Amsterdam/Northeastern Syria/New York, April 21, 2020—The first case of COVID-19 in northeastern Syria was confirmed two weeks after tests were taken and after the patient had died, highlighting how unprepared the region is to respond to a coronavirus outbreak, said the international medical humanitarian organization Doctors Without Border/Médecins Sans Frontières/Doctors Without Borders (MSF) today.
A collapsed health system, delays in testing, and border closures are major obstacles preventing an adequate response to COVID-19 in the region. MSF calls on authorities in Iraqi Kurdistan and northeastern Syria to facilitate urgent access for humanitarian organizations and to allow the movement of humanitarian supplies and international staff across their borders.
“We respect the COVID-19 measures put in place by the authorities in Iraqi Kurdistan,” said Will Turner, MSF emergency manager. “However, exemptions must be granted to humanitarian workers to ensure that [enough] support reaches northeast Syria. Much of the humanitarian support to northeastern Syria [has to] pass through Iraqi Kurdistan. We have much needed additional supplies and medical staff ready to travel, but we lack the guarantees that they can enter Iraqi Kurdistan and move on into northeast Syria.”
Currently, the only testing capacity available for northeastern Syria is through the Central Reference Laboratory in Damascus. It is difficult to get people with suspected COVID-19 tested and to receive results quickly—according to local health authorities, it took two weeks for them to receive results for the patient who died from COVID-19.
“The lack of reliable and timely testing capacity in the region makes it nearly impossible to detect cases at an early stage, significantly hindering the ability to slow transmission within communities early on, when it is most important,” said Crystal van Leeuwen, MSF medical emergency manager for Syria.
After nine years of war, many health facilities in northeastern Syria can no longer function, and those that can were already struggling to respond to existing medical needs. Due to limited supplies and medical staff, several health services and facilities have been forced to close, leaving patients with chronic diseases and compromised immune systems even more vulnerable to COVID-19. The few functional medical facilities in the region could very quickly become overwhelmed with an influx of COVID-19 patients putting even more people at risk, said MSF.
“We are deeply concerned about the lack of laboratory testing, the absence of contact tracing, inadequate hospital capacity to manage patients, and limited availability of personal protection equipment (PPE),” said van Leeuwen. “The response in northeast Syria at this time is not nearly enough. A significant increase in assistance from health actors, humanitarian organizations, and donors is essential.”
MSF is collaborating with local health authorities and other organizations in northeastern Syria to prepare for an increase in patients suffering from COVID-19 in Al Hassakeh National Hospital and in Al Hol camp, where 65,000 people (94 percent women and children) are living in overcrowded and unhygienic conditions with little or no access to medical services or clean water. MSF began providing medical and humanitarian assistance in the camp in January 2019.
MSF stands ready to support a COVID-19 response in northern Syria and Iraq, but its response remains limited as long as movement of supplies and staff across borders is not granted. MSF urges authorities in Iraqi Kurdistan and northeastern Syria to facilitate urgent access for humanitarian organizations in the region.
MSF in northeastern Syria
In northeastern Syria, MSF is part of the COVID-19 humanitarian task force, chaired by the local health authorities. At the Al Hassekeh National Hospital, MSF is training staff and preparing the facility for COVID-19 patients, by creating a 48-bed isolation ward, introducing surveillance measures, case identification and management, and patient flow and triage processes, and training on infection prevention and control (IPC) and personal protective equipment (PPE) usage to mitigate overuse. MSF also provides logistical support to facilitates, including rehabilitation wards, to ensure they are ready to receive patients.
MSF is continuing its regular activities and support to Raqqa National hospital, Raqqa outpatient department clinic and Kobane Maternity Hospital, although the lack of supply and access for staff to enter the country is significantly hindering these responses.
In Al Hol camp, MSF runs an inpatient nutrition center and a tent-based wound care program for people who cannot reach the clinics, as well as water and sanitation support.
When there are water supply cuts in Al Hassakeh, MSF trucks water to the most vulnerable communities.
MSF in northwestern Syria
Since the beginning of the COVID-19 pandemic, MSF teams in northwestern Syria have been reviewing the triage systems and patient flow in the hospitals and health centers that it supports in Idlib governorate to ensure fast detection of potential COVID-19 patients. Read more about MSF’s work in northwestern Syria.
MSF in Iraq
On April 1, MSF began supporting Ibn El Khateeb Hospital, a Ministry of Health (MoH) hospital in Baghdad, identified as one of the main hospitals treating COVID-19 patients in the city. MSF is providing the facility with technical training on patient triage and infection protection and control.
In Mosul, MSF has equipped a 50-room building (run by the MoH) in Al Salam hospital complex intended for the isolation of patients. Al Shifaa, located in the same complex, was rebuilt by MSF in 2019 and is now being used as the main COVID-19 referral point for patients in Ninawa province. Here, MSF will set up 40 isolation rooms and 30 beds for mild and severe case management in its center for post-operative care. Read more about MSF’s response in Iraq.