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A multi-level programme to tackle COVID-19 in a region plagued by conflict and displacement
A multi-level programme to tackle COVID-19 in a region plagued by conflict and displacement

A case study by SCI and ATAA in Syria

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Updated over a week ago

Country and region: North West Syria

Organisation: Save the Children International (SCI) in partnership with the local NGO Al-Atta for Relief and Development (known as ATAA)

Point person and Role: Dima Maarrawi (Hygiene Promotion Focal Point for ATAA) and Abdul Hammed Khaled (WASH Coordinator for ATAA)

Population served by the programme: 1700 internally displaced households

Unique characteristics of the setting:

This region has been affected by 10 years of war and dozens of military operations. This has led to a large proportion of the population being displaced, exhausted and traumatised. In Idlib and in Aleppo governorates, where ATAA and SCI have supported vulnerable displaced persons since February 2020, all services are currently provided by humanitarian organisations. The density of the displaced population (most of whom reside in camps), is high and gaps in service provision make the population particularly vulnerable to the risk of COVID-19 transmission.

Number of cases and deaths due to COVID-19 at time of publishing: National data cases: 944, deaths: 48. Regional data for North West Syria as of 4th August 2020 - Cases: 2, deaths: 0.


Image: Handwashing device distributed to one of the households © ATAA

Briefly describe the key components of your COVID-19 response programme.

Our programme focuses on 5 key messages of basic hygiene and COVID-19 prevention behaviours. These are:

  1. Wash hands with soap at critical times

  2. Always use water that comes from a treated water source

  3. Use, clean and maintain latrines

  4. Physically distance

  5. Use face masks and avoid touching your face

To encourage these behaviours we have implemented an approach which targets multiple levels.

At the community and institutional level: We are organising water trucking and supporting the rehabilitation or upgrading of community water systems to increase the quantity and quality of water that can be collected by local populations. At the water points, we have installed multiple taps which are placed 1.5 meters from each other to enable physical distancing. We have implemented mass-cleaning campaigns that involve clearing solid waste and cleaning and disinfecting communal facilities.

Image: Newly constructed water points with taps that are spaced apart to enable physical distancing. ©ATAA

At the household level: We are constructing additional latrines to reduce the number of people who share latrines. We are running awareness sessions and distributing hygiene kits. For COVID-19 we adapted our hygiene kits to include extra soap, locally-made handwashing facilities and cleaning products.

At the individual level: We are regularly conducting hygiene promotion sessions within communities and at public facilities (such as Health Care Facilities, Temporary Learning Centres or Child-Friendly Spaces). The focus of these sessions is to increase knowledge about COVID-19 transmission, symptoms and preventive behaviours. Our household-level awareness sessions have specifically targeted children with disabilities and their caregivers, as these groups had been overlooked within the broader response. We have constructed inclusive latrines, encouraged households with a person with a disability to actively participate in hygiene promotion activities and we have ensured that all consultations with communities and learning activities involve these households. We have also been sharing information with populations via mass media such as radio, Facebook and loudspeaker messaging.

What process did you use when designing your COVID-19 response programme?

We knew that we had to respond quickly to the COVID-19 pandemic. Therefore we decided to develop our programme based on our existing expertise and understanding of the context, examples of what was working elsewhere and by taking time to learn from communities. For example, ATAA partners have been working in this region for almost 10 years and were aware of the historical and cultural context as well as the priorities of the population. At the same time, we utilised SCI’s broader network to understand how other organisations were responding in other regions of the world. Our focus behaviours were heavily influenced by the HY5 programme that was developed by SCI, UNICEF and MERN (local NGO) in the Philippines. We complemented and adapted this approach based on the findings of a Knowledge, Attitudes, and Practices (KAP) survey focused on COVID-19 prevention. As we implement our programme, we are adjusting and updating the content of our activities in conjunction with our partners and conducting regular consultations with the camps’ WASH committees.

What is one thing that has been working really well so far and is there something other programmes could learn from this?

Currently, the population is receiving bundles of bread on a regular basis from another organisation. We decided to work with them to include hygiene promotion messages on the bread packaging. We realised that it was valuable to try and reach the population through a range of channels and messaging on the bread bags gave us the opportunity to communicate with people while limiting in-person interactions so that transmission risk is minimised.

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Image: Hygiene promotion messages printed on a bread bag bundle © ATAA

What is one challenge that you have encountered and how are you trying to overcome this?

This population has already experienced years of suffering and tragedy due to the armed conflict. In this context, COVID-19 is just one of many challenges that families are facing. To overcome this challenge we have tried to make sure that we focus on positive messages and on promoting children’s participation. For example, we are using stories, interviews with children and also a video song on how to prevent COVID-19 transmission. Our interventions aim to bring joy and happiness to children despite the challenges these populations are experiencing with COVID-19, years of conflict and displacement. So far this child-focused positive programming has been received positively by communities. In fact, we have had so many children interested in taking part in our activities that we have had to scale up our response to accommodate this interest.

How have you been engaging communities throughout your programme and what feedback have you received?

In each IDP camp, a WASH Committee has been established to work in collaboration with the ATAA team. Each WASH Committee is composed of 6 members who represent the population diversity of their camp (men and women, youth and camp managers). Committees attend all COVID-19-related meetings with our partner and are involved in the assessment, planning, design and implementation of all project activities. They inform us about any COVID-19-related issues in the camps, help to relay COVID-19 prevention messages to their communities and monitor WASH activities.

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