MSF on conflict in Syria and donation appeal

OUR COVID-19 RESPONSE IN SYRIA

In northeast Syria, MSF has partnered with local health authorities in a COVID-19 humanitarian taskforce, providing training and supporting preparedness measures to help healthcare workers during the crisis. Our COVID-19 work in northeast Syria has focused on three sites: Al Hassakeh National Hospital, Al Hol camp and Raqqa National Hospital. To date, the pandemic has not affected northeast Syria as rapidly as first expected.

Following conversations with the community and local authorities, MSF has handed our COVID-19 activities in Al Hassekeh National Hospital to local health authorities. MSF teams created a 48-bed isolation ward in the hospital, and introduced surveillance measures, processes for case identification and patient care, patient flow and triage, and supported training of staff. Our teams remain on standby, ready to provide support should we see a rise in COVID-19 cases in the region.

In Al Hol camp, where MSF started providing medical and humanitarian assistance in January 2019, the overcrowded camp now houses around 65,000 people, 94 per cent of whom are women and children. We continue to run an inpatient therapeutic feeding centre and a wound care program for those who cannot reach the clinics, while also providing water and sanitation support in the camp. We have also started mapping vulnerable people who are more likely to develop severe illnesses as a result of COVID-19 and are sharing targeted health awareness messages and hygiene kits accordingly. We are preparing to reorganise the feeding centre for care of COVID-19 patients if required.

We continue to support the Raqqa National Hospital in their emergency, surgery and inpatient activities, and are continuing our routine vaccination activities and assessments of health and humanitarian needs for those living in informal settlements.

Inside Al Hole Camp, Eastern Al-Hasakah Governorate, Northeastern Syria. © MSF

In northwest Syria, the first COVID-19 case in an area outside of government control was confirmed by local health authorities on 9 July. Dozens of additional cases have been confirmed since then, many of whom are healthcare workers working in the few remaining functional hospitals.

Our teams in the COVID-19 treatment centre in Idlib National Hospital have reviewed the triage systems and patient flow to ensure fast detection of potential COVID-19 cases and isolation from other patients.

Our support of health centres in northwest Syria has also included additional staff and donations of personal protective equipment, when needed. Testing and contact tracing is underway to help prevent the spread of the virus.

More than 2.7 million people are displaced in northwest Syria, many of whom live in overcrowded camps where the water and sanitation conditions are dire and physical distancing impossible. In the camps and settlements where we have projects, we are spreading awareness of the virus and distributing non-food items and hygiene kits. We have started a distribution of hygiene products to 8,000 families in camps in north Idlib.

Can you make a donation to support our COVID-19 response?

Right now, Médecins Sans Frontières is providing much needed support and medical care in over 70 countries to counter the COVID-19 pandemic.

Our teams are also gearing up to confront potential outbreaks in the hundreds of areas we were already working before the pandemic struck. We are deploying medical staff, sending supplies and applying nearly 50 years of experience fighting epidemics to protect the most vulnerable and save lives.

Can you help increase our capacity to respond by making a donation to our COVID-19 Crisis Appeal?

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FIND OUT MORE ABOUT CORONAVIRUS COVID-19

Hundreds of thousands of Syrian civilians have lost their lives in over 7 years of armed conflict, which began with anti-government protests before escalating into a full-scale civil war.

More than 11 million people have been forced from their homes amongst clashes between supporters of President Bashar al-Assad and those opposed to his rule - as well as jihadist militants from the so-called Islamic State.

The United Nations has estimated that over 13 million Syrians are in need of immediate humanitarian assistance. An estimated 6.5 million people are internally displaced in Syria, with over 5 million Syrians seeking asylum internationally.

Closed borders, appalling living conditions and limited assistance have compounded their suffering. People fleeing violence live in camps, improvised shelters or with host families.

Violence, attacks on health facilities, the absence of government authorisation and the reneging by armed groups on guarantees of safety for MSF teams have been major obstacles to a more extensive program of medical humanitarian aid in Syria.

The conflict in Syria is defined by brutal violence that does not distinguish between civilians and combatants.

Indiscriminate Targeting of Civilians

Siege warfare has been widely used in Syria. Civilian areas have been routinely bombed and deprived of assistance.

Early on, the systematic bombing of civilian areas made it a priority to help treat the wounded. We opened surgical facilities in the north, provided supplies and training to health staff across the country, and set up cross-border trauma care in Jordan. As living conditions deteriorated in the north, we set up a surgical burns unit.

MSF was one of the only organisations to start providing medical assistance inside Raqqa, through a primary healthcare unit and a stabilisation point. Even as the violence subsided, and residents started to return home, staff saw a sharp increase in the number of patients wounded or killed by booby traps, improvised explosive devices (IEDs), mines and explosive ordnance that littered the city or deliberately left in homes, on agricultural land and along roadsides.

Attacks on Medical Staff

MSF has been present in Syria since 2009. Teams continue to provide medical and humanitarian assistance in the country but activities are severely limited by insecurity and constraints on access. Thousands of doctors, nurses, pharmacists and paramedics have been killed, kidnapped, or displaced by violence, leaving a massive gap in medical expertise and experience.

In 2017, 11 medical facilities supported by MSF were hit by bombs or shells on 12 occasions in targeted or indiscriminate attacks.

The Syrian government has not granted MSF authorisation to operate in the country despite repeated requests, and our presence in areas outside government control is minimal. Unable to obtain government permission to assist the sick and wounded, we started by supporting underground medical networks.

Our main programs are in the governorates of Aleppo, Idlib, Raqqa and Hassakeh. In addition to providing medical care, we carry out water and sanitation activities and distribute relief items.

Tal Abyad hospital, Raqqa and Ain Isa refugeecamp

Raqqa, the west side of the city. People are slowly returning to their homes to find in either damaged of fully destroyed. While bombs and gunfire cause death and destruction across large parts of Syria, many more people are threatened by the collapsing medical system. © Van Wessel / MSF

Destroyed Health System

Syria’s once fully-functional healthcare system has been devastated as hundreds of medical facilities have been bombed, and medical staff have fled or been killed. Preventable diseases have made a resurgence as common needs go unaddressed. Syrian health staff have been forced to improvise operating theatres and work in deplorable conditions, overwhelmed by the emergencies they face.

Basic essentials such as medical supplies are restricted amid intense bombing and shelling. Unable to enter these areas, we remotely support medical facilities in besieged areas as necessary.

The consequences of interrupted treatment for chronic diseases such as high blood pressure or diabetes can lead to serious complications. Mobile clinics have increasingly become a central part of our response, to provide preventative care and basic treatment to besieged districts as well as camps in surrounding areas. Since no regular vaccinations have been administered in some areas (such as Aleppo) since 2014, MSF launched a large-scale vaccination campaign.

The bulk of our activity in Syria focuses on the health needs of people with common illnesses, pregnant women, and improving vaccination coverage to prevent childhood diseases.

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