Controlling outbreaks of disease in crowded refugee shelters

03 October 2014
UNRWA Archives

Over the decades, the UNRWA health programme has dramatically rolled back the burden of communicable and vaccine-preventable disease among Palestine refugees in Syria. The health of Palestine refugees increasingly mirrors global trends, where non-communicable diseases such as cancer, hypertension and diabetes are a greater threat.

Now, in clinics in Syria, UNRWA doctors are dealing daily with diseases that were unthinkable only a short time ago. “We are still dealing with diabetes and chronic disease,” says one doctor in a shelter for internally displaced people close to Damascus. “And also we now see more and more skin diseases like scabies and other diseases like diarrhea.” 

Such illnesses are caused by crowded conditions in the shelters and camps and by the scarcity of good drinking water. Over 50 per cent of Palestine refugees in Syria (including UNRWA staff) have been forced to flee their homes and take shelter elsewhere. “We also see more cases of high blood pressure, stress and depression, which is not surprising in an area that suffered mortar attacks every day until very recently. All in all, the number of consultations per day has gone from 100 before the conflict, to more than 500 today,” the doctor explains. 

A senior health staff member at UNRWA in Syria is also concerned about the potential spread of contagious disease. “Most of these diseases are related to water and there is a real danger of drought. Many of the water networks have been affected by the fighting and many of the remaining pumps are not strong enough to bring water to the surface. Tests have shown that the little tap water that is available often does not contain chlorine,” the staff member says. 

Such an outbreak was feared in Yarmouk, one of the hardest places to reach in Syria. When UNRWA staff heard rumours of typhoid on a food distribution mission to Yarmouk in July, they lost no time taking blood and water samples from symptomatic patients for testing, some of which returned positive. Within 24 hours, UNRWA had transferred typhoid medicine for treatment into Yarmouk. The speed of the response was crucial in preventing an outbreak; the number of new cases is now decreasing and under control.

UNRWA staff remain positive about managing disease outbreaks due to a longstanding and successful early warning system. Every patient who visits an UNRWA health clinic or temporary health point is automatically tested for a range of the most common contagious diseases. Any positive cases are immediately brought to the attention of senior UNRWA staff. At the UNRWA office in Damascus, stockpiles of appropriate medicine are kept in case of an outbreak. Individual clinics also stock three months worth of medicine in case of an interruption in supply from Damascus. However, rising prices and logistical challenges remain a problem across Syria. Accessibility is the greatest concern to UNRWA, as the areas most in need tend to be isolated, insecure and difficult to reach. 

The support of donors has been essential to allow UNRWA to successfully respond to Palestine refugee needs. EuropeAid has funded a large portion of UNRWA health work, allowing more than 371,000 refugees to access UNRWA health facilities between January and June 2014. Ongoing EuropeAid funding will support the provision of essential medicines to a further 340,000 refugees.

Read more on the water crisis in Yarmouk camp here.

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