Between two fires: Danger and desperation in Syria’s Al-Hol camp

Al-Hol camp

Syria 2022 © Florent Vergnes

On November 7, 2022, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) released a report highlighting the deteriorating situation for approximately 53,000 people—most of them children—left to languish in Al-Hol camp, northeastern Syria.

Executive summary 

Under the auspices of the global fight against the Islamic State (IS) group, exceptional policies have been implemented involving the indefinite and arbitrary detention of women, children and men in Al-Hol camp in northeast Syria.

The responsibility for implementing these measures was devolved by the US-led Global Coalition against IS to the Autonomous Administration of Northeast Syria (AANES), a de facto autonomous region in northeast Syria, and to the Syrian Democratic Forces (SDF) – the military branch of AANES. Members of the Global Coalition, as well as other countries whose nationals remain held in Al-Hol, and other detention facilities and camps in north east Syria, have failed to take responsibility for protecting their nationals or for identifying long-term solutions to their indefinite containment. Instead, they have delayed or simply refused to repatriate all their nationals, in some cases going so far as to strip them of their citizenship, rendering them stateless. Overall, no measures have been taken to ensure that the fundamental rights of the camp’s population are protected.

Left to manage the largest camp in northeast Syria and its more than 53,000 detainees of 60 nationalities, AANES and SDF have been ill-equipped and poorly guided to manage these processes in a way that is in keeping with international standards and law. Repeated breaches of human rights and recurrent patterns of violence and exploitation have been observed in Al-Hol camp. These have an enormous impact on people living in and around the camp, affecting their safety, security, dignity and access to humanitarian aid. They also impact the providers of humanitarian aid, who are increasingly constrained and exposed to violence and criminality.

Rather than taking steps to address the pervasive insecurity and dire living conditions in Al-Hol, the Global Coalition has outsourced the management of the situation by providing funding to AANES and SDF for securitization and containment measures – measures which have so far failed to ensure safety and security for people in and around Al-Hol. Residents have described themselves as being trapped “between two fires”: on the one side, the persistent threat of extreme violence committed by armed groups in the camp, and on the other, the increasingly harsh security measures implemented by camp authorities in an attempt to manage the situation in Al-Hol.

The containment of thousands of men, women and children in Al-Hol is a short-term security measure which is unlikely to address the threat posed by the IS group until the immediate safety, protection and long-term welfare of the people inside the camp are addressed. MSF calls on the all relevant parties – including the Global Coalition, local authorities in northeast Syria, and states with nationals in Al-Hol – to assume responsibility for the welfare of people in Al-Hol. It also calls on the Global Coalition to support local authorities in taking immediate steps to guarantee people’s wellbeing, protection and fundamental human rights. This includes investing in measures to reduce violence, insecurity and criminal activity, in accordance with international law, and strengthening capacity for providing humanitarian assistance in the camp, improving living conditions and identifying sustainable long-term solutions for the camp’s population that are in keeping with international standards and law.

Al-Hol camp
A child runs beside shelters in Al-Hol camp, northeastern Syria.
Syria 2021 © Florent Vergnes/MSF

Purpose and scope of the report

Counter-terrorism policies have trapped thousands of civilians in Al-Hol camp in a cycle of indefinite detention, danger and insecurity, which permeates every aspect of their daily lives and deprives them of their fundamental human rights. This report documents and reflects on the impact of the pervasive violence, exploitation and lawlessness in Al-Hol camp on its population through their voices and experiences. It draws on the testimonies of population of the Main Camp and Annex, the first-hand observations of MSF frontline humanitarian staff, and medical data from MSF health facilities in the camp collected between July 2021 and March 2022.

The report describes the personal experiences and accounts of our patients, the wider population of Al-Hol and our staff testimonials. Through these accounts, Al-Hol is portrayed as a detention camp, more than a humanitarian camp setting, where movement in and out of the camp is restricted, rights and entitlements are stripped from people. They lack access to livelihoods, and continue to be held in prison-like conditions with very limited access to basic services and with no way out.

MSF activities in Al-Hol camp

MSF launched a response in Al-Hol camp in January 2019, initially providing emergency medical care in the reception area for new arrivals and providing essential relief items. Currently, MSF runs a clinic for patients with non-communicable diseases and provides home-based medical services to the population of the Main Camp who are unable to walk to a health facility. MSF also provides outpatient consultations, women’s health services and mental health support in the Service Area adjacent to the Annex, where foreign nationals are held. MSF teams also run mobile clinics within the Annex. MSF also provides emergency water trucking to areas of the Main Camp and supplies water, via a water network, to the Annex and to one of the most densely populated sections of the Main Camp which houses more than 20,000 people.

A view of Al Hol camp.

Between two fires: Danger and desperation in Syria’s Al-Hol camp

Read the full report