Syria: “Hospital closures will be a death sentence to people like me”

Doctors Without Borders calls on international donors attending Monday’s Brussels Conference to prioritize financial support for the health system amid finding cuts.

MSF medical activities in northwest Syria

A medical consultation at the MSF-supported Mashhad Rohin Primary Health Care Center in northern Idlib governorate. | Syria 2023 © Abdulrahman  Sadeq/MSF

AMMAN/BRUSSELS/NEW YORK, May 24, 2024—Ahead of the European Union’s Brussels Conference on May 27, Supporting the Future of Syria and the Region, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) calls on donors and donor states attending the conference to prioritize financial support to the Syrian health sector.

International financial support for the health system in northern Syria is in decline and the medical needs in the region far exceed the medical services available, yet this dire situation is being met with further funding cuts.

Syrian people are bearing the greatest burden of the funding cuts as the limited support has forced hospitals and health facilities across the region be forced to close. In the several months, 77 health facilities in northwest Syria have been forced to suspend activities due to a lack of funding, including 17 hospitals—nine of which are women and children’s hospitals. 

After more than a decade of conflict, millions of people in northern Syria are facing increasingly greater challenges to access health care as international financial support for the Syrian health system continues to decline said Doctors Without Borders. Nearly one third of health facilities in Idlib and northern Aleppo governorates have either closed or partially suspended activities due to underfunding, leaving 1.5 million people without access to lifesaving and emergency health care, with 112 health facilities at risk of closing by the end of June, according to local authorities. Doctors Without Borders urges international donors and governments to immediately boost their financial support for the health system in northern Syria. 

The dire state of health care in Syria

The situation for health care in Syria is dire. In 2024, US$4.07 billion of funding is required to respond to humanitarian needs in the country. However, only 6 percent—$326 million—has been funded through the Humanitarian Response Plan (HRP). International donors and donor states must allocate sufficient funds for health care, as the situation is becoming more difficult for people, with fewer functioning health facilities, overcrowding in the facilities that remain functional, shortages of medications, and a lack of staff.

“Syrian people are bearing the greatest burden of the financial shortfall because hospitals are not being funded,” says Carlos Arias, MSF medical coordinator for northwestern Syria. “Because of [underfunding], when people seek health care, they find hospitals either closed or there’s no doctors or no medications. If they find a doctor, they’re asked to go buy medicine from private pharmacies, which is unaffordable.”

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The funding shortfall and the impact on the health care system could lead to the deterioration of long-term health conditions, increased outbreaks of diseases, and compromise people’s quality of life. Children, pregnant women, and others could be particularly affected if, for example, there is a lack of vaccination campaigns. This comes as the region is already reeling following the destruction inflicted by the February 2023 earthquake and more than 13 years of conflict. 

People are facing growing water scarcity, leading them to be more dependent on water trucking and water networks. However, these initiatives are hampered by unstable power supplies and high fuel costs. As a result, the lack of water is forcing people to adopt negative coping mechanisms such as reducing water consumption or using unsafe drinking water.

Responding in a region still reeling

Doctors Without Borders covers a limited portion of needs by delivering critical medical and humanitarian assistance to communities in Idlib and Aleppo governorates. In 2023, our teams co-managed or supported six hospitals, provided over 1 million outpatient consultations, and more than 150,000 consultations for non-communicable diseases, such as diabetes and hypertension. Teams assisted more than 20,000 births and provided more than 25,000 mental health individual consultations.

“We have expressed our concerns on many occasions that the deteriorating health situation in Syria can’t be addressed with further funding cuts,” says Thierry Goffeau, MSF head of mission for northwestern Syria. “Our teams and partners are witnessing the direct and severe impact due to of lack of funding on patients.”  

“We had to leave our homes because of the war and come to northwestern Syria,” says Salim Mohammed, who is internally displaced in northwest Syria. “Since we’ve been here, it’s been very hard to get medical care because hospitals that were working have now stopped. I am 68 years old and a diabetic; hospital closures will be a death sentence to people like me.” 

“MSF received requests to directly support at least six hospitals and five basic health care centers, three of which are critical in the medical landscape of northwest Syria,” says Karim El-Rawy, MSF field coordinator in Idlib. “While MSF relies on [private] funds, many other NGOs are sustained by public funding and their work is jeopardized by the cuts.”   

In order to improve access to health care facilities for people in northwest Syria, it is essential to secure adequate funding. This will enable the rehabilitation of health structures damaged by earthquakes and ensure the provision of resources for the facilities to become operational and offer—at the very least—the same level of services that were available before the earthquake. The disparity between rising needs and shrinking funds is unacceptable. 

About our work in northwestern Syria

In northwestern Syria, Doctors Without Borders focuses on delivering critical medical and humanitarian assistance communities in Idlib and Aleppo governorates. Our teams have co-managed or supported six hospitals, offering a comprehensive range of specialist services including maternal and pediatric care, vaccinations, surgery, mental health support, treatment for chronic diseases and skin conditions, and health promotion. In addition, MSF runs a burns facility, where our multidisciplinary approach comprises surgery, mental health services, physiotherapy, and palliative care. We also run or supports 12 general health care centers, with a particular emphasis on sexual and reproductive health and community health promotion, and deploy 11 mobile clinics across the region, delivering essential medical services to displaced people in remote and inaccessible areas. Our other outreach activities include managing two clinics for non-communicable diseases, facilitating patient referrals through ambulances, and delivering crucial water, sanitation, and hygiene services in more than 100 camps.