FIVE YEARS OF THE CONFLICT IN SYRIA: Internal chaos and external trauma
Since 15 March 2011, the civil war in Syria has caused the deaths of 250,000 people, with one and a half million injured. It has led to the internal displacement of seven million people and driven five million refugees to flee for their lives. Today 13.5 million men, women and children are in need of assistance, a figure which represents around 60% of the population (estimated before the conflict at 21 million)[1].
How can healthcare be provided to these survivors when almost 70% of health centres are barely operating or can no longer operate at all[2] ? Access to health services is under threat from the escalating violence, the collapse of the healthcare system and extremely inadequate supplies of essential medical equipment.
2015 was marked by repeated attacks on healthcare facilities. Between August 2012 and December 2015, 330 healthcare facilities (including 177 hospitals) were destroyed by bombardment. In 2015, a total of 112 attacks were recorded. Among the 26 health centres supported by Doctors of the World, seven of them were deliberately targeted. Since the beginning of the conflict, around 700 healthcare staff have lost their lives[3].
In this context of chaos, over half of Syria’s healthcare workers have left the country [4]. The majority of these refugees are living in neighbouring countries or are trying to reach Europe, where they are unable to practise their profession, even among their compatriots.
The recent bombardments carried out on 15 February 2016 against hospitals are evidence of this practice of targeting healthcare facilities which is a complete violation of humanitarian law and international conventions. Since Russia officially entered the war, the conflict has intensified markedly. The Aleppo Governorate is currently the most severely affected, involving almost three million people, with over one million displaced[5].
Survivors who manage to leave Syria are still at risk of losing their lives. In 2015, 3,771 people perished in the Mediterranean Sea, over 800 of them in the Eastern Mediterranean[6]. Yet once they have overcome this danger, the Syrians face renewed injury and trauma from walls, barriers and barbed wire. While over 4.5 million Syrian refugees are currently in just five countries[7] – Turkey, Lebanon, Jordan, Iraq and Egypt – Europe is continuing to construct a fortress. How many more people will have to die?
“We call on the European Union to respond collectively to this unprecedented humanitarian crisis, without doubt the most serious since the Second World War, by welcoming across its borders these refugees who have survived such barbarism. This war has already been a terrible waste for the country and its people, but this is now a historic moment for Europe. The Member States can choose to offer solidarity and protection to these traumatised families by extending to them a dignified welcome which upholds the founding values of Europe”, declared Dr Françoise Sivignon, President of Doctors of the World France.
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DOCTORS OF THE WORLD’S WORK IN SYRIA AND NEIGHBOURING COUNTRIES in 2015
Doctors of the World sees the Syrian crisis as a regional crisis. The organisation has been active in Syria since 2008 and also provides assistance to Syrian and Iraqi refugees and displaced persons in the neighbouring countries of Iraq, Turkey and Jordan.
In Syria, Doctors of the World has established fixed and mobile clinics to compensate for the lack of infrastructure in the north of the country and to offer primary healthcare to the population of Idlib Governorate. The organisation also supports Syrian partners and contributes to the salary costs of their healthcare staff. It supplies medication, equipment and consumables, of which there are terrible wartime shortages, to the health centres and hospitals which are still operating in Aleppo, Damascus and Daraa. In addition, Doctors of the World supports two post-operative care centres in northern Syria and in Reyhanli, in southern Turkey. The staff are trained to treat and care for victims of the conflict who are seriously injured and traumatised and are seeking to recover from their experiences.
In 2015, there were 166,252 consultations at the Doctors of the World clinics in Syria and 512,907 patients were treated in the 26 health centres supported by the organisation.
In Lebanon, the 1,069,111 Syrian refugees officially registered with the UNHCR have difficulty in accessing essential services. Doctors of the World supports five health centres and a mobile clinic in southern Beirut and in the Bekaa Valley, where there are particularly large numbers of refugees. Through Doctors of the World, victims of the Syrian conflict and the most vulnerable Lebanese people are able to receive care and medication free of charge. Working with local partners provides them with financial support and facilitates work on the quality of care and support for the beneficiaries.
For the treatment and care of psychological problems experienced by the groups concerned, psychotherapists provide consultations and therapeutic follow-up in the centres. They are supported by a team of community workers who carry out prevention and advice work within the communities themselves.
In 2015, there were 107,032 consultations at the health centres supported. Over 1,300 people attended at least one consultation with a psychologist and 4,754 people benefited from mental health prevention and referral programmes. Overall, our activities reached over 75,000 beneficiaries.
In Iraq, the hostilities which have affected the north and west of the country since 2014 have led to the displacement of over three million Iraqis. Yezidi, Christian or Muslim – they have all fled to escape the rapid advance of Islamic State. Those directly exposed, the displaced populations, the Syrian refugees and the people of the host regions are all direct or indirect victims of the conflict.
Doctors of the World is active in the displaced persons’ camps in Iraqi Kurdistan and in Kirkuk Governorate, as well as in the Iraqi refugee camps in Turkey, in southern Anatolia. Medical teams provide primary and sexual and reproductive healthcare, paediatric care, psychosocial support, nutritional screening and health education sessions. Further south, in Kirkuk Governorate, Doctors of the World has set up three mobile clinics to respond to the massive new influx of displaced persons and the needs of the host populations. In addition, the organisation is working with Iraqi and Syrian refugees on the other side of the border, in the camps of Diyarbakir and Batman.
In 2015, 110,296 medical consultations were provided, including 1,090 on sexual and reproductive health issues.
In Jordan, the 635,000 Syrian refugees represent over 10% of the overall population. The vast majority of them are living in the north of the country, in urban areas and in camps, in particular the Zaatari and Azraq camps. Since the end of 2014, the refugees have been required to make a financial contribution for the healthcare services provided by state medical centres.
Doctors of the World has set up a health centre in Ramtha and two others at the Zaatari camp and has provided them with essential medicines. This means the refugees can access basic care and also receive ongoing care for chronic illnesses. The organisation also provides health education workshops, infant immunisations, family planning services and antenatal care.
Psychologists and community teams are also available at the health centres and in the urban areas and the Zaatari camp. General practitioners are trained to identify people suffering from mental health problems.
In 2015, 18,000 Syrian refugees received psychological support; 79,000 people at the Zaatari camp and 80,000 in Ramtha were able to access our services. 200,000 primary care consultations were provided at the Doctors of the World health centres at Zaatari and Ramtha.
Check out the portraits of five Syrian families in exile