nlp-thedeep/humsetbias huggingface dataset:
At the time of writing, only the Qamishli machine is reportedly operational, with a total of 18 tests administered as of 24 April, all of which were negative. The PCR machine is currently operational twice a week, although there is reportedly flexibility to extend the operating period should it be required. On 23 April, local health authorities received a further donation of 2 PCR machines.
UNICEF is supporting ongoing capacity building sessions on awareness message delivery in Aleppo, Deir Ez Zor, Homs and Hama for 137 health workers and volunteers.
451 staff of members trained on nutrition programmatic adaptations in context of COVID 19 – Communitybased Management of Acute Malnutrition  ( CMAM ) , IYCF E, Surveillance, etc.; 1,323 staff of members received personal protective equipment  ( PPE )  tools  ( e.g. masks, gloves, hand sanitizers, etc. )
As of 21 August 2020, 4,845 samples have been tested and 59 people have tested positive for COVID 19 in Northwest Syria  ( NWS )
In particular, we focus on reports from the capital of Damascus, for which the governorate released a statement on 2nd August 2020 reporting the number of deaths recorded by the Damascus mortuary office between 25th July   1st August
To date, WASH assessments have been conducted in 15 hospitals across the country. Out of these facilities, UNICEF has supported commencement of light rehabilitation of WASH systems in five facilities in Lattakia  ( Al Hafa Hospital and Al Qerdaha Hospital ) , and Aleppo  ( University Hospital, Zahi Azraq Hospital, and Ibn Khaldoun Hospital ) .
Nutrition Cluster members are implementing the recommended adaptations in the context of COVID 19 which include: continuity of life saving nutrition services, integration of IPC measures for mitigation of COVID 19 infection in all platforms, enhanced communication on IYCF E in context of COVID 19, simplified protocol for treatment of acute malnutrition, surveillance, supply pre positioning to avoid stockouts, etc
Contact tracing is continuing for all positive cases and health partners are focusing on additional preventative measures
In NES  ( as of 13 June ) , awareness campaigns and training of partner staff, including in camps, IDP settlements and collective shelters are ongoing. In April, WHO, UNHCR and UNICEF completed a COVID 19 awareness campaign covering the five formal IDP camps, 74 collective shelters, 43 IDP settlements in Ar Raqqa and Deir Ez Zor and two informal camps in Menbij. In addition, in the reporting period four trainings for 61 NGO healthcare workers in Al Haskaeh, Al Hol and Areesha camps on COVID 19 awareness were completed.
To date, WHO has delivered more than one million PPE items across Syria, including surgical masks, gloves, reusable heavy duty aprons, gowns, headcovers, alcohol hand rubs, medical masks, goggles and coveralls, in addition to alcohol hand rub. Shipments of PPE and sterilization items have been delivered to Qamishli National Hospital, the DoH in Al Hasakeh, and Deir Ez Zor Additionally, WHO supported an IPC training session and correct use of PPE for 24 INGO partner healthcare workers, with other trainings to take place later in April.
Members shared with the Nutrition Cluster some of the challenges being encountered in adjusting their operations in the context of COVID 19 according to the Nutrition Cluster guidance. The main challenges include lack of PPE, lack of infrared forehead digital thermometer to facilitate isolation at facilities, inadequate WASH services, and mobility restrictions.
UNDP has also continued, with MoH, supporting WASH rehabilitation within priority healthcare facilities, with further rehabilitation  ( including WASH )  planned at Al Qadmous Hospital in Tartous, with discussions underway to support rehabilitation  ( including WASH )  at Dummar Hospital in Damascus Governorate. A WASH partner has completed the light rehabilitation of WASH systems at one isolation centre  ( Al Bassel Education Centre )  in Dar'a Governorate and has progressed work at another  ( Health Institute )  in Deir Ez Zor Governorate. The same partner is also supporting light WASH maintenance and provision of cleaning/hygiene items to 15 childcare centres in Damascus, Rural Damascus, Homs and Aleppo governorates.
Development has commenced in most camps with the tender process completed. During the reporting period, UNICEF continued support of construction of WASH facilities at the designated isolation centres in Areesha and Mahmoudli camps, in addition to their regular support to camps and collective shelters
Due to COVID 19: Projected further job depletion, resulting in increasing need for support in terms of livelihood opportunities, income and employment, adding to the people already in need of livelihoods. support prior to the crisis
In addition to continuing to support disinfection campaigns and increased sanitation activities at the nine official and accessible Palestine refugee camps  ( and one informal camp ) , UNRWA has also distributed PPE to its frontline staff, with more than 74,000 gloves, 79,000 disposable masks, 132 goggles and 6,500 liters of disinfectant liquid delivered to date. As detailed in previous reports, WASH sector partners are continuing to deliver increased quantities of soap and hygiene kits
Working closely with WHO and MoH, the RCCE Group has developed and widely disseminated a multi component package, including a toolkit of key messages covering a wide range of issues related to COVID 19. The Group has also finalized online training materials in Arabic and trained several partners in NES and other parts of the country.
At Washokani, partners have agreed on protocol and procedures of case management, and a partner confirmed isolation centre management. At Abu Khashab, Shelter and WASH works for the isolation centre are ongoing. At Roj, isolation works are expected to commence soon, with UNICEF covering WASH facilities.
The presence of vulnerable population groups more at risk of complications if infected with the virus was reported in a significant proportion of assessed communities, with chronic diseases reported as a health problem in 80% of the assessed communities, and acute respiratory infections were reported by KIs in 44%3 of the assessed communities.
A WHO partner continued delivering awareness activities in 212 different public facilities. One partner distributed soap to 7,341 households and trained 17 water unit staff on COVID 19 sensitization.
Some Nutrition Cluster members have procured light PPE for their non health staff who are involved in routine Middle Upper Arm Circumference screening to ensure continuity of this activity as it informs the nutrition situation and impact of COVID 19 on children and PLW. However, the procured quantities are insufficient due to funding constraints.
As previously reported, the rehabilitation and light maintenance of WASH facilities in 14 collective shelters in Hama, Tartous, Lattakia and Homs has been completed with PUI support. PUI is coordinating with partners to commence light rehabilitation of WASH systems at two other shelters in Damascus. UNICEF has finalized the preparations to rehabilitate WASH facilities in informal settlements in As Sweida
Humanitarian partners have begun installing CBI centres with a total capacity of 1,400 beds across 28 locations in Idleb and Aleppo governorates, to provide adequately equipped isolation centres separate from overcrowded camps and communities. Two CBI centres are expected to be operational by the start of May, with the rest expected to be subsequently phased into operation
During this time, a number of non pharmaceutical interventions  ( NPI )  were implemented in Damascus, including curfews, school and work closures and suspension of religious prayers, however most of these are reported to have been implemented prior to 11th May 2020 with many being relaxed on 26th May
As detailed in previous reports, development, printing and distribution of information, education and communication  ( IEC )  materials in addition to awareness raising on social media, WhatsApp, radio and television channels, and direct community engagement/person to person, including during distributions and in mosques and churches is ongoing.
Further, Shelter partners have conducted 47 assessments of collective shelters in Aleppo, Damascus, Deir Ez Zor, Homs, Lattakia and Tartous to identify repairs to hygiene facilities, improve privacy and reduce overcrowding.
Assessment results indicate that additional WASH support is required in 47  ( 62% )  facilities to enhance IPC measures.The Health and WASH Working Groups are currently mobilizing partner capacity to address these gaps and working towards division of responsibilities between partners
In all assessed settlements in Deir ez Zor, it was reported that only a few  ( around 25% )  or no IDPs were engaging in social distancing. The most frequently cited reason was that living conditions do not allow it  ( 90% of assessed settlements ) , with KIs in 51%3 of settlements also reporting that IDPs are unsure of the reasons why they should practice social distancing.
As of 2nd September, 120 COVID 19 deaths had been reported in Syria, with 60 deaths in Damascus
An estimated 12 million people have been reached by television and radio awareness campaigns, and printed IEC materials. More than six million people have been reached through social media.
In terms of health, KIs in all 109 assessed communities reported healthcare to be accessible, whether in the community or in other nearby communities. However, the unaffordability of services, a lack of medicines at facilities and the high cost of transportation were all largely reported by KIs as barriers to accessing healthcare
In May, 4 96 community leaders, imams, local councils, and youth and women leaders across NWS completed a two day psychological first aid  ( PFA )  COVID 19 training.
As outlined in previous reports, samples continue to be collected by RRTs and sent to the Central Public Health Laboratory  ( CPHL )  in Damascus or regional laboratories in Aleppo, Homs and Lattakia with WHO support. In June at the time of writing, 883 samples were collected from 12 governorates, including one case from Al Hasakeh and four from Deir Ez Zor.
Three NFI partners have also reallocated funds for hygiene kits. While NFI partners are resuming distributions, there is a shortage of PPE in the market
Temperature checks were in place in 26 sub districts and distribution of soap/disinfectant/masks were available in 27 subdistricts. 82% of assessed communities lack testing provision for COVID 19, and 68% lack space in health facilities to monitor suspected cases of the virus.
Regarding WASH, difficulties accessing sufficient water and key hygiene items can heighten the risk of COVID 19 contamination if an outbreak was to arise in the area.
Similarly, while key items such as water containers and soap were reportedly available in all assessed communities, KIs reported that they were not affordable for the majority of people in 84 assessed communities  ( 77% )  for water containers and 69 communities  ( 63% )  for soap. Washing hands less frequently was however not reported as a coping strategy for lack of water by KIs in any of the assessed communities.
UNICEF have also expanded awareness volunteer campaigns to reach university campuses as they have reopened, and during national exams, supported awareness campaigns at 5,000 exam and accommodation centers hosting students.
Many partners report prioritizing frontline and health care staff while relying on other mitigation measures. In addition to support detailed in previous reports, UNHCR distributed sanitation items to 15,379 families in Hama in the reporting period. Overall, NFI distributions increased in June.
Access to sufficient water for all households was reportedly not guaranteed in 67% of assessed communities. The price of water trucking – which KIs report as the most common source of drinking water – constituted the most commonly reported barrier to accessing sufficient water.
Some 204 intensive care unit  ( ICU )  beds offer mechanical ventilation in Damascus across the private and public health system, with 47% estimated to be available for COVID 19 cases after accounting for expected occupancy due to non COVID19 health problems  ( 34
As also detailed in prior reports, UN agencies, specific sectors and partners continue awareness raising activities during existing programmes  ( such as distributions )  and/or as separate initiatives, including through social media campaigns.
The Health Resources and Services Availability Monitoring System  ( HeRAMS )  estimated there were 3,245 hospital beds in functional hospitals in Damascus in 2020
Overcrowding may cause difficulties to social distancing and increase the risk of potential COVID 19 transmission between individuals sharing a shelter. KIs in 84% of assessed communities reported at least some residents to be living in overcrowded shelters, with 80% of KIs reporting up to 20% of residents in overcrowded shelters. Of even greater concern, KIs in all assessed IDP hosting communities reported at least some IDPs to be living in overcrowded shelters.
UNFPA also continues to conduct awareness raising in its reproductive health clinics and mobile teams in 13 governorates. UNHCR report that in the reporting period, 2,416 outreach volunteers reached approximately 43,930 people across 13 governorates on awareness raising. In addition, UNICEF continued support of edutainment activities for children around COVID 19 awareness in Rural Damascus, Dar'a, and Quneitra, in addition to door to door visits.
NES NGOs rely on a combination of local procurement for basic medical items  ( such as basic PPE ) , procurement from the Kurdistan Region of Iraq  ( KRI )  and international procurement. The COVID 19 outbreak has contributed to an acute shortage of essential supplies, including PPE, medical equipment and certain medicines. Local supply chains in NES have been affected by disruption to cross border commercial activity and the current economic crisis, while NES partners also face restrictions on procuring items in KRI for export.
Using estimates of the proportion of beds in public health systems  ( 26 )  , we estimate there are approximately 4,300 beds in functional hospitals in Damascus across both the private and public health systems
In NWS  ( as of 11 May ) , 563 samples have been collected from Aleppo and Idleb governorates, of which all have been tested using PCR in laboratories in Idleb and Aleppo. All tested negative.
UNICEF supported 29 awareness sessions in nine accommodation centers for students in Ar Raqqa, and in Homs, UNICEF further supported a five day training for 74 health workers on COVID 19 related risk communication principles
As reported previously, construction of the planned isolation area at Al Hol is complete, with capacity for 60 individuals, including two rub halls, two large tents and three family size tents.
the Council would have requested the Secretary‑General, in view of the grave risk posed by COVID 19, to report by no later than the end of August on the impact of the pandemic on the need for and the delivery of humanitarian assistance, including medical and surgical supplies, to people in need throughout Syria, including non government controlled areas
Shelter sector partners in coordination with MoLAE continue assessments  ( including interagency missions )  to determine needed repairs to address issues such as overcrowding, poor hygiene and inadequate sanitation facilities, with upgrades completed in 11 shelters as of 8 May.
The trainees subsequently have commenced leading smallgroup sessions at health centers and schools, as well as home visits. INTERSOS are also supporting a training for SARC volunteers in Hama and Tartous to conduct focus group discussions on COVID 19 awareness in targeted communities.
As of 24 July, almost 3,000 samples had been tested for COVID 19. Precautions against a potential spread of the virus have been scaled up in response to the identified cases, including restrictions on movements, gatherings, commercial activities, and in person education services.
WHO, UNICEF, Health and WASH partners are working closely with relevant authorities to enhance IPC measures across public spaces, support health facilities, and to integrate measures across humanitarian programmes.
Regional outreach is also ongoing. In Homs, UNICEF has been supporting the physical distancing initiatives in public health facilities, as well as general community awareness raising.
• Members shared with the Nutrition Cluster some of the challenges being encountered in adjusting their operations in the context of COVID 19 according to the Nutrition Cluster guidance. The main challenges include: lack of PPE, lack of infrared forehead digital thermometer to facilitate isolation at facilities, inadequate WASH services, and mobility restrictions
Today after weeks of negotiations, members of the UN Security Council decided to close yet another critical channel of aid that has helped to sustain millions of Syrians, the majority of whom are women and children.
To date, WHO has delivered over 1.3 million PPE items across Syria, including surgical masks, gloves, reusable heavyduty aprons, gowns, head covers, alcohol hand rubs, medical masks, goggles and coveralls, in addition to alcohol handrubs. Shipments of PPE and sterilization items have also been dispatched to Qamishli National Hospital, the DoH in AlHasakeh, and in Deir Ez Zor
To date, WHO has delivered two shipment of PPEs and six thermal screening devices to Al Hol Camp  ( four for the main gate, two for the Annex ) ; with two devices delivered in the reporting period; and has trained personnel in thermal screening
A few Nutrition Cluster members have procured light PPE for their non health staff who are involved in routine MUAC screening to ensure continuity of this activity as it informs the nutrition situation and impact of COVID 19 on children and PLW. However, the procured quantities are insufficient due to funding constraints
A regional dispatch of 20 MT of medical supplies  ( including PPE, 14 intensive care unit  ( ICU )  beds, three X ray machines, and seven ventilators )  airlifted to Qamishli has been completed, with deliveries to the Al Hasakeh, Qamishli, Menbij, Tabqa and ArRaqqa national hospitals, as well as to the Deir Ez Zor and Al Hasakeh health authorities, Al Hol camp, and to SARC. More than 3,400 items of PPE, a ventilator, and a basic x ray system were delivered to Al Hol camp.
December 2019, GBV SC members distributed 152,537 dignity kits. Based on beneficiaries' feedback, those kits where critical in responding to their increased need for personal hygiene products in time of COVID 19
In the reporting period UNICEF supported hygiene promotion and RCCE training for 30 volunteers, in addition to 15 focus group discussions, to prepare for an awareness campaign in Al Hasakeh, including at Al Hol camp and in collective shelters
COVID 19 outbreak could potentially cause a further deterioration of the nutrition situation during the second half of 2020 attributed to dysfunctional markets, limited livelihoods opportunities, inflation, low purchasing power, increasing food insecurity, and disruption of access to health and WASH services
We are deeply concerned that the United Nations Security Council has voted today to scale back humanitarian assistance to millions of acutely vulnerable people in Syria, just as the first case of COVID 19 is confirmed in Idlib.
UNICEF, in its capacity as the WASH cluster lead, continued to engage with the Health Sector and other actors to strengthen IPC in healthcare facilities, schools and learning spaces, youth centres and communities. UNICEF is supporting the ongoing light rehabilitation of WASH systems in 15 hospitals across the country, including in Lattakia, Aleppo, Quneitra, Rural Damascus, Da'ra, Homs and Hama governorates and at the Al Hol camp.
Following the announcement of confirmed COVID 19 cases, many health facilities in northwest Syria reinforced several restrictions on service provision as precautionary measures against COVID 19. This has reportedly curtailed women and girls' access to critical medical services, including deliveries in some incidences.
They were perhaps two thousand stranded Syria returnees. Women, children and men sheltering from the unbearable heat and sun, on hill tops, under the scattered olive trees offering no shadow, carrying half empty jerrycans with water and waving at cars asking for help.
In addition, UNICEF supported a mine risk education and COVID 19 campaign in Areesha camp, including the training of 12 community volunteers. Technical support and follow up was also further provided to RCCE committees at Mahmoudli, Al Hol and Areesha camps. At Al Hol, 44 community leaders attended three workshops as a part of community mobilization and community engagement activities. Action Against Hunger further reported conducting awareness sessions on IYCF best practices during COVID 19 in Al Hasakeh.
In the reporting period, partners reported improvement in water supply in all phases of the camp. UNICEF has further continued IPC measures at the camp including disinfection of all communal kitchens, WASH facilities and the isolation area.
The needs on the ground are at an all time high after 9 years of conflict and as the Syrian economy is collapsing, rendering the most basic food items unaffordable to most Syrians. With the first case of COVID 19 confirmed in Idlib, an area with a severely weakened health infrastructure, this is a devastating blow.
In addition, WHO delivered 30 tons of medical equipment from Lattakia to Qamishil by road shipment of five trailers on 10 May. This shipment includes basic 4 x ray machines, 6 mobile x ray machines, 25 general operating tables, 8 ICU beds,10 infant incubators, and 3 portable oxygen concentrators.
WHO continues to engage closely with the MoH with technical teams meeting daily. Severe acute respiratory infection, one of the case definitions of COVID 19, is covered by the early warning alert and response system  ( EWARS )  in Syria
Syrians are now hit by another wave of suffering: economic collapse, sanctions, hyperinflation, rising unemployment, businesses that barely survived the conflict are now shutting down, more hunger with families skipping meals, and shortages of medicine.
The complex operational environment and access constraints mean that Damascus based responders have been unable to regularly reach all areas cross line.
To treat suspected and confirmed cases in north west Syria, three hospitals supported by health cluster partners are ready to receive patients in the coming weeks, in Dana, Idleb and Kafr Takharim, and three additional hospitals with ICUs are being modified and repurposed as COVID 19 isolation case management centres.
Currently 1,271 sentinel sites report cases through EWARS system across all 14 governorates. With the support of WHO, MoH is conducting active surveillance utilizing a network of surveillance officers across 13 governorates, who are in regular contact with and actively visit private and public health facilities to monitor admissions.
At the central level, the MoH has announced 14 fully equipped isolation centers are currently running. On 18 April, the MoH announced that 2,115 people had been quarantined to that date, of whom 1,898 had left and 217 remained still under supervision.
The devaluation of the local currency, the constraints and the blockage of international transfer of money are driving Syrians to extreme poverty. Syrian sons and daughters living abroad are experiencing serious challenges to send the 100 or 200 dollars, to parents who are still living in Syria. The impact is catastrophic.
With the support of WHO, the Syrian MoH is conducting active surveillance utilizing 1,932 surveillance officers across 14 governorates, who are in regular contact with and actively visit private and public health facilities to monitor admissions. Within Syria, including NES, all relevant stakeholders have agreed to collect samples through rapid response teams  ( RRTs )  for referral to the CPHL for testing  ( in line with similar established mechanisms for sample testing ) .
It means, your 70 year old mother, will no longer have a decent meal because she can't afford it. It means, your 80 year old father is no longer able to buy the asthma medication he needs for his survival.It means that even emotionally and psychologically, Syrians are affected to the very core of their identity and dignity.
This Security Council resolution comes at a time where the country is bracing for a COVID 19 outbreak, where hundreds of thousands of Syrian families are extremely vulnerable to the disease given their lack of access to healthcare services, hand washing and physically distanced shelter arrangements.
In coordination with the United Nations Department for Safety and Security  ( UNDSS )  training unit, online awareness raising sessions were conducted for the GBV Sub sector members on Gender and COVID 19. The sessions aimed to enhance knowledge and awareness of 53 participants from local partners on Gender Analysis and Response in the wake of COVID  19.
Continuation of learning needs: o Childcare arrangements for children whose parents are healthcare workers  ( in coordination with the Child Protection sub cluster ) . o Adaptation of existing curricula and implementation through printed materials and/or social media and selflearning programmes. o Assessment of students', parents' and teachers' access to affordable internet connectivity and internet enabled devices. Consider paper based individual home learning assignments based on current curricula as alternative. o Hold meetings virtually to consult with school governance bodies on the proposed approach. o Provision of education materials and supplies to children affected by COVID 19 to enable them to continue education through distance learning. o Provision of exercise sheets to all students, regardless of whether they have access to online platforms.
Due to the prolonged crisis in Syria, the public health system is fragile and requires considerable support to reinforce its capacity to support a potential outbreak of COVID 19.
WHO is accelerating the procurement of equipment to support the repurposing of the three additional hospitals to serve as COVID 19 case management centres, including for an additional 90 ventilators, eight oxygen concentrators and threeX ray machines. To further mitigate risk of COVID 19 transmissions in medical settings across north west Syria, work is ongoing to enact tents to serve as COVID 19 triage stations at 190 health facilities.
In addition, in the reporting period, UNICEF distributed 13,605 PPE items and 3,000 bottles of hand sanitizers to NGO and health partners in five governorates. Furthermore, one partner, in addition to reviewing IPC measures in its supported health care centers, distributed 8,250 PPE items in Homs, Dar'a, Quneitra, Aleppo and Deir Ez Zor.
To date, 344 RRT personnel in 13 governorates have received dedicated training on COVID 19 case investigation, sample collection and referral, with further trainings scheduled in June. In NES, five RRTs are active in Al Hasakeh, five in Ar Raqqa and four in Deir Ez Zor, while Menbij/Kobane is being covered from Aleppo. WHO also continues to support the Syrian MoH with contact tracing through the WHO developed application “Go.Data'. The MoH continues active case finding applying random sampling methods. During the reporting period, approximately 471 cases were investigated.
The reality is basic COVID 19 mitigation measures including social distancing, masks, and supply of soap and water are often not available to the huge numbers living in crowded camp conditions. These people, who have suffered so much over the last nine years of war, require humanitarian assistance more than ever at the moment to provide even the most basic needs
Where possible, UNICEF's fixed health clinics are applying the triage system, in addition to the RRT referral pathway in coordination with WHO. UNRWA have also continued a triage system in their 25 health centers; to date, 14,188 patients at UNRWA facilities with respiratory complaints have been examined following triage care and related protocols; no COVID 19 case has been detected.
In 80% of assessed settlements, around 25% or lower proportions of IDPs were reportedly aware of social distancing. In all assessed settlements in Deir ez Zor, it was reported that only a few  ( around 25% )  or no IDPs were engaging in social distancing. The most frequently cited reason was that living conditions do not allow it  ( 90% of assessed settlements ) , with KIs in 51%3 of settlements also reporting that IDPs are unsure of the reasons why they should practice social distancing.
In line with global WHO guidance, the UN in Syria emphasizes the urgent need for a rapid increase in testing to properly track and monitor a possible outbreak.
The most common challenge was the availability of internet connection amongst beneficiaries, which has limited the utilization of online platforms to provide services to people in need. To overcome this, UNFPA is currently exploring the possibility of designing a new service to provide beneficiaries with free internet bundles, while maintaining the beneficiaries' privacy  ( keeping their phone numbers private )
( 16/09/2020, Aleppo/Idlib )  20 cases in the countryside of the Aleppo governorate, and 9 in the Idlib governorate have been recorded as of 16 September. According to the statistics of the Syrian Observatory, the number of positive cases since the 9th of July until today has risen to 451 people, including doctors and medical personnel
In NES  ( as of 12 June ) , at least 197 samples have been collected in response to alerts received through one of the three surveillance systems operational to track reports of suspected cases, conduct case investigation and ultimately contain the virus's spread.
Border closures, the volatility of the exchange rate  ( and banking challenges in Lebanon ) , and other factors that impact the import of certain medical supplies critical to an effective COVID 19 response are also a concern. Other materials, for example pumps, sterilization equipment and PPEs are in short supply in the local market, resulting in the inability of partners to procure items, or increased costs due to price hikes. The fluctuation of the exchange rate during this period led to a difficulty in procuring pharmaceutical products and essential equipment such as ultrasound with a stable price..
Border closures, the volatility of the exchange rate  ( and banking challenges in Lebanon ) , and other factors that impact the import of certain medical supplies critical to an effective COVID 19 response are also a concern.
Active surveillance activity has been taking place across 125 hospitals, 25 active surveillance teams and 115 personnel
Also in Aleppo, a solid waste management project to reduce and prevent infections has been initiated, as has the rehabilitation and replacement of 2,000 meters of damaged sewer pipelines in Dar'a, to improve sanitation and public health conditions for 15,000 people.
Of these, six samples were confirmed as positive; one case via Syrian MoH testing capacity in Damascus  ( having been identified through an alert through the EWARS network ) , two cases tested by local authorities via PCR testing capacity  ( both of which have since recovered, having recently received a negative PCR test result and positive antibody test result ) and a further three cases which were confirmed via positive antibody tests administered by the local authorities indicating a previous infection
“While the UN and humanitarian partners have been taking steps to safely deliver all necessary services curtailed due to COVID 19, including malnutrition screening and surgeries, I emphasize that all parties must ensure families at Al Hol have reliable and regular access to water, health care and other basic items and services, as required by international humanitarian law. Above all, durable solutions must be found for every person living at the camp', said Mr. Riza.
( NW 09/2020 )  borrowing money from family or friends is the most commonly reported coping strategy for households to meet their basic needs. KIs also noted households sending children to work as a common livelihood coping strategy among residents and IDPs in 67% and 76% of locations, respectively.
As of 12 June, 61 swab samples  ( Hassakeh 3, Deir ez Zor 33, Raqqa 25 )  were collected in response to alerts received through the EWARN system, managed by a partner in Turkey. These samples were transferred to Idleb for testing  ( with one sample tested in Turkey ) . All proved negative, with seven tests pending at the time of writing.
The COVID 19 outbreak exacerbates the pre existing humanitarian needs of the population. Of the 4.1 million people living in northwest Syria, 2.7 million people  ( 65% )  are estimated to be internally displaced. 51% of IDPs live in camps and settlements in precarious conditions. Humanitarian needs remain very high in all sectors, especially for shelter, food, water, sanitation, hygiene, and protection  ( OCHA Situation report 16 – 26 June 2020 ) .
The UN and humanitarian partners continue to provide a range of critical assistance to Al Hol, including emergency, primary and reproductive health care; water trucking; shelter, NFIs, food and hygiene distributions; nutrition; and protection.
As of 12 June, 77 swab samples  ( all in Hassakeh ) , an increase of 18 over the last two weeks, were taken by the local authorities and transferred to Qamishli for testing. Of these, 75 samples were confirmed as negative, with two samples coming back positive on 29 April
However, access to some basic services, including regular water supply and emergency healthcare, has been increasingly compromised in recent months, for reasons such as disruptions to water supply from the Alouk water station and COVID 19 precautionary measures.
To enhance surveillance efforts, WHO is working with the MoH to simplify the case definition for COVID 19 as well as expand active surveillance beyond the existing 125 hospitals to all primary healthcare facilities.
While a number of factors, including the pre emptive closure of PoEs, movement restrictions, low population density of many areas  ( e.g. rural villages ) , and a rapid lockdown of the neighbourhoods where cases were confirmed and warmer temperatures may have limited transmission, it is also likely that low surveillance capacity has resulted in undetected community transmission in some areas
In north west Syria, as of 25 April 10,000 gloves, 1,400 disposables gowns, 900 face shields, 500 N95 masks, 200 protective googles and 10,000 surgical masks have been delivered
More than 1.3 million PPE items, including surgical masks, gloves, reusable heavy duty aprons, gowns, headcovers, alcohol hand rubs, medical masks, goggles and coveralls, and alcohol hand rubs have been delivered to the MoH, partners and national hospitals, including in Qamishli, Al Hasakeh, Menbij, Ar Raqqa and Tabqa;
Eighteen ambulances have been specially equipped to support COVID 19 related referrals.
When the People in Need was calculated at the end of 2019; an estimated 3.4 million people were in need, however given recent displacement from the NWS and possible new needs from COVID 19, this number is expected to increase.
The tragic deaths have occurred at a time when health services at the camp are under increased pressure due to the COVID 19 pandemic. Since the beginning of August, five health workers at Al Hol have tested positive for COVID 19, leading to the temporary closure of one field hospital and disruptions to another, amid growing PPE shortages.
For planning purposes, partners are preparing for two scenarios: i )  a possible spike in cases in the short term as lockdown measures are lifted and movements into NES increase and; ii )  a possible continuation of the current status quo, with no/very few new cases reported over the summer months ahead of an anticipated ‘second wave' next winter. Maintaining readiness remains critical under both scenarios.
COVID 19 has influenced the delivery of NFI assistance in Syria; since March an estimated 371,000 people were affected due to disruption of NFI assistance as a result of precautionary measures to reduce large gatherings and limited movements.
In April and May 2020, 2,221 NGO staff from 123 health facilities were trained on surveillance for COVID 19, including physicians, nurses, community health workers and other health professionals.
However, funding for the response within Syria remains a major concern; the current gap for case management alone is 90 per cent  ( US $6.5 million )  of overall requirements, while only 10 per cent of these supplies  ( ventilators, oxygenators, intubation etc. )  can be procured locally, with local exchange rate fluctuations further complicating the situation
In the second quarter of 2020, 973,602 people were reached with core NFIs and, 710,763 with winter/supplemental NFIs.
218 persons were employed through the creation of short term work opportunities, in light rehabilitation works of road and drainage systems or in COVID 19 awareness raising campaigns. 70 persons provided regular employment access in the field of media and advocacy works in Maaret Tamsrin in Idleb. • 98 people were supported by entrepreneurial activities, mostly women and youth supported to start a business or service or farmers provided with micro loans.
At all points of entry  ( PoE ) , the MoH has stationed at least one ambulance with medical personnel. To date, WHO has supported screening efforts by providing PPEs, infrared thermometers, guidance notes, registration forms and one thermal scanner camera
In NES  ( as of 13 June ) , a continued high level of movement/activity has been reported in the past two weeks through PoEs to NES  ( comprising one airport, nine land border crossings and six crossing points between local authorities and GoS or Turkish areas of control ) . Qamishli airport  ( in GoS areas )  has reopened to commercial flights from Damascus, with screening and tests  ( thought to be Rapid Diagnostic Tests  ( RDTs )  )  administered upon arrival.
As of 12 July, local authorities have confirmed a total of six cases of COVID 19 in NES, all from the same cluster in Al Hasakeh city.
Despite these limitations, UNICEF and partners continue to provide essential lifesaving services including water trucking, and health, nutrition and child protection services. UNICEF is also supporting community volunteers to further raise awareness on COVID 19 preventive measures.
Of the 16 land bordercrossings into NES  ( three into Turkish controlled areas ) , one crossing is/was considered ‘open' while eight crossings ‘partially open'.
Even though the number of suspected and confirmed cases is lower than initially expected, the risk of transmission remains high due to pre exiting vulnerabilities amongst internally displaced people  ( IDPs ) , overcrowded last resort sites, dense urban centres and limited health system capacity.
COVID 19, with the resulting movement restrictions and quarantine measures, is making a critical situation even worse. Recent confirmed infections among camp workers have led to a pause in some health and education services, and to a temporary reduction in the number of workers operating in the camp
Furthermore, sanctions are disproportionately affecting Syria's response to the COVID 19 pandemic and the Syrian healthcare system.
In NWS  ( as of 4 June ) , seven of the 13 cross border/cross line PoEs, are partially open and have measures in place to screen travelers, suspect and refer cases. WHO has strengthened the measures within five PoEs through its implementing partners, by increasing the number of human resources, deploying a vehicle for referrals and providing equipment and supplies, including PPE. Of those five POEs, three are cross border  ( Alhamam, Bab Alsalameh and Bab ) , and two are cross line  ( Ghazawiyet and Deir Ballut )
Further, WFP, as the Logistics Cluster lead, continues to monitor ports of entry for cargo movement including operational status, capacity, new developments and restrictions. The Food Security Sector continues liaison with the Logistics Cluster to update partners with pertinent information as necessary.
In addition, since mid May there has been a significant increase in movements into NES, both via cross line transit points between GoS and areas outside of Government control or border crossings with the Kurdistan Region of Iraq  ( KRI ) , including students traveling from areas outside of Government control to GoS areas to sit their national exams, as well as Syrians returning to NES via border crossings with the Kurdistan Region of Iraq  ( KRI )
In Suran, northern rural Hama, UNICEF has been reaching children and mothers with health and nutrition services despite COVID 19 challenges.
Mr. Rajasingham, who is also UN Assistant Secretary General for Humanitarian Affairs, emphasized that rising patient numbers are putting more pressure on Syria's fragile healthcare system.
In the last two weeks of May, a total of 1,385 travelers crossed in both directions across the Alhamam PoE and almost 11,965 travelers crossed in both directions across the Der Balut PoE.WHO received information that the crossline PoEs in northern Aleppo  ( Abu Zendin and Um Jloud )  were opened few times for special circumstances. With national exams set to take place in June, significant movement is expected within the two crossline PoEs and maybe within Mezanaz PoE as well. WHO and the Health Cluster continue to coordinate with their implementing partners to ensure the proper coordination with the local authorities and the Turkish authorities. This includes the deployment of a mobile team to screen travelers and refer suspected cases when the PoE will be opened.
The sanctions that have been placed on Syria by the EU  ( including the UK )  and USA have caused dire humanitarian consequences for Syrian citizens in Government controlled areas  ( which is 70% of the country )  who are seeking to rebuild their lives.
In addition to date, WHO has provided 94 enzyme kits, 177 extraction kits  ( 26,250 reactions ) , 172 screening kits and 15 confirmatory testing kits, 18,000 swabs and viral transport medium for sample collection, and five polymerase chain reaction  ( PCR )  machines, in addition to 5,000 waste bags and 21,000 bags for samples, and PPE for laboratory staff. WHO has further supplies and equipment in the pipeline.
Local supply chains in NES have been affected by disruptions to cross border and cross line commercial activity and the overall economic crisis, while partners also face restrictions on procuring and importing items from KRI, including restricted humanitarian supply movement across the border
Over the reporting period, WHO delivered to the Syrian MoH, 40 screening kits, extraction kits  ( 28,750 reactions )  and a quantitative RT PCR kit  ( 2,500 reactions ) , and 4,000 swab and viral transport mediums to CPHL. In addition to date, WHO has provided 44 enzyme kits  ( 4,400 reactions ) , 107 extraction kits  ( 4,375 reactions ) , 82 screening kits  ( 7,872 reactions )  and 11 confirmatory testing kits  ( 1,056 reactions ) , 14,000 swabs and viral transport medium for sample collection, and five polymerase chain reaction  ( PCR )  machines, in addition to 5,000 waste bags and 10,000 bags for samples, and PPE for laboratory staff.
In the NES  ( as of 24 April ) , as mentioned above, WHO has already airlifted a 20 ton shipment of medical supplies, including supplies for COVID response. This assistance was distributed to health facilities in NES, including Menbij, Tabqa and Raqqa National Hospitals, which received a limited number of ventilators and ICU beds as part of this package
The COVID 19 outbreak has contributed to an acute shortage of essential supplies, including PPEs, medical equipment  ( such as ventilators )  and certain medicines. Local supply chains in NES have been affected by disruption to cross border commercial activity, while NES partners also face restrictions on procuring items in KRI for export.
Over the past weeks there have been widespread reports of shortages in basic medicines at pharmacies in NES, with over 80 per cent of all pharmaceuticals in NES manufactured within Syria.This has contributed to an increase in prices at both public and private facilities, already contributing to an increase of admissions at ‘free' healthcare points, including NGO supported facilities.
Given the legacy of the conflict that has ripped apart a country and its people for more than 9 years, leaving 6.2 million people internally displaced and over 13 million people in need of humanitarian assistance, it is appalling that the people of Syria must face further suffering, inflicted and compounded by economic sanctions.
in view of the current lack of demand for testing due to low levels of surveillance, the lack of testing capacity  ( in terms of PCR testing kits )  and a need to ensure quality compliance, the laboratory strategy of local authorities has shifted in recent weeks
The Syrian health system, already fractured by years of conflict, is being further destroyed by sanctions.
Shortages in testing materials continues to remain a critical challenge. At present, local authorities have less than 1,500 PCR testing kits available. Partners are continuing their efforts to source additional diagnostic supplies so testing can be ramped up.
At least 500,000 additional people among the displaced population, returnees and host communities are not reachable by ERL partners with the currently available funding. This groups need to be urgently reached with: o Support to businesses in both urban and rural environments.  Start up support through grants or micro credit;  Support for micro businesses and businesses to contain the impact of the COVID 19 on their activities.
o Rehabilitation/restoration of access to basic utilities, local economic infrastructure and other social infrastructures, including:  Electricity  ( provision of electricity through solar panel installation, etc. ) ;  Access ways/roads to markets for farmers, shopkeepers and business owners, to cultivatable lands, and to and from IDPs camps;  Markets;  Water systems  ( water pipes, pumping stations, groundwater tanks to ease stress on overburdened services ) ;  Rehabilitation of sewage channels and drainage systems to ease stress on overburdened services.
This reporting period has continued to be characterized by persistence of child protection concerns in northwest Syria, aggravated by COVID 19 pandemic and the devaluation of the Syrian Pound and its impact on the local economy. The impact of the devaluation exacerbates an already dire humanitarian situation for children in northwest Syria that is resulting in a steep increase in occurrence of child labour including worst forms of child labour. Reports from the field in this period confirm increase of child labour and child marriage including an increase on numbers of children in the street until very late at night begging or hoping for casual labour
Restoration of essential services and basic infrastructure to prioritise activities that would support the preventive and curative health response to COVID 19, including rehabilitation of health centres and facilities, retrofitting of designated quarantine facilities, equipping of isolation centres, waste management,restoration of water and sanitation services and provision of energy to these facilities, in close coordination with other sectors and local governance structures.
Activities that continued with COVID 19 countermeasures included specialized services such as case management for high risk and individual cases and referrals for child protection, GBV and mine action, individual protection assistance and physical rehabilitation. Where feasible, psychosocial support, legal awareness raising, and counselling on housing, land, and property rights and civil documentation have also continued  ( in centres, via outreach, and in camps )
Then, during an 8 July videoconference meeting, it announced that a second draft  ( document S/2020/658 ) , submitted by the Russian Federation, was not adopted due to its failure to obtain the required number of votes. That text would have enabled aid to pass through Bab al Hawa until 10 January 2021.