In South Syria, fighting intensified in February and March as opposing forces vied for control of the city of Dara´a. As bombings and aerial attacks in Eastern Dara´a increased, hospitals and medical structures in the area were forced to close to avoid being targeted. The fighting has also resulted in a surge of 30,000 internally displaced people. Many have fled to surrounding farmlands or returned to villages previously abandoned and destroyed. MSF recently responded to this crisis with an emergency distribution of 893 kits of essential relief items, distributed to families in two areas. Some residents have witnessed civilian structures being targeted by airstrikes.
Displaced people in South Syria face acute insecurity and limited access to aid and medical care. As their living conditions become more precarious, their health will further deteriorate. Fighting has resulted in an increase of injuries. In the past two months, MSF has seen 65 war-wounded Syrians arrive in the emergency room of Ramtha hospital, in northern Jordan. Thirty-seven of them were admitted into MSF’s emergency surgical project there.
MSF remains significantly constrained in its presence and medical activities, mainly due to shifting frontlines, insecurity in armed opposition areas and a lack of authorisation to operate in government-controlled areas. MSF nevertheless continues to directly operate four health facilities in the north of Syria, a number of hospitals in the South and works to support more than 150 health facilities countrywide. However, the capacity of these facilities is shrinking, with most facilities unable to respond to specialised surgical needs of war-wounded Syrians.
As bombing and aerial attacks in Eastern Dara’a have increased, many roads have been blocked or partially closed because of the conflict. This has resulted in difficulties in delivering humanitarian assistance. In terms of healthcare, most hospitals are not receiving enough supplies and medications.
One of the biggest concerns at the moment is the protection of vulnerable populations and meeting their basic shelter needs. There are few formal camps in the Dara’a area and despite concerted efforts, the needs of proper shelter and tenting of the displaced population have still not been met. Thousands of people live in makeshift conditions on the streets, or on farmland, conditions which pose significant risks in terms of security and health.
There are also still very large gaps in all aspects of healthcare — whether it’s secondary and tertiary healthcare, routine vaccination, mental health, chronic diseases, and reproductive health. Although MSF and the other organisations have sought to anticipate periods of increased violence, hospitals and medical facilities in the south as a whole continue to be understaffed and underfunded.
The lack of specific medical equipment and the very limited number of medical specialities still present in Syria have resulted in a fragile healthcare system, mostly decimated after six years of war. According to recent information, an estimated 15,000 doctors fled the country - which is almost half the number of doctors present in pre-conflict Syria, depriving hundreds of thousands of civilians from receiving even basic healthcare.