Report for Second Annual Conference in Geneva - UOSSM by UOSSM

Health System in Syria: Challenges and Developments

CONFERENCE REPORT

Acknowledgments: We acknowledge the following staff and volunteers of UOSSM-Switzerland who contributed to this conference report ÂŤ Health System in Syria: Challenges and developments Âť

Camila Finat Ayman Fatwa Moaz Sabbagh Shadi Alshhadeh

TOGETHER, SAVING LIVES & BUILDING HOPE _________________________________

Table of contents

Executive Summary .............................................................................................. 8 Preface .......................................................................................................................... 9 Welcoming remarks and opening session ............................................. 13 Panel 1 ......................................................................................................................... 15 Syrian NGOs: Challenges and sustainability. ...................................... 15 Panel 2 ......................................................................................................................... 19 Importance of data collection and management in conflict zone. ...................................................................................................................................... 19 Panel 3 ......................................................................................................................... 27 The role and importance of education and training. ........................ 27 Panel 4 ......................................................................................................................... 31 Direct channels between local and international NGOs. ............... 31 Recommendations .............................................................................................. 37 Annexe 1 â&#x20AC;&#x201C; Programme of the conference ................................................ 39 Annexe 2 â&#x20AC;&#x201C; Speakers biographies ................................................................. 40 Annexe 3 - References ......................................................................................... 45

Executive Summary UOSSM’s second annual conference « Health system in Syria: challenges and developments » brought together, on March 25, 2017, individuals representing academies, international organisations, doctors, students and civil society. Their purpose was to discuss the issues of developments and sustainability faced by humanitarian organizations, and especially the medical NGOs in Syria – embodied by UOSSM. The fledgling NGO sector in Syria – especially medical – is facing critical challenges that have recently emerged in the country. The purpose of the conference was to rely on the panellists’ experience and expertise to highlight the diverse aspects to be taken into account in the development and management of an NGO. The conference was organized around four panels, presenting the main themes. The first panel discussed the challenges and sustainability of any NGO, and the main dimensions to support in order to maintain quality and sustainability in the long run, especially in conflict situations. It is a matter of being integrated in the socio-economical fabric of the country but also of the humanitarian response network, by strengthening the NGO’s position, role and work. The second panel examined importance of data collection and management in conflict zone. This section detailed the different ways of collecting and using data, as well as the challenges posed by data in conflict settings. Data collection is crucial in order to enhance the knowledge on a specific issue, but also its possible solutions and developments. The third panel analysed the role and importance of education and training, will it be in conflict setting or not, and how it can be delivered and improved in order to maintain the quality of the response and develop long-term reconstruction policies. Finally, the last panel discussed direct channels between local and international NGOs. After acknowledging the problematic characteristics of the international relief system, the panellists detailed the concept of localisation, i.e the decentralisation of the humanitarian action and the full and fair integration of local and national actors in the international relief system. The conference allowed the UOSSM-Suisse team to highlight the major recommendations to be made to enhance the sustainability and development of any NGO in the following report.

Preface Most of the Syrian non-governmental organisations (NGOs) have emerged during the current crisis. The organisations existing before - only a few nonpolitical organisations1 - were under the control of the Syrian government, and were therefore not unanimously considered as NGOs, and the same applies to the NGO sector in Syria. The outbreak of the crisis in 2011, in the wave of the Arab Spring protests, quickly escalated to an armed conflict causing severe consequences to the population. In this regard, the Syrian humanitarian crisis remains considered as one of the largest since World War II. Since the health care system collapsed after the triggering of the crisis, providing health care is one of the main challenges of the civil society. Indeed, the crisis resulted in the fragmentation of the country and denying access to state services. Therefore, the Syrian civil society took over the responsibility to provide emergency relief and services to those in need, and fill the government vacuum left by the retreat of the state 2 , and have transformed into humanitarian organisations. Beyond the legal and financial constraints brought by the sanctions imposed on Syria3, the work of Syrian NGOs has been challenged by their novelty and consequent lack of professionalism (organisational and managerial experience, finance, human resources, etc.) and integration into the international relied system, restraining them to conduct small-scale projects related to their field of expertise. Moreover, they are in competition with International Non-Governmental Organisations (INGOs) and United Nations agencies, which are organised structures benefiting from their complete integration into the international relief sector, especially as regards to their secure funds. Despite their nascent character, Syrian NGOs have done an outstanding job, due to three main aspects. The Syrian civil society is highly educated. 1

UNITED NATIONS OCHA, USG Security Council Briefing on Syria, July 2013 [Online : https://docs.unocha.org/sites/dms/Documents/USG%20Security%20Council%20Briefing% 20on%20Syria%2016Jul2013.pdf] 2 DIXON S.J., ROMERA MORENO E., SADOZAI A., HAJ ASAAD Ahmed, Localisation of humanitarian response in the Syrian crisis, Confluences Méditerranée, Paris : L’Harmattan, 2016. 3 The sanctions imposed on Syria hamper financial transactions. At a practical level, banks often delay – and even deny – every transaction involving the term « Syria », which led many NGOs to change their names. Also, Syrian NGOs had to register in foreign countries, which is restrictive.

Therefore, at the outbreak of the crisis, fledging NGOs benefit from a remarkably skilled and qualified staff. Also, the civil society could rely on an active global diaspora network, rich in material, financial and human resources – as demonstrated by UOSSM’s example. Finally, Syria had a wealthy and active business community, which has been able to sponsor many local NGOs and their humanitarian activities4. In the years that have passed since the outbreak of the crisis, the number of Syrian NGOs has increased exponentially, experience has been gained and efficiency has been improved, factors which are of inescapable importance in the management of the humanitarian aid. Relevant questions that need to be addressed are “ how can NGOs – and particularly Syrian medical NGOs – ensure the quality and sustainability of their action during a long-lasting crisis? “ and “what are the challenges they face and may face in the future?”. The conference addressed the main dimensions to be taken into account when rethinking of sustainable options for relief operations in areas of conflict, such as Syria. This reflexion had become necessary due to the sharp escalation of the scope and scale of violence in Syria, especially the targeting of health workers, hospitals and medical facilities. Indeed, while hundreds of thousands of civilians have become displaced and/or besieged and the Syrian government is failing and refraining to provide medical care to areas out of his control, it is crucial to rethink the delivery of humanitarian medical relied when the health system is absent, as well as the sustainability and the match of international standards during crisis and conflict settings. To that end, UOSSM-Suisse invited experts in the medical and public health sector, management of non-profit organizations and Syria’s policy to outline practical steps towards quality and sustainability 5 , to address the main dimensions of quality and sustainability for NGOs, which are the following: ●

● ● ●

How can we ensure the sustainability and quality of our services while matching international standards, even through the most complicated conditions? Why and how can we collect data, communicate it and how to manage it in the best ways? Why and how can we develop the level of our training and education work to fulfil needs? How can the international community best support local NGOs providing medical care in Syria?

DIXON S.J., ROMERA MORENO E., SADOZAI A., HAJ ASAAD Ahmed, Op. Cit. In this regard, the underlying reflexion of the conference is concentrated on the NGOs and their potential contribution to the humanitarian action, and is fully separated from any consideration related to the Syrian government. 5

On behalf of UOSSM, we want to express our sincere gratitude towards all the participants, and especially the panellists and volunteers that contributed to make this conference a successful event providing an important input to the reflexion on NGOs’ quality and sustainability. The city of Geneva, The university of Geneva, MSF, MDM, CERAH, WHO, Humanitarian Forum, Global Mentoring Initiative, UN OCHA and the Medical student association at UNIGE. Mr. Rémy Pagani Dr. Anne Golaz Dr. Ghanem Tayara Dr. Tawfik Chamaa Dr. Hani El Bana Dr. Naveed Sadozai Mr. Ajay Kumar Goel Mr. Max Morel Dr. Raphael Pitti Mr. Koenraad Van Brabant Ms. Elsa Romera Moreno Mr. Abed Al Ahmed Mr. Jonas Niederberger Ms. Ghada Al Rayan Mr. Sebastian Abbet Mrs. Jehan Lazrak-Toub Mrs. Regula Zellweger Mr. Badr Al-Akshar Mr. Ahmad Majbour

Dr. Marie-Claude Hofner Ms. Line Mahfouz Ms. Sara Tayara Mr. Zaidoun Al Zoubi Mrs. Smruti Patel Dr. Anas Al Kassem Dr. Dorian Job Dr. Ziad El Issa Dr. Redwan El Khayat Mr. Ali Gokpinar Ms. Amal Sadozai Mrs. Julie Harboe Ms. Camille Sonderegger Ms. Eliabeth Ferreria Mr. Simon Russel Mr. Kheir Allah Shatee Mr. Thomas Risse Mr. Khalid Hmidi

Welcoming remarks and opening session Welcoming remarks In his opening remarks, Dr Tawfik Chamaa, General Secretary of UOSSM International, member of its board and president of UOSSM-Suisse, formally opened the Conference. Rémy Pagani, Mayor of the City of Geneva, warmly welcomed the relocation of UOSSM Head Quarters from Paris to Geneva. He asserted the need to stop the targeting of humanitarian workers and medical facilities and their related impunities and respect the Geneva Conventions, emphasising that “the International Humanitarian Law is not an option, but rather what makes humanity human”. As future Mayor of the City of Geneva, he offers his support to organise platforms where relevant actors – as UOSSM – can work on defending the International Humanitarian Law and peace. Dr Marie-Claude Hofner, public health doctor associated to the Violence Medical Unit and representative of Switzerland in the “European ministry of health national focal persons for violence and injury prevention” of the World Health Organisation, expressed gratitude to participate in the conference. As a medical doctor but more importantly as a citizen, she expressed her admiration for the work, engagement and bravery of UOSSM to relieve the affected population’s pain, characterizing it as “the honour of the medical profession”. She also affirmed her willingness to advocate for the urgent need to allow and facilitate the welcoming of refugees in Switzerland. Dr Anne Golaz, lecturer and researcher at the Centre for Education and Research in Humanitarian Action, noted the sixth anniversary of the war in Syria, and stresses the “weaponisation of health workers and medical facilities, as well as suffering and destruction, to an extend never observed since World War II”. She emphasise the importance of the work on the ground to remind everyone of our humanity. As she noted that “learning from [UOSSM] will strengthen our lives”, she stressed the importance for

universities to work closely with the reality on the field. Documenting and sharing the experiences of humanitarian workers is a crucial aspect of education and humanitarian action in General. Line Mahfouz, student in the medical school of Geneva, stressed the importance of highlighting the challenges of humanitarian aid in Syria, especially for medical students. As the doctors of tomorrow, the presence of medical students is important, whether for their “fresh look” or their concern about medical health care workers being systematically targeted.

Opening session Dr Ghanem Tayara, President and founder of UOSSM International, looks back on the creation of UOSSM at the outbreak of the crisis of Syria. Founded by Syrian diaspora’s doctors pooling their expertise to help and assist people in need in Syria, UOSSM has a unique style. He noted the pride of the work done and the progress made since its creation: UOSSM is today the largest Syrian organisation operating on the ground. He then warmly thanked all the staff courageously working on the ground and abroad; “they are the real heroes”. Sara Tayara, a Syrian student passionate about human rights, spoke during the conference to highlight the ongoing dynamic with regard to the humanitarian situation in Syria, and – more broadly – in the world. “We seem to think that people suffering along the way is just a natural part of the process”, she said, emphasising the loss of humanity in crisis management. “People have become figures and children have become statistics”. After 6 years of war in Syria, “The humanitarian situation is deteriorating at a heartbreaking pace”, notably due to the violation of international law. Sara ended her speech urging us to find a way to increase humanitarian aid, regardless of political or religious beliefs and ideologies, to improve lives to the best of our ability by providing medical aid and security. Dr Tawfik Chamaa highlighted the two components supported to face the humanitarian challenge in Syria: the transnational and trans generational characters of UOSSM. The organisation is no longer solely Syrian: UOSSM’s work is conducted from different locations in the world – Holland, Canada, Switzerland, Turkey, United States of America, etc. - by Syrian and nonSyrians from all ages facing the humanitarian challenge together, acknowledging the unifying character of the Syrian crisis. “What is happening in Syria is threatening our future as human beings” (Dr Tawfik Chamaa).

Panel 1: Syrian NGOs: Challenges and sustainability. Panelists: ! Moderator: Zaidoun Al Zoubi, CEO of UOSSM-International ! Dr Hani El Bana, President of the Humanitarian Forum and cofounder of Islamic Relief. ! Smruti Patel, Founder of Global Mentoring Initiative ! Dr Naveed Sadozai, Medical Officer at the GPEI team (World Health Organisation)

The main dimensions to maintain quality and sustainability. In general, fledging and growing NGOs face many challenges in conducting their daily activities, most of them related to the conflict situations. The duration and relentlessness of the Syrian crisis also necessitates a reflection on the dimensions that should be strengthened and emphasized in order to ensure the quality and sustainability of the support provided in the long-run. In this regard, the following dimensions and challenges are highlighted:

The capacity of delivering results In the context of fledgling NGOs, the capacity of delivering results is conditioned, in the long run, to the imperative of professionalization, strategic planning and operational capacity. Although it is the main purpose of the action, other dimensions shall be taken into consideration in order to maintain this capacity in the long run. Regardless of the skills usually needed by an NGO, the complexity of the Syrian context and the level of violence observed require the development of specific war-related skills. Remaining neutral in a highly politically polarized situation is challenging, especially for medical organisations aiming at providing global health care. At a practical level, the issue of the access to certain zones requires negotiation, networking with mediator organisations and local administration councils, emergency and quick change preparedness, etc. The relationship with the armed groups is one of the most daunting challenges of Syrian NGOs, and in particular medical NGOs; they are needed by the fighters, but are also under pressure to provide them preferred treatment.

The capacity to commit and act. During the implementation of a policy, a project or any relief action, it is necessary to ensure the provision of quality support in the long run,

especially when the crisis has been lasting for several years. Its length and the continuous atrocities witnessed by the humanitarian workers can also lead to a certain tiredness that will undeniably affect the action. The humanitarian workers need to be supported by the organisation, whether physically or mentally.

The capacity to relate and attract. At the outbreak of the crisis, some hard and soft skills were neglected in favour of concrete emergency relief actions, being considered as complementary skills for conflict situations. More emphasis must be put on long-term organisational and communicational aspects, whether internal or external. To some extent, this dimension is tied to the international credibility and legitimacy required to enhance NGOs’ attractiveness and secure their funding. In this regard, meeting internationally recognized standards would be a first step towards international recognition. Local NGOs in Syria are still strongly dependent on donations from individuals, government-related agencies or INGOs. Therefore, professionalization of the funding sector of NGOs – i.e reorienting the relation with the donors6, establishing their own fund-yielding projects and being able to self-generate revenues - is crucial.

The capacity to adapt and self-review. In a rapidly changing context, it is important not to carry on with a measure no longer appropriated. The notion of adapting here refers to stepping back and looking at the new realities, adjusting or changing the policies adopted in a previous – and maybe no longer relevant – context. The self-reviewing of an organisation’s action requires learning from experiences and communication with all the stakeholders involved. Lowering the discrepancy between the different levels of the NGO in order to hear every actor is crucial. This leads to proper and efficient internal governance, enabling in return a more efficient action, in opposition to a disorganised action conducted by fragmented actors. Moreover, Syrian NGOs, and especially medical NGOs, face the challenge of post-conflict activities. When the crisis ends, the war-related medical conditions and the restoration of the healthcare system will have to be taken in charge. Therefore, NGOs will have to switch from humanitarian emergency response to sustainable and long-term action, and become more self-reliant.

The issue of the mutual misunderstanding – and sometimes mistrust – characterising the relationship between Syrian NGOs and the international donor community will be assessed in the fourth section.

The capacity to achieve coherence and direction-setting. Within the framework of a continuing action and coherent implementation, maintaining a high level of communication between the humanitarian workers and actors involved is essential: achieving a goal on the ground requires the definition of a coherent action beforehand, which necessitates a high level of interconnection between the resources and the strategies. Beneficiaries and decision-makers are therefore equally concerned. Achieving coherence also requires the clarity of the mission. Studies have shown that many see humanitarian action as political, since a large number of Syrian NGO staff are emotionally involved in the crisis. In this regard, medical NGOs adopt clear principles. UOSSM’s action is therefore based on the refusal of any political affiliation and the willingness to help and heal any individual indiscriminately.

The capacity to strengthen the external relations. Every organisation should be fully integrated in the regional – if not international - socio-political fabric. This implies conducting continuous external networking with all types of social, political and economic entities in order to develop strong and beneficial partnerships, whether with the government or organisations with different backgrounds. Also connectivity, cooperation and coalitions are valued as they lead to diversity in partnerships and a comprehensive and constructive approach to relief action, while avoiding any ideological bias. Developing unions, think tanks, informationsharing platforms, networks, consortiums and syndicates enables the organisation to work collectively and more efficiently on building infrastructures and managing relief action. Medical professionals in the front line should be able to rely on other entities taking care of their own specialist field. Yet, and unfortunately, Syrian medical NGOs have not launched any kind of consortium, and this constitutes a concrete, although achievable challenge. External relations with the neighbouring countries require special emphasis in the concrete implementation of activities. Since the UN Resolution 2165 allowing cross-border operations, Syrian NGOs have had to interact with their governments – Lebanon, Jordan, Turkey and Iraq, as in the example of UOSSM’s operational centre in Gaziantep.

The capacity to adopt a leading role, and defend it. The sustainability of a relief organisation also lies on its leading role, which has to be constantly strengthened by becoming a legitimate and credible reference. An important cornerstone of establishing credible leadership is to adopt a forward-looking advocacy strategy (e.g., conducting research, publishing papers, giving speeches or sharing the institutional “history”).

Advocacy enables the identification of needs, the lobbying of donors, raising awareness of the cause and collaboration with other organisations. Such a leading role also requires internal transparency: especially regarding the use of the funds; the organisation has to be exemplary.

The capacity to lean on partnerships at the local level, and especially civil society. Engaging civil society should be the cornerstone of any relief action; the endusers are the best suited for assessing needs and thus, ensuring efficient projects. Bringing civil society and local councils around the table adds value and coherence to the pursued action. Also, localism7 and commitment to empowering communities contribute to the strengthening of community resilience and long-term reconstruction. Therefore, the development of an open community-to-community dialogue is vital, especially in a constantly changing context, as the challenges cannot be assessed in the same way in different areas.

The issue of localism will be further discussed in the fourth section.

Panel 2: Importance of data collection and management in conflict zone. Panelists : ! Moderator : Dr Anas Al Kassem, President of UOSSM-Canada ! Ajay Kumar Goel, Data analyst (World Health Organisation) ! Dr Dorian Job, Medical Coordinator (Médecins Sans Frontières) ! Max Morel, Director of Médecins du Monde Switzerland. Health data is central to medical aid; it provides necessary information on the overall health status of the population, the areas particularly affected and the specific health care needs. Prior to the conflict, the Ministry of Health administrated the health data surveillance. However, since the outbreak of the conflict, data collection has been challenging due to the destruction of healthcare facilities, health worker flight8 and difficulties with follow-up. This section will address the issue of data collection and management in conflict zones in their key aspects.

UOSSM has no confirmed number of doctors having left Syria, but total amounts to thousands.

The importance of data in the humanitarian response. There are two different data systems in the humanitarian sector: the crisis/humanitarian information system and the health information system in humanitarian emergency. Data is an essential aspect of humanitarian responses, since the humanitarian workers need the right information, in the right format and at the right time to develop and implement a coherent, efficient and sustainable project. Various types of information can be relevant and used as significant data, whether it be maps, locations, lists, charts, graphics, videos, satellites images or even messages. Humanitarian data is usually composed of the traditional database (survey, interview, registries, census records, lists of health facilities, disease surveillance, resources database) and spatial database (shape files, geo-databases and digital maps), but also of satellite imagery and social media. The latter category is particularly useful in emergency settings, in which data collection on the ground is very complex.

How is it collected? Emergency settings prevent the collection of data in the traditional way. Therefore, data collectors have to be inventive and imaginative in their ways of working; it will be a matter of finding the needed and relevant information, and translating it in the right format later. Conflict settings give a new emphasis on spatial thinking, and especially Geographic Information Systems play an important role in the development of visual representations and interactions with geographic data and information. Spatial thinking is based on the idea of using the properties of space (distance, direction, elevation), visual representations (maps and diagrams) and reasoning processes to structure and solve problems9. In this regard, in a collaboration perspective, spatial databases enable to show â&#x20AC;&#x153;who does what and where?â&#x20AC;? to be shown, thereby reinforcing the effort to define when help is needed, how one can help, and globally addressing the emergency situation. 9 Examples of spatial thinking and the humanitarian response include the interaction between people, the places they live, the risk and war zone that surround them, the war events that affect them, and the broader networks of support that are drawn upon, are all multiscale space-time phenomena that must be considered in any aspect of conflict response. It also includes making judgment about the safest and shortest routes for evacuation planning, reasoning and developing understanding of the spatial relationships between destruction of infrastructures, rebuilding efforts, support and development planning.

Quantitative data and methods Quantitative research methods are based on the collection of information that is analysed numerically, and the results of which are usually presented by statistics, tables and graphs. As quantitative data is numeric and based on representative samples, it is likely that its analysis will accurately represent the impact of the crisis to the whole population.

In conflict settings, the lack of secondary data provided by the government compels the collection of primary data. Field questionnaires to be filled in are given to the patients, providing information about the general health level in different countries. Particular attention should be paid to the design of these questionnaires. Quantifying the magnitude and scope of the crisis – whether compared to pre-crisis data or according to humanitarian indicators - is a pillar in the decision-making process.

Qualitative data and methods Qualitative research methods are usually textual observations portraying attitudes, perceptions or intentions10. Collecting figures, narratives, stories and pictures – always protecting the identity of the patients – provides a human aspect to the statistics by acknowledging priority needs of affected population. In this regard, qualitative data enables the provision of adequate MSPHSS services to the affected population. The relevance of private interviews is to improve the quality of the direct services provided, and its challenge is to ensure a positive and welcoming attitude towards the patients. The quality of the answer might be influenced 10

WORLD FOOD PROGRAMME, Emergency Food Security Assessments (EFSAs) Technical guidance sheet n°8, Introduction to qualitative data and methods for collection and analysis in food security assessments, February 2009 [Online: http://documents.wfp.org/stellent/groups/public/documents/manual_guide_proced/wfp1972 98.pdf]

by various factors, including their socio-economic, educational and cultural position in the community.

Crowdsourcing data and tools Social media has recently become inescapable in data collection in conflict settings: its accessibility on smartphones and other communication devices enables it to be used by the population. In the Syrian context and experience, it turned out that social media has been the cornerstone of data collection. As an example, “Syria tracker” is a combination of automated data mining and crowd-sourced human intelligence used to detect, interpret, categorize and map 400 witness reports and 160’000 official news reports. In other words, the population is micro tasking to gather and present information that will be later analysed by experts11 . A further example is Ushaidi, an enterprise developed to map reports of violence12.

Information management tools The data collection method is different in every organisation. However, it is possible to distinguish between two different methodologies, especially concerning the final outcome of the data collection. The most widely used reports methodology is a standardized approach to data management, such as the Health Resources Availability Mapping System (HeRAMS). Used by OCHA and others international organisations, HeRAMS are a standardized approach supported by a software-based platform. Adapted to Syria in early 2013 - after many consultative meetings with the Syrian ministry of Health (MOH) and health sector partners – HeRAMS is dedicated to develop a tool regarding the priority identified areas of the health sector, by assessing the availability of the health services. In particular, new data collection mechanisms – as remote reporting – have been introduced to fill in the gap of the shortage of available information, in order to support the decision makers in monitoring the health situation and services. In September 2013, 64 (70%) out of 91 MOH public hospitals from 11 governorates reported to the HeRams, via NGOs13. UOSSM, however, embodies a different approach. First, the surveyed hospitals are mostly in the Northeaster of Syria or Government-controlled 11

For more details: https://syriatracker.crowdmap.com/feeds For more details: https://www.ushahidi.com/ and http://www.crowdmap.com 13 WHO, Availability of the Health Resources and Services in Public Hospitals in Syria; Using HeRAMS, Third Quarter 2013 [Online: http://applications.emro.who.int/dsaf/libcat/EMRDOC_2013_EN.pdf?ua=1] 12

area of Syria, therefore complementing the areas not reached by HeRAMS. Also, UOSSM uses a different report methodology: the surveys are based on direct visits to the hospitals, where relevant hospital staff directly fills the questionnaires, while HeRAMS relies on NGOs to fill in the questionnaires, generating gaps in data accuracy and accessibility. More specifically, UOSSM focus on hospitals – rather than health care centres – and examines various aspects of medical services previously not analysed 14 . Therefore, UOSSM’s own data-collecting team conducts all necessary phases of surveying, and takes into account every relevant aspect of the health sector, whereas HeRAMS relies on cross-matching data from different NGOs. UOSSM is therefore leading the hospitals data collection and management in Syria through its comprehensive approach and action.

How is it used? All kind of data can be relevant and serve diverse objectives and needs. When collecting data, it is crucial to define the purpose and the strategy behind its collection. To that extent, three main objectives should be highlighted: care quality, programme monitoring and advocacy.

Specific and quality health care Any health system is, in a certain way, based on health information. Collecting and managing information during humanitarian emergencies is an essential step in health care services: the needs assessment. The gathering of reliable data on the health status of affected people, their demographics, their location and urgent needs, the resources and supply available and missing, is vital in terms of providing specific social advice and access to the adequate health care.

Programme monitoring The needs assessments allowed by the aggregated data also helps the making of strategic decisions, monitoring of changes, prioritisation of action, allocation of resources, programme management, strategic implementation of activities, as well as efficient monitoring tools. In some cases, data can even be used to predict and prevent future conflicts, by elaborating accurate and effective conflict early warning systems to prevent conflicts. A refined data selection methodology, merged with a 14 Union of Medical Care and Relief Organizations, Syrian Health Care Methodology, 13 April 2016 [Online: http://www.uossm.org/syrian_health_care_research]

strategic use of machine learning algorithms could participate to the â&#x20AC;&#x153;early warningâ&#x20AC;? toolkit15.

Advocacy Data collection boosts advocacy, providing it with concrete hard data, whether at the operational or political level. At the operational level, the data collected contributes to justifying the financial and material needs of the NGOs to the donors or partners. Particularly when the access to conflict zones is difficult, data can play an important role in the negotiations, as it forces the acknowledgement of a reality that can not be denied by the competing political forces. In this framework, advocacy based on data can be a critical game-changer.

In this regard, qualitative data enables the translation of numbers into meaningful human conditions, thereby influencing decision-makers. The challenge is to transmit the results to the highest levels of the decisionmaking process, or to the appropriate organisations, to enable positive changes. The hospital surveillance report16 issued by UOSSM holds the three different objectives. The report participates in the objective evaluation of the medical 15

PERRY Chris, Machine Learning and Conflict Prediction : A Use Case, Stability : International Journal of Security and Development, London, October 2013

needs in Syria, as well as in the prospective and strategic thinking regarding the humanitarian programs’ implementation, monitoring and development. Furthermore this report is a big boost to advocacy: it was designed to enhance the protection of hospitals in Syria.

What are the challenges posed by data in conflict settings? The warfare context In conflict zones, one of the main challenges regarding data collection is obtaining accurate data. Since the national stewardship is missing or inefficient, data is often incomplete. Lack of security, fast population movements, breakdown in health information and surveillance systems, as well as manipulation of health information are crucial factors affecting the data collection capacity and accuracy. Conventional research methodology applied to conflict settings without appropriate adaptation may affect the quality of the results. The difficulty in collecting data is particularly problematic when it comes to communicable disease17.

Ethics and data responsibility Field research and data collection in conflict zones is challenging, whether for methodological or ethical reasons. Political polarization, security issues, the presence of armed groups and actors, and the large-scale traumatization imply a greater attention to the ethical imperative of research, “Do no harm”. Protecting vulnerable populations from harms caused by data is of collective responsibility of the entire humanitarian data ecosystem18. When politically sensitive, the data must be ethically disseminated in order to avoid repercussions. Also, it must be borne in mind that asking those affected to talk about traumatic experiences could increase the associated trauma.

Union of Medical Care and Relief Organizations, Syrian Hospitals Surveillance Study, Paris, March 2017 [Online : http://www.uossm.fr/rapport_exclusif_syrian_hospitals_surveillance_study] 17 ISMAIL S.A., ABBARA A., COLLIN S. M., ORCUTT M., COUTTS A.P., MAZIAK W., SHLOUL Z., DAR O., CORRAH T., FOUAD F.M., Communicable disease surveillance and control in the context of conflict and mass displacement in Syria, International Journal of Infectious Diseases, Aarhus : Eskild Petersen, May 2016. 18 UNITED NATIONS OCHA, Building data responsibility into humanitarian action, OCHA Policy and Studies Series, May 2016 [Online : https://docs.unocha.org/sites/dms/Documents/TB18_Data%20Responsibility_Online.pdf]

Universal language The different data collected is presented in a wide range of formats, making it particularly difficult to analyse. Notably, two elements make it difficult to accurately collect and analyse data in many countries. First, health systems and rules for health coverage are different in each country. Also, in relation to NGOs operating on a voluntary basis, the volunteer turnover implies different approaches in data collection, and therefore a wide range of formats to compile in order to analyse the data. The universal data format challenge is assessed by protocols on how to exchange and receive data in a standardised format19 (for example, HXL20), as well as exchange platforms21. Also, issuing standard sets of questions and questionnaires guides is important for the aggregation of data. Working towards a common language could cater to the necessity of sharing the data between organisations and specialists in a globalised effort of developing the knowledge and humanitarian tools to assess a humanitarian catastrophe.

Relations with donors Data is a crucial factor in the granting of funding or aid to NGOs: a large number of donors â&#x20AC;&#x201C; whether individuals or INGOs â&#x20AC;&#x201C; expect certain requirements to be fulfilled before funding a project. However, certain data and documentation is inaccessible, depending on the group controlling the area. These areas â&#x20AC;&#x201C; i.e, ISIS-controlled or besieged areas - usually suffer from an extreme shortage of health services. Collecting data in these areas is therefore of critical importance in the delivery of health services.

www.humanitarianresponse.info HXL is a different kind of data standard, designed to improve information during a humanitarian crisis, without adding extra reporting burdens. Adding HXL to the data helps make it more understandable and easier to process in the future. For more information: http://ww hxlstandard.org 21 https://data.humdata.org/ or HIS, a set of data collection platforms implemented by a coordinated group of humanitarian actors. 20

Panel 3: The role and importance of education and training. Panelists: ! Moderator: Dr Ziad El Issa, President of UOSSM-France. ! Dr Raphael Pitti, Pedagogical counsellor and member of UOSSM-France. ! Dr Anne Golaz, Lecturer and researcher at CERAH. ! Dr David Nott, Consultant surgeon. ! Dr Redwan El Khayat, consultant psychiatrist and psychotherapist. Why is education and training important in conflict settings? In conflict settings. “If you want peace, prepare for war”. Julius Caesar. This Latin adage is unfortunately erroneous, since it is in only very rare cases that war can be predicted. In 2011, no one could have foreseen the outbreak of the war in Syria. In 2017, more than 22 million of people are suffering from its consequences. In particular, the health system has been profoundly damaged. The distinction between a non-international armed conflict and an international armed conflict is relevant in this section, in the sense that the organisation of medical and military facilities differ. Traditionally, international armed conflicts are characterised by two armies facing each other, both structured with their own military facilities, field hospitals and doctors specially trained for war. However, the Syrian case is a non-international armed conflict22 and an urban war, in which regular civilian hospitals are used as war hospitals. Besides the unexpected outbreak of the war, this 22

In this section, we consider the conflict in Syria as a non-armed international conflict, understood as – according to ICRC definition - a “prolonged armed conflict between government forces and one or more armed groups, or such armed groups with each other, occurring on the territory of a signatory state of the Geneva Conventions. The confrontation must attain a minimum level of intensity, and the parties involved in the conflict must prove a minimum of organisation”. We acknowledge that the evolution of the internal armed conflict tends to designate it as an international armed conflict. We have chosen not to further analyse this aspect of the conflict, since the report is focused on the humanitarian situation and action.

configuration implies a lack of preparation of the medical facilities and their medical staff in dealing with the consequences of the confrontations. Moreover, regardless of the conflict category, the medical activity is split up in three echelons: the paramedics on the frontline, the triage facilities and the hospitals. Additionally, besides the war-related requirements in Syria, the medical personnel have to continue taking in charge the usual medical conditions. Therefore, training and education is crucial in order to adapt to the necessities of warfare. Indeed, medical personnel – and especially doctors – are not prepared, trained or organised to treat war-related injuries, nor to organise or prioritise their work in a theatre of war. Furthermore, education and training are important to cover the shortage of medical workers on the field as well as to boost the morale of humanitarian workers in the field. In this regard, UOSSM has established a Qualification and Training Department. As an example, we can mention the training centre set up an UOSSM member in 2013. Situated at the Turkish border, this centre offers diverse trainings, ranging from chemical weapon preparedness and injuries, STSG, ATMG, Chemical Warfare Decontamination Course, Ultrasound training, Medical Emergency Training to dealing with the refugee crisis and providing specific psychosocial support. Also, in a capacity-building and post-conflict reconstruction perspective, the centre provides Technical Support on Training, with practices and specific equipment. Over a 5 years period, over 16’00023 people have received training from UOSSM staff, who have demonstrated an extraordinary level of determination and dedication to continue sharing their expertise, despite the regular bombings of the training centres.

In non-conflict settings Education and training is also essential in non-conflict situations. Academic institutions can engage humanitarian students and civil society, and develop their knowledge and expertise. Experienced field-workers contribute to inspiring young students to get engaged, and thereafter qualified. In addition, one can only recognize the positive impact of properly equipped and trained health workers on their communities, since they usually pass on their knowledge within it. 23

At the end of 2016, the exact number of people having recieved a training by UOSSM is 16’150.

How can it be delivered? In the context of a war, providing training and education requires creativity and imagination. Indeed, There is a critical lack of qualified personnel and training centres regularly suffer from the confrontations. In this regard, communication technologies and social media â&#x20AC;&#x201C; as well as the Internet in general â&#x20AC;&#x201C; can play a significant role in education and training by connecting the trainer and the beneficiary. Humanitarian workers on the ground can be trained and supervised through online courses and training, downloadable applications and podcasts, or via phone or Skype. Thereupon, transnational cooperation should be strengthened in order to reach medical goals, as well as improving the quality of the service delivered and its sustainability. Therefore, we strongly support the development of a wider international panel allowing the discussion of actual cases with doctors, surgeons, and psychiatrists on a regular basis. An initiative worth mentioning is that of David Nott, a surgeon in London, who gives training and instructions during operations, via Skype, to surgeons he trained in Aleppo back in 201324.

For more details: http://www.davidnottfoundation.com

How can it be improved? Being able to provide primary health care in war situations is essential, although insufficient to provide a comprehensive and long-term caregiving process. Indeed, due to the emergency imperatives, some aspects of global healthcare are often neglected. These include mental and emotional health, disabilities, sexual education, care services for the elderly and children, which are either pushed into the background or no longer available; this is demonstrated by the fact that only two psychiatrists are currently working in Syria25. However, Syrians, as well as the majority of the victims of war, experience terrible traumatic experiences, that leave invisible scars. War and conflict situations entail severe psychological consequences, such as post-traumatic stress disorder (PTSD), anxiety and other mental health disorders, behavioural problems - violence or depression â&#x20AC;&#x201C; which affect their future health, as well as social and economic life skills. In general, trauma can change the brain structure of a patient in the long term, leading to detrimental hormonal changes in the body. Especially, children suffer from immediate but also long-term health effects of warfare. The danger of letting untrained and unqualified staff provide mental health treatment â&#x20AC;&#x201C; or not treating such illnesses at all â&#x20AC;&#x201C; is a long-term and post-conflict reconstruction matter. Therefore, special attention should be given to global health and future consequences of conflict.

One work in the North, and the second in the South, which are regions out of the government control and under that of PYD or ISIS.

Panel 4 Direct channels between local and international NGOs. Panelists : ! Moderator : Koenraad Van Brabant, Expert. ! Ali Gokpinar, Associate Humanitarian Affairs Officer (UN OCHA) ! Elsa Romera Moreno, Graduate Institute Researcher ! Amal Sadozai, Graduate Institute Researcher. It has been recognized that the humanitarian needs increase more rapidly than the capacity to address them, particularly due to the intensity and duration of the Syrian crisis. In this context, the Syrian humanitarian community provide access to humanitarian efforts within Syrian borders, and especially in non-regime held territories. But local actors provide more than access, and contribute to a more appropriate, effective and sustainable humanitarian action. However, their capacity is dependent on their relationship with the humanitarian community. The relationships between local and international organisations and nongovernmental organisations remain a delicate and complicated topic, with a wide divergence of practice. A connection between local, national and international organisations exists. Yet, it must be reoriented, since the hierarchical and centralised international relief system can be detrimental, will it be in terms of appropriateness, effectiveness and sustainability. In this section, we will acknowledge the international relief system and present the concept of localisation - which addresses the inequity of the relationships between international, national and local actors â&#x20AC;&#x201C; applied to the Syrian context.

Acknowledgment of the international relief system. The analysis of the international relief system enables to highlight its most problematic characteristics26. The excessive centralisation of the international relief system leads to a certain discrepancy between key decisions - whether strategic, financial or operational – and its end-users, as well as a certain inadequacy with the crisis zone. The centralisation is also observed on the financial level: the funds allocated to humanitarian aid often involve intermediaries. Indeed, there is a certain level of mutual misunderstanding and mistrust between local NGOs and the international donor community, implying a certain preference for UNagencies or national branches of INGOs. The financial overstretch and excessive centralisation, in turn, leads to a very problematic dynamic: after going through intermediaries, the funds are doled out in drops to the “first responders”. Those struggle to maintain their emergency preparedness and concrete efficiency, and – even more so – to invest in organisational capacities. The control over the financial resources product a structural dominance of INGOs and international agencies over national and local NGOs, thus leading to unequal partnerships: national actors become contractors of local subcontractors for INGOs. Also, the institutional humanitarian aid is merely sent to a few UN agencies, INGOs and Red Cross & Red Crescent Movements. The international relief action is consequently concentrated in the hands of a few organisations, impeding local and national leadership and therefore their organisational and institutional capacity development. The international relief sector is principally funded by western citizens, which could never lead to any financial sustainability. Somehow colonialist, the structural dominance of the international relief sector is also characterised as paternalistic: local actors and civil societies remain excluded from the driving seat, therefore annihilating any efforts to develop their capacities.

http://www.gmentor.org

Localisation: a way forward? The concept of localisation tries to address the above-mentioned characteristics of the international relief system by decentralising the humanitarian action and allowing local actors to fulfil their intended function. Indeed, their inherent closeness and knowledge of the occurring crisis and its consequential humanitarian effects make them the best placed to access the humanitarian crisis, assess the needs and their fulfilment in the long run, as well as build resilience. Therefore, the concept of localisation insists on an increased funding and ownership of local actions designed and implemented by local actors, and considers it as a key to a more efficient and sustainable humanitarian system. It is in this process of reflexion that a coalition of NGOs created the “Charter for a Change”, promising to transfer 20% of their funding to local actors, as well as to advocate and concretely work for their greater role in the humanitarian relief system27. Also emanating from the reflexion on localisation, the “Grand Bargain” agreement is a package of reforms to humanitarian funds adopted during the 2016 World Humanitarian Summit. Among other commitments aimed at “better serving people in need” aimed at supporting local and national responders on the front line, the signatories commit to improve the use of cash and increase the flexible funding28.

How does localisation address the problems highlighted? Funding The funding is a major problematic aspect of the international relief system. When it comes to the “lack of funding”, it is important to specify that more than the actual amount of resources dedicated to the relief efforts, it is its distribution that is problematic: the funds allocated to local actors represent a very small portion of the total humanitarian assistance. Only a few national organisations get funding and, when it is the case, it is usually the regional and/or national branches of larger international and well 27

CHARTER 4 CHANGE, Charter for Change : Localisation of Humanitarian Aid, July 2015 [Online : https://charter4change.files.wordpress.com/2016/02/charter-for-change-july20152.pdf] 28 Organisation for Economic Co-operation and Development E, The Grand Bargain – A Shared Commitment to Better Serve People in Need, Istanbul, May 2016 [Online: http://www.oecd.org/dac/conflict-fragilityresilience/docs/Grand_Bargain_final_22_May_FINAL-2.pdf]

known organisations. In this regard, we can mention that only 0.4% of the funds goes to national organisations. This lack is expected to increase, as demonstrated by the planned budget cuts announced by the United States: the amount allocated to the foreign aid is expected to decrease by 40%. This lack of funding is usually explained by the perceived risk of corruption in local and national organisations29. The negligible direct funding received by local and Syrian NGOs highlights a concerning dynamic: they generally uniquely get project-based funding, whereas effectiveness requires long-term and flexible funding. Indeed, flexibility in the funding enable organisation to reallocate the money to other needs when unplanned conditions arise, as well as invest in strengthening their organisational structures and develop long-term projects in a postconflict perspective. The project-based funding of NGOs leads to a perverse effect: local NGOs tend to accept projects solely to receive funds, and not always based on a need assessment, as well as relief projects are more easily fundable than long-term programming projects30. The project-based funding system is also troublesome, since the donors do not consider some areas â&#x20AC;&#x201C;especially Daech-controlled areas, even though they are particularly vulnerable.

Partnership The underlying dynamic of humanitarian assistance funding reflects the scope of their actual place in the humanitarian relief system: local and national NGOs merely work as sub-contractors: the humanitarian projects are remotely designed and managed, and locally implemented by local and/or national NGOs. With the increased violence against aid workers and facilities, INGOs turn to local actors to provide the humanitarian aid, considering them as less exposed to the risk31 and more familiar with the language and the culture. However, the reliance on local actors is observed only due to the risk-averse character of INGOs, and not to their acknowledgment of the role that local actors have to play in the relief effort. While 75% of the overall assistance is delivered by local NGOs, they are still merely considered as sub-contractors and not equal partners.

Yet, this should be called into question since it has been demonstrated that a large part of the corruption happens within international organisations. 30 DIXON S.J., ROMERA MORENO E., SADOZAI A., HAJ ASAAD Ahmed, Op. Cit. 31 INGOs are risk-averse and assume than local actors are less exposed to risk, in: DIXON S.J., ROMERA MORENO E., SADOZAI A., HAJ ASAAD Ahmed, Op. Cit.

The prevalence of remote design and management raises legitimate concerns about the effectiveness and ethics of the humanitarian assistance. First, as mentioned above, local actors are the best placed to assess and address the needs in a conflict setting, especially because of their bigger opportunity to interact with affected communities and because of the issue of access. Second, remote project design and management can sometimes to the undue neglect of the socio-political context, therefore leading to contradictory effects. As an example, one can mention the administrative procedures and standards required by INGOs that severely hamper the implementation of projects, and even more the security of the beneficiaries32. Third, local actors are the best placed to work beyond the emergency, in the sense that they work within the political, economical and framework of the country, therefore ensuring the sustainability of the action. In this regard, including local actors should be an end in itself: capacity building has proved to be as important as emergency relief in the long run. In this regard, UOSSM is working hard on a multifaceted energy resilience project in Syria. The damaged electrical infrastructure deeply affected the functional life: in Syria: a dependency on fossil fuels emerged, and became severely dangerous when, in the summer of 2015, diesel supply routes were cut off, consequently shutting down a large number of medical facilities. UOSSM pursued the natural direction towards renewable energy to power health facilities. With local engineers, UOSSM installed an advanced off-grid solar electric system in one of the most critical hospitals in the North of Syria. In addition to its intrinsic effectiveness, solar energyâ&#x20AC;&#x2122;s enormous potential is also to reduce the dependency on diesel, thereafter contributing to the dismantlement of the war-economy. This instrument of peace building is - even more so â&#x20AC;&#x201C; sustainable: the reduced of the operating costs for the civilian and health facilities allows resilience in cases of fuel outage, but also participates in the transition to a clean-energy-based economy. There is a crucial need of changing the mind-set from seeing local organisations as a tool to implement projects. It has been demonstrated that when equity between international and national organisations is observed, very dynamic relationships are created33. 32

Ibid. DIXON S., ROMERA MORENO E., SADOZAI A., Syrian Civil Society and the Swiss Humanitarian Community, Challenge, Opportunity and the Future of Syria, Geneva : The Graduate Institute of International and Development Sutdies, January 2016. 33

Capacities As mentioned above, local NGOs are considered as sub-contractors. While growing immensely since the outbreak of the crisis, local NGOs are unable to develop their institutional, managerial, organisational and sustainable capacities due to the lack of flexible funding. Especially, in order to be sustainable and effective, local NGO’s capacity building should be community-based: the beneficiaries of the humanitarian work should be fully involved in the definition of the support strategies: the participation revolution34. However, trends show that when local NGOs explicit their need to build their capacities, INGOs either transfer a small amount of funds to a limited-scale organisational project, either make available technical expertise from their international staff.

Visibility and policy influence As national NGOs work merely as sub-contractors, larger international organisations take credit for the services provided in the field, therefore gaining influence and undermining NGOs’ representation and influence in the international relief system. Adopting equal partnerships would enable greater visibility for the work and achievements of local actors, which, in turn, would contribute to their greater international recognition. The increased capacities and visibility will lead to a key-player role in the international policy discussions. Gaining strength and influence will, in turn, involve greater efficiency and sustainability by addressing the problem of leadership. Indeed, local and national actors do not receive direct funding due to their ineffective representation in governance mechanisms of the humanitarian system. The greater participation of national and local actors in international coordination mechanisms is also crucial to mitigate the inadequacy often observed in international humanitarian plans. Indeed, humanitarian workers from international organisations bring their own set of cultural behaviours, which are not relevant for every specific case. Humanitarian workers with no experience with Syrian culture can lead to perverse effect, particularly regarding the needs assessment and projects implementations.

INTER-AGENCY STANDING COMMITTEE, Grand Bargain Participation Revolution work tream, Agreed, practical definition of the meaning of « participation » within the context of this worktream, May 2017 [Online : http://interagencystandingcommittee.org/system/files/participation_revolution__definition_of_participation.pdf]

Recommendations Challenges and sustainability of NGOs. o Support NGOs in their development and strengthening of the capacities mentioned in the first panel. " Capacities and leadership, whether by sharing expertise or supporting them on the material, financial and human resources level. o Develop and strengthen partnerships with civil society organisations, based on an open community-to-community dialogue. o Reinforce and support local and national Syrian NGOs to develop their capacities and leadership, whether by sharing expertise or supporting them on the material, financial and human resources level. " Invest in management, human resources, organisational skills. o Strengthen advocacy and research poles of NGOs. o At the global level, develop good practices in providing health care in conflict settings, to be shared with other medical organisations, INGOs, states and international organisations. o States and International organisations should support the work of small NGOs by helping their actions and financing them. Data collection and management. o Develop and further the data collection and management, both in conflict or non-conflict settings. " Be attentive to the challenges of data collection mentioned in the second panel: ethics, war context, etc. o Rely on civil society and social medias for data collection: untraditional but more efficient than usual indicators in conflict settings. o Follow the existent procedures and recommendation regarding data management: respect the common language et share the data collected in a global effort to improve humanitarian action. The exchange of information between organisations and specialists is crucial to maintain quality and sustainability in humanitarian action. o Develop the advocacy and political component of data: more reports and share them in order to improve the monitoring. o Undertake research involving all parts of the population in order to guarantee the neutrality of the work conducted. o Participate in the elaboration of guidelines to support the data collection and management, and follow the rules decided.

Therefore, this processes has to be participative and include local and national NGOs to take into account their realities and difficulties in the domain. The instruments advised by OCHA are not necessarily available for local and national NGOs. Education and training. o Develop the education and training dynamic in a larger scale, especially for medical staff, in order to adapt to the circumstances and new tasks brought by the crisis. o Develop the transnational cooperation on the education and training of humanitarian workers. Support transnational networks, platforms, and dynamics. o Be creative and innovative in how to deliver education: social medias, Internet etc. o Develop the psychiatrist component of the medicine to handle the psychosocial consequences of the crisis. o Need for creativity and imagination in the education and training process o Develop and strengthen, through training and capacity building assistance, the resilience of the affected population in a longterm and post-conflict perspective. Direct channels between local and international NGOs. o Support the initiatives towards localisation and raise awareness about these dynamics. o Lobby the INGOs in order to develop equal partnerships, and therefore support advocacy. o Always take into account the set of cultural behaviours and previous experience brought by international humanitarian workers: use their experience, but more importantly rely on civil society and local humanitarian workers which are best integrated and aware of the current situation. o The principles of equal partnerships and adaptive programming and management must be the cornerstone of any collaboration. o Establish mechanisms of control to ensure the representation of NGOs in international negotiation and international governance mechanisms.

Annexe 1 – Programme of the conference Saturday 25 March, 2017 - 11h00-18h00 11:00 – 11:30

Reception

11:30 – 11:50:

Welcoming words by: - M. Rémy Pagani du Conseil administratif de la ville de Genève - Dr Marie-Claude Hofner a Swiss doctor and president Violence Medical Unit - Dr Anne Golaz a lecturer and researcher at CERAH & The University of Geneva. - Line Mahfouz a student in the medical school of Geneva. 11:50-12:00 Opening Remarks by Dr Ghanem Tayara President of UOSSM, and Dr Tawfik Chamaa Secretary general 12:00 - 13:10: Panel 1: Syrian NGOs Challenges and Sustainability ● Moderator: Zaidoun Al Zoubi CEO of UOSSM ● Speaker 1 Hani El Bana President of Humanitarian forum cofounder of Islamic relief ● Speaker 2: Smruti Patel Director, Global Mentoring Initiative ● Speaker 3: Dr Naveed Sadozai Medical Officer at the GPEI team - WHO 13:10 - 14:20 Panel 2: Importance of data collection & management in conflict zone. ● Moderator: Dr Anas Al Kassem President of UOSSM-Canada ● Speaker 1 Ajay Kumar Goel Data analyst - WHO ● Speaker 2 Dr Dorian Job Medical Coordinator - MSF ● Speaker 3 Max Morel Director of the Médecins du Monde (MDM-Swiss) 14:20 – 14:50:

Coffee Break & Snack

14:50 – 16:00 panel 3: The role and importance of education and training ● Moderator: Dr Ziad EL Issa President of UOSSM-France ● Speaker 1 Dr Rapahel Pitti War injuries doctor, Member of UOSSM-France ● Speaker 2 Dr David Nott Consultant surgeon. ● Speaker 3 Dr Anne Golaz Lecturer and researcher at the CERAH 16:00 - 17:10 Panel 4: Direct channels between Local & International NGOs ● Moderator Koenraad Van Brabant Expert ● Speaker 1 Ali Gokpinar Associate Humanitarian Affairs Officer UN OCHA ● Speaker 2 Elsa Romera Moreno Graduate Institute Research ● Speaker 3 Amal Sadozai Graduate Institute Research 17:10 – 18:00: 19:00 – 22:00

follow up & tea, aperitif and social chat Syrian dinner offered by UOSSM-Suisse

Annexe 2 – Speakers biographies Welcoming

Rémy Pagani

Dr. MarieClaude Hofner

Dr. Anne Golaz

Line Mahfouz

A politician figure, vice-president of the Geneva’s Canton and head of the construction and development departments. He is also a member of Ensemble à Gauche. A doctor specialized in public health. She created the Violence Medical Unit of the University Hospital of Lausanne and opened the first medico-legal and community-oriented consultation center for victims of interpersonal violence in Switzerland. She also represented Switzerland for 10 years in the Violence and Injury Prevention Health Ministry European Network of the World Health Organization. A lecturer and researcher at the University of Geneva Center for Education and Research in Humanitarian Action (CERAH) and at the Global Studies Institute (GSI). She has over 20 years of field experience in humanitarian work, and worked as a medical epidemiologist for the US Centers for Disease Control and Prevention; as a senior advisor for humanitarian emergencies for the UNICEF Regional Office for South Asia in Kathmandu and for the Geneva Office, as well as for the HQ and Regional Offices A medicine student at the university of Geneva and responsible of the international action of the medicine student association of Geneva University (AEMG)

Geneva City

Independent

UNIGE

Opening

Dr Ghanem Tayara

Dr Tawfik Chamaa

Panel 1 Moderator

Zaidoun Al Zoubi

A general practitioner with an interest in cardiology, UOSSM practicing medicine in the United Kingdom since 1995. He is a chairman of UOSSM and a trustee of Syria relief. A doctor, currently the Director of Service Medical UOSSM Junction-SMJ, a multi disciplinary medical group. He is actually the president of UOSSM-Suisse and the general secretary of UOSSM International. Syrian NGOs Challenges and Sustainability Holds a PhD Degree in Management. A pacifist activist UOSSM from Syria & the CEO of the Union of Medical Care and Relief Organizations UOSSM with more than 1500 workers building and running hospitals in Syria. At various levels, he is engaged with civil society issues in Syria and beyond, as well as he invests in networking, youth engagement, humanitarian support mechanisms, conflict resolution and mediation. He is also engaged with UN Office of Syria’s Special Envoy through facilitating Women Advisory Board and Civil

Society Support Room. Speaker

Dr. Hani El Bana

Speaker

Smruti Patel

Speaker

Dr. Naveed Sadozai

A doctor and co-founder of Islamic Relief, the largest Humanitarian Western-based international Muslim relief and forum development NGO, established in 1984 in England. Dr El Bana is currently the president of The Humanitarian Forum, an international network of NGOs, bringing together both Muslim and Western charities providing a platform for dialogue, promoting mutual understanding advocating for a legal framework for greater transparency and accountability, promoting humanitarian principles and standards and improving communication and co-operation. Obtained a BA Degree in International Policy Global Mentoring Administration and International Relations She has Initiative been working in and on humanitarian action since 1997, in diverse locations, ranging from Thailand, Chechnya, Afghanistan, India to Myanmar. She worked with local and national partners of NGOâ&#x20AC;&#x2122;s to promote greater accountability of relief agencies to affected populations. She also conducted in-depth consultations with Syrian organisations. She is also the founder of the Global Mentoring Initiative (GMI), which focus on the creating mentoring platform to accompany capacity strengthening of local NGOs. A public health specialist with an extensive WHO experience. After 10 year working at the UNICEF in the areas of child protection and child health, Dr Sadozai have since been working at the World Health Organization, primarily in the global polio eradication initiative (GPEI). He established the polio teams in charge of developing strategies flexible and tailormade to the ground realities of countries going through a civil war. In northern Syria in 2013, he coordinated the implementation of polio SIAs and guided local NGOâ&#x20AC;&#x2122;s and local councils in the implementation of polio campaigns in order to interrupt the transmission of wild poliovirus. He recently became a member of the transition and strategy unit. In parallel, he has been closely working on advocacy and innovations with colleagues.

Panel 2

Importance of data collection & management in conflict zone A Minimally Invasive and Trauma Surgeon. After UOSSM showing leadership skills in Trauma, Dr Al-Kassem was offered the position of trauma team leader at the Ottawa Civic Hospital. Dr Al-Kassem has also been active in many humanitarian organizations. He is a cofounder of UOSSM and Its chapter, UOSSM Canada. Dr Al-Kassem has initiated the electronic data registry system to advance patient care and research in Syria despite the war.

Moderator

Dr Anas Al Kassem

Speaker

Ajay Kumar Goel

Has been working as Data Analyst for global polio WHO eradication and Immunization programs for last 18 years. He has international experience in disease surveillance and laboratory information systems. His role includes collecting, managing and analysing epidemiological and other public health data. He is here on his personal capacity.

Speaker

Dr Dorian Job

Speaker

Max Morel

Has been working with Médecins Sans Frontières MSF (MSF) since 2002 and on the field in different conflicts countries : in somalia (2002), in Irak (2003), in South Sudan (2004), in Ivory cost (2006), in North Sudan & Darfur (2007-2008), in Irak (2009), as medical coordinator in Afghanistan (2010-2011) including Kunduz projet, in Lybia (2012), E desk (2014-2016: Ukraine, Yemen and Borno), Cell 3 since Oct 2016 (Niger, CAR, RDC and Grece). MdM Has worked with Médecins du Monde (MdM) and Médecins sans Frontières in Angola, Cote d’Ivoire, DRC, Liberia, Nepal, Niger, Burkina Faso, Mali, and Haiti. From 2008-2012 he worked with Médecins du Monde (MdM) based in Paris, first as a Programme Manager, and then in the international network office where he helped to launch Doctors of the World-USA. Since 2013, he is Executive Director of Médecins du Monde in Switzerland. He holds a Bachelor’s degree in International Affairs from the University of Colorado and a Master’s degree in International Affairs from Sciences-Po Paris.

The role and importance of education and training

Panel 3 Moderator

Dr Ziad EL Issa

A French-Syrian doctor. He obtained a PhD in UOSSM anesthesia and surgical resuscitation and is currently head of the anesthesia department at the Clermont de lâ&#x20AC;&#x2122;Oise Hospital, in France. Also CEO of UOSSMFrance and president of the Education Committee of UOSSM-International. In this context, he has been going back and forth to Syria for medical humanitarian missions and to collaborate in the medical training of doctors, nurses and midwives.

Speaker

Dr Rapahel Pitti

A professor in emergency and disaster medicine. UOSSM General doctor of the French Army, he exercised during various medical war missions worldwide. he is also the founder of the training program of UOSSM and its scientific and pedagogic councilor. He has also been going back and forth to Syria for medical humanitarian missions and to collaborate in the medical training of doctors, nurses and midwives. Therefore, he is an honorary member of UOSSMInternational.

Speaker

Dr David Nott

A consultant surgeon who works mainly in London David Nott hospitals as a general and vascular surgeon, but also Foundation volunteers to work in disaster and war zones and now, with his wife, organizes training for others in this emergency work. Dr Nott is working a lot with UOSSM on the training programs where UOSSM trained about 12'000 persons. He has been honored for this dangerous work and is now often styled the "Indiana Jones of surgery".

Speaker

Dr Anne Golaz

She is Board Certified in Public Health and General Preventive Medicine, graduate and post-graduate education in public health. She also has over 20 years of field experience in humanitarian work, and worked as a medical epidemiologist for the US Centers for Disease Control and Prevention; as a senior advisor for humanitarian emergencies for the UNICEF Regional Office for South Asia and for the Geneva Office, as well as for the HQ and Regional Offices of the WHO in Cairo (EMRO) and New Dehli (SEARO). She currently is a lecturer and researcher at the University of Geneva Center for Education and Research in Humanitarian Action (CERAH) and at the Global Studies Institute (GSI).

CERAH

Panel 4 Moderator

Koenraad Van Brabant

Speaker

Ali Gokpinar

Speaker

Elsa Romera Moreno

Speaker

Amal

Sadozai

Direct channels between Local & International NGOs Independent Has been working in and on conflict for more than 25 years. Part of that in humanitarian action with different consultant international non-governmental organizations, part of it focused on conflict-reduction and peace building, with national teams as strategic partners- Currently he works as an independent consultant, who can provide thematic/methodological expertise, but also acts as facilitator, trainer, partnership broker, strategic and organizational adviser. Currently associated with the ChaĂŽne de Bonheur/Swiss Solidarity fundraising and donor-partner platform, he is also helping a multilateral organization strengthen its institutional competency at working with conflict-sensitivity. For more detail: www.navigation360.org. An Associate Humanitarian Affairs Officer with OCHA UN OCHA Geneva focusing on localization and coordination. He previously worked in Turkey, Lebanon, and USA on humanitarian affairs and peace building. He is a former Fulbright and Harvard University Program on Negotiation fellow. Holds a Master of International Affairs at the Graduate Independent Institute in Geneva. Working with Geo Expertise on its Syrian Civil Society Support Program, she was interested in the interplay between armed conflicts and humanitarian action and especially in the localinternational partnerships in Syria. She is currently working at IMPACT initiatives on better humanitarian action by co-constructing and promoting knowledge, tools and practices. Holds a Masters in International Affairs from the Independent Graduate Institute of Geneva. Having worked on Geo Expertise's Syrian Civil Society Support Program, her interest lies in the role of humanitarian partnerships between local and internal actors in armed conflicts, within the broader context of localization. For the last two years, her academic and vocational focus on Syria has helped her gain valuable fieldwork experience.

Annexe 3 - References CHARTER 4 CHANGE, Charter for Change : Localisation of Humanitarian Aid, July 2015 [Online : https://charter4change.files.wordpress.com/2016/02/charter-for-change-july20152.pdf] DIXON S., ROMERA MORENO E., SADOZAI A., Syrian Civil Society and the Swiss Humanitarian Community, Challenge, Opportunity and the Future of Syria, Geneva : The Graduate Institute of International and Development Sutdies, January 2016. DIXON S.J., ROMERA MORENO E., SADOZAI A., HAJ ASAAD Ahmed, Localisation of humanitarian response in the Syrian crisis, Confluences Méditerranée, Paris : L’Harmattan, 2016. INTER-AGENCY STANDING COMMITTEE, Grand Bargain Participation Revolution work tream, Agreed, practical definition of the meaning of « participation » within the context of this worktream, May 2017 [Online : http://interagencystandingcommittee.org/system/files/participation_revolution__definition_of_participation.pdf] ISMAIL S.A., ABBARA A., COLLIN S. M., ORCUTT M., COUTTS A.P., MAZIAK W., SHLOUL Z., DAR O., CORRAH T., FOUAD F.M., Communicable disease surveillance and control in the context of conflict and mass displacement in Syria, International Journal of Infectious Diseases, Aarhus : Eskild Petersen, May 2016. Organisation for Economic Co-operation and Development E, The Grand Bargain – A Shared Commitment to Better Serve People in Need, Istanbul, May 2016 [Online: http://www.oecd.org/dac/conflict-fragilityresilience/docs/Grand_Bargain_final_22_May_FINAL-2.pdf] PERRY Chris, Machine Learning and Conflict Prediction : A Use Case, Stability : International Journal of Security and Development, London, October 2013. UNITED NATIONS OCHA, Building data responsibility into humanitarian action, OCHA Policy and Studies Series, May 2016 [Online : https://docs.unocha.org/sites/dms/Documents/TB18_Data%20Responsibility_Online.pdf] UNITED NATIONS OCHA, USG Security Council Briefing on Syria, July 2013 [Online : https://docs.unocha.org/sites/dms/Documents/USG%20Security%20Council%20Briefing% 20on%20Syria%2016Jul2013.pdf] Union of Medical Care and Relief Organizations, Syrian Health Care Methodology, 13 April 2016 [Online: http://www.uossm.org/syrian_health_care_research] Union of Medical Care and Relief Organizations, Syrian Hospitals Surveillance Study, Paris, March 2017 [Online : http://www.uossm.fr/rapport_exclusif_syrian_hospitals_surveillance_study] WHO, Availability of the Health Resources and Services in Public Hospitals in Syria; Using HeRAMS, Third Quarter 2013 [Online: http://applications.emro.who.int/dsaf/libcat/EMRDOC_2013_EN.pdf?ua=1] WORLD FOOD PROGRAMME, Emergency Food Security Assessments (EFSAs) Technical guidance sheet n°8, Introduction to qualitative data and methods for collection and analysis in food security assessments, February 2009 [Online : http://documents.wfp.org/stellent/groups/public/documents/manual_guide_proced/wfp1972 98.pdf]

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