Syria: when things can get worse
• Of all the armed conflicts in the world, Syria has for years been one of the worst examples of violence against healthcare. Nearly 500 attacks on staff and infrastructure have been recorded in the last five years.
• Humanitarian organisations face multiple barriers to reaching the population.
• The number of internally displaced people has increased by 20 per cent in just one year. 13 million have already had to flee their homes.
Madrid/Paris/Istanbul, 26 March 2021 - Ten years after the beginning of the conflict in Syria, the situation in the country continues to deteriorate with no end in sight. This year, the number of people in need of assistance has increased from 11 million in 2020 to more than 13 million in 2021, and the number of internally displaced persons has risen by 20 per cent. Understandably, the mental health of these millions of people is collapsing, unable to get the help they need.
And the worse the situation gets, access is becoming more difficult for humanitarian organisations, as they face daily physical and administrative obstacles in reaching those in need of urgent assistance. "Living conditions in the camps along the Turkish border and inside Syria are terrible, and people are almost entirely dependent on the services and aid provided by NGOs," says Elena Urdaneta, director general of Médecins du Monde Spain, who recently returned from Syria. "The Afrin (Hamame/Olive Branch) crossing provides essential humanitarian access to the Syrian population, and we call on the international community gathered at this conference to ensure that this access is operational," she stresses.(1)
Protecting those who heal: health workers at the centre of attacks
A decade of conflict has forced many professionals to flee the country, leaving health centres and hospitals understaffed, especially specialists such as midwives, to meet the growing health needs of the Syrian population, particularly in the north-east and north-west (NES and NWS). Only 58% of hospitals and 53% of primary care centres are currently functioning in Syria. We call for the protection of health workers and an increase in their training, so that the number of health workers can be steadily increased.
Not only are there too few health workers, but those that do exist are under attack. Between 2016 and 2019, 494 attacks on health facilities or health workers were confirmed. According to the WHO: of all the armed conflicts in the world, Syria has for years been one of the worst examples of violence affecting healthcare. The non-compliance with UN Resolution 2286 and the impunity for these crimes is unbearable.
And if the situation was already complex before the COVID-19 pandemic, it is now dramatic. Because it is not only humanitarian aid that is encountering barriers, but also vaccines. Therefore, on the basis of international humanitarian law, we call on the parties to the conflict to guarantee access to immunisation, without discrimination. This should include health workers as one of the priority groups, since of the 44,000 confirmed cases of COVID-19 in Syria in February, 6% of this number are health workers, one of the most affected.
More needs, less money
While support needs continue to increase, funding remains stagnant. In 2020, the UN Humanitarian Response Plan (including COVID-19) received only 58% of the funds requested ($2.217 billion of the $3.817 billion requested), down from 2019. And 2021 does not look any better. Access to funds to support informal settlements and the population outside the camps is very difficult as, due to the non-extension of UN Resolution 2504, virtually only the camps in northeastern Syria receive funds. On top of this, UN humanitarian aid to Syria is expected to decrease dramatically.
What does Doctors of the World do?
Doctors of the World works in 12 health centres to ensure access to primary care, including sexual and reproductive health, mental health and psychosocial support. We have set up a mobile team to care for displaced people living in collective shelters, while community workers carry out home visits.
In terms of the response to COVID-19, PCR kits have been donated and logistical support has been provided for the transport of samples to the central laboratory. A rapid response team has also been supported. All the centres we work with have been adapted with the relevant protocols to reduce the risk of transmission and management of suspected cases and staff receive ongoing training.
In North East Syria (NES), 1.4 million people (54% of the total population) currently face multiple life-threatening needs. In addition, in North West Syria (NWS), 2.8 million people (70% of the total population) are in need of humanitarian assistance.
(1) The Al-Bab and Hamame crossings should ensure cross-border access according to United Nations Security Council Resolution 2533. The Al-Bab crossing assists 2.4 million people on average each month, most of which is delivered by the UN operation.