Support integrated Health  ER services in Northwest Syria (Envelope 1  Envelope 2) As a part of cholera response plan, this 6-months multisectoral project aims to reduce mortality and morbidity rates, enhance access to healthcare services for the most vulnerable groups in Idleb and Aleppo governorates through:
1) Health:
a) CTCs: operating two CTCs in Dana (60 beds) and Atareb (50 beds) for six months to provide case management services 24/7 to cholera-suspected and confirmed cases and implement standard management protocols, in addition to integrated PFA, Psychosocial (PSS) Counselling to the Cholera patients and frontline workers at the CTCs.
Each CTC will have 10 GPs, 21 nurses, 12 IPC workers, 2 pharmacy technicians, 4 PSWs, and other support staff.
b) RCCE activities: aims at educating, engaging, and encouraging communities to adhere to cholera prevention practices through 40 Community Health Workers (CHWs) in Dana 10, Maret Misrin 10, Afrin 10, and A'zaz 10 sub-districts for six months, 
c) Referral services: as a part of the Central Referral System, 4 Cholera referral cars will provide Cholera referrals in Dana (2), amp Atareb (2), these cars will serve the two areas to integrate with our CTCs there.
Additionally, 10 pre-existing ambulances will continue their services for emergency referral services in Dana (3), Deir Hassan (1), Harim (1), Haranbush (1), Afrin (1), Bulbul (1), Sharan (1), and A'zaz (1), to transport critical cases between levels of care, cross-border, Hospitals, and other health facilities.
Each ambulance will operate 24/7 through 3 shifting teams, and each team consists of 1 paramedic with advanced first-aid experience and 1 driver with basic first-aid experience, the ambulances will be provided with operating costs including fuel, maintenance, etc., we'll have 2 ambulances with 2 female paramedics.
d)  Provision of specialized healthcare services to children through supporting the pediatric hospital in Salama / A'zaz sub-district for 6 months, the hospital provides 24/7 child healthcare services under supervision of pediatricians through these departments:
1- Outpatients department (OPD): on daily basis, providing assessment and management to patients including General and sub-speciality clinic.
2- Pediatric inpatient department (IPD) with 20 beds capacity for children required inpatients medical treatment, close monitoring and follow-up, includes isolation ward devoted for highly contagious communicable diseases.
3- Pediatric ICU with 6 beds (NICU 3 incubators, PICU 3 beds), supported by 2 ventilators, 3 CPAP machines, portable X-ray machine, and phototherapy device.
4- Neonatology department has 15 incubators, 1 intensive phototherapy device (submarine), 2 phototherapy devices, and fully equipped.
5- The hospital equipped with emergency treatment protocols, equipment, X-ray amp lab etc...

2) ER:
Recurrent flooding in NWS in winter severely impacts access to IDP sites and health facilities by rendering roads completely or partially impassable. Heavy winter rains trigger flooding and an onslaught of road traffic, 
The ER component will integrate with the health component by providing critical improvements to road and associated flood drainage infrastructure to enhance access to health facilities and facilitate the referrals transportation, especially to cholera treatment centers in Dana and Atareb (attached technical study) through the following key activities: 
a) Rehabilitating critical flood-affected roads which connect IDP sites to host communities. (Please see attached map).
A rutted roadway is hard to pass by the ambulances and cars in winter due to the destruction on its surface, and it is the only road that connects Sarmada and the western area to Harim and connects several key health facilities in the area.
b) Providing rehabilitating services for cholera centers in Dana and Atarib.
c) Creating short-term work opportunities to involve local community members to directly contribute to and benefit from preventative rehabilitation works in dana.