Help and Hope for Syrian Refugees: The Many Ways We Take Action in a Crisis

• The Syrian crisis begins.
• Camps for refugees open in Turkey.

"The first time I set foot in the Za’atari refugee camp in Jordan, in Fall 2012, I couldn’t have imagined how much the crisis would grow. At the time, the camp hosted about 25,000 Syrian refugees – today, that number has more than tripled. It’s easy for diseases to spread quickly in situations like this, so the camp asked us to help set up a system to catch and report outbreaks early. Shortly after that, we helped set up an Early Warning Alert and Response Network (EWARN) to track priority diseases in northern Syria. It was a difficult time — there was no information coming from opposition-controlled areas, and no UN agency could go in. We had to set up the EWARN system from Turkey. This is the same system that later reported a polio outbreak in Syria, enabling us to act quickly to start vaccinating and stop the spread."
Farah Husain

Key Events

• CDC travels to Za’atari refugee camp in Jordan to make recommendations to UNHCR for a surveillance, outbreak alert, and response system.

"I was in Jordan and it was snowing. Many people were living in tents. I couldn’t imagine what it must be like to live there, especially in the desert summers. We went into the city, into apartment complexes where other refugees were living. We talked to them and tried to address their concerns about tuberculosis (TB) – concerns for their families and concerns about interruptions in treatment. We realized how much the refugees really wanted someone to pay attention and help provide care for them. People were coming to Jordan because they couldn’t receive treatment at home in Syria. Some had developed multidrug-resistant tuberculosis, which is more lethal and more costly to treat than other forms of TB. This is a reality in the disruption of health services when people are forced to migrate: diseases that should be eliminated quickly can take months to treat and may end up being much worse than if treated promptly."
Susan Cookson

Key Events:

• CDC works in Jordan to increase awareness about how TB spreads and to improve the ability of healthcare professionals to diagnose and treat TB among Syrian refugees.
• CDC and partners train healthcare professionals working on Syria’s frontlines on how to collect data for EWARN and investigate outbreaks.

• The number of Syrian refugees passes the 2 million mark, with an additional 4.25 million IDPs.
• EWARN detects a polio outbreak in oppositioncontrolled Syria, initiating a vaccination campaign.
• CDC provides ongoing assistance with acute flaccid paralysis surveillance for polio cases.

"In Za’atari, we went door to door to collect information about the nutritional status of Syrian refugees living in the camp. We know that malnutrition is often a problem among refugees; however, it’s also linked with many infectious diseases, like measles. We measured children to see how they were doing: weight, height, mid-upper arm circumference, and their hemoglobin levels. While there were few malnourished children, we found many with anemia. Together with partners, we recommended programs to make sure refugees have easy access to fortified flour and more nutritious diets. We have also worked with partners who are providing services inside Syria’s borders, where our challenges are different. We have had to provide remote support to local partners who are able to reach places we cannot go, and these partners deserve a lot of the credit. It’s dangerous work."
Eva Leidman

Key Events

• CDC travels to Jordan to help UNICEF conduct a quality review of nutrition and health surveys of Syrian refugee and host populations.

• CDC develops guidelines with partners to evaluate EWARN in response to the Syrian crisis.

"You try not to think about it – how close you are to danger. Mosul had been taken over, and ISIS was mere hours away. Near the Iraqi city of Erbil, people in camps tried to make life as normal as possible — children going to school, trying to carry on with everyday life. I was there to help respond to an outbreak of cholera in the country. In addition to working on clean water and sanitation, the Iraq Ministry of Health and key partners were conducting a two-dose oral cholera vaccination campaign to try to prevent the outbreak from moving into Syria. After the second round of immunization, we helped conduct a coverage survey using electronic tablets to send real-time data, allowing us to make corrections immediately if needed. We found that vaccination coverage was close to 90%, despite the complexity of the situation."
Eugene Lam

Key Events:

• In Iraq, CDC helps plan and conduct the first round of an oral cholera vaccination campaign, strengthens surveillance for cholera, and implements water, sanitation, and hygiene procedures.

• CDC evaluates EWARN in refugee and IDP camps in Iraq.
• CDC mental health expert mentors an Emory University student to conduct a mental health survey among Syrian refugees in Atlanta.

• CDC assists the U.S. Embassy in Greece in a rapid public health assessment of refugee sites across Greece after implementation of the European Union-Turkey agreement.

• As the crisis expands, CDC continues to provide expertise and assistance to Syria’s refugees.