More than 100,000 people are trapped at the Turkish border in the Azaz District of northern Syria's Aleppo Governorate as the frontlines continue to draw nearer. More than 35,000 people who'd already been displaced have fled once more since April 10, after the fighting got too close or the Islamic State group occupied the camps in which they'd been living.
Doctors Without Borders/Médecins Sans Frontières (MSF) runs a 52-bed hospital in Azaz and has been trying to assist the displaced people along the border. Here, Muskilda Zancada, MSF head of mission, discusses the situation:
Our main concerns at the moment are about the safety the newly displaced people. The situation is still critical for the tens of thousands of people who have been displaced over the last 10 days. Front lines remain active, and this of course reinforces the fear of the people.
I was talking with a colleague inside Syria today, and he was saying that everyone is very scared. They are afraid that as front lines are active and some are as close as seven kilometers [from where people are living]. They are scared that their safety is not assured.
An Uncertain Situation
It’s impossible to predict what will happen. The area is very kinetic and active, but in the last few days there have not been new people fleeing. We sincerely hope that the situation will stabilize, but it’s very difficult to predict. What we do know is that in the immediate future, the significant needs of these newly displaced people will remain.
What we are hearing from our teams inside Syria is that people are traumatized. Fleeing yet again is very traumatic, and people are extremely scared for their safety. The fighting is close, and they are scared of the Islamic State group taking over different areas. They tell us they are feeling hopeless about their future.
They gather whatever they can and seek the safest areas, but [even these are not] that safe. They are worried for their basic needs. They need food, they need water, [and] sanitation is an issue. How they will survive is obviously a big and urgent concern for them.
MSF's Response
MSF teams have been working under incredibly difficult conditions. We have had to reduce services in our hospital to lifesaving care for emergency cases. In these extremely challenging conditions, we have been able to do 1,200 emergency consultations since April 10, when the latest phase of this crisis began.
In addition, we have been able to treat 25 war-wounded, and 16 babies have been delivered. The reduced team has been running well, and we have not yet seen any worrying indicators in terms of health.
Meanwhile, the second team inside has been doing excellent work to support people newly displaced in western part of the district. They have been providing essential items like mattresses, blankets, and other basic items needed to survive.
So far, 5,000 people have received support from MSF and we are also coordinating with other nongovernmental organizations and doing assessments to make sure urgent food, water, and sanitation needs are being met.
Waves of Displacement
In this recent displacement, which began around 12 days ago, there were two waves of people. The first wave who fled had time to gather belongings. Remember, these are people who had already been displaced. They managed to move with their tents, jerry cans, and other relief items.
Then there was a second flow of people who had to flee the fighting [that] came rapidly closer to where they were. So they had to rush away very quickly. They were not able to bring much of anything and, as a result, they are the ones who are most in need. They need basic shelter; they need the basics with which to survive.
They came from western Azaz and had been scattered there since February, staying in improvised settings, wherever they could. Now there are a significant number who are accommodated in towns, and in collective centers, schools, and squares.
At the [Turkish] border there is not intense pressure by the newly displaced gathering there. This is not happening according to what we are seeing. In terms of the reports of Turkish soldiers shooting Syrians trying to cross, we know about the reports, but MSF cannot confirm that this has happened and we have not received any cases in our hospital.
The border has been closed for more than one year, but there is a limited number of humanitarian workers who are allowed to cross back and forth, as well as medical doctors who can cross under controlled conditions.
In terms of referring emergency lifesaving cases into facilities inside Turkey from Syria, we have not faced any problems so far; all referrals have happened with no problems.
The Word from Inside Aleppo
In Aleppo, recently [the situation] has again become very worrisome, as there has been intense fighting. Once again the medical teams there supported by MSF are under unimaginable pressure. We have been able to reach the 23 health facilities we support with regular donations of medical supplies and fuel they need to continue offering care.
What concerns us is that the fighting will increase risk for people inside and they will become besieged. There is only one road in and out of Aleppo that is not under the control of the government of Syria, and if this route is closed, then we fear the situation will be very grave.
The consequences would be dramatic for those remaining, as it would likely be a siege for the 250,000 or so people who are in the non-government held parts of Aleppo. They would be added to the grim list of between 1.5 and 2 million people who are already living under siege in Syria.
MSF runs six medical facilities across northern Syria and supports more than 150 health centers and hospitals across the country, many of them in besieged areas. MSF’s hospital in Azaz District has doubled its capacity since February when fighting brought thousands of internally displaced people into the area.