Vulnerable Groups in Syria Crisis

Unmasking the Syrian Population – March 2014 1
Mapping of Vulnerabilities
Unmasking the Syrian Population
1. Introduction
There is limited indication of an imminent end to the Syrian conflict. The number of IDPs and refugees
continues to increase week after week, human rights abuses across the region are rife, and
regionalisation of the conflict has become a reality1
. The crisis is characterized by widespread
violations of human rights and of international humanitarian law, including targeted attacks on
civilians, restricted access to basic services and supplies, gender-based violence, and grave violations
against children, including recruitment and unlawful detentions2
. The capacity of neighbouring
countries to accommodate Syrian refugees is increasingly strained with hosting, displaced, and
refugee communities competing for scarce commodities and basic services. Although humanitarian
aid is scaling up, it cannot keep pace with increasing needs3
.
The three-year-old Syrian crisis has resulted in heightened protection concerns for all affected
populations, IDPs, refugees, and conflict-impacted communities alike1
. As of February 2014, nearly
2.5 million people -- three-quarters of whom are women and children -- are estimated to have left the
Syrian Arab Republic, seeking refuge in neighbouring countries4
. Within Syria, over 9.3 million people
have been directly impacted by the violence, including more than 6.5 million IDPs5
.
Categorising or labelling large and diverse groups of people as vulnerable can lead to fragmented and
ineffective interventions, which ignore overlapping vulnerabilities and the changing nature of
vulnerabilities over time, even during one specific crisis”6
. To effectively and strategically respond to
the protection needs of populations across the conflict impacted region, decision makers must
determine which vulnerable groups are most in need of humanitarian support and what the factors
are that increase and compound their vulnerabilities. Only by understanding the specific
vulnerabilities to multiple and multi-faceted risks which result from, and are enhanced by, the ongoing
Syrian crisis can an accurate picture of needs be determined, and appropriate prioritization of the
most vulnerable in the context of an ever-increasing demand and limited resources.
2. Methodology
A desk review of key documents was undertaken from October to December 2013 during which time
publicly available data generated through the humanitarian response in the five countries was
reviewed7
. Background documents, assessments, situation reports, appeal documents, monitoring
reports, and emergency plans, and some confidential materials shared directly through interviews and
emails, was included. In response to findings from the desk review, vulnerabilities and protection risks
were mapped by country, diversity group, and need.
Semi-structured interviews were carried out with key informants (KIs) and focused on understanding
stakeholder perceptions of trends in terms of protection issues, pre-existing vulnerabilities and
capacities based on age, gender, and diversity dimensions, as well as the emergence of new
vulnerabilities created by the conflict. From this, links between pre-existing and conflict-caused
vulnerabilities were explored. An understanding of gaps in the inclusion of particularly vulnerable
groups in the response was also examined. This brief report summarises the findings of the desk
review and KIs.
1
Due to time limitations, vulnerability within hosting communities was not examined in detail.

3. Findings
Crises affect people differently, with the poor disproportionately impacted upon. Women, children,
older people and people with disabilities, the chronically ill, the injured, the politically marginalised
and oppressed minority groups are consistently more exposed to risks and typically have less capacity
withstand the impact of a crisis. The dynamic interplay between cross-sectoral needs, issues of access
both for affected populations and humanitarian service providers, types of displacement and location
in either camp or non-camp settings, and disruption to and unavailability of services multiplies the
impact a crisis has on vulnerable populations and must be considered when planning and
implementing response, recovery, and resilience activities8
.
Whether IDPs, refugees, or non-displaced conflict-affected populations, the impact of the conflict
varies according to scope (the ways in which people have been impacted), magnitude (the numbers
of people affected), and duration (the length of time that the conflict has impacted various groups).
Each of these characteristics has overlapped and become convoluted for vulnerable persons
throughout the lifetime of the Syrian conflict to make a clear delineation of the most vulnerable
complex and time and location dependent. The needs of displaced populations are multi-faceted and
have undergone repeated iterations. Long term and repeated displacement into urban and rural and
camp and non-camp settings, disruption of and increased demand on services, and ensuing
competition over scarce resources has put pressure on IDPs, refugees, and host communities alike.
Coping strategies of all affected communities, both within Syrian and across neighbouring host
countries, have been stretched to the limit as assets have been depleted and new debts incurred9
.
In light of this multi-dimensional backdrop, vulnerability is best seen as falling along a continuum of
time, location, and resilience. To characterise all conflict affected populations as vulnerable is neither
strategically nor programmatically helpful given the vast numbers of conflict affected persons in need
and the multiplicity of their needs across the region. Rather, the questions that need to be asked are:
1. Which groups are most critically exposed to protection risks?
2. At what point in their experience of displacement are they most at risk?
3. What combination of factors exacerbates pre-existing vulnerabilities?
Intersecting factors that contribute to and compound the effects of violence and discrimination
include sex, age, disability, minority status, and social or economic status10
. In light of this,
vulnerabilities and protection risks emerging from the secondary data review were mapped by country
firstly, and then within country according to categorisation as a Cluster cross-cutting issue (age and
gender) or as an AGDM indicator (age, gender, diversity) to enable comparison across the region11
. As
such, findings are presented below according to these categories of vulnerability.
3.1 Risks related to age
3.1.1 Children
Comprising more than half the population of concern12
, children and youth are a critical group of
vulnerable persons. Inside Syria, the main threats to children’s physical safety are civil, political, and
armed violence, explosive remnants of war (ERW)13
, kidnapping, and torture in detention14
. Beyond
Syria’s borders, the combined effects of displacement, economic destitution, and family separation
are putting conflict affected children at higher risk of violence and exploitation, including child labour,
trafficking, and child marriage.
Findings from the desk review indicated that circumstances that increase the exposure of children to
protection concerns are the following:

a. Health issues impacting children are myriad and inter-related. Within Syria, the breakdown of
medical services has disproportionately affected children <5. Disruption of vaccination
programmes has been widespread, resulting in children across the region, especially in
crowded IDP and refugee locations, at particular risk of measles. Polio vaccination rates in
Syria have decreased from 95% coverage in 2010 to an estimated 45% in 201315
. Although a
recent vaccination campaign in Syria by UNICEF, WHO, UNHCR and MOH has successfully
reached 3.3 million children, including in hard to reach areas16
, the impact of interruption
continues to leave displaced and refugee children at risk. Poor nutrition in conflict zones
across Syria also increases the susceptibility children have to communicable diseases.
b. In conflict zones within Syria, exposure to ERW and ongoing fighting intensifies children’s risk
of injury. For both conflict affected Syrian children and for Syrian refugees, of particular
concern are the increasing numbers of children with permanent disabilities17
.
c. Separated and unaccompanied children are seen among all conflict affected communities.
Separation is due to a variety of situations, including the death of parents, during movement
to safer areas, due to disappearance during the conflict as well as the result of deliberate
separation where families send children to work or stay with relatives. Families who had sent
children out of Syria cited their motivations as safety, economic hardship and to protect
children from being used by armed forces and armed groups18
. Separation puts children at
risk of abuse, exploitation, and discrimination, and increases their likelihood of recruitment
into armed forces, their exclusion from education, and reduces their access to health care.
d. Household economic need combined with limited opportunities for adults to earn a livelihood
is resulting in child labour being widespread among both conflict affected Syrians inside the
country as well as among Syrian refugee children. Within Syria, evidence from IDPs in Aleppo
indicated that 50% of children aged 6-12 years have been pushed to work to support their
households because their fathers are disabled, missing, or dead. Children reportedly worked
over 12 hours per day and complained about harsh working conditions, in addition to verbal
abuse and beatings by other children and/or adults at work19
. Syrians cited an increase (up
by 2/3 since the onset of the crisis) in children working outside the home, with some children
involved in the worst forms of child labour20
jeopardising the physical, mental and moral well-
being of working children and contravening their basic human rights21
. Syrian refugee children
must also work to support themselves and their families out of economic need; in Lebanon,
many have found employment in circumstances that endangers their well-being, including on
the streets, in the fields, at construction sites, or in commercial locations22
.
e. Both age and gender exacerbate children’s inability to access services within Syria. 63% of
assessed respondents noted that girls have less access to basic services than boys. Similarly,
children’s age affects their access to services with 80% of children under 15 seen as having
less access than older children23
.
f. Unaccompanied children and separated children living with older caregivers were found to be
at particular disadvantage in accessing services24
compared to other refugee children,
especially in unregistered older persons refugee headed households which have limited
access to humanitarian services, thus negatively impacting the well-being of both older carers
and children.
g. Displacement, security constraints, and disruptions in the registration system are further
creating a setting for future vulnerability of children with many IDPs and refugees not
registering new-borns’ births, thereby leaving them without critical documentation of either
identity or citizenship.
3.1.2 Youth
Most concerns experienced by children, including exposure to ongoing fighting, family separation,
child labour, and limits in access to services as noted above, are also increasing the vulnerability of
youth. However, within the context of the Syrian crisis, youth have additional needs and capacities
which need highlighting. These include:

a. Within Syria, the recruitment of youth (predominantly boys aged 12-18) by armed forces
and armed groups (and ensuing detention by opposing forces for some) is increasingly
reported in a range of locations and situations25
. In some refugee communities, as noted by
male adolescent refugees in Lebanon, people in host communities expect male refugee
youth to return to Syria to fight26
.
b. Among refugee populations, male youth (aged 12-18) are consistently seen to top the most
vulnerable or at risk category as both perpetrators and victims of violence. The poor
integration of single males in both host communities and in refugee camps was perceived to
present security risks. In Za’atari Camp (Jordan) and Domiz (Iraq), young men and boys,
especially those without extended family, were found to be struggling with their aggression,
prone to disturbing others in the camp, and faced with boredom27
.
c. Economic hardship for refugee households, exacerbated by length of time of displacement
and by numbers of relocations, is demanding that refugee youth (predominantly boys aged
12-18) engage in paid labour to help meet basic household needs. The protection risks for
IDP and refugee youth engaging in unsafe labour is compounded throughout the region by a
lack of safe and appropriate livelihood/ economic opportunities for youth, including access
to skills training, flexible learning programmes, and learning and earning opportunities28
.
d. Lack of access to adequate sexual and reproductive health information and services is a
serious problem for adolescent and youth refugees in both urban and camp locations29
. This
is a particularly acute problem when combined with child marriage, since complications from
pregnancy and maternal mortality is a particular risk for girls under 19.
3.1.3 Disruption in Education for Children and Youth2
Prior to the conflict, Syria was close to achieving universal primary education30
. Since the start of 2012
school year, almost two million Syrian children have dropped out of school, nearly 40% of all pupils
registered in grades 1-9, and nearly half all IDP children31
. Over 20% of Syria’s 22,000 schools no longer
function due to damage, use as IDP shelters, and displacement of trained teachers across the region32
.
Nearly three years in crisis have reversed over a decade of progress in children’s education in Syria33
.
In countries hosting refugee children, education opportunities, particularly for those outside camp
settings are limited. Access to education for Syrian refugee children and youth in urban, peri-urban
and rural areas across all regions is inadequate34
. Between 75-90% of school-aged refugee children
and youth in non-camp settings are not in formal education due to space limitations, language
barriers, and difficulty of access3536
, of these 76% had attended school in Syria37
. In 2012 and 2013,
only 60% of primary school-aged boys and girls in Turkish camps were enrolled in school38
, and only
14% of refugees outside camps attend school39
. Likewise in Lebanon, only 20% of Syrian refugee
children are enrolled in formal school programs, numbers which contrast sharply to the 93%
primary and 67% secondary school enrolment rates in Syria prior to 201140
.
Ongoing interruptions, distress, and displacement mean that refugee children have not maintained
the educational continuity or progress that many enjoyed in Syria. This stunts the development of
individual students’ numeracy and literacy skills, but also impedes the collective wellbeing of refugee
communities, stifles long-term prospects for family earnings and livelihoods, and diminishes refugees’
hopes and opportunities for the future41
. In Lebanon, for example, many Syrian children aged 11+ who
had dropped out of school in Syria before becoming refugees find it even harder now to re-enter the
education system. Instead of going to school, many try to find jobs in agriculture or construction
work42
. Risks for out of school youth compound with issues of gender and social and economic
factors43
.
2
Disaggregation of education services and data was not readily found during the secondary data review. While drop out levels increase
from primary to secondary to tertiary levels, more detailed information on the impact of disruption of educational for Syrian conflict
affected populations and for refugees, across all levels of education, is necessary to ensure accurate targeting of services.

Children not attending school risk marrying earlier and having less healthy children (especially girls),
having worse paid and more limited workplace opportunities, and are less able to participate in
decision making at all levels44
.
3.1.4 Older People
Older people were insufficiently accounted for within the data, with roughly 3% of the registered
refugee population across Jordan, Iraq, and Turkey over the age of 60 years. These numbers contrast
starkly with the estimated 6% of the Syrian population above 6045
and illustrates the particular
vulnerability of older people, with many unable to flee or choosing to protect assets in Syria leaving
older people behind with no or limited support as other family members move away46
. An August
CLMC assessment on older Syrian refugees in Lebanon showed that 30% of persons aged over 60 years
were not registered47
. Preliminary findings of a joint HelpAge International and Handicap
International research reveals that the proportion of older people within the refugee population
(registered and unregistered) in Jordan and Lebanon is 5%, while the registered refugees aged over
60 are only around 2.5% in both countries48
. The lack of disaggregated data on older persons raises
their invisibility in humanitarian response and indicates an absence of consultation in humanitarian
activities which directly impact their lives, the lives of those in their care, and the lives of those who
care for them.
Older people throughout the region were seen to engage in negative coping strategies increasing their
vulnerability. A lack of livelihoods opportunities, depleted assets and savings, combined with
disrupted medical care for chronic illnesses, reduced nutritional intake, and family separation
(resulting in increased care-giving responsibilities) has led to older persons adopting damaging
strategies such as: skipping meals; reducing meal sizes and diversity of food; and taking on debt49
.
Throughout the region, older people reported being unable to afford medication, particularly for
treatment of chronic disease, leaving them exposed to increased risk of ill health and reduced capacity
to care for themselves and others. The onset of winter has further increased the vulnerability of older
persons by exacerbating health issues50
. In all refugee hosting countries, many older people depend
on humanitarian assistance for basic needs, including food, because they have no livelihood
opportunities51
. When and where older persons are not registered, or are unknown to humanitarian
stakeholders, they have been seen to be omitted from humanitarian interventions resulting in risks of
abuse as well as social and economic exploitation as older people adopt risky behaviour to meet their
basic needs.
Older refugees and, in particular, unaccompanied older people are increasingly in need of enhanced
assistance, especially in camps where older people are at risk of violence, discrimination, and abuse
(a problem also seen by women, boys and girls), and in non-camp settings where their invisibility
restricts access to services.
3.2 Risks related to gender
3.2.1 Women and girls
For women and girls, the main circumstances that put Syrian women and girls at risk have been
identified as:
a. An estimated minimum of one in five refugee3
households is female headed. In Jordan in April
2013, a survey found that 18% of assessed Syrian refugees hosted in urban centres were
female-headed households52
. Similar findings emerge from Lebanon where an estimated 20%-
25% of refugee households are headed by women53
and in Turkey where most refugee
3
Data on the numbers of female headed conflict affected households in Syria was not found during the course of the secondary data review.

households are headed by women 54
. These numbers may be underestimates, however, as
they do not account for households where the woman is effectively the head of the
household, but men (both non-present and/or not contributing economically) are attributed
a symbolic role as head of household and recorded as such in assessment data55
. The
increasing numbers of female headed households, including widows and women whose
husbands are in detention in Syria, and increasing lengths of time that female-headed
households are displaced are contributing to changes to traditional social roles with economic
need requiring women to take on traditional male roles as economic providers.
b. Extreme restrictions on access and mobility, especially in areas of high fighting intensity,
throughout Syria and in camp and non-camp refugee locations, are putting the lives of
women, girls and their families at high risk decreasing their access to critical services and
increasing pressure to adopt negative coping strategies. In Jordan, for example, 41.2% of
women living outside refugee camps frequently do not leave the home, with one in five never
leaving56
. This is of particular concern for pregnant women, both IDPs and refugees, who are
just days away from giving birth who often have no options but to deliver at home, with no
medical help, or who risk their lives by fleeing in the hope of delivering safely elsewhere57
.
Prior to the conflict, Syrians had good access to health care with 96% of pregnant women in
2009 giving birth in the presence of a skilled health attendant58
. In Za’atari (Jordan), 88% of
the 1,628 deliveries from January to August 2013 were attended by skilled personnel, a
neonatal mortality audit was introduced and maternal mortality remains at zero59
. But this is
by no means the experience for all expectant Syrian refugees, and even in Za’atari, women
lamented that the quality of services had deteriorated due to the large number of refugees
that had arrived in 201360
.
c. When women and girls do venture outside the home, they report physical and verbal
harassment, including sexual violence61
.
d. Economic hardship is keenly felt in the steep rise in prices of rented accommodation outside
camps in both urban and rural areas creating direct protection risks for women (particularly
for women headed households). Combined with depletion of saving and limited economic
opportunities, this has led some women to resort to use of survival sex as a coping
mechanism62
.
e. Factors such as frustrations of male family members as they remain unemployed, economic
difficulties, mental stress, large families living in cramped housing, and boredom amongst
youth are leading to increased levels of domestic violence63
. The social isolation of women
and girls, due to multiple experiences of displacement and separation of families and larger
extended social support network, are adding to the risk that domestic abuse cases go
undetected and unreported.
f. Within Syrian, rape and sexual violence were cited as the most extensive form of violence
faced by women and girls64
and a primary reason for fleeing the conflict65
. The fear of rape is
so significant that many families are marrying off their daughters to protect them from rape;
others revert to early marriage if their daughters have been sexually assaulted to safeguard
their honour66
. Many women and girls relayed accounts of being attacked in public or in their
homes, primarily by armed men. These rapes, sometimes by multiple perpetrators, often
occur in front of family members.
g. While early and forced marriage of girls existed in some Syrian communities before the war,
the practice is now used by some IDP and refugee families to better protect girls in the absence
of male family members and ease financial pressure on families67
. Less expensive dowries and
fewer conditions on marriage are further changes in patterns of early marriage which
contribute to the protection risks of girls <18 years68
. Early marriage affects girls more
frequently than boys and coincides with other rights violations, including but not limited to
domestic violence and impeded access to reproductive health care and education.
h. Reports of early marriage may camouflage concerns about the vulnerability of Syrian refugee
children to being trafficked. Refugee girls and young women are highly vulnerable to
trafficking, given the financial desperation of their families and the social deprivation of their

lives. Once married (or removed from her family), a girl leaves the protection of her biological
family and may forfeit her autonomy to a marriage of un-equals (at best) or to criminal activity
(at worst)69
.
3.2.2 Men and boys
Many refugee men report stress and feelings of powerlessness because they are unable to fulfil
traditional roles as family providers and protectors. As well as losing their role as breadwinners, men
seeking jobs and services face threats and discrimination from some members of host communities70
.
With displacement and ensuing changes in livelihoods patterns resulting in economic hardship and
inability to meet basic needs, men may turn to domestic violence. Older male refugees find their loss
of social status (associated with displacement and lack of legal status), their inability to provide for
their families, and the constant exploitation and uncertainty over working conditions and payment
difficult71
. Households without recourse to livelihood opportunities are likely to put household
members who are already vulnerable at increased levels of protection risk. The risk of domestic
violence increased in families with a person with a newly acquired disability72
, as a result of increased
stress due to limitations in services and assistance, over-crowded accommodation, and a lack of
income generation opportunities.
3.3 Risks related to ethnic background
Although smaller in number than the vast population of women and children impacted by the conflict,
an estimated 540,000 Palestine refugees of Syria (PRS) have been measurably affected, with over half
in need of assistance73
. Palestine refugee camps and neighbourhoods in Aleppo, Damascus, Dara’a,
Rural Damascus, and Homs have experienced some of the most intense armed engagements of the
Syrian conflict, with casualties occurring daily. At least 50% of all PRS have been displaced at least once
during the conflict, including over 54,000 children; many have experienced multiple displacements74
.
In Lebanon, only 35% of PRS children have enrolled in school, and in Jordan, borders have been closed
to PRS fleeing violence in Syria since January 201375
. PRS are among the most vulnerable refugees
with little in the way of support networks, limited recourse to economic opportunity, and pre-crisis
indicators reflecting a socioeconomic frailty below that of the wider Syrian population76
.
In addition to PRS, stranded migrant workers within Syria remain extremely vulnerable, with reports
of high incidents of exposure to physical, verbal, and sexual abuse and limited access to basic health
care. As of June, over 6,800 extremely vulnerable migrant workers in Syria were in need of assistance,
the majority of whom were unaccompanied female migrants working for Syrian families77
.
3.4 Risks related to disability, injury, and chronic Illness
Persons with disabilities generally represent 15% of a given population, and in armed conflict, this
incidence increases. As of November 2013, roughly 18% of refugees in Jordan and Lebanon were found
to have at least one impairment78
. However, for example, only 1% of the UNHCR registered population
in Lebanon are persons with a disability79
. Rehabilitation is important not only to prevent impairments,
but also for optimizing inclusion. Without visibility of, consultation with, and inclusion of persons with
disabilities in the humanitarian response, this will not be possible.
The Syrian crisis is leaving an increasing number of people disabled, with a large number of
amputations and a higher proportion of spinal cord injuries than seen in other crises. Persons who
have been injured either directly or indirectly as a result of the conflict have seen treatable injuries
turn into permanent impairments needing long term rehabilitation and care due to a lack of functional
and/or accessible health services, medication, and treatment as well as shortages of physiotherapy
and rehabilitation services80. Persons with new impairments are also unable to access longer-term

rehabilitation that might in turn support their access to and inclusion in community services and
programs, exposing them to a range of protection concerns81
.
A lack of access to transportation, services and assistance increases the risk of persons with disabilities
and their families to financial disadvantage and exploitation in comparison to refugees without
disabilities. In camp settings, persons with disabilities have reported paying people to push them to
services in their wheelchairs. As health partners are increasingly only able to cover the costs of urgent
and life-saving procedures, persons with disabilities may travel from one provider to another, seeking
certain services, and/or paying for these services directly, depleting the limited funds they have and
adding to the financial strain on them and their families. Hence, they experience a cycle of disability
and poverty which exposes them to further protection concerns, such as isolation, exploitation, and
abuse82
.
Persons with intellectual impairments are particularly vulnerable violence in the home, as a result of
added stress, over-crowding and changes in social support structures, which can lead to negative
coping strategies such as the use of physical restraint or physical abuse. Persons with intellectual
impairments also experience violence outside the home, with reports of sexual violence against
adolescent girls with intellectual disabilities, and both physical and emotional violence against men
and boys with intellectual disabilities. These groups are more vulnerable because of community
perceptions that they will be unable to defend themselves or report incidents of violence, lack of
knowledge which means they may be more easily targeted, and a loss of community structures and
protection mechanisms. Multiple persons with disabilities in a single family, family size and quality of
housing may also compound factors for protection concerns in this group 83
.
Across the region, children with disabilities have limited access to services and virtually no
involvement in education. The desk review only uncovered one example, in Akcakale camp (Turkey)
where 30 disabled children attend a special class84
. In Za’atari camp (Jordan), reasons for children
with disabilities not attending school were: physical barriers to accessing the school (cited by 40% of
respondents); and attitudinal barriers (cited by half). Child Friendly Spaces and kindergartens in
Za’atari were further found to be inaccessible for children with disabilities85
, a challenge not limited
to Jordan. All children, including children with disabilities, have the right to education which is being
directly violated in the humanitarian response through oversight and lack of inclusive planning.
Mental health services and psychosocial support represent significant needs among IDPs in Syria,
particularly women and children, given reports of trauma, sexual and gender based violence (GBV),
and violence against children86
. Arriving from conflict zones, refugees bring a raft of invisible baggage:
experiences of violence and torture, loss and grief. Life as a refugee brings its own slew of psychosocial
challenges, among them unfamiliar surroundings, cramped or shared living conditions, and
unemployment87
. In Turkey, alone, half the refugee population stated that they or their families were
in need of psychosocial support88
.
The lack of long-term rehabilitation for people with new impairments increases dependence on
caregivers as well as social isolation and exclusion, which in turn increases the risk of protection
concerns such as violence and abuse89
.
4. Gaps in Knowledge
The following groups are known to constitute vulnerable populations, according to global learning.
However, within the context of the Syrian crisis, little is known about their levels of vulnerability,
exposure to protection risks because of their diversity characteristic, and their humanitarian needs,
either in Syria or within the dispersed refugee populations.

• Incarcerated prisoners and detainees90
in Syria. The media has picked up on some of these former
prisoners who are now involved in the opposition. Beyond this, there is limited information on
imprisoned populations, especially in areas where fighting is intense. Accurate numbers of
detainees imprisoned over the life of the conflict vary, but estimates are as high as 200,00091
.
Detainees are virtually impossible to visit and family members report having little information
about their whereabouts and well-being92
. In addition, there no information in the literature on
incarcerated pre-crisis populations.
• Institutionalised populations in Syria – little information is available on children and adults who
had been resident in institutions for the visually impaired, the aurally impaired, and persons with
cognitive impairment/mental disability who had been in care homes before the conflict started.
It is unclear whether they have been released into family care, remain institutionalised, or are
without family support and self-sustaining. The lack of data makes it impossible to determine
levels of access to and inclusion in the response.
• Disaggregated information remains scant on the impact of the conflict on minority groups93
,
specifically Christian, Assyrian, and Kurdish94
populations both within Syria and in neighbouring
refugee hosting countries, and on their experiences of discrimination and/or exclusion.
• Lesbian, Gay, Bisexual, Transgender, and Intersex persons who, while recognised as an at risk
population globally, remain conspicuously absent in all the secondary data encountered.
5. Conclusion
1. Which groups are most critically exposed to protection risks?
• Children living in female headed households
• Children engaging in child labour
• Children living with older or disabled caregivers
• Children who are unaccompanied and separated
• Single female heads of households, especially those with multiple dependents
• Adolescent girls at risk of early or forced marriage
• Victims of GBV, domestic violence, and harassment.
• Male youth, aged 12-18, who need safe and appropriate livelihood opportunities
• Older people who are often invisible in humanitarian assessments and registration process
• People with disabilities, people with injuries, and people suffering from chronic disease
• Palestinian refugees of Syria (PRS) who have little way of support networks and limited recourse
to economic opportunities.
2. At what point in their experience of displacement are they most at risk?
To determine where and when which group is most at risk demands a more detailed analysis than
was possible during the desk review. With additional time and resources, comparisons within
refugee hosting countries would be both possible and strategically useful in comparing multiple
cross cutting levels of vulnerability between camp and non-camp locations, urban, peri-urban, and
urban locations, and in light of duration of displacement.
3. What combination of factors exacerbates pre-existing vulnerabilities?
Pre-conflict pre-existing vulnerabilities which people had before the crisis which make them already
vulnerable to a range of concerns include, among others: age; gender; disability; minority status;
poverty; and living in areas which have been historically underserved by Government of Syria
services4
. Findings from the desk review indicate that there is not one single set or sets of combination
4
Notably, Al-Hasakeh, Deir-ez-Zor and Ar-Raqq governorates.

of factors which put an individual or a household more at risk. Rather, it is a combination of multiple
factors which interact and intersect with economic need which put both refugees and conflict affected
populations within Syrian borders most at risk.
The perfect storm of vulnerability for Syrians, both inside the country and beyond borders, occurs
when persons with diverse pre-existing vulnerabilities are exposed to repeated and multiple
circumstances which increase their exposure to protection risks demanding that they adopt negative
coping strategies which then critically exposed to further and more extreme protection risks.
6. Recommendations
Recommendations for operational agencies and all humanitarian stakeholders are as follows:
Improve coordination and implementation of effective referral systems.
Build the capacity of staff to assess vulnerability factors in individuals and households.
Implement intergenerational programming.
Disaggregate evidence according to age, gender, and disability and use that evidence to assess
needs and capacities and inform strategic planning and programming response.
Implement programming that is multi-sectoral, interagency, and pro-actively includes both
host and displaced populations.
Develop programmatic responses that are sympathetic to longer-term development needs to
mitigate the probability of vast populations slipping into poverty.
Advocate for continued rights based programming for all persons affected by the conflict.

7. Endnotes
1
ACAPS/SNAP, October 2013. Lebanon: Baseline Information
2
SHARP, 8 December 2013. Syrian Humanitarian Assistance Response Plan 2014.
3 SNAP, 30 October, 2013 Regional Analysis Syria: Crisis Overview.
4 UNHCR http://data.unhcr.org/syrianrefugees/syria.php, accessed 13 December 2013, updated 17 February 2014.
5 OCHA, 19 November to 2 December, 2013. Humanitarian Bulletin: Syrian Arab Republic, Issues 38.
6
The Sphere Project, Humanitarian charter and minimum standards in humanitarian response (Rugby: The Sphere Project, 2011), p. 11.
http://www.sphereproject.org/handbook/.
7
A bibliography of all documents reviewed can be found in Annex 1 along with Key Informants.
8
DFID, September 2011. The UK Government’s Humanitarian Policy.
9
Child Protection in Emergencies Working Group Workshop, July – August 2013 and OXFAM and Abaad Resource Centre for Gender
Equality, September, 2013. Shifting Sands: Changing gender roles among refugees in Lebanon.
10 UNHCR, 23 October 2012. Guidelines on International Protection No. 9: Claims to Refugee Status based on Sexual Orientation and/or
Gender Identity within the context of Article 1A(2) of the 1951 Convention and/or its 1967 Protocol relating to the Status of Refugees.
11
Age refers to the different stages in one's life cycle. Gender refers to the socially constructed roles for women and men, which are often
central to the way in which people define themselves and are defined by others. Diversity refers to different values, attitudes, cultural
perspectives, beliefs, ethnic background, nationality, sexual orientation, gender identity, ability, health, social status, skill and other
specific personal characteristics. While the age and gender dimensions are present in everyone, other characteristics vary from person to
person. See UNHCR, 2013 (accessed 22/12/2013). UNHCR Age, Gender and Diversity Policy: Working with People and Communities for
Equality and Protection.
12
Over half of registered refugees are children, see UNHCR http://data.unhcr.org/syrianrefugees/syria.php.
13 UN General Assembly, 15 July 2013. Protection of and Assistance to IDPs: the situation of IDPs in the Syrian Arab Republic and SNAP, 26
September 2013. Regional Analysis Syria – Part II Host Countries.
14
Child Protection Working Group (CPWG), September 2013. Syria Child Protection Assessment.
15
ACAPS, 29 October 2013. GEO review: Syria.
16
See OCHA, 19 November to 2 December, 2013. Humanitarian Bulletin: Syrian Arab Republic, Issues 38.
17
Ibid, UN General Assembly, 15 July 2013.
18
Ibid, Child Protection Working Group, September 2013.
19
OCHA, 27 August – 9 September. Humanitarian Bulletin: Issue 33.
20 I.e. children working with armed groups or in dangerous activities.
21 ILO, 2014. Worst Forms of Child Labour. http://www.ilo.org/ipec/facts/WorstFormsofChildLabour/lang--en/index.htm
22
Harvard University, January 2014. Running out of Time: Survival of Syrian Refugee Children in Lebanon.
http://reliefweb.int/sites/reliefweb.int/files/resources/Running%20Out%20of%20Time.pdf
23
24
25
26
IRIN, 8 August 2012. LEBANON-SYRIA: No school today - Why Syrian refugee children miss out on education.
http://www.irinnews.org/report/96053/lebanon-syria-no-school-today-why-syrian-refugee-children-miss-out-on-education
27IMC, 22 October 2013. Syria’s Young Refugees Live in Fear and Yearn to Return to Syria.
28Personal communication WRC, February 2014.
29
WRC and Inter-agency Working Group (IAWG) on Reproductive Health in Crises, 2013. Reproductive Health Findings from Za’atri Camp
and Irbid City, Jordan, Participants’ Report 18-21 March 2013. http://www.womensrefugeecommission.org/programs/reproductive-
health/research-and-resources, and personal communication WRC, February 2014.
30
OXFAM and Abaad Resource Centre for Gender Equality, September, 2013. Shifting Sands: Changing gender roles among refugees in
Lebanon.
31
OCHA, 27 August – 9 September. Humanitarian Bulletin: Issue 33.
32 Ibid, UN General Assembly, 15 July 2013.
33UNCHR, 2013. A Year in Review 2013 UNHCR Syria.
34
SNAP, November 2013. Regional Analysis: Crisis Overview.
35
Save the Children, access November 2013. Help and Hope for Syrian Children and Refugees.
36
IMC, 22 October 2013. Syria’s Young Refugees Live in Fear and Yearn to Return to Syria.
37
NRC Iraq and UNICEF, 24 July 2013. One in Ten in School: an overview of access to education for Syrian refugee children and youth in the
urban areas of Kurdistan Region of Iraq.
38
Brookings, 17 January 2014. Education for Syrian Refugees in Turkey – Beyond Camps. http://www.brookings.edu/blogs/education-plus-
development/posts/2014/01/17-turkey-syria-refugees-education-ackerman
39 UN, 2014. 2014 Syrian Regional Response Plan: Turkey.
40 Ibid, Harvard University, January 2014.
41
Ibid, Harvard University, January 2014.
42
Ibid, IRIN, 8 August 2012.
43
IMC, 22 October 2013. Syria’s Young Refugees Live in Fear and Yearn to Return to Syria.
44
UNICEF MDGs, 2014. Goal: Eradicate extreme poverty and hunger. http://www.unicef.org/mdg/index_proverty.htm
45
Danish Refugee Council, December 2012. Population Survey.
46
CLMC, August 2013 and Assessment Working Group for Northern Syria, 28 March 2013. Joint Rapid Assessment of Northern Syria:
Aleppo City Assessment.
47
Caritas Lebanon Migration Center (CLMC), August 2013. Forgotten Voices: an Insight into Older Persons among Refuges from Syria in
Lebanon.
48 HelpAge International, Handicap International, forthcoming report on vulnerabilities in the Syrian refugee population in Jordan and
Lebanon.
49HelpAge International and Handicap International, findings from field research (unpublished), April to June 2013.
50
Ibid, SHARP 8 December 2013.
51
Ibid, IRIN, 6 September 2013

52 Ibid, CARE, April 2013; and Regional Response Plan 6 (RRP6), 2014. http://www.data.unhcr.org/syria-rrp6/regional.php
53 Oxfam, CLER/LCSR, and BRIC, November 2013. Survey on the Livelihoods of Syrian Refugees in Lebanon.
http://www.oxfam.org/sites/www.oxfam.org/files/rr-bric-livelihoods-syrian-refugees-lebanon-211113-en.pdf
54
Ibid, Regional Response Plan 6 (RRP6), 2014. http://www.data.unhcr.org/syria-rrp6/regional.php
55
Ibid, Oxfam, CLER/LCSR, and BRIC, November 2013.
56
Ibid, Regional Response Plan 6 (RRP6), 2014.
57
OCHA, 30 July – 12 August 2013. Humanitarian Bulletin: Syria Issue #31.
58
Ibid, OXFAM and Abaad Resource Centre for Gender Equality, September, 2013
59 Ibid, Regional Response Plan 6 (RRP6), 2014.
60 Ibid, WRC and IAWG, 2013.
61
62
63
64
Forced Migration Review, September 2013. Forced Migration Review mini-feature: Syria Crisis.
65
IRC, January 2013. Syria: A Regional Crisis – The IRC Commission on Syrian Refugees. http://www.rescue-
uk.org/sites/default/files/Syria-%20A%20Regional%20Crisis.pdf
66
Ibid, IRC, January 2013.
67 Ibid, UN General Assembly, 15 July 2013 and OXFAM and Abaad Resource Centre for Gender Equality, September, 2013.
68 Child Protection in Emergencies Working Group – Lebanon, January-February 2013. Child Protection Rapid Needs Assessment – Lebanon
2013.
69
Ibid, Harvard University, January 2014.
70
Ibid, OXFAM and Abaad Resource Centre for Gender Equality, September, 2013
71
CARE, April 2013. Syrian Refugees in Urban Jordan: baseline assessment of community-identified vulnerabilities among Syrian refugees
living in Irbid, Madaba, Mufraq, and Zarqa.
72
WRC and IRC, 2012. Building capacity for disability inclusion in GBV programming in humanitarian settings – Jordan November 2012.
http://www.womensrefugeecommission.org/programs/disabilities/research-and-resources/967-building-capacity-for-disability-inclusion-
in-gender-based-violence-programs-in-humanitarian-settings/file
73
Ibid, SHARP, 8 December 2013.
74
Ibid, UN General Assembly, 15 July 2013.
75
Ibid, Forced Migration Review, September 2013.
76
Ibid, Forced Migration Review, September 2013.
77
Ibid, SHARP, 8 December 2013
78
Data from a forthcoming study on the impact of the Syrian crisis on older and disabled people, Handicap International and HelpAge, The
Situation of refugee vulnerable persons in the Syrian Crisis.
79 Ibid, ACAPS/SNAP, September 2013 and Lebanon Protection Working Group 18 September, 2013.
80 Handicap International, 17 April 2013. Beneficiary Accessibility Assessment.
81
Women’s Refugee Commission, 2013. Disability inclusion in the Syrian refugee response in Lebanon.
http://www.womensrefugeecommission.org/programs/disabilities/research-and-resources/948-disability-inclusion-in-the-syrian-refugee-
response-in-lebanon/file
82
Ibid, WRC and IRC, 2012 and Women’s Refugee Commission, 2013.
83
Ibid, Women’s Refugee Commission and IRC, 2013; ibid, Women’s Refugee Commission, 2013.
84
UNHCR 22 November, 2013. UNHCR Turkey Syrian Refugee Daily Sitrep, 22 November 2013.
85 Handicap International, 7 May 2013. Accessibility Assessment: Child Friendly Spaces, Za’atari Refugee Camp.
86 Ibid, UN General Assembly, 15 July 2013.
87 International Medical Corps Lebanon, January – June 2013. Syrian Refugee Response
88
UN, 2014. 2014 Syrian Regional Response Plan: Turkey.
89
Ibid, WRC, July 2013.
90
Ibid, SNAP, November 2013.
91
New York Times, 24 August 2013. Accounts of Syrian Prisoners Describe a Volatile Mix of Chaos and Control. and Syrian Observatory for
Human Rights, accessed November and December 2013
92
KI with ICRC, November 2013, CNN, 23 September 2013. One Woman’s Story: In Syria, Remember the Prison Inmates, they suffer the
most and ICRC, 30 September 2013. Syria: Untold Numbers of People Missing or Detained.
93 Human Rights Watch, 2013. You Can Still See Their Blood: Executions, Indiscriminate Shootings, and Hostage Taking by Opposition
Forces in Latakia Countryside.
94
Particularly those outside the Autonomous Kurdish region of Northern Iraq.

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