WHO and health partners battling to respond to Syria’s health tragedy

The lives of thousands of Syrians have been devastated as a result of the turmoil that has engulfed the country for the past three years. Moustafa’s case is no exception.

The 11-year-old boy is suffering from fractures to his right leg and muscle loss in his left. “Moustafa will eventually recover, but this will take time, efforts and money,” says his father, Adnan. Moustafa was referred to al-Mouwassat hospital in Damascus a few months ago after a mortar fell on his family’s house in Jaramana in the rural belt outside the Syrian capital where he was playing with friends. “I lost my friend Ahmad … and another friend, Maher, had his leg amputated,” Moustafa recounts. Maher is only one among the many thousands left disabled by the conflict.

Since 2011, over 190 000 people have been killed, almost 1 million injured and almost 6.5 million internally displaced. The prolonged conflict has left Syria with a weak health system and a health profile that will take a long time to recover to its pre-conflict status.

“The effect on the health of the Syrians will endure for generations … today, more than ever, we need to unite our efforts to help relieve the suffering of Syrian people,” says WHO Representative to Syria, Elizabeth Hoff.

In Syria, people have increasingly limited access to basic services, including life-saving health care. Medical personnel, health facilities and medical supplies are being deliberately targeted by parties to the conflict: approximately a quarter of public hospitals and almost one-fifth of the public primary health-care centres have been destroyed. There is a shortage of health workers, especially surgeons, anaesthetists and female health professionals.

Devastated health services
Moreover, the dramatic increase in the number of injured – an average of 25 000 new injuries each month – combined with severe shortages in surgical supplies (including basic anaesthetic medicines), as well as frequent power cuts, make it impossible for hospitals to cope with the demand for surgical treatment.

“The effect on the health of the Syrians will endure for generations … today, more than ever, we need to unite our efforts to help relieve the suffering of Syrian people.”
Elizabeth Hoff, WHO Representative to Syria

Many people are going without critical treatment. “In a bad week, we receive up to 100 injured people, and because of the shortage of basic treatments, we are not able to treat them adequately,” explains Dr Abrash, who is an administrative director of a hospital in the western city of Homs.

The delays faced in referring patients with trauma wounds to public hospitals increases the risk of people losing injured limbs due to heightened exposure to infection, resulting in disability.

Before the conflict, Syria was producing a wide range of medicines. But since, production has dropped 70%. The devaluation of the Syrian Pound has reduced patients’ ability to purchase imported medications and treatments. “We used to serve 35 000 patients per month, but with more people fleeing their homes that has more than doubled, to 90 000 consultations,” exclaims one medical worker in a Rural Damascus health centre.

The cramped living conditions, together with a sharp drop in the overall vaccination coverage, have left the population increasingly vulnerable to communicable diseases such as measles, typhoid and whooping cough. In October 2013, wild poliovirus re-emerged in Syria – a “disaster” according to WHO polio expert Dr Salah Haithami.

As the security context continues to deteriorate, it is becoming increasingly difficult to provide Syrians with medical care. The United Nations estimated that over 4.7 million civilians are in hard-to-reach areas, 240 000 of whom are trapped in besieged locations.

WHO support crosses battle lines
To date, WHO has delivered medical assistance for over 8 million Syrians in both government- and opposition-controlled areas, including to besieged locations such as Eastern Gouta. In July and August, over 70% of WHO’s support went to opposition-controlled areas. Recently, the Organization provided surgical supplies to four hospitals in Eastern Aleppo city with surgical supplies and medicines to five opposition-controlled villages in Daraa governorate.

This year, WHO has received more than US$ 50 million to support its response to the Syrian crisis. Donors include Canada, Finland, Kuwait, Norway, the United Kingdom, the United States and the UN Office for the Coordination of Humanitarian Affairs. But more than US$ 120 million is needed to meet the urgent medical needs of the Syrian people between now and the end of 2014.

WHO has categorized Syria’s health crisis as a “Grade 3” – or most serious – humanitarian emergency, requiring an intensified response from across the Organization. This is one of 5 such G3 parallel crises on-going that WHO is coordinating the health responses to. The others are the Ebola outbreak in West Africa, and the humanitarian emergencies in neighbouring Iraq, plus South Sudan and the Central African Republic.

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