Thread by @WHOEMRO

Happening now: Brussels 7 Conference online panel discussion on

“Working together for a risk-informed, recovered & shock-resilient health system in Syria”.

Join @WHO, @UNFPA and Austria 🇦🇹 in this live panel discussion

Register to submit your questions: bit.ly/3MMqum2

"I would like to extend my sincere thanks to all of you for coming together at this side event of the Brussels 7 Conference. We are gathered today because we share a common vision of a healthier, more resilient #Syria."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

"Earlier this year, I traveled to #Syria and saw firsthand the devastating impact of the earthquake, war, economic instability, and sanctions on innocent Syrians whose health and wellbeing continues to deteriorate."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

"In Aleppo, which has been heavily affected by the conflict and devastation of the earthquake, I met mothers who had lost their husbands and children during the earthquake, and children who had lost their parents."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria

"Their resilience — which had remained with them through more than a decade of war — was shattered. Witnessing their anguish was a difficult experience for me personally."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria

"In Dara’a, once a hotspot of intense fighting and where parts of the governorate remain in ruins, I met an elderly lady undergoing dialysis treatment who burst into tears as she spoke to me about her medical condition and the fate that had befallen her country."

-Dr Al-Mandhari

"Sobbing, she turned to me and asked: “What happened to us?”

It was a hard question for me to answer."

- Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean

https://twitter.com/WHOEMRO/status/1667150364825509888?s=20

#Syria

"The populations in these areas [northeast & northwest] continue to struggle with access to even basic health services while reckoning with the continued impact of ongoing hostilities, insecurity and displacement that have left many people living in camps and last resort sites."

"Prolonged conflict, outbreaks of infectious diseases, economic shocks, & the recent earthquake have resulted in minimal coping capacities for both the Syrian people & the health system that serves them, as well as profound challenges for those involved in humanitarian response."

"Public health has been negatively impacted – both directly or indirectly – by political tensions, insecurity, sanctions, economic instability, and disruptions in fuel, water, and power supplies."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria

1/2 "While these challenges have highlighted the strength & resilience of the #Syrian people and the health workforce that remains unwavering in their commitment to serve, the harsh reality is that the coping capacity of the Syrian people is not limitless.."

2/2 "short-term, emergency approaches to the problems they face is no longer a solution. And lack of sustainable, strategic investments have further contributed to chronic deterioration of the systems & services that are designed to protect them."

"Health needs in #Syria now are greater than ever before: humanitarian actors, @UN agencies & donors must join forces to support Syrians and ensure sustained access to basic services – helping the population to restore their livelihoods & overcome the many challenges and shocks."

"The World Health Organization believes that a durable solution is an integral part of our collective response in #Syria."

@WHO

"Lessons learnt from the 12-year protracted emergency, the #COVID19 pandemic and cholera, measles and meningitis outbreak, and the recent devasting earthquake have demonstrated that strengthening the preparedness and responsiveness of the health system is essential to attain.."

"#Syria’s health system requires both sustained, principled access, as well as collective commitment to strategic investment in order to become more aware, absorptive, agile, and adaptive to current and emerging needs."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

" @WHO is committed to strengthening preparedness and response and system resilience in #Syria, and we have done this by enhancing the functionality of health facilities."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

"...including repair & rehabilitation, working to progressively expanding coverage & quality of essential health services, delivering essential medicines & medical equipment, training health care workers, and maintaining & expanding disease surveillance & laboratory capacity."

"Special attention emphasis has been placed on strengthening services that respond to those most vulnerable and in need, such as mental health."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria

"@WHO has worked alongside our partners on ground to establish integrated mental health and psychosocial support interventions that are also linked to referrals for gender-based violence. More than half of Syria’s primary health care centers now offer MHPSS services."

"At the community level, NGOs and local partners are critical for the response in #Syria, stepping in to provide services in affected areas with limited access to health care."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

"Their role – and the role of local communities – is vital in reaching the most vulnerable populations in hard-to-reach and marginalized areas."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

https://twitter.com/WHOEMRO/status/1667155656992858114?s=20

"Working with our NGO partners, WHO is strengthening basic services in vulnerable areas through outreach and preparing areas of return by setting up health infrastructure, ensuring the availability of skilled health staff, and providing essential health supplies."

"Local initiatives involve affected populations, allowing us to tailor our response accordingly to improve relevance to beneficiaries."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria

"Principled partnerships – including collaboration with NGOs and local health authorities – has proven to be invaluable in bolstering community resilience and expanding access to health services at all levels, impacting the lives of millions of people across the country."
#Syria

"Under @WHO’s Regional vision of #HealthForAll_ByAll, we believe that all people, everywhere, deserve access to health services, regardless of their political affiliation or geographical location."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

"Unimpeded and sustained access to people-in-need is a core pillar of humanitarian response that must be upheld, regardless of political lines of control."

- Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director

#Syria #HealthForAll_ByAll

"Until a political solution is achieved, our capacity to address the root causes of Syria’s current health crisis remains limited, leaving millions of people in Syria vulnerable to poor health outcomes."

Dr Ahmed Al-Mandhari, @WHOEMRO Regional Director
#Syria #HealthForAll_ByAll

"By placing the health needs of the people of #Syria at the heart of our response, we strive to maximize our ability to reach out to all affected populations – particularly those most vulnerable and in need – with essential services and to protect them from outbreaks..."

"We look forward to rich discussion today in the lead up to Brussels 7 and we encourage all countries and donors to join us in our efforts to support Syria’s health preparedness and resilience to face future shocks and emergencies and to recover from them."

-Dr Ahmed Al-Mandhari

“A health system needs basic functioning services. Based on my visit to #Syria, there is a lot of dysfunctionality because of the war and other events.”

-H.E. Peter Krois, Ambassador of Austria in Damascus, #Syria

@MFA_Austria

I have come to admire the work of @WHO which under extremely difficult circumstances have been able to deliver services in cooperation with partners.”

- HE Peter Krois, Ambassador of Austria in Damascus, Syria

@MFA_Austria @AustriaUN

“There is a very stark contrast between the public health sector and private health sector, which is not affordable for 90% of the population.”

- HE Peter Krois, Ambassador of Austria in Damascus, Syria

@MFA_Austria @AustriaUN
#Syria

“Another thing I noticed during my visits was the brain drain. Many doctors who were trained by the Syrian tax payer have left to other countries.”

- HE Peter Krois, Ambassador of Austria in Damascus, #Syria

@MFA_Austria @AustriaUN

“The water sector is in bad shape. If there is no water treatment, there is immense pollution.”

- HE Peter Krois, Ambassador of Austria in Damascus, #Syria

@MFA_Austria @AustriaUN

“What I hear from local sources is that a lot of people could’ve been saved if there were equipment ready in place [in health facilities] – and not expensive equipment, but apparatuses like x-ray machines.”

HE Peter Krois, Ambassador of Austria in Damascus, #Syrian

@MFA_Austria

"Allow me first to begin by expressing our collective gratitude to @WHO for its steadfast efforts to safeguard the health & lives of communities throughout the world, and certainly inside Syria."

Diana Garde, head of @UNFPA Regional Humanitarian Hub for Syria and the Arab States

"In order for any response, anywhere, and for any emergency through recovery to be successful, it must be a collective effort, both from the standpoint of the responding and supporting agencies and from the community."

- Diana Garde

"And we fail at being our best when we do not target the most vulnerable or include the perspectives of all affected people."

- Diana Garde

@UNFPA @UNFPA_Arabic
#Syria

https://twitter.com/WHOEMRO/status/1667159420126593025?s=20

"I view things through a @UNFPA lens. UNFPA, which is the UN’s sexual and reproductive health agency, has dedicated itself to the empowerment and wellbeing of women and girls across the globe."

Diana Garde, head of UNFPA Regional Humanitarian Hub for Syria and the Arab States

"Our mandate is firmly rooted in the belief that every individual - women, men, girls, boys have the right to access sexual & reproductive health information & services and that this fundamental right should remain unassailable, even in the face of the most daunting challenges."

"As in other humanitarian crises, it is the majority of women and girls throughout the region who bear the brunt of the Syria crisis, particularly when it comes to their ability to access essential and life-saving reproductive health services."

-Diana Garde
@UNFPA @UNFPA_Arabic

"As in other humanitarian crises, it is the majority of women and girls throughout the region who bear the brunt of the Syria crisis, particularly when it comes to their ability to access essential and life-saving reproductive health services."

- Diana Garde
@UNFPA @UNFPA_Arabic

"The results of this are severe and far-reaching, and they include escalating rates of unintended pregnancies, obstetric complications, harmful medical practices, preventable infant and maternal mortality or life long disability."

- Diana Garde
@UNFPA @UNFPA_Arabic

"Sexual and reproductive health is an essential part of a bigger public health picture - without it, frankly, women suffer and in too many instances, they die."

- Diana Garde

@UNFPA @UNFPA_Arabic

"To capture the scope of what we are referring to, across the WOS:
-approximately 235,000 currently pregnant women
-of those, in the next month - more than 3900 will experience obstetric complications
-in the next month - an estimated 5000 newborns will experience complications."

I want to read a quote from a young woman living in North East Syria:

“When I was pregnant, I was worried because the ambulance had stopped working at night due to the insecurity. I woke up in labor, and I knew I couldn’t reach the health services. I was terrified;"

"I was terrified; I knew I should give birth with a doctor or midwife but if I stepped out of my tent I could be attacked. There is no transport at night, and I couldn’t walk. This is why I gave birth to my son in my tent, alone."

https://twitter.com/WHOEMRO/status/1667164268544811008?s=20

"We need to be better at ensuring safe & sustainable access to health services for the whole of #Syria, not just maternal & infant care, but for access to contraceptives, treatment for sexually transmitted infections,rapid assessment & response for post abortion care/miscarriages

The health ramifications of this crisis are consistently affected by gender inequality. In Syria & throughout the region, harmful gender norms continue to impact the ability of women & girls to exercise their right to access quality healthcare or have agency over their own bodies

"This can be demonstrated by gendered restrictions on movement, discrimination based on age, refugee, displaced, or marital status, in addition to the mounting risks of gender-based violence."

Diana Garde, head of the UNFPA Regional Humanitarian Hub for Syria and the Arab States

"In some cases, this includes restriction of vital health care for women and girls by a partner or family member."

- Diana Garde, head of the @UNFPA Regional Humanitarian Hub for Syria and the Arab States

@UNFPA_Arabic

https://twitter.com/WHOEMRO/status/1667166456717426689?s=20

"Our response must therefore be rooted in a commitment to gender equality. A coordinated and gender-responsive approach is crucial to ensuring that the needs of women and girls are not merely an afterthought, but a priority, integral to all of our health strategies and actions."

"Despite immense challenges, notable strides have been made in providing essential health services. However, the fragility of these gains cannot be overstated."

- Diana Garde, head of the UNFPA Regional Humanitarian Hub for Syria and the Arab States

@UNFPA @UNFPA_Arabic

"As the international community convenes in Brussels, we must underscore the necessity of not only protecting these gains but also augmenting them with coordinated gender-responsive, and community involved health interventions."

- Diana Garde

@UNFPA @UNFPA_Arabic

"Given the protracted nature of the crisis and spiraling needs, we must think beyond immediate care. A comprehensive approach to health necessitates the integration of sexual and reproductive health services with mechanisms to prevent and respond to gender-based violence."

"It is only through such an integrated, multi-sectoral response that we can hope to adequately address the health needs of Syrian women and girls, and we can do this together."

- Diana Garde

@UNFPA_Arabic @UNFPA

https://twitter.com/WHOEMRO/status/1667167127504056323?s=20

"In the face of systemic barriers, natural disasters, and the brutal realities of conflict, it is all too easy for women and girls to be rendered invisible. However, we must strive to not only see them but to ensure they are heard."

- Diana Garde @UNFPA_Arabic @UNFPA

"The inclusion of women's voices in decision-making processes is pivotal to creating sustainable and impactful change."

- Diana Garde

@UNFPA_Arabic @UNFPA

"Responding agencies can work together to rationalize services, ensure that our efforts are well coordinated, to fill gaps and reduce redundancies, and to strategize effective placement of interventions, while focusing on building a strong sense of ownership in local communities"

"Our efforts to create a truly harmonized response have yielded a wide array of impactful programmes, good practices, and a growing body of knowledge that is consistently informed by the people we serve."

- Diana Garde

@UNFPA @UNFPA_Arabic

"I am sure that we will hear more about some of these good practices from our “speakers from the field”.

- Diana Garde, head of the UNFPA Regional Humanitarian Hub for Syria and the Arab States

@UNFPA @UNFPA_Arabic

"The magnitude of the challenges, however, calls for a much more robust and collective response from the international community."

- Diana Garde, head of the UNFPA Regional Humanitarian Hub for Syria and the Arab States @UNFPA @UNFPA_Arabic

"Let us be guided by the strength and resilience of Syrian women and girls, who are not just survivors of this crisis but are also agents of change, sources of innovation, and beacons of hope for their communities."

- Diana Garde

@UNFPA @UNFPA_Arabic

"When we invest in their health and hear their voices, we invest in the future of Syria."

- Diana Garde, head of the UNFPA Regional Humanitarian Hub for Syria and the Arab States

@UNFPA @UNFPA_Arabic

The delivery of health services, especially SRH services, must be guided by the principles of humanity & impartiality. It is paramount that we delink our health response from political considerations & geographic boundaries to ensure equitable access & effective service delivery

When we provide humanitarian responses, we are obligated to think about how we serve those with the highest needs and those left furthest behind, first & foremost. These actions should be separated from politics and should be implemented regardless of invisible & shifting borders

"Overcoming these challenges also necessitates living up to the commitments collectively made in The Grand Bargain and reinforcing our investments to local, women-led organizations and partners."

- Diana Garde

@UNFPA @UNFPA_Arabic

"Let us ensure that our efforts to build a healthier #Syria are not just about treating the wounds of the past but about nurturing the potential of the future. Let us leave no woman or girl behind."

- Diana Garde

@UNFPA @UNFPA_Arabic

"Let us build a future where every woman and girl in Syria and the region has access to the health services she needs, the respect she deserves, and the opportunities she has the right to."

- Diana Garde

@UNFPA @UNFPA_Arabic

"With limited access to and coverage of services for the general public, it is clear that the health system has collapsed."

Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria

@MedairInt
#Syria

"There exist gaps in all of the components of the health systems, and these gaps continue to affect the provision of services, both in terms of availability and quality."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria

@MedairInt
#Syria

"There are severe shortages of healthcare workers, and the capacity of available personnel that is on hand is restricted. Some of this is attributed to the fact that healthcare workers are not paid a living wage."

-Raija-Liisa Schmidt-Teigen-Country Director, @MedairInt #Syria

"Medair recently rehabilitated and re-equipped a much needed maternity clinic in Deir-Ez-Zor."

-Raija-Liisa Schmidt-Teigen-Country Director, @MedairInt #Syria

"However, because of the lack of available healthcare workers, there are only two staff working there currently. The Governor’s response to our inquiry on this was that it is hard to employ when they can leave to the non-GoS region and get paid in USD."
Raija-Liisa Schmidt-Teigen

"In addition, the distribution of healthcare workers is uneven, with a concentration in urban areas and private hospitals."

Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria
@MedairInt

"Together DEZ and RAQ have a catchment population of around 1 Million people with only one referral hospital in place, which is semi -destroyed. There is no option of referral destination of obstetric emergencies for example."

- Raija-Liisa Schmidt-Teigen

@MedairInt #Syria

"The frequent absences of medical staff at public hospitals cause service interruptions in basic and life-saving health services."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria
@MedairInt #Syria

"Several times, @MedairInt has assessed a clinic to be rehabilitated in more rural communities with high needs, but because of the lack of availability of staff, we have not provided assistance in these communities."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair #Syria

"Additionally, the lack of fuel has proved challenging, resulting in some staff not even being able to get in to work at the clinic.

All of these examples create barriers in access to good healthcare."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair #Syria

"Lack of electricity has also meant that appointments using equipment like an ultrasound cannot be carried out because electricity cuts will shut down the equipment."

- Raija-Liisa Schmidt-Teigen-Country Director, @MedairInt #Syria

"It means that cold chain cannot be sustained, thereby cutting out the ability to store some medicines, including vaccines."

- Raija-Liisa Schmidt-Teigen-Country Director, @MedairInt #Syria

https://twitter.com/WHOEMRO/status/1667172209834557443?s=20

"@MedairInt has started providing solar power with rehabilitation, but this alone will not solve the energy crisis that the healthcare system is being severely impacted by."

- Raija-Liisa Schmidt-Teigen-Country Director, @MedairInt #Syria

"The health sector's financial flexibility is nevertheless limited by insufficient funding - government & donor funding are insufficient to fully address the extensive population's health needs with increasing out-of-pocket expenditures reported to meet individual health needs."

"The pharma supply chain is disrupted with frequent out of stock essential medicines and lack of basic medical equipment at health facilities."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria
@MedairInt #Syria

"International procurement of medicines by health actors is very challenging given the high cost and very long lead time for delivery. The capacity of the local market for medicines is limited and the quality of medicines procured is not assured."

https://twitter.com/WHOEMRO/status/1667172927622598657?s=20

"Due to the restrictions placed by the Ministry of Health that restrict access to the health facility program data, health actors throughout #Syria continue to face difficulties in recognizing the scope and severity of health needs to carry out efficient health planning."

"The coverage and quality of care for services provided are impacted by the limited number and capacity of available staff. Access to and utilization of health facilities are unequal by all population groups with PLWD disadvantaged."

- Raija-Liisa Schmidt-Teigen

@MedairInt

"The limited or poorly functional referral system (Inadequate ambulances) continues to impact on the continuum of care for the population."

- Raija-Liisa Schmidt-Teigen, Country Director, Medair-Syria
@MedairInt

"Health facilities functionality vary with damaged or destroyed facility structures impacting on the access and quality services delivery."

- Raija-Liisa Schmidt-Teigen, Country Director, Medair-#Syria

@MedairInt

"Functional health facilities are grossly lacking in infection, prevention and control measures putting patients are risk of hospital acquired infection."

- Raija-Liisa Schmidt-Teigen, Country Director, Medair-#Syria @MedairInt

"Government refusal for incentives of staff health workers is contributing to limited oversight of staff and impact on quality."

- Raija-Liisa Schmidt-Teigen, Country Director, Medair-#Syria

@MedairInt

"The Lack of clarity for health actors on the Syrian health policies & the lack of opportunities to support policy development, implementation or provision of technical assistance are missed opportunities to contribute to the strengthening of the Syrian health system"
@MedairInt

"However, there is a high risk that this further contributes to the weakening of the health system as higher salaries provided largely pulls staff out of the ministry of health system."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria
@MedairInt

"Health actors in #Syria, are challenged by bureaucratic restrictions, leading to delays in project field implementation due to the long delays in obtaining approvals."

- Raija-Liisa Schmidt-Teigen-Country Director, Medair-Syria

@MedairInt

"Reduced donor funding, and the increasing humanitarian needs with limited number of donors able to operate in the government of Syria controlled areas also challenges the ability of humanitarian health actors."

- Raija-Liisa Schmidt-Teigen

@MedairInt

"Donor funding for health must be increased above what it is currently if the general population are to gain meaningful access to quality health services and for the healthcare system to be positioned to be able to withstand the public health threats that remain."

@MedairInt

"Joint Advocacy by donor and health sector partners to the ministry of health is of utmost importance in order to influence the direction of Syrian healthcare policy and to ensure that access to healthcare by all groups is improved."

- Raija-Liisa Schmidt-Teigen
@MedairInt

"In order to improve the performance of the healthcare system, we need to ensure that quality services are supported by partners through joint supervision."

- Raija-Liisa Schmidt-Teigen

@MedairInt

“Most health facilities in northwest #Syria now have health personnel who are trained to receive victims of sexual harassment and protocols to support victims of rapes.”

- Dr Abdulselam Diaf, Strategic Advisor and Epidemiologist, Syria Relief and Development NGO

“The challenge for us is to think what communities need in the short-term and long-term.”

- Dr Abdulselam Diaf, Strategic Advisor and Epidemiologist, Syria Relief and Development NGO

“We must think of strengthening the health system by providing medical equipment and supplies, and training health workers.”

- Dr Abdulselam Diaf, Strategic Advisor and Epidemiologist, Syria Relief and Development NGO

“Comprehensive health services that address physical and mental health are crucial for the health and well-being of communities.”

- Dr Abdulselam Diaf, Strategic Advisor and Epidemiologist, Syria Relief and Development NGO

“There are gaps in sexual and reproductive health care in #Syria. All pregnant women are vulnerable to noncommunicable diseases, malnutrition and anaemia.”

-Rondi Anderson, Certified nurse midwife, Syria

“The midwifery story in #Syria is a success story. Syrian midwives are providing life-saving care. They are experts in women’s health.”

-Rondi Anderson, Certified nurse midwife, Syria

“Let’s focus on populations and their needs whether across-borders or close. We need to re-shape health delivery, think smarter and ensure that what we deliver on the ground is resilient.”

- @ImanShankiti , @WHOSyria Representative

#Syria

“We need to have a stronger preparedness element.”

-Iman Shankiti, @WHOSyria Representative

@ImanShankiti #Syria