U F E A - REACH Resource Centre
Transcription
U F E A - REACH Resource Centre
URBAN AREA HUMANITARIAN PROFILE: EASTERN ALEPPO URBAN FACTSHEET: EASTERN ALEPPO SYRIAFC RISIS URBAN ACTSHEET: EASTERN ALEPPO FOOD, HEALTH AND WATER ASSESSMENT URBAN : EASTERN ALEPPO AUGUSTFACTSHEET 2014 URBAN CENTRE HUMANITARIAN PROFILE: EASTERN ALEPPO URBAN FACTSHEET: EASTERN ALEPPO URBAN FACTSHEET: EASTERN ALEPPO CONTENTS LIST OF MAPS AND TABLES LIST OF ACRONYMS GEOGRAPHIC CLASSIFICATIONS INTRODUCTION ................................................................................................................................................................1 METHODOLOGY ...............................................................................................................................................................2 DISPLACEMENT & ACCESS OVERVIEW .............................................................................................................................4 FOOD FINDINGS ...............................................................................................................................................................6 SEVERITY LEVEL ......................................................................................................................................................................................... 6 MARKET STOCKS......................................................................................................................................................................................... 6 ACCESS CONSTRAINTS .............................................................................................................................................................................. 7 AVAILABILITY ISSUES AND SHORTAGES ................................................................................................................................................. 7 FUNCTIONING OF BAKERIES ..................................................................................................................................................................... 8 PRIORITY INTERVENTIONS ........................................................................................................................................................................ 8 HEALTH FINDINGS ...........................................................................................................................................................9 SEVERITY LEVEL ......................................................................................................................................................................................... 9 MAIN HEALTH CONCERNS ......................................................................................................................................................................... 9 MEDICAL SERVICE COVERAGE AND ACCESS ...................................................................................................................................... 10 FUNCTIONING OF HEALTH CENTRES ..................................................................................................................................................... 10 PRIORITY INTERVENTIONS ...................................................................................................................................................................... 11 WATER FINDINGS ..........................................................................................................................................................12 SEVERITY LEVEL ....................................................................................................................................................................................... 12 WATER NETWORK DEFICIENCY .............................................................................................................................................................. 12 PRIORITY INTERVENTIONS ...................................................................................................................................................................... 13 CONCLUSIONS ...............................................................................................................................................................14 GENERAL .................................................................................................................................................................................................... 14 FOOD ........................................................................................................................................................................................................... 14 HEALTH ....................................................................................................................................................................................................... 14 WATER ........................................................................................................................................................................................................ 14 About REACH REACH is a joint initiative of two international non-governmental organizations - ACTED and IMPACT Initiatives - and the UN Operational Satellite Applications Programme (UNOSAT). REACH was created in 2010 to facilitate the development of information tools and products that enhance the capacity of aid actors to make evidence-based decisions in emergency, recovery and development contexts. All REACH activities are conducted in support to and within the framework of inter-agency aid coordination mechanisms. For more information, please visit: www.reachinitiative.org. You can write to us at: geneva@reach-initiative.org and follow us @REACH_info. LIST OF MAPS AND TABLES Map 1: Assessed neighbourhoods of Eastern Aleppo City, 25 July 2014 ........................................................................................ 3 Map 2: Food insecurity severity in Salah al-Din, Bustan al-Qaser, Fardos, and Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 .................................................................................................................................................................. 6 Map 3: Health conditions severity in Salah al-Din, Bustan al-Qaser, Fardos, Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 .............................................................................................................................................................................. 9 Map 4: Drinking water situation severity in Salah al-Din, Bustan al-Qaser, Fardos, Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 ................................................................................................................................................................ 12 Table 1: Severity Scale, from 6 (“Catastrophic situation”) to 0 (“No problem”) ................................................................................ 3 Table 2: Resident population and Internally Displaced Persons per assessed neighbourhoods of eastern Aleppo city, 25 July 2014 .................................................................................................................................................................................................. 4 Table 3: Groups most in need of assistance in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ........................... 5 Table 4: Access constraints to food in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ......................................... 7 Table 5: Food availability issues and shortages in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ...................... 7 Table 6: Factors impacting bakeries’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ................... 8 Table 7: Priority food interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 .......................................... 8 Table 8: Average medical service coverage compared to needs in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ................................................................................................................................................................................................ 10 Table 9: Health centres’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014..................................... 10 Table 10: Main factors impeding health centres’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 11 Table 11: Priority health interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ................................... 11 Table 12: Water availability issues in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ........................................ 13 Table 13: Access constraints to water in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 ................................... 13 Table 14: Priority water interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 .................................... 13 LIST OF ACRONYMS IDP KI NFI NGO SINA Internally Displaced Person Key Informants Non-Food Items Non-Governmental Organisations Syria Integrated Needs Analysis GEOGRAPHIC CLASSIFICATIONS Governorate District Sub-District City Neighbourhood Highest form of governance below the national level Sub-division of a governorate in which government institutions operate Sub-division of a district composed of towns and villages Urban centre located within a sub-district Lowest administrative unit within a city Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 INTRODUCTION Since the beginning of 2014, the Syrian city of Aleppo has been under constant aerial bombardment, and high intensity ground fighting1. Barrel bombings and switching off of the water pumping stations and electricity have caused extensive shutdowns across Aleppo city. These combined factors caused the displacement of more than 550,000 persons from eastern Aleppo city towards other areas within Aleppo governorate and across border into Turkey2. Since mid-June 2014, eastern Aleppo city has been under an increasing threat of being besieged3. As a result, access to this area is constrained, with main roads and most southern entrances to the city being open on a sporadic basis. For the last two years, since July 2012, eastern Aleppo was already one of the most difficult areas to reach by humanitarian organisations. The potential of a complete blockade for external aid delivery will worsen an already critical humanitarian situation for the population still living in this area of the city. This assessment presents an analysis of data collected by REACH enumerators between 22 and 25 July, 2014, in the eastern, opposition-controlled side of Aleppo city – an area which encompasses the northern, eastern, and southern parts of the city, historically known as “the crescent of the poor”. Previous assessments that took place between 17 April and 7 July allow REACH to do a comparison of trends and needs over time in this context. The findings from this assessment highlight sector specific humanitarian needs and gaps in order to inform the relief response for affected populations in four frontline neighbourhoods of eastern Aleppo city: Salah al-Din, Bustan al-Qaser, and Fardos, in the south, and Sheikh Maqsoud, in the north. In these consistently populated neighbourhoods, humanitarian needs are dramatically impacted by the volatility of the security situation, constraining access to basic utilities and services. While other neighbourhoods reportedly host residents and IDPs as well, fluctuations of population numbers and services do not allow for a representative assessment of the situation. This urban centre humanitarian profile specifically focuses on the sectors of Food, Health and Water in each of the four neighbourhoods. This assessment does not aim to provide detailed programmatic information; it is designed to share with a broad audience a concise overview of the current situation in this area and to guide further assessments. As part of the presentation of key findings for each of the sectors covered by this assessment, suggested priority interventions are included to inform aid actors in planning timely and appropriate relief response for affected populations in eastern Aleppo. Barrage of Barrel Bombs, Human Rights Watch (July 30, 2014) Aleppo City - Key Informants Assessment Report REACH (June 2014) 3 Syrian troops advance in key city of Aleppo (Al Jazeera, July 7, 2014) 1 2 1 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 METHODOLOGY The methodology applied for this assessment included one phase of primary data collection and analysis, between 22 and 25 July 2014, and secondary data review covering the period 1 July – 8 August 2014. These data are compared here with two previous assessments. The first one was carried out between 16th April and 6th May 2014, and the second phase was undertaken between 1st and 7th July 2014. Due to access and security constraints, purposive sampling was selected as the most appropriate method for this assessment, which was carried out using a combination of two data collection methods: Key Informants’ (KI) interviews and direct observations by teams of trained enumerators. Out of the 8 enumerators who participated in the assessment in Eastern Aleppo, 5 had been trained by an interagency team of trainers during the Syria Integrated Needs Assessment (SINA)4 carried out in 2013. This training took the shape of a multi-sector training to ensure a good understanding of key terms and underlying factors for each assessed sector, as well as assessment techniques such as triangulation and interviewing. The remaining 3 enumerators were trained by the REACH team in Turkey, who also facilitated specific training with leaders of enumerator teams, covering assessment standards, terminology, methodology and tools, as well as humanitarian principles. A multi-sector questionnaire designed by REACH and the Inter-Sector Coordination Group, and based on data collection tools for SINA, was provided to enumerators, who received training on assessment and humanitarian principles and tools, triangulation methodologies, and methods for reliability ranking. The questionnaire includes an evaluation of needs severity in each sector, based on the perceptions of KI, coupled with direct observations made at locations visited. Multiple KI interviews and observation visits were conducted whenever possible in eastern Aleppo city. KI were asked to rank severity on a seven-point scale, from 0, meaning “normal situation”, to 6, “catastrophic” (Table 1). Four questionnaires, focusing on the northern and southern neighbourhoods of Sheikh Maqsoud, Salah al-Din, Bustan al-Qaser, and Fardos were completed for this assessment (Map 1). KI were selected based on their knowledge of sector-specific issues5, such as local leaders working with private or public services providers, in the eastern area of Aleppo. To increase the reliability of data collected through KI interviews, enumerators were asked to triangulate their findings through different sources familiar with the context in eastern Aleppo. Face-to-face and remote debriefings of enumerators were conducted by REACH assessment staff, to review and validate completed questionnaires. Team leaders were also asked to share field observations as well as to present evidence, including photos of damages or strategic water and electricity infrastructures, when possible. REACH assessment staff also conducted shorter debriefing interviews with enumerators to cross-check the information shared by the team leader. Due to the recurrence of population movements and the ongoing limited access to eastern Aleppo city, population numbers are difficult to estimate. For this reason, the population and displacement figures provided in this factsheet should be interpreted as estimates only, and should be used with care, although they remain in line with the displacement patterns reported in secondary sources. The main limitation for this assessment is the high reliance on KI interviews as the primary data collection method. This constrained the analysis of results, despite the checks and balances outlined above in regards to triangulation of collected data. Further, the assessment comprised a limited number of interviews due to the context briefly described in the Introduction. 4 5 Assessment Working Group for Northern Syria, 31/12/13 KI usually include, but are not limited to, local council, relief committees, and health and education officials, along with community leaders. 2 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 Map 1: Assessed neighbourhoods of Eastern Aleppo City, 25 July 2014 Table 1: Severity Scale, from 6 (“Catastrophic situation”) to 0 (“No problem”) 6 Catastrophic situation for <sector name>. Affected population faces life-threatening conditions causing high level of suffering, irreversible damages to health status and deaths. Large number of deaths are reported directly caused by the current <sector name> conditions and will result in many more deaths if no immediate <sector name> assistance is provided. 5 Critical situation for <sector name>. Affected population faces life-threatening conditions causing high level of suffering, irreversible damages to health status and deaths. Deaths are already reported, directly caused by the current <sector name> conditions, and more deaths are expected if no immediate <sector name> assistance is provided. 4 Severe situation for <sector name>. Affected population faces life-threatening conditions causing high level of suffering and irreversible damages to health, which can result in deaths if no humanitarian assistance is provided. 3 Situation of major concern for <sector name>. Majority of people are facing <Sector name> problems or shortages causing discomfort and suffering which can result in irreversible damages to health, but they are not life threatening. Affected population will not be able to cope with the <Sector name> current conditions if the situation persists and no humanitarian assistance is being provided. 2 Situation of concern for <sector name>. Many people are facing <sector name> problems or shortages causing discomfort and suffering, but they are not life threatening. Affected population is feeling the strain of the situation but can cope with the current situation with local resources. 1 Situation of minor concern for <sector name>, but conditions may turn concerning. Few people are facing problems or shortages in <sector name> but they are not life threatening. Affected population is feeling the strain of the situation but can cope with the current situation with local resources. 0 3 Normal situation for <sector name>. Population is living under normal conditions. All <sector name> needs are met. Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 DISPLACEMENT & ACCESS OVERVIEW While displacement trends within the city are unpredictable, the neighbourhoods REACH assessed have remained consistently populated throughout the conflict and attracted high number of IDPs, including from within eastern Aleppo city. Barrel bombing in eastern Aleppo city increased over the past six months, after resolution 2139 was passed on February 22, 2014. Impacts concentrated on highly populated neighbourhoods located within vicinity of front-line positions6. The four assessed neighbourhoods, although they meet these criteria, were targeted to a lesser extent, and traditionally did not report the same levels of housing damage. Bustan al-Qaser, Salah al-Din, Fardos and Sheikh Maqsoud have thus been the most commonly sought ‘safe’ areas by IDPs since the beginning of the conflict (Table 2). Table 2: Resident population and Internally Displaced Persons per assessed neighbourhoods of eastern Aleppo city, 25 July 2014 Neighbourhoods Population IDPs7 IDP arrivals in last 30 days Bustan al Qaser 42,000 900 600 3,900 600 300 Salah al Din 65,000 10,000 100 Sheikh Maqsoud 20,000 1,430 40 130,900 12,930 1,040 Fardos Total Reduced conflict intensity that occurred in eastern Aleppo city between 7 and 25 July allowed for scaled-up deliveries through the gradual reopening of Bustan al-Qaser crossing gate – the only gateway between western and eastern Aleppo city until it was closed in August 2013. Both reduced conflict intensity and increased aid delivery allowed for 12,000 people to settle back in Bustan al-Qaser, between 1 and 25 July. Three access roads to eastern Aleppo city, including Kallaseh road, are currently open from 6am to 6pm. Although consistently targeted by shelling and snipers, conflict intensity decreases during these hours. As the threat of a siege was increasing throughout July 2014, KI reported an on-going wave of displacement via these roads, from eastern Aleppo city towards northern sub-districts and Turkey. If eastern Aleppo city is eventually besieged, these routes could be cut off, similarly to what previously happened in Damascus and Homs8. Barrage of Barrel Bombs, Human Rights Watch (July 30, 2014) The number of IDPs for Fardos and Salah al-Din could not be assessed at the end of July. These data are from an assessment carried out from 1 – 7 July, 2014. 8 Aleppo rebels caught between Islamic State, Regime Al Monitor (June 30, 2014) 6 7 4 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 KI’s reports and debriefings with enumerators from April/May 2014 emphasised that the remaining residents of eastern Aleppo city were already facing severe financial and safety constraints preventing them from leaving unsafe areas. Frequently, these residents cannot afford to pay for either: (1) transportation costs to leave the city, (2) rental of housing outside Aleppo city, (3) cost of living in neighbouring countries, and (4) – in the case of some fees for housing in collective shelters or border area camps. Other reported impediments include (1) fear of arrest en route to or once in Western Aleppo city (exacerbated by the considerable number of checkpoints), (2) the stigma and fear of criminality, and associated protection concerns in camps, and (3) wishing to protect and/or remain in their home. As they face challenges to leave, these residents become IDPs and tend to relocate on a sometimes daily basis as they flee from aerial bombings, and congregate in basements and vacated buildings. KI reported them to be amongst the most vulnerable groups in need of assistance, for all four neighbourhoods (Table 3). As the majority of IDPs and residents in eastern Aleppo city are found in the four assessed neighbourhoods of Salah al-Din, Bustan al-Qaser, Fardos, and Sheikh Maqsoud, these neighbourhoods are a priority for humanitarian action in eastern Aleppo city. Table 3: Groups most in need of assistance in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 5 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 FOOD FINDINGS SEVERITY LEVEL: MAJOR CONCERN (3) Map 2: Food insecurity severity in Salah al-Din, Bustan al-Qaser, Fardos, and Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 Food security conditions are reportedly less severe, compared to late June 2014. KI qualified food shortages as being of major concern, although not life-threatening, in all assessed neighbourhoods. Affected populations reportedly face “problems or shortages causing discomfort and suffering, which can result in irreversible damages to health”. These populations will not be “able to cope with the current food conditions if the situation persists and no humanitarian assistance is provided.” KI emphasised that improved access to the city allowed to scale up aid delivery, which mitigated the severity of food insecurity (Map 2). MARKET STOCKS 6 No significant changes have been reported by KI since April 2014 in markets’ stocks, although they have improved in Salah al Din. KI emphasised that all four neighbourhoods now have most or all required stocks to supply residents with basic food and non-food items. Traders in these neighbourhoods can also still replenish their stocks within seven days if needed. More acute food shortages and needs may however be under-reported. First, stock levels could be overestimated, since financial and security challenges faced by eastern Aleppo’s residents may prevent these residents from accessing markets, which in turn cannot sell their food products. Secondly, the poorest residents, who face the heaviest financial challenges, tend to rely to a large extent on external food supply and may not resort to markets. Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 ACCESS CONSTRAINTS KI’ reports on access constraints are similar to those from July 2014. Financial impediments – pricing and lack of resources – are still the main obstacles to securing food in all four neighbourhoods. Prohibitive prices of basic food and food-related items, such as eggs, oils, cooking fuel and gas, are found in Salah alDin, Sheikh Maqsoud and Bustan al-Qaser respectively. These price levels highlight the limited availability of such products. Additionally, the current drought affecting northern Syria is considerably impacting yields, and will likely further increase prices of basic food items such as bread9. KI also emphasised safety constraints as preventing residents from accessing markets (Table 4). Despite the recent decrease in barrel bombing on these neighbourhoods, on the ground fighting is still a threat to residents’ safety, and reduces their mobility. Table 4: Access constraints to food in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 AVAILABILITY ISSUES AND SHORTAGES The main reported issues across the assessed neighbourhoods are 1) lack of locally produced food, 2) lack of food diversity on markets, and 3) shortages in infant formula (Error! Reference source not ound.). Lack of infant formula is a consistently reported issue in the southern neighbourhoods of Bustan alQaser, Salah al-Din, and Fardos. Besides low levels of local food production, caused by heavy losses of agricultural land, KIs emphasised that eastern Aleppo city was affected by lack of diversity in the food available on markets. While locally produced food can be delivered to the city from several access roads, external assistance is needed to counterbalance local production shortages affecting food stocks and diversity. Table 5: Food availability issues and shortages in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 9 Syria: Red Cross and Red Crescent alarmed about water shortages (ICRC, July 25, 2014) 7 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 FUNCTIONING OF BAKERIES Bakeries in Bustan al-Qaser and Salah al-Din10 and Sheikh Maqsoud are facing serious electricity, wheat flour and fuel shortages (Table 6). The decrease in barrel bombing was reflected in KI’ interviews, which emphasised that bakeries are less threatened by conflict destruction and more easily accessible to workers, notably in Sheikh Maqsoud, compared to May and early July 2014. Several deliveries of wheat flour took place in July 2014, reportedly reaching more than 80% of residents in these neighbourhoods (over 100,000 people), contributing to reduce food insecurity. One delivery included 75 tons of wheat flour supply to one major bakery11 located in these neighbourhoods, to cover daily bread needs for over 4,000 households a month for the next 5 months. Table 6: Factors impacting bakeries’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 PRIORITY INTERVENTIONS As a result of financial challenges and lack of food diversity, KIs prioritised food baskets and cash assistance as the most urgently needed interventions in each neighbourhood (Table 7). There is also a critical need for infant formula in Al Fardos, and for cooking fuel in Salah al-Din, Bustan al-Qaser, and Sheikh Maqsoud. Table 7: Priority food interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 10 Al-Fardos does not have any bakery, and thus relies on those found in Bustan al-Qaser and Salah al-Din. 11 One of the bakeries is underground which has allowed it to remain functioning despite continued barrel bombing in the area. 8 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 HEALTH FINDINGS SEVERITY LEVEL: SEVERE (4) (SHEIKH MAQSOUD, BUSTAN AL-QASER) AND OF MAJOR CONCERN (3) (SALAH AL-DIN, FARDOS) Health conditions have reportedly improved throughout July 2014. The “critical” situation reported at the end of June is of major concern, but no longer life-threatening in Salah al-Din and Fardos. In Sheikh Maqsoud and Bustan al-Qaser however, health conditions are still life-threatening and the situation is “severe”. Despite a decrease in severity for all four neighbourhoods, the situation will reportedly worsen again if no humanitarian assistance is provided ( Map 3). Map 3: Health conditions severity in Salah al-Din, Bustan al-Qaser, Fardos, Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 MAIN HEALTH CONCERNS 12 9 KI reported conflict related injuries as the most prevailing health issues in southern neighbourhoods of eastern Aleppo. This suggests that on the ground fighting is still affecting residents, despite the recent decrease in bombing intensity. While KI did not single out chronic diseases at the end of June 2014, they are now a major concern again, due to lack of medicine and qualified health staff to treat these diseases. This is however expected to improve, since 10 metric tonnes of medical supplies were provided to four hospitals in eastern Aleppo city on 30 July, to cover the needs of 22,300 people12. WHO and the Syrian Arab Red Crescent Reach Eastern Aleppo City and Mouadamiya in rural Damascus (WHO, July 31, 2014) Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 MEDICAL SERVICE COVERAGE AND ACCESS Medical services coverage is still low (Table 8), even in neighbourhoods such as Sheikh Maqsoud, where it has reportedly improved13. The population in these neighbourhoods remained thoroughly the same, when compared to early July, meaning the proportion of services per individual has not changed. Bustan al-Qaser’s population has however increased by 12,000 people, which resulted in an increased pressure on medical consultation services. KI also reported that access to health facilities is still very limited, since medical coverage has not improved. Despite a decrease in conflict intensity, safety constraints prevent affected residents from obtaining the level of care they need. KI’ reports from late June 2014 already emphasised an increase in severe diseases affecting children under five14, which are still a prevailing issues in Bustan al-Qaser and Sheikh Maqsoud. Malnutrition is of particular concern, since it is compounded by almost non-existent growth surveillance services. Table 8: Average medical service coverage compared to needs in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 FUNCTIONING OF HEALTH CENTRES Similarly to previous findings from May and June 2014, a small proportion of health centres is no longer functioning because of conflict-related damage (Table 9). For other non-functioning health centres KI singled out lack of key resources – medical staff, supplies and funding – as the main critical impediments (Table 10) Table 9: Health centres’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 The coverage for the following medical services has improved in Sheikh Maqsoud: reproductive health and obstetric care, chronic diseases management, emergency and injury management, emergency health services/ambulances, and medical consultations. 14 Severe diseases affecting children under five include communicable and non-communicable diseases, along with leishmaniasis, malnutrition, and polio. 13 10 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 Table 10: Main factors impeding health centres’ functionality in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 PRIORITY INTERVENTIONS KI identified 1) medical staff, 2) medical supplies (medicine and consumables), and 3) mobile clinics as the most urgently needed interventions to improve health centres’ functionality and coverage (Table 11). The provision of qualified health staff and medical equipment would ensure a better coverage in terms of existing medical services. On the other hand mobile clinics would allow to mitigate safety risks associated with static health centres, more prone to be damaged by bombing, and thus facilitate access to medical services. Table 11: Priority health interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 11 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 WATER FINDINGS SEVERITY LEVEL: MAJOR CONCERN (3) (SALAH AL-DIN, BUSTAN AL-QASER, FARDOS) AND OF CONCERN (2) (SHEIKH MAQSOUD) KI in south eastern neighbourhoods of Aleppo city again reported that the “majority of people are facing water access problems or shortages causing discomfort and suffering which can result in irreversible damages to health, but they are not life threatening. Affected population will not be able to cope with the current water access conditions if the situation persists and no humanitarian assistance is being provided” (Map 4). Map 4: Drinking water situation severity in Salah al-Din, Bustan al-Qaser, Fardos, Sheikh Maqsoud neighbourhoods of eastern Aleppo city, 25 July 2014 Water conditions in Sheikh Maqsoud have however improved since late June 2014. They are no longer reported as a “major concern”, but as a situation of “concern”, with affected population being able to “cope with the current conditions with local resources”. Although KI do not consider current water conditions to be life threatening, they are likely related to a reported high prevalence of diseases and symptoms originating from poor sanitation conditions15. WATER NETWORK DEFICIENCY 15 KI singled out lack of electricity to run the water network, along with damages to this network, as main factors for the reduction of water supply in these neighbourhoods ( Table 12). Throughout July 2014, electricity has reportedly been available from 4 to 20 hours a day in eastern Aleppo city, while water was available 4 or 5 hours a day. KI additionally highlighted lack of water tanks, to collect and store water when it is available, as a major factor impeding the coverage of residents’ drinking water needs. This is an especially acute issue in Bustan al-Qaser and Salah al-Din. Leishmaniasis and diarrhoea, associated with water- and vector-borne diseases have been reported as major issues by KI. 12 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 The reduced availability of water resulting from the lack of electricity and lack of resources to purchase bottled water have further led residents to dig wells they are reportedly unable to consistently chlorinate (Table 13). At the end of July 2014 KI further emphasised that water in these neighbourhoods does not taste or look good, but could not be tested to assess if it was polluted. Table 12: Water availability issues in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 Table 13: Access constraints to water in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 PRIORITY INTERVENTIONS Critical shortages of electricity to improve the network functionality and tanks to store water when available led KI to identify these as the most urgently needed interventions. They also highlighted the need to dug new wells to cover residents’ daily needs, along with a lack of water treatment chemicals to safely resort to existing, although drying up, wells (Table 14). Table 14: Priority water interventions in assessed neighbourhoods of eastern Aleppo city, 25 July 2014 13 Urban Area Humanitarian Profile: Eastern Aleppo, August 2014 CONCLUSIONS GENERAL The remaining residents of eastern Aleppo face acute challenges which prevent them from leaving the city, yet forcing them to relocate from their area of origin to other neighbourhoods, such as Salah al-Din, Bustan al-Qaser, Fardos, and Sheikh Maqsoud. KI emphasised an improved access to the city, resulting from a decrease in barrel bombing. More roads are now open, allowing residents to leave the city and aid to be delivered in eastern Aleppo. As a result, about 12,000 residents reportedly managed to settle back in Bustan al-Qaser. However, access is still constrained, these roads remain dangerous and are open on a sporadic basis. Despite reduced barrel bombing intensity, on-the-ground fighting still prevents residents’ access to medical facilities and markets for instance. FOOD KI emphasised insecurity and limited resources, notably lack of financial means in a context of high food prices, as the main constraints impeding eastern Aleppo residents’ access to food. KI also reported lack of food diversity to be correlated to shortages in local production. Similarly to early July 2014, markets are reportedly able to replenish their stocks within seven days. Stocks may appear sufficient as a result of traders not being able to sell food because residents cannot afford it. KI reported that the functioning of bakeries was significantly constrained by the irregularity of electricity provision, shortages in wheat flour, and lack of flour. Priority interventions to improve food security were identified by KI to be food baskets and cash assistance. These interventions would allow to counterbalance low levels of local production as well as residents’ financial constraints. HEALTH Health worker KI reported similar levels of medical service coverage throughout July 2014. Prevailing health concerns at the end of July include conflict-related injuries – due to on the ground fighting, chronic diseases, and severe diseases affecting children under five. Health centres’ functionality is reportedly consistently diminished by lack of key resources – namely medical staff, funding, and equipment. Priority interventions to improve health centres’ functionality were identified by KI to be medical staff and medical supplies, along with mobile clinics, considered to be safer. WATER KI singled out the lack of electricity as the major impediment for residents in eastern Aleppo. Shortages in water tanks, water treatment chemicals, and lack of resources to purchase bottled water, were also emphasised. Priority interventions to mitigate water issues were identified by KI to be electricity, along with water tanks, to store water when it is available, and the diggings of new wells. However, shortages in chemicals to purify existing wells would still be a constraint preventing access to new wells. 14