Syria: Latest MSF Updates

The Reach of War: A Day in the Life of the Syrian Conflict

In late 2013, MSF sent teams to MSF projects in Iraq, Lebanon, and Jordan on the same day to record the work we are doing with Syrians, to experience the situation through the eyes of staff members trying to provide desperately needed assistance. The goal was to chronicle “a day in the life” of this brutal, relentless conflict, to collect imagery and narratives that might foster a deeper understanding of the reach of this war. More at reachofwar.msf.org.

As the bitter conflict in Syria continues, people are suffering immensely, not only from the direct consequences of war but also from having to leave their homes and belongings, and having their regular lives and medical treatments interrupted.

 

According to recent estimates, more than 120,000 people had been killed through the end of 2013 and more than six million have either been displaced within Syria or driven out of the country.

 

MSF has established programs inside Syria and in neighboring countries to tend to those affected. Below is an overview of MSF's activities related to the war in Syria:

 

An overview of MSF's Syria programs, as excerpted from MSF's 2014 International Activity Report:

With millions of people in need of assistance, Doctors Without Borders/Médecins Sans Frontières (MSF) should be running some of the largest medical programs in its 44-year history, but it is prevented from doing so.

Violence and insecurity, attacks on health facilities and medical workers, the absence of government authorization, and the reneging by armed groups on guarantees of safety for our teams have been some of the main obstacles to a more extensive program of medical humanitarian aid.

The war entered its fourth year in 2014, and continued to be defined by brutal violence that does not distinguish between civilians and combatants. An estimated 200,000 people have been killed, and half the population is displaced either within Syria or in neighboring countries. Entire communities are besieged and cut off from any outside assistance and people are trapped between the ever-shifting front lines. Thousands of doctors, nurses, pharmacists, and paramedics have been killed, kidnapped, or displaced by violence, leaving a massive gap in medical expertise and experience.

On January 2, 2014, ISIS (later renamed Islamic State; IS) abducted 13 MSF staff members. Among them were eight Syrian colleagues who were released after a few hours. The remaining five international staff members were held captive for up to five months. The abduction led to the withdrawal of MSF’s international teams and the closure of health facilities in IS held areas. MSF closed its field hospital in the mountainous region of Jabal Al-Akrad, in the west of Syria’s Idlib governorate, as well as the two health centers it was running nearby.

Aleppo Governorate

MSF runs three health facilities within Aleppo governorate, which has seen some of the most intense fighting, and is one of the main corridors for Syrians attempting to flee the country. One of the hospitals has 28 beds, and offers emergency, maternity, and outpatient care. Vaccinations, orthopedic services, and treatment for some chronic diseases are also provided. The team stabilizes patients at this hospital before transferring them to other facilities when necessary. From this base, MSF donated drugs and medical supplies to 10 field hospitals, nine first-aid points, and three health centers.

A second MSF hospital in the Aleppo area had to be closed in August for security reasons. It provided access to health care for adults and children, including surgery for war wounded, trauma cases, and burns patients, as well as emergency services, maternity, ante- and postnatal care, and outpatient consultations.

On the outskirts of Aleppo, a third MSF hospital has a capacity of 12 beds. At this location teams carried out some 22,000 outpatient consultations, more than 12,300 emergency room consultations, over 500 surgical interventions, and admitted 1,200 patients. Vaccinations, antenatal care, and mental health support were available and the hospital has a referral system in place for people who need additional services.

Idlib Governorate

There are extreme shortages due to the war, and the poor-quality fuel that families have to use for stoves and heaters frequently causes explosions, resulting in severe burns. In Idlib governorate MSF runs the only burns unit in northern Syria where people can get the specialist care they need, such as wound cleaning (debridement), dressing changes performed in the operating theater under anesthesia, skin grafts, and physiotherapy. The 15-bed hospital has an emergency room, and a team offers psychological support to patients. More than 1,800 burns patients came to the facility in 2014 and over 5,800 patients were treated in the emergency room. The team performed more than 3,800 surgical interventions.

In response to reports of several measles cases in a community of some 100,000 internally displaced people along the border with Turkey, MSF conducted a vaccination campaign. More than 11,000 children were vaccinated against measles in camps and villages in August. MSF is continuing routine vaccinations for children under three years old. The absence of routine vaccination schedules as a result of the war has led to a rise in preventable childhood illnesses.

Ar-Raqqah Governorate

The health centers and hospitals that are still operational in Ar-Raqqah governorate are struggling to maintain supplies, staff numbers, and to ensure drugs are stored at the correct temperatures. It is estimated that up to 40,000 people across the governorate have been forced to leave their homes, and this has put additional pressure on local communities who are sheltering them in their houses, in schools, and in former health centers. MSF continued to run a basic health care clinic in the Tal Abyad Referral Hospital, and supported a pediatric ward in the facility. Mobile teams provided emergency assistance to the displaced in multiple locations, and also supported routine vaccination activities by health workers in the region. More than 5,200 outpatient consultations were conducted, and 7,000 children were vaccinated against measles before these activities were handed over to the Ministry of Health and the local authorities in May.

Al Hasakah Governorate

In northeast Syria, acute shortages of drugs, medical supplies, and skilled personnel are having a devastating impact on health care. MSF provided staff and supplies to support pre- and post-operative care in a hospital’s trauma ward. A team also assisted in the maternity ward, which MSF rehabilitated and furnished with new equipment. MSF started to run two clinics offering outpatient consultations and mother and child health care.

MSF has been running mobile clinics in the region bordering Iraq since 2013. Basic health care, with a focus on the health needs of mothers and children, is provided to displaced people and to the host communities on the Syrian side of the border. MSF also conducts routine polio vaccinations campaigns in the area—in October 2013, the first case of polio in Syria in 14 years was reported.

The border with Iraq, which had been closed since September 2013, reopened in one direction in June—allowing people to travel from Iraq to Syria. In August, tens of thousands of Iraqis crossed the border, fleeing violence in Iraq’s Ninewa governorate. MSF teams working on both sides of the border responded to the increase in needs by running mobile clinics and setting up health facilities in transit camps and in camps for displaced people.

Support Programs for Syrian Doctors

Despite the increasing access restrictions, MSF doctor-to-doctor networks continued to provide clandestine support to medical facilities run by Syrian doctors in both government- and opposition-controlled areas. These support programs allow dedicated Syrian medical staff to work, often in extremely hazardous conditions, and bring a minimum level of health care to people trapped by the conflict.

MSF has developed a program of large-scale support to over 100 underground and improvised health care facilities at two locations along Syria’s borders and across six governorates, almost half of which are dedicated to besieged areas in the Damascus governorate. The facilities are in both government-held areas and opposition-controlled zones—all locations where it is not possible for MSF teams to be physically present. These programs are increasingly focused on areas under siege, and supply essential drugs and medical items, distance training, and technical support, as well as tailored support such as ambulances in some areas.

At the end of 2014, MSF had 729 staff working in Syria. MSF first began working in the country in 2009.

Patient Story

A man who brought his sister to an MSF field hospital

We heard the sound of explosions… I told my sister to move and find shelter, as it was close. She was behind me, about five meters. A bomb landed near her. She was covered in rubble. I shouted: “Are you hurt, sister?” She replied: “Yes, I am!” I ran towards her and saw that shrapnel had hit her face. Blood was coming out of her neck … We shouted for a car. Thankfully there was one nearby. We took her to the hospital, where they stopped the bleeding. Her situation is stable now.

If there were no hospital, she’d have died. We need medical care. In my sister’s case, she needs doctors, care, drugs. As you know, we have nothing here. We need support in medication, doctors, ambulances capable of transporting patients immediately, everything.

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