Refaat could result in further displacement in the region.

The GoT-led military offensive had displaced approximately 137,000 people from Afrin and surrounding areas as of March 29. An estimated 90,000 people—approximately 66 percent of the displaced population—had arrived in Aleppo’s Tell Refaat sub-district, while approximately 30,000 people arrived in Aleppo's Nabul and Zahra towns, and more than 17,000 people arrived in Aleppo’s Menbij District and other locations across northern Syria, according to the UN. Meanwhile, the UN estimates that approximately 50,000–70,000 people remain in Afrin town and surrounding areas.

Northeastern Syria

As of April 1, an estimated 100,000 people had returned to Ar Raqqah city since October 2017; however, extensive unexploded ordnance contamination is hampering safe returns and impeding humanitarian response activities in the city, the UN reports. Since October, explosive hazards have killed approximately 130 people and injured nearly 660 others, according to the UN.

Clashes between Syrian Democratic Forces and the Islamic State of Iraq and Syria in southern rural areas of Dayr az Zawr Governorate near the Euphrates River resulted in nearly 100 civilian casualties between February 1 and March 14, the UN reports. Amid improving security conditions, more than 137,000 people have returned to areas of origin in western Dayr az Zawr since November 2017, according to the UN.

A UN interagency team conducted an assessment mission to Ar Raqqah city on April 1, representing the first time a humanitarian mission was able to access the city since the October 2017. The team observed a high level of property destruction, with nearly 70 percent of buildings destroyed or damaged, according to the local council. In addition, basic services, including water, electricity, and health care services, are either absent or severely limited. While some education activities have resumed, schools still lack required materials and supplies, the UN reports. The UN and partner organizations are working to address gaps and priority needs and strengthen the provision of basic services in the city.

Despite continued access constraints, relief organizations—including U.S. Government (USG) partners—are responding to the emergency needs of populations displaced from Afrin and Eastern Ghouta. On March 25, a UN and Syrian Arab Red Crescent (SARC) interagency convoy delivered humanitarian assistance—including food commodities, relief items, and health and nutrition supplies—for approximately 50,000 IDPs in Tell Refaat, according to the UN; the delivery additionally provided food assistance for approximately 25,000 host community members in Tell Refaat. Interagency teams accompanied the convoy to conduct a rapid needs assessment, which will inform future UN response efforts. The delivery followed a March 21 joint International Committee of the Red Cross (ICRC) and SARC cross-line humanitarian convoy that delivered approximately 25 metric tons (MT) of emergency relief items—including blankets, hygiene kits, kitchen sets, safe drinking water, and winter clothing—to displaced populations in Tell Refaat.

The UN continues to stress the importance of ensuring sustained access to affected areas—particularly Afrin District and Tell Refaat—to provide life-saving humanitarian assistance. This includes facilitating emergency medical evacuations from Aleppo’s Afrin and A’zaz districts; at least four people died in late March due to insufficient access to health care services, according to the UN. Additionally, the UN and USG continue to advocate for unrestricted movement for IDPs, as displaced households recently reported that SARG forces were prohibiting individuals from entering Aleppo city and returning to areas of origin in Afrin.

On March 15, a joint UN, ICRC, and SARC humanitarian convoy delivered a one-month supply of food for more than 5,200 households in Douma, according to the ICRC. Although intermittent shelling occurred near the convoy during offloading, the convoy completed the delivery of assistance and exited the region safely, the UN Office for the Coordination of Humanitarian Affairs (OCHA) reports. The operation represented the third convoy to reach Eastern Ghouta since a February 24 UN Security Council Resolution (UNSCR) demanding a 30-day ceasefire in Syria and unimpeded, sustained humanitarian access.

From March 7–8, a pilot convoy of eight UN trucks transported critical health and nutrition supplies—sufficient to meet the needs of up to 40,000 people—from Iraq to Syria through the Yaroubia border crossing. The convoy marked the first cross-border delivery of humanitarian assistance through Yaroubia since the July 2014 adoption of UNSCR 2165, and subsequent renewals, which authorizes cross-border assistance into Syria via four approved crossings. While relief agencies will continue to utilize existing delivery routes within Syria to deliver emergency assistance, the availability of the cross-border route through Yaroubia enables additional flexibility and capacity to address critical humanitarian needs of conflict-affected populations in northeastern Syria.

As of February 28, an estimated 2.3 million people were residing in UN-identified hard-to-reach (HTR) areas of Syria, including more than 413,900 people in besieged locations. The figure represents a decrease of approximately 570,400 people since December 2017, when the UN estimated that 2.9 million people resided in HTR areas, including nearly 417,600 people in besieged locations. The decrease is attributed primarily to improvements in humanitarian access to Rif Damascus and northeastern Syria’s Dayr az Zawr, Al Hasakah, and Ar Raqqah governorates, the UN reports.

In February, the UN removed 97 locations in Ar Raqqah and 23 locations in Al Hasakah from its list of HTR areas, reducing the HTR population of each governorate by 61 percent and 65 percent, respectively. Additionally, the HTR population of Dayr az Zawr and Rif Damascus declined by 22 percent and 32 percent, respectively. Furthermore, the UN classified 120 new locations in Idlib as HTR. According to the UN, the population in besieged and HTR areas of Damascus and Dar’a, Hamah, and Homs governorates did not change from December to February.

Concurrent conflicts in Afrin and Eastern Ghouta have destroyed health infrastructure, hindered health response activities, and exacerbated health needs in the two regions. From February 18–March 12, airstrikes hit at least 27 health facilities, including five facilities twice, in Eastern Ghouta, the UN reports. The airstrikes destroyed approximately eight of the medical centers and killed at least nine health care workers, according to health organizations. Médecins Sans Frontières (MSF) reports that 19 of its 20 previously-supported health facilities in Eastern Ghouta had ceased operations in recent weeks due to deteriorating security conditions.

Health services in Afrin District are a priority need due to the lack of operational health facilities and the displacement of health workers, according to the UN. As such, USAID/OFDA partner the UN World Health Organization (WHO) reports an urgent need to facilitate medical evacuations from Afrin to hospitals in Aleppo city. On March 7, opposition elements wrested control of the April 17th Dam and shut off water supply to Afrin town, requiring civilians to rely on untreated water sources and potentially increasing the risk of water-borne illnesses, local media report. In response, on March 11, the SARC and UN Children’s Fund (UNICEF) commenced water trucking to neighborhoods of Afrin town hosting significant IDP populations.

Relief organizations operating at the collective centers hosting Eastern Ghouta IDPs report that new arrivals are experiencing numerous health challenges. Although the SARC and other humanitarian agencies have mobilized a strong health response at the sites, poor hygiene and sanitation conditions and the potential for communicable diseases pose the greatest risk to IDPs at the sites, particularly those arriving with pre-existing medical conditions, OCHA reports. As of March 21, UN agencies had deployed nine mobile primary health teams and 11 mobile health teams to provide reproductive health and gender-based violence response services at the collective centers. WHO had also dispatched 9 MT of health supplies—sufficient to support 180,000 medical treatments—and additional routine vaccination supplies to the SARC to respond to the health needs of displaced populations. WHO continues to coordinate with the SARC, national health authorities, and health organizations to address health needs of Eastern Ghouta IDPs.

Humanitarian agencies are constructing shelter and WASH infrastructure at the sites, although new IDP arrivals are outpacing the construction activities, OCHA reports. Overcrowding and limited site management have further complicated the efforts of relief agencies attempting to construct additional shelter and WASH infrastructure. As a result, many IDPs are residing in open areas with limited access to WASH facilities.

Relief organizations report that improving shelter conditions remains a priority need in the Rif Damascus collective sites. In response, State/PRM partner the Office of the UN High Commissioner for Refugees (UNHCR) recently provided more than 2,200 shelters kits to the SARC, and shelter organizations are establishing ten additional communal shelters capable of hosting approximately 30,000 IDPs in the governorate, according to the UN.

In February, UNICEF improved access to safe drinking water for nearly 12.5 million people through the provision of water disinfectants and for more than 232,500 people by trucking nearly 66 million liters of water. The UN agency has also repaired WASH infrastructure, benefitting approximately 247,000 people, and distributed WASH items to nearly 357,000 people since January 1.

During February, USAID/FFP partner the UN World Food Program (WFP) delivered emergency food assistance to approximately 2.7 million people in all of Syria’s 14 governorates, including to 131,000 people in 10 besieged and HTR locations. The February caseload represents a 13 percent increase compared to January and more than 90 percent of WFP’s monthly target of 3 million people. WFP attributes the increase to the resumption of operations in northeastern Syria in mid-February following a temporary agreement between the SARG and the Autonomous Administration (AA)—a Democratic Union Party-affiliated governance body presiding over parts of northern Syria. The SARG and AA had previously disagreed on national non-governmental organization (NGO) procedures, resulting in a temporary suspension of WFP-supported national NGO activities in early January. The UN continues to advocate for sustained humanitarian access to populations in Dayr az Zawr, Al Hasakah, and Ar Raqqah, where WFP assists more than 350,000 people with food and nutrition assistance on a monthly basis.

WFP also delivered three-month supplies to treat moderate acute malnutrition for nearly 330 children and pregnant and lactating women in Al Hasakah, and 55 children and pregnant and lactating women in Eastern Ghouta’s Nashabiyeh town as part of a cross-line interagency convoy in February. Moreover, more than 20,500 pregnant and lactating women received cash-based nutrition support for the purchase of foods in Aleppo, Hamah, Homs, Latakia, Rif Damascus, and Tartus governorates.

According to WFP, food prices in Dayr az Zawr decreased by nearly 75 percent between January 2017 and January 2018. WFP reports that improved security conditions in rural areas of the governorate have enabled a large reduction in the price of food, contributing substantially to the overall decrease in food prices. Meanwhile, food prices in Ar Raqqah decreased by 21 percent between January 2017 and January 2018. The reduction in food prices in Ar Raqqah is a result of increased market functionality in the governorate, WFP reports.

WFP reports that there were no functioning bakeries in Eastern Ghouta in February. In parallel, due to a shortage of food in local markets, the price of a standard food basket increased by 4 percent between January and February. In February, the price of a food basket in Eastern Ghouta was SYP 195,800—or $450—compared to the national average of SYP 24,500—or $48. Additionally, many staple food items—including rice, sugar, wheat flour, and vegetable oil—were either in limited supply or unavailable across Eastern Ghouta in February. Participants in a survey conducted by WFP indicated consuming one meal a day composed of cereal and leafy vegetables. In some severe cases, households led by women or by a people with disabilities reported consuming just parsley and radishes. Due to diminishing dietary quality, sugar-deficiency fainting episodes have risen in Eastern Ghouta, particularly among women and children, WFP reports.

In February, UNICEF reached approximately 305,600 people in 140 HTR locations with life-saving nutrition interventions and participated in an ICRC and UN convoy to Eastern Ghouta, delivering nutrition supplies for nearly 9,000 people and conducting rapid multi-sector needs assessments. The UN agency provided additional nutrition supplies to approximately 36,000 people, screened more than 84,000 children and lactating women for acute malnutrition, and admitted nearly 260 children for treatment of severe acute malnutrition. UNICEF also provided training to more than 40,000 pregnant and lactating women on appropriate infant and young child feeding practices during the month.

The most effective way people can assist relief efforts is by making cash contributions to humanitarian organizations that are conducting relief operations. A list of humanitarian organizations that are accepting cash donations for disaster responses around the world can be found at

The USG encourages cash donations because they allow aid professionals to procure the exact items needed (often in the affected region); reduce the burden on scarce resources (such as transportation routes, staff time, and warehouse space); can be transferred very quickly and without transportation costs; support the economy of the disaster-stricken region; and ensure culturally, dietary, and environmentally appropriate assistance.

Last updated: April 09, 2018

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