Assessing the Health of the Syrian People After 13 Years of Conflict

 

March 15 marks 13 years since the war in Syria began

 

• Only 59% of hospitals and 57 % of primary care centers are fully operational

• More than a decade of conflict has forced many health professionals to flee the country, leaving health centers and hospitals with few health staff

• The region is experiencing an escalation of attacks on critical infrastructure such as oil refineries, water stations, power grids and other key facilities such as health centers

 

March 15, 2024, Amuda, North-East Syria – 13 years of war, death, displacement, destruction, crisis and resilience. What is the state of health of the Syrian people? Can they go to the health center when they need it, do they have access to medicine, what is the state of their mental health after such a prolonged crisis? Doctors of the World, which has been working in northeast Syria since 2017, wants to draw attention to the fragility of the moment and demand that attention be paid to a country that only manages to cover 36% of the funding for its humanitarian health needs.

 

What is the state of health of the Syrian people?

 

After 13 years of war, the Syrian people are resisting with a weakened health system: private consultations are unaffordable and the public system is very fragile. Across Syria, the World Health Organization (WHO) notes that only 59% of hospitals and 57% of primary health care centers are fully operational. For its functioning, there is a great dependence on NGOs. Primary health care centers without NGO support often lack health professionals, the necessary equipment and quality standards. In addition, in northeastern Syria, where Doctors of the World works, the NGO denounces that vaccine shortages are contributing to outbreaks and epidemics. It also notes a significant and repeated increase in the prices of medicines and pharmaceuticals by the Syrian Government and private pharmaceutical companies over the past two years. “This is a crime, buying medicine is a crime. A doctor’s visit costs 40,000 Syrian pounds. Today I don’t have anything to buy my medication,” said Ahmad Al Sali, a patient at the Kalasa Health Center in northeastern Syria.

A decade of conflict has forced many professionals to flee the country, leaving health centers and hospitals understaffed, especially specialists such as midwives.

“The lack of midwives has been and continues to be a major constraint in our work with sexual and reproductive rights. We are forced to employ non-certified midwives (nurses with basic sexual and reproductive health training) in some locations due to the challenge of securing qualified candidates. Sometimes, the recruitment process takes several months without being able to recruit a single midwife,” explains Ejaz Ahmed, coordinator of Médicos del Mundo in northeastern Syria.

Another public health challenge in the region is to raise awareness of epidemics and outbreaks – such as seasonal leishmaniasis, cholera, measles, acute respiratory infections and diarrhea, among others – and malnutrition, which are the result of poor living and health conditions exacerbated by the ongoing conflict situation. In addition, Doctors of the World warns of the high levels of malnutrition among women of reproductive age and minors in northeastern Syria. Certain areas such as Deir-ez-Zor, Al Hasakeh and Ar-Raqqah report catastrophic levels of stunting exceeding 30%. In addition, 1 in 4 women between the ages of 15 and 49 suffer from anemia, with an even higher prevalence among adolescent girls, where 1 in 2 girls has anemia.

 

 

Syrian people living in post-traumatic disorder

 

The NGO recalls that for full health we are not only talking about physical health, but also and to a large extent about mental health. As a result of the ongoing conflict, the fragility of the security situation increases chronic illnesses and mental health and psychosocial disorders.

“In general, the whole of society experiences post-traumatic disorder. And this has consequences: anxiety, stress, depression, etc. As psychology professionals, we don’t know how long it can last. It could last 10 years, or it could last longer,” explains Ramadan Derwish, a psychologist at Sireen Health Centrer, Kobane.

Going to a psychologist is still a great taboo for the Syrian population, especially women and adolescent girls, which is why Doctors of the World is one of the few actors in the field that works on mental health from health center to health center and house to house: through raising awareness in the communities and the provision of mental health teams and psychosocial support in the public health system.

 

What is life like in northeastern Syria after 13 years of war?

 

People’s biggest concern is putting a plate of food on the table, sometimes even above the situation of insecurity. Going to the market or paying for a doctor’s consultation has become almost a luxury expenditure with the strong inflation of last 3 years (650% since 2020), which has seriously deteriorated the economic situation.

In addition, in recent months the region has experienced an escalation of attacks from Turkey on critical infrastructures such as oil refineries, water points, electricity grids and other key facilities such as health centers, which directly affect the most basic means of life of the population: more than 1 million inhabitants in eleven large cities, as well as more than 2,750 villages in the region. They are now completely without electricity. Additionally, gas prices have increased tenfold. Increasing water scarcity has skyrocketed the prevalence of waterborne diseases. Health facilities in the region report an upward trend in cases of acute diarrhea, reflecting inadequate water, sanitation and hygiene services

 

The work of Doctors of the World 

 

Considering the severity of the current situation in Syria, Doctors of the World denounces the current funding of the humanitarian response in Syria. At the moment if fails to respond to the needs of the Syrian people. According to OCHA data, at the end of 2023, the funding required in the Humanitarian Response Plan for health was barely covered by 36%, while only 24% was covered in nutrition. Doctors of the World denounces that donor interest in Syria has declined further due to other regional crises and there is an urgent need for adequate funding to ensure funding for health and nutrition.

 

Doctors of the World has been working with the public health system in northeast Syria since 2017 to provide lifesaving services and create a resilient system in which local authorities can gradually take over health responsibilities. From the reconstruction of health centers, to their equipping and provision of health personnel, Doctors of the World works on physical and mental health through primary care, specialized consultations, sexual and reproductive health care and mental health and psychosocial support. In addition, it provides the health system with free access to medicines. Another important part of Doctors of the World work in the field of health involves awareness-raising and home visits to the public, technical support in training and technical supervision of Syrian health personnel, and response to emergencies such as last year’s earthquake, cholera outbreaks and the COVID-19 pandemic. During 2023, our NGO reached more than 600,000 people with more than 1.2 million consultations. 

 

 

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Kelly Idlib