Brussels/New York, September 28, 2017—An escalation in the bombing of medical facilities since September 19 has forced the closure and evacuation of hospitals throughout northwestern Syria, leaving people trapped in a war zone without access to health care, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) in a statement today.
On September 26, the MSF-supported Hama Central/Sham hospital was hit by an air strike at around 6:30 a.m. local time, putting it out of service. Fortunately, no medics or patients were killed in the strike. The attack on Hama Central/Sham hospital was just one in a series of attacks on medical facilities in the past several days. Three other hospitals were hit and put out-of-service on September 19 in Idlib governorate, and two major hospitals in the district of Jisr al-Shugur were evacuated on September 27 for fear of being bombed. This leaves the remaining medical facilities in the region overwhelmed and struggling to cope with wave after wave of wounded patients.
“It is demonstrably evident that hospitals are not safe from bombings in Idlib at the moment, and this is outrageous,” said Brice de le Vingne, MSF director of operations. “Fear is causing hospitals to close or reduce services. The impact of this will be on all people, the sick, the wounded, pregnant women, everyone who needs health care.”
As one of the key referral centers in southern Idlib and northern Hama, the Hama Central/Sham hospital was the only facility in the area still performing lifesaving major surgeries as other hospitals there were damaged or evacuated. Since the strike on Tuesday morning, local capacity to perform lifesaving care has been dramatically reduced, a pattern seen throughout the region.
“We had expected an attack to happen,” said the director of the MSF-supported hospital. “The hospital I manage has been hit by more than 10 airstrikes throughout different stages since we started it in 2012.”
Six other MSF-supported hospitals and health centers in Idlib and Hama governorates have received a total of 241 wounded from September 20 to 27; they have reported 61 dead. One of these hospitals received 99 wounded and reported 21 dead on September 20 and 21 before evacuating all patients and reducing activities due to concerns about being targeted. The other hospitals remain operational but staff and patients are constantly in fear of being bombed.
An unusually high number of the wounded have been severe cases; of the 241 wounded patients treated over the past week, 100 were severe, 93 moderate, and 48 mild. The proportion of severe cases in the hospital signals that people are trying to avoid a place that they consider a likely target: unless it is absolutely necessary, people are staying away from hospitals for fear of being bombed there. Of the wounded patients, 129 (more than 50 percent) were women and children under 15 years old, indicating that there is a significant civilian toll in the bombings.
MSF has been rushing additional medical supplies to hospitals that are still functioning, to help them maintain core lifesaving services. However, this assistance can only have limited effect if facilities continue to be bombed.
“Under International Humanitarian Law—the ‘rules of war’—people needing medical care, be they fighters or civilians, must be granted access to such care, and the medical facilities treating them cannot be summarily attacked,” said de le Vingne. “The fighting parties, and their political and financial backers, must stand by the many commitments they have made in United Nations Assembly and Security Council resolutions. If the fighting parties and their supporters really wanted to uphold their responsibilities to avoid striking health care facilities, they could surely do so.”
While not the primary support organization, MSF had been supporting the Hama Central/Sham hospital with regular monthly medical supply donations since 2014. MSF directly operates four health facilities and three mobile clinic teams in northern Syria, has partnerships with five facilities, and provides distance-support to 73 health facilities countrywide, in areas where MSF cannot be directly present. No MSF staff are present in supported facilities. MSF’s activities in Syria do not include areas controlled by the Islamic State group since no assurances about safety and impartiality have been obtained from its leadership, nor can MSF work in government-controlled areas since MSF’s requests for permission have to date not resulted in any access. To ensure independence from political pressure, MSF receives no government funding for its work in Syria.