Hundreds of thousands of people have been killed in this devastating war. Almost 12 million people have been uprooted and humanitarian assistance has been consistently obstructed or denied.
Civilian areas have been routinely bombed and deprived of assistance, and access to healthcare remains extremely poor in many areas. MSF’s presence is significantly constrained despite the immense needs. The Syrian government has not granted MSF authorisation to operate in the country, and our presence in areas outside government control is limited by insecurity.
In areas where access could be negotiated, we run or support hospitals and health centres and provid healthcare in displacement camps. In areas where no direct presence is possible, we maintain a system of distance support, consisting of donations of medicines, medical equipment and relief items; remote training of medical staff; technical medical advice and financial assistance to cover facilities’ running costs.
Why are we here?
Since the 2011 protests in Syria, medics treating the wounded have been persecuted by the government and forced to develop underground networks. As the conflict escalated, so did the crackdown on medical assistance for people in opposition-held areas. Unable to obtain government authorisation to aid the sick and wounded, we started by supporting underground medical networks and entered northern Syria to provide medical care in an area largely cut-off from official assistance channels.
What used to be a fully functional health system has been devastated. Hundreds of medical facilities have been bombed, many medical staff have been killed or have fled, and supplies are lacking. We’ve seen the resurgence of preventable diseases, and inadequate services to meet common needs, let alone deal with mass casualties and acute emergencies. Syrian health staff have been forced to improvise operating theatres and work in deplorable conditions, overwhelmed by the emergencies they face.
Early on, the systematic bombing of civilian areas made it a priority to help treat the wounded. We opened surgical facilities in the north, provided supplies and training to health staff across the country, and set up cross-border trauma care in Jordan. As living conditions deteriorated in the north, producing more injuries from domestic accidents, we set up a surgical burns unit.
An estimated 6.2 million people remained internally displaced in Syria at the end of 2018. Closed borders, appalling living conditions and limited assistance have compounded their suffering. People fleeing violence live in camps, improvised shelters or with host families. Our main programmes are in the governorates of Aleppo, Idlib, Raqqa and Hassakeh. In addition to providing medical care, we carry out water and sanitation activities and distribute relief items, also in the south of Syria.
Siege warfare has been widely used in Syria, at its most extreme in the town of Madaya, where men, women and children have starved to death. Basic essentials such as medical supplies are restricted amid intense bombing and shelling. Even medical evacuations of sick children are often denied. Unable to enter these areas, we remotely supported medical facilities in besieged areas. One-by-one, the areas have been taken over by the military and there are now very few still under siege.