After years of detention, former residents of Syria's Al-Hol face uncertain future

Throughout the transition period, access to health care for people in the camp was severely compromised. MSF stayed until the closure, but many humanitarian organizations were forced to suspend activities due to insecurity and shifting control of the area.

“The sudden closure of the camp, without a clear, rights-based plan for residents’ futures, underlines the arbitrary nature of both their prolonged detention and their release,” said Stephen MacKay, operations manager for MSF programs in Syria. “It also underscores the sustained failure over the past seven years to meet their basic humanitarian needs or to resolve their legal limbo.” 

MSF calls on Syrian authorities and international actors to ensure uninterrupted access to essential health care for all people relocated from Al-Hol camp. The organization also urges authorities to provide legal documentation for Syrian nationals, strengthen protection measures — particularly for women and children — and facilitate voluntary repatriation.

Al-Hol: An open-air detention camp

In 2018, Al-Hol refugee camp effectively became an open-air detention center, holding people displaced during the battle of Deir ez-Zor between Syrian Democratic Forces and the Islamic State in Syria (ISIS). The population of the camp swelled to a more than 76,000 people in 2019 — the majority of them women and children. The camp was divided into two areas: one for Syrian and Iraqi nationals, known as the main camp, and another for nationals of other countries, known as the annex. By January 2026, the camp’s population had reportedly fallen to around 23,000 following multiple repatriation trips, predominantly to Iraq. 

Throughout this period, MSF has repeatedly condemned the dire conditions faced by thousands of people trapped in Al-Hol. 

In late January, control of the camp shifted from the Syrian Democratic Forces to the Government of Syria. Amid growing chaos and insecurity, the camp’s population declined sharply, with reports of people escaping or being smuggled out. 

In the week leading up to the closure, remaining residents either returned to their areas of origin or were relocated to the new Aq Burhan camp in Akhtarin, northern Aleppo, which was set up to host residents from Al-Hol while their identification documentation is processed. Gaps in health care, protection, and assistance have been reported in Aq Burhan camp. MSF is particularly concerned that women and children face heightened risks of violence, exploitation, and further displacement as a result of this haphazard relocation process.

Carrying years of exhaustion in Aq Burhan

As people left Al-Hol, emotions were mixed. “Some were relieved, some were confused, and some were angry they were going to another camp instead of home,” said Hessel. “But almost everyone was carrying years of exhaustion. One resident told MSF that he hoped the new camp would at least have trees and some green space, as Al-Hol had felt like ‘a dead place’. After seven years in Al-Hol, many people did not ask where they were going next — they were simply grateful to be leaving.” 

Throughout the transition period, access to health care for people in the camp was severely compromised. Many humanitarian organizations were forced to suspend activities due to insecurity and shifting control of the area.

“We spoke to families and individuals — some had waited for more than 14 hours to leave, while others were still trying to arrange for their belongings to be collected,” said Barbara Hessel, head of MSF’s programs in northeastern Syria. “The lack of clarity around the process created anxiety, while at the same time everyone I spoke to was looking toward a more hopeful future.”

MSF present until the end 

Despite these challenges, MSF remained one of the few organizations providing health care and access to clean water in the camp until the final day before its closure. MSF teams continued operating a water treatment plant supplying drinking water to both the main camp and the annex. Primary health care services were maintained as long as possible, and continuity of care was prioritized for people with noncommunicable diseases. Patients already enrolled in MSF treatment programs received extended supplies of medication, while newly presenting patients were also provided with initial supplies in an effort to prevent treatment interruption.

“When we gave patients with chronic diseases a three-month supply of medication, you could see immediate relief — especially among those who were not previously enrolled in our programs,” said one MSF staff member.

Nevertheless, many patients could not be reached. Prior to the Syrian government takeover of the camp, MSF estimated that at least 347 people were enrolled in its noncommunicable disease cohort alone, many of whom MSF lost contact with during the chaotic transition.

Years of coercion, exploitation, and abuse imposed on camp residents 

During MSF’s years of presence in Al-Hol, our teams directly witnessed and documented neglect and violence imposed on the camp’s residents. People, including children, were consistently treated as a security threat rather than as individuals with rights and needs. For some, their time in the camp involved a history of coercion, exploitation, and abuse, reflecting a far more complex reality than is often acknowledged.

“For seven years, the international community has participated in and maintained a system of indefinite confinement in the desert of northeastern Syria, justified in the name of security,” said MacKay.

MSF again calls on Syrian authorities and international actors to ensure uninterrupted access to essential health care for all people relocated from Al-Hol camp, including continuity of care for noncommunicable diseases. MSF also urges the authorities to uphold their commitment to provide legal documentation for Syrian nationals, enabling people to rebuild their lives.

MSF is concerned about the fate of the foreign nationals who previously resided in Al-Hol, many of whom had been treated by MSF medical teams. MSF calls on all concerned governments to strengthen protection measures, particularly for women and children, to safeguard them from violence, exploitation, and abuse, as well as to facilitate their voluntary repatriation.