This report is produced by OCHA Syria in collaboration with humanitarian partners. It covers the period from 31 March to 17 April 2019. Situation reports on Al Hol camp are published bi-weekly. The next report will be issued around 30 April 2019.

HIGHLIGHTS

• The total current population of Al Hol is now 73,393 people, having doubled between February and March. In the last week, around 71 families (approx. 174 individuals) have arrived to Al Hol, mainly from neighbouring camps such as Al Roj and Ein Issa. Around 70 per cent of the camp population is under the age of 18 and 65 percent under the age of 12.

• While the reduction of new arrivals has to some extent relieved pressure on emergency services in the reception areas, multiple specific protection needs remain. These include the notable absence of adolescent boys and men between the age of 15 and 65 years old (reportedly been detained and unable to communicate with their families) as well as significant challenges related to civil documentation.

• Site preparation, including demarcation and WASH works, have commenced in phases 6 and 8 following delays due to bad weather. Currently, around 15,000 people are being hosted in large tents and rub halls while they wait these works to be completed. Despite the ongoing expansions, a further 846 plots (enough to accommodate around 3,000 people) are required to transfer all camp residents currently being hosted in large tents to family-sized tents.

•Health partners have improved the medical referral system, activating a dedicated hotline and assigning focal points responsible for the prioritisation and rapid transfer of the most urgent cases. In the last week, the Kurdish Red Crescent referred 350 cases to hospitals in Al Hasakeh and Qamishly.

•Crude mortality rates have been kept within emergency sphere standards of 1.0/10,000/day. As of 15 April 2019, 262 deaths have been registered – a CMR of 0.5 deaths/10,000/day.

•Four information desks providing information on existing services have been established in phases 3, 4, 5, and 7, however more structured communication with community initiatives, as well as risk awareness, needs to be put in place, including gender age and gender considerations.

•On 6 April, the Camp Administration, in coordination with the Iraqi government and UNHCR, resumed its voluntary repatriation programme following a four-month suspension. So far, 1,769 households have registered with the camp administration. There are approximately 30,000 Iraqis in the camp. The exact timeline for departures is not clear, although movements will likely occur in small batches over an extended period.

• The Syria Humanitarian Fund (SHF) has launched two reserve allocations for some US$16 million. Some US$4.3 million has already been disbursed to partners implementing projects protection, health, nutrition, multi- sector, WASH and shelter & NFIs.

SITUATION OVERVIEW

• The needs of the population remain critical across all sectors and teams on the ground are undertaking needs assessments in the camp to ensure a more efficient, prioritized response. Efforts to scale up the response continue for infrastructure and services, including shelter, solar lamps, tents, adequate communal spaces, WASH and health facilities and services.

• Site preparation remains a priority with more than 63,500 IDPs having arrived in the last 4 months. Interior and exterior works on phase 6 are expected to be ready by the end of April and phase 8 by the end of May. These two phases will have capacity for around 2,700 households (between 10,000 – 13,000 people) – land for a further 846 plots (3,000 people) still needs to be identified. In the meantime, installation of 2,380 tents in ongoing in the Annex.

• Capacity of surrounding hospitals to accept additional referrals is limited and efforts are therefore ongoing to increase the availability of medical facilities within the camp, including through the establishment of field hospitals. At the beginning of April, a 20 bed hospitainer was transferred from Harasta to provide reproductive and maternal health services to women are girls; installation of a 50-bed hospitainer supported by the SHF is also planned.

• While humanitarian indicators are expected to stabilise in the coming months in relation to accommodation, water, sanitation and health, these will not resolve the long-term protection issues which are diverse and complex in nature, and require coordinated approaches, increased presence of protection actors, and specific expertise including on legal issues. Currently, protection challenges are aggravated by the unique context, with the presence of non-Syrian nationals (Iraqi and other countries) and the complex restoration of family links; severe psychological distress affecting the population; specific needs of children, particularly unaccompanied and separated children (UASC), and detentionrelated issues.

• Access to third country nationals (TCNs) in the annex is subject to additional approvals, including names of staff who plan to enter, preference for female staff and details of planned activities. Several partners do have access to the annex including mobile medical units, teams constructing WASH facilities, partners setting up tents and camp management personnel and those providing services through child-friendly spaces. In addition, recently, a health NGO which had faced difficulties in establishing a static presence was able to resolve these challenges and has now been granted permission. Nevertheless, it remains a challenge for new partners to negotiate access and build trust, at a time when rapid scale up of services and assistance is required – in particular, static and regular presence is difficult to obtain and protection activities are subject to more oversight which undermines specific interventions as case work. In addition, uncertainty over the fate of male and adolescent boys – including TCNs – has contributed to a tense environment amongst the newly arrived families, particularly those from the Baghouz area, with many women expressing concerns over the whereabouts and well-being of their male family members separated en route and possibly transported to places of detention. There is a need for continued case work and communication with the women and children in these areas to clearly outline existing efforts, and subsequent limitations, of forming links with families.