The Syrian Ministry of Health and WHO collaborate on the National Multi-Sectoral Action Plan for prevention and control of NCDs. Photo credit: WHO Syria30 April 2024, Damascus, Syria – In collaboration with the Syrian Ministry of Health, WHO conducted a central meeting from 29 to 30 April to prepare the National Multi-Sectoral Action Plan for prevention and control of noncommunicable diseases (NCDs). Chronic conditions, including cardiovascular diseases, diabetes, respiratory conditions, cancer and mental health disorders, are responsible for an estimated 50–70% of all deaths in Syria.

The Action Plan is in line with WHO’s regional and global frameworks and aims to promote healthy lifestyles and address the rising prevalence of chronic diseases by targeting risk factors such as tobacco use, unhealthy diet, physical inactivity, harmful alcohol consumption and exposure to air pollution.

Representatives of the Syrian Ministry of Health and WHO discuss the National Multi-Sectoral Action Plan for prevention and control of NCDs. Photo credit: WHO SyriaDr Iman Shankiti, acting WHO Representative to Syria, said, “This comprehensive strategy prioritizes collaboration among relevant sectors to analyse the current situation, develop a multisectoral national plan and implement joint planning, implementation, monitoring and evaluation to minimize population exposure to preventable risk factors. In the end, we aim to address one of the biggest threats to mortality and morbidity in the country, ensuring better health and longer lives for all people in Syria.” 

At the meeting, participants discussed critical topics, including the need for a national strategy on NCD prevention and control and chronic diseases management. The group also discussed the role of WHO and stakeholders in addressing significant challenges and fostering partnerships to advance health care in Syria, using the life-course approach. This approach aims to improve health outcomes by addressing social, economic and environmental determinants of health across different stages of life, from prenatal care through to older age.

Related links

Noncommunicable diseases: Regional framework for action

Global Coordination Mechanism on the Prevention and Control of NCDs

Yusra engages in physical therapy sessions at the rehabilitation centre to regain her mobility. Photo credit: Physicians Across Continents29 April 2024 – “I felt the ground shaking heavily, I ran to wake up my parents and my grandfather, then I went to wear clothes to run outside,” recounts Yusra*, a 23-year-old university student from Idlib governorate, north-west Syria. “That is all I can remember. My life had changed forever.”

Yusra’s house collapsed on her as she was rushing to take cover during the series of deadly earthquakes that struck Syria and Türkiye in February 2023. Yusra was trapped beneath the rubble for many hours.

In Syria alone, the disaster caused nearly 5900 deaths and left more than 12 800 people injured. It uprooted hundreds of thousands of families, and severely damaged infrastructure already made weak by the conflict.

Most injuries sustained in the earthquake were those requiring specialized interventions and long-term rehabilitation. For example, spinal cord injuries, traumatic brain injuries, and orthopaedic conditions like fractures or crushed limbs, some of which called for amputations or other specialized orthopaedic care.

Yusra suffered from hemiplegia – a spinal cord injury that leads to paralysis on one side of the body – resulting in loss of movement in her right leg.

The psychological toll of the harrowing experience of both the earthquake and her physical injury was so profound that Yusra resisted treatment for many months.

Finally, her family convinced her to visit Step of Hope in Azaz, a subdistrict of Idlib. This WHO-supported rehabilitation centre is operated by Physicians Across Continents, a national nongovernmental organization, with generous funding from the Central Emergency Response Fund.

Individualized treatment and rehabilitation

A triumphant moment for Yusra, and the entire medical team at the Step of Hope rehabilitation centre, as she takes her first steps following physical therapy. Photo credit: Physicians Across ContinentsReluctant to engage in treatment at first, Yusra gradually began to open up to the possibility of recovery thanks to the consistent support and encouragement of the Step of Hope staff.

A tailored treatment plan for Yusra was drawn up to address both the physical and psychological aspects of her condition. Physical therapy sessions focused on improving mobility and functions. Occupational therapy aimed to restore independence in daily activities. She also received psychological support to overcome her trauma and rebuild her mental resilience.

The collaborative efforts of the centre’s health workers, including therapists, counsellors and support staff, played a pivotal role in her rehabilitation journey. Over time, Yusra made remarkable progress. She regained her mobility with the help of a walker, and her outlook became increasingly positive – so much so that she resumed her education.

“When I started the treatment, I was sceptical and afraid I would not be able to make any progress. I cannot describe my happiness being able to stand up and move my legs,” says Yusra. “Now I am determined to pursue my dreams, complete my education and become a teacher.”

In the aftermath of the earthquake, WHO supported 5 rehabilitation centres to provide similar inpatient rehabilitation services, reaching more than 23 000 people in north-west Syria.

*Name has been changed to protect privacy and security.

Immunization activity in rural Damascus, Syria, 2024. Photo credit: WHO Syria23 April 2024, Damascus, Syria – Syria’s first round of its Big Catch-Up vaccination activity began this week. The 10-day initiative was launched by the Syrian Ministry of Health in partnership with WHO and the United Nations Children’s Fund (UNICEF). Two further rounds of vaccination activity under the campaign are scheduled for July and October 2024.

WHO is providing technical support to the Ministry of Health and covering the operational costs of the Big Catch-Up campaign. This has been made possible by generous contributions from Gavi, the Vaccine Alliance, and the United States Agency for International Development’s Bureau for Humanitarian Assistance.

The first round of activity will involve screening more than 2 million children aged under 5 years across Syria. These children were missed during previous campaigns owing to factors including access and population movements. All the screened children will receive the bivalent oral polio vaccine (bOPV), regardless of their vaccination history.

To achieve this, 7393 health workers from the Ministry of Health – including 4541 vaccinators at fixed sites and 1097 mobile medical teams – will be deployed to 993 health facilities and 70 temporary vaccination posts. To monitor the vaccination activity, 365 supervisors at different levels will check on progress during its implementation.

Further, 1769 communications officers will join the effort, to ensure proactive risk communication and community engagement – crucial to promote vaccination of children. To further encourage vaccine uptake, 1755 mosques and 209 churches will share key messages with communities.

Dr Iman Shankiti, acting WHO Representative to Syria, emphasized the importance of vaccination as a crucial public health strategy. “Vaccination saves millions of lives globally and is among the most cost-effective health interventions available,” she said. “WHO remains dedicated to its mission of ensuring that all children in Syria are protected from vaccine-preventable life-threatening diseases.”

The first round of the Big Catch-Up initiative overlaps with World Immunization Week, which takes place every April. This annual campaign aims to promote the use of vaccines to protect people of all ages against disease. This year’s theme is “Humanly Possible: Saving lives through immunization”.

In 2024, WHO and partners also mark 50 years of the Expanded Programme on Immunization (EPI). This anniversary highlights the great progress being made to catch up on essential immunization and get back on track to ensure that more people are protected from preventable diseases.

WHO marks 13 years of the Syrian crisis with renewed commitment and support14 March 2024, Damascus, Syria – As the Syrian conflict enters its 14th year, WHO reaffirms its unwavering support to the people of Syria.

The prolonged crisis has inflicted immense suffering on the civilian population. A record 16.7 million people in Syria need humanitarian assistance, including 7.2 million who have been internally displaced.

Health needs are overwhelming. But the disrupted health system is struggling to provide life-sustaining and life-saving health services in a context marked by conflict, economic instability, disease outbreaks and natural disasters. Currently, 65% of Syria’s hospitals and 62% of its primary health care centres are either closed or only partially functioning.

“Thirteen years into the crisis, Syria’s health care system is at its highest need and WHO’s support is more critical than ever,” said Dr Iman Shankiti, acting WHO Representative in Syria. “Investing in essential health services is not only about saving lives today but also about preventing a complete collapse of the health system in the future.”

Since the start of the crisis in 2011, WHO has worked with the Ministry of Health and partners to help ensure that critical health care is available to those who need it most. Since the beginning of the crisis, WHO has provided almost 80 million medical treatments, supported over 11 million medical procedures and 3.3 million trauma consultations, and trained about 178 000 health professionals.

Yet, there is still more work to be done. For instance, rates of depression in Syria have doubled over the past year, as more and more people lose their homes and livelihoods and spiral into poverty.

WHO has focused on strengthening mental health services across the country. This work has included integrating mental health treatments into primary health care services and supporting almost 2 million mental health consultations. WHO has also trained tens of thousands of non-specialized health professionals on basic mental health interventions and psychological first aid.

The need for humanitarian health assistance will remain across the country for the foreseeable future. WHO will continue its life-saving operations, targeting the most vulnerable and in need, and at the same time support the country’s longer-term efforts to rehabilitate and rebuild the health system.

14 February 2024­, Damascus, Syria – WHO has concluded the Gender-based Violence and Prevention of Sexual Exploitation and Abuse Victim’s Support in Earthquake-Affected Areas project, which it delivered with the Syrian Ministry of Health and the Syrian Commission for Family Affairs and Population. The project was launched in February 2023, following the devastating earthquake, to tackle gender-based violence (GBV) and prevention of sexual exploitation and abuse (PSEA) in the affected governorates of Aleppo, Hama and Latakia.

Throughout the project period, WHO collaborated with the Ministry to ensure the safety, rights, dignity and well-being of survivors of GBV and sexual exploitation and abuse. A clear referral pathway was established, ensuring prompt identification and support for over 50 reported cases of GBV and sexual harassment. Assistance was readily available in shelters and community centres,  where many incidents were reported as having taken place amid crowded living conditions.

To complement these efforts, a WHO-supported team of experts, volunteers and local organization members ran more than 500 awareness sessions in the community. These aimed to educate residents about GBV and PSEA, available services and how to seek support. This two-pronged approach addressed both the immediate needs of survivors and long-term community understanding.

“Every step we take towards preventing gender-based violence is a stride towards healing, dignity, and a brighter future for all,” emphasized Dr Iman Shankiti, acting WHO Representative in Syria. “By working together, we are not only addressing a crisis, but also laying the foundation for a society that values and ensures the rights and safety of every individual.”

Thanks to the generous support of Kuwait, the project reached 100 locations across the 3 governorates, empowering numerous people with the knowledge and tools to address GBV and PSEA. WHO remains committed to fighting GBV and expanding these critical services across Syria to pave the way for a safer and more just future, where individual rights and dignity are respected and prioritized.

6 February 2024, Damascus, Syria – It is one year today since a devastating series of earthquakes struck Syria and Türkiye, causing more than 1400 deaths and injuring about 2357 people in Syria alone. Hundreds of thousands more were displaced. Today, WHO reflects on its work to help the people of Syria recover from the disaster and to support the reconstruction of affected areas.

Over the past year, WHO has supported nearly 69 000 outpatient consultations and over 9000 trauma consultations in Syria. More than 550 000 people in hard-to-reach areas have received essential health services through 28 mobile medical teams supported by WHO, and over 197 000 children have been vaccinated. WHO has also supported mental health services for over 922 000 traumatized survivors of the disaster.

These efforts have been critical in meeting immediate health needs and also preventing long-term disabilities and health conditions among the affected population.

WHO continues to provide critical medical equipment to support the Syrian health system in the earthquake-affected areas. Donated equipment includes computed tomography (CT) scanners, a magnetic resonance imaging (MRI) machine, X-ray machines, ultrasonic devices, ambulances, patient beds, ventilators, oxygen generators and patient monitors.

WHO has also provided enough components for 325 prosthetic devices to be made at the Rehabilitation and Artificial Limbs Centre in Damascus. WHO continues to work with communities to engage and inform them about how to reduce their health risks and better protect themselves in the aftermath of natural disasters.

Dr Iman Shankiti, acting WHO Representative in Syria, said: “As we reflect on the past year, the remarkable resilience of Syrian communities and health workers serves to inspire us in our own work. Their strength in the face of adversity drives our commitment to rebuild Syria’s health infrastructure, to ensure a healthier, more resilient future.”

WHO’s commitment to the people of Syria is unwavering. Thanks to the generous contributions of its donors, WHO will continue its work to support health system rehabilitation and enhance the health and well-being of those affected by this traumatic event.

Dr Siham Makhoul, Director of the National Hospital of Latakia, Syria. Photo credit: WHO Syria6 February 2024 – I retain vivid memories of the earthquake. At just after 04:00, I was jolted awake by deep rumbling and roaring, and strong shaking. I live with my elderly mother, who is unwell, and my 2 sons; my first thought was to get them to safety. We got out of our building just in time before the quake totally flattened our home.

Once we were outside, my son asked me if I would be going to the hospital. I told him that of course I would go there immediately. There was no safe place for my family, so I took them with me. We all stayed in a room at the hospital for the first 24 hours.

At the hospital, I had to quickly assess the situation. How many staff did we have? How many surgeons were on call? Did we have enough ambulances, operating theatres, anaesthesia medicines? We had dire shortages of medicines and essential equipment like advanced X-rays, anaesthesia machines and [computed tomography] CT scanners.

Before the earthquake, managing the hospital from day to day was like walking a tightrope; I always felt that with the slightest nudge, we would fall. The earthquake wasn’t just a nudge, though; it was a powerful blow that shook us to the core.

In the days following the earthquake, the hospital was chaos. We were inundated with dead bodies, injured patients, and survivors looking for loved ones. One of our first admissions was a baby who had not survived. It was heartbreaking, but we knew we couldn’t let our emotions get the better of us.

One of my most painful memories is having to treat one of our own doctors, who had been admitted with very severe injuries. I could see that he was dead, but his colleagues tried to resuscitate him nonetheless. I told them that he had not survived and asked them to focus on the living. It was an agonizing moment.

I also remember the incredible solidarity. So many of our staff turned up spontaneously to help the emergency response. The local community brought food and drink. The Ministry of Health helped us tremendously. International organizations donated medicines and supplies. The hospital staff were remarkable. Our surgeons operated round the clock to save lives. Many nurses stayed in the hospital for days on end, treating wounds, caring for patients and supporting their families.

We got through those very difficult days, and we saved many lives. There is no doubt, though, that the trauma of this experience remains with us. To this day, you can see the panic in the eyes of our staff and patients whenever they hear unexpected noises.

25 January 2024 – Abd Nour, a 52-year-old father from Aleppo, has been displaced 3 times with his family owing to the ongoing conflict in Syria. Once a shopkeeper, Abd became a day labourer to support his family after they were forced to flee their home. “For us, it has been very difficult,” he said. “It was hard to make plans not knowing how I would be able to support my family. As a father, I worried a lot.”

In summer 2023, Abd contracted leishmaniasis, which turned his world upside down.

Leishmaniasis remains a major health problem in Syria. Each year, the country typically records 70 000 to 80 000 cases of cutaneous leishmaniasis, the most common form. It is caused by a protozoan parasite that is transmitted to people through the bites of infected sandflies.

The neglected tropical disease has various clinical symptoms and, left untreated, can cause severe lesions, including ulcers. Infection can lead to serious disability and stigma, but timely treatment can prevent such complications. For Abd, the disease caused severe pain that left him unable to walk.

“I was terrified of the thought of passing this illness on to my pregnant wife and young son,” Abd explained.

WHO has been actively supporting the leishmaniasis programme in Syria since 2015, helping families and communities across the country. In 2023, in partnership with national authorities, WHO carried out leishmaniasis control activities in the most affected governorates: Aleppo, Hama and Idlib. This effort involved the indoor residual spraying of more than 73 000 houses, to protect over 369 000 people from the risk of infection. The programme also provides treatment, as well as training for Ministry of Health staff to enhance local capacity for effective case management.

WHO’s support for comprehensive, evidence-based treatment of leishmaniasis is a lifeline for patients. Dr Hassan Al-Zaher, Director of Al-Zahera Polyclinic in Damascus, where Abd was treated, reported that the clinic provided free treatment to 450 leishmaniasis patients in 2023 alone. This was possible thanks to WHO and Ministry of Health efforts.

Dr Iman Shankiti, Acting WHO Representative in Syria, further stressed the importance of comprehensive disease management to tackle leishmaniasis: “Beyond treatment of leishmaniasis, our efforts in Syria include educational campaigns and preventive measures to reduce the burden of this neglected tropical disease.”

Today, Abd Nour has resumed his daily work: “After looking back at my journey, I am thankful for every day. This experience taught me the importance of health and access to quality health care.”

3 January 2024 – “After years of suffering, I am finally feeling empowered to regain control over my own destiny,” shared Hana, aged 29 years, who has suffered a series of devastating losses.

A decade ago, Hana was forced to flee her home when fighting intensified close to her village in northwest Syria. She left her relatives without saying goodbye, uncertain if she would ever see them again.

Having taken shelter at Sundian camp in Idlib governorate, Hana, her husband and 3 children struggled to make ends meet. The hardships endured in the camp took a serious toll on Hana’s mental health.

More than 12 years of conflict, displacement, lack of livelihoods and dire living conditions, combined with the February 2023 earthquakes, have been detrimental to the mental health of many people in northwest Syria.

WHO estimates that nearly 1 million people in northwest Syria suffer from a mental health disorder – of which 230 000 people suffer from a severe mental health disorder.

Ongoing cycle of loss

When 7 months pregnant with her fifth child, Hana suffered a miscarriage. The loss haunted Hana and she was left feeling overwhelmed by fear and anxiety.

Six months later, when the devastating earthquakes struck northwest Syria and Türkiye, Hana tragically lost her sister and the sister’s 4 children.

Hana felt trapped in a cycle of loss. She lost her appetite and more than 28 kg in weight and was no longer able to care for her children.

A recovery plan for Hana

Hana’s husband Ahmed saw her mental and physical health decline and was eager to help. He joined an awareness-raising session on mental health and psychosocial support run by Hope Revival Organization, a WHO partner. On learning of the services available, Ahmed went with Hana to the mental health clinic in the camp.

Hana had a series of psychosocial assessments and was prescribed medications and given a recovery plan. This plan included 8 therapy sessions with a psychologist to explore Hana’s emotions, thoughts and behaviours.

Hana helps her youngest son with his homework at Sundian camp, Idlib governorate. Following the successful completion of her treatment, Hana has been able to re-engage in caring for her children. Photo credit: WHO/ Hope Revival Organization Remarkable changes were soon observed in Hana. She regained her ability to care for her children and reconnected with her extended family. Her eating habits improved, and her mood stabilized.

“Mental health services are an absolute necessity given the harsh living conditions in these camps,” said Hana’s psychologist. “The mental health services we provide to Hana and so many others equip them with the skills to manage stress, adopt new, positive thoughts and navigate their emotions.”

Seeing Hana’s progress, her mother also sought support at the mental health clinic.

“My journey has been challenging,” said Hana, “but with these services, it has ultimately led me to a place of joy and strength.”

The need to sustain and scale up support

Mental health care remains scarce in northwest Syria. Only 4 health facilities provide psychiatric services and just 2 psychiatrists serve a population of 4.5 million. WHO has been pivotal in supporting these facilities, through capacity-building, technical supervision and provision of psychotropic drugs and other medicines.

Mental health clinics set up in camps for internally displaced people in northwest Syria provide psychosocial support and therapeutic interventions. Photo credit: WHO/ Hope Revival Organization In 2023, with generous funding from the Central Emergency Response Fund, WHO supported the provision of mental health services for internally displaced people and host communities in northwest Syria. It did so through existing mental health services in primary health care facilities and by setting up specialized mental health clinics and mental health psychosocial support mobile teams.

Mental health clinics set up in camps consist of a resident mental health gap action doctor, 2 psychologists and 3 psychosocial workers. Each clinic serves as a hub for integrated services, offering individual consultations, psychoeducation sessions, and peer support. To extend the clinics’ reach, mobile teams run awareness-raising sessions and provide services in remote areas of northwest Syria.

In addition, the Mental Health and Psychosocial Support Technical Working Group in northwest Syria led by WHO supports mental health and psychosocial assessments, service mappings and the integration of mental health services within primary and secondary health care facilities to ensure greater access to such services.

Training on risk assessment and outbreak investigations. Photo credit: WHO/WHO Gaziantep Field Presence Office5 December 2023, Cairo, Egypt, and Gaziantep, Türkiye – To strengthen the response to disease outbreaks and public health emergencies in northwest Syria, WHO conducted a training on risk assessment and outbreak investigations in Gaziantep, Türkiye.

The training was for 24 health professionals from northwest Syria who are engaged in the implementation of early warning, alert and response network. Led by the WHO Regional Office for the Eastern Mediterranean and the WHO Field Presence Office in Gaziantep, the training ran from 27 to 29 November 2023.

Participants are now equipped with the knowledge and skills to address health risks and acute public health emergencies in a more timely and effective manner.

“The training provided a great opportunity for health actors to work in the same direction and to the same standard operating procedures to better detect, assess, report and respond to public health events,” said Ms Rosa Crestani, Head of Office, WHO Gaziantep, in her opening remarks.

Training participants. Photo credit: WHO/WHO Gaziantep Field Presence Office The training boosted participants’ skills in conducting rapid risk assessments and situation analysis during public health emergencies and acute events in northwest Syria. Health actors from northwest Syria will collaborate with WHO Gaziantep and the WHO Regional Office in future to ensure rapid intervention during outbreaks.

“We hope that this training will also strengthen collaboration between WHO and its partners and among partners themselves, and that the training can cascade down to other partners working in northwest Syria,” said Dr Aura Corpuz, Team Lead, Public Health Intelligence, Health Emergency Information and Risk Assessment Unit, WHO Regional Office.

This training is vital given the severe, long-term disruption to northwest Syria’s health system, which has been made worse by COVID-19, other disease outbreaks, the February 2023 earthquake and renewed hostilities.

Moreover, the political and administrative context in northwest Syria, and the absence of a health ministry, make it increasingly challenging to report through the International Health Regulations (2005). Timely and effective risk assessment and outbreak investigation are thus more important than ever to control diseases and prevent and manage public health emergencies. Such efforts are critical to strengthen health emergency response in this setting.

This training is part of a series of trainings offered by the WHO Regional Office that aims to strengthen the capacities of Member States and territories to conduct rapid risk assessments and public health situation analysis.