A confidential UN plan for responding to humanitarian needs of about one million Syrians, based on a joint assessment carried out with Syrian officials from March 18-26, was obtained by Reuters on Thursday.

Syria's infrastructure has been significantly damaged in more than a year of conflict, water and electricity supplies have been disrupted and many families cannot meet their basic daily needs, a United Nations mission has found.

The United Nations is preparing a major aid operation and its "Syria Response Plan" forms the basis of a $180 million appeal presented to donor countries last Friday at closed-door talks in Geneva.

More than 9,000 people have been killed in the uprising against President Bashar al-Assad, who is under international pressure to honour a U.N.-backed ceasefire that went into force on April 12.

On Thursday, Syria blamed "terrorist" bomb makers for an explosion that damaged a building and killed 16 people in the city of Hama, where hostility to Assad runs deep.

At least one million Syrians need humanitarian aid in the 10 provinces the U.N. team visited, most of which reported shortages of essential medicines and sharp rises in food prices, it said.

"Jobs and livelihoods have been disrupted, the cost of ...  goods has risen and many can no longer meet their basic daily needs or access essential social services due to insecurity and financial strain," the document said. "...housing, infrastructure and social service facilities have sustained significant damage in areas where armed hostilities have taken place, while shortages of fuel have affected electricity and water supplies," it added.

In some areas, sewage networks have been damaged, water has been contaminated and garbage collection has stopped, setting the stage for outbreaks of water-borne diseases such as cholera.

The six-month plan lays out 46 projects across 11 sectors including food, health, shelter, and water and sanitation.

But Syrian authorities must still approve the plan and issue visas for U.N. aid workers and customs clearances for shipments, it said. Staff will need security, including armoured vehicles.

Shortages of essential medicines

The number of casualties has placed "unprecedented demands on the health system in Syria," the U.N. document said.

"Many health facilities have been damaged during armed hostilities and the medicine supply chain has been significantly impacted," it said.

Some 90 per cent of medicines used locally were previously produced in Syria, but fuel shortages and higher raw material prices have hit output and "shortages of essential medicines were reported in nearly all the governorates visited..."

The U.N. plan calls for repairing crucial health facilities, deploying mobile medical teams, providing trauma and first aid kits, and drugs for treating cardiovascular, respiratory and diabetic diseases.

Psychological and social support and education is planned for children. "In all of the areas visited by the assessment mission, children showed signs of stress and trauma, such as hair loss, sleeping problems and bed wetting," it said.

The United Nations has been largely shut out of Syria but has been able to distribute food and other supplies through the Syrian Arab Red Crescent, whose capacity has been "significantly overstretched".

U.N. aid chief Valerie Amos won agreement for the joint assessment to besieged towns after a trip to Syria in mid-March.

The evaluation, carried out with the Organization of Islamic Cooperation, covered provinces including Aleppo and Idlib in the north, the central flashpoint towns of Hama and Homs, Deraa in the south and Deir-al-Zor in the east.

But it did not visit four provinces, including Damascus, or  take into account the needs of about 600,000 mainly Iraqi and Palestinian refugees or migrant workers living in Syria.

Poor farmers and herders, whose incomes have dropped by more than 90 per cent in some places, need emergency aid as they are also reeling from a drought now in its fourth year, it said.

Many people who have fled the fighting no longer have access to subsidised food, and food prices have risen by 30 to 60 per cent in most places and by up to 80 percent in Hama, it said.

The U.N.'s World Food Programme (WFP) said on Tuesday that it aimed to deliver food aid to 500,000 people in Syria "in the coming weeks", double the number of people it thinks it will have fed by the end of April.

Under the plan, the WFP would aim to provide food to 850,000 in all and its operations account for $85 million of the budget.

The loss of jobs and of remittances from relatives outside Syria has taken a toll on the average household, it said.

All these factors have made life much more difficult, in a country where "one-third of the population was already living under the national poverty line prior to the unrest," it said. – Reuters