On March 19th 2018, MdM France and the Union of Medical Care and Relief Organizations (UOSSM) joined forces to show their support to health professionals in Syria. A photo operation was organized in Place de la République in Paris. Today, the situation in Syria is still dramatic and both charities have decided to stand together to ask for: Immediate evacuation of the injured and access to civilians in Syria.

“More than 400,000 dead and 5 million displaced

7 years of darkness and mass murder

7 years of horror and war crimes made commonplace

7 years of anguish for an entire people

7 years of brutality

7 years of civilians besieged, starved and bombed without respite

7 years of international community impotence

7 years and more than 800 health carers killed on Syrian soil

7 years of failure by international conflict-resolution mechanisms

7 years of International Humanitarian Law trampled underfoot

7 years of medical facilities bombed and more than 800 health carers killed

We demand unconditional access to all Syrian territory to deliver humanitarian aid unhindered

We demand immediate protection for all civilians

We demand an immediate halt to military operations to allow delivery of medical aid and evacuation of the wounded

We demand urgent diplomatic solutions to re-establish peace

We demand strong political action and not fine words

We will not stand by as Syria is destroyed.”

A new report from The Association of International Development Agencies (AIDA), a coalition of more than 70 INGOs working in the occupied Palestinian territory (oPt), documents the grim reality of life under occupation. The report, 50 Years of Occupation: Dispossession, Deprivation and De-development, illustrates the systemic, decades-long squeeze of Palestinian economic prospects and human rights.

The report also documents how the Oslo Accords of the 1990s were never fully implemented, leaving Palestinians in a state of prolonged hopelessness. In the 25 years since the first Oslo Accords, the oPt has become more fragmented and the occupation more entrenched. Meanwhile, the number of settlers in the West Bank has more than doubled.

“We see daily how difficult life is for Palestinians under occupation. They struggle with poverty and unemployment, restricted movement and access to essential services, as a result of Israeli policies, coupled with exploitation of water, land, and other natural resources,” said William Bell, Head of Middle East Policy and Advocacy, Christian Aid.

50 years of Israeli occupation have had dire economic consequences for Palestinians in the oPt. In addition to stifling the Palestinian economy, Israel’s persistent and widespread violations of international law have created growing humanitarian needs and adversely affected the protection of Palestinians.

In Area C of the West Bank and East Jerusalem, communities are at risk of forcible transfer because of continued settlement expansion, demolition of homes, infrastructure, and livelihood structures, as well as an unlawful planning regime that makes it almost impossible for Palestinians to obtain building permits. In Gaza, ten years of blockade has crippled access to health and other essential services, stalled economic development, and increased dependency on humanitarian assistance.

“Despite increasing health needs, Israeli policies obstruct the construction and development of medical infrastructure and the professional development of health-workers. As health services fall further behind, higher numbers of Palestinians need to travel for treatment yet Israel is blocking many of them, with higher numbers of patients subsequently dying,” said Aimee Shalan, CEO of Medical Aid for Palestinians.

AIDA hopes that this new report will draw attention to the economic dependency trap which the Palestinian economy is caught in, the deepening humanitarian needs of Palestinians in the oPt, and Israel’s recurrent violations of international law, and calls on third states to work towards ending the occupation.

“The only solution to improving the lives of Palestinians in the oPt in any meaningful way is to end Israel’s 50-year-long occupation”, Chris Eijkemans, Oxfam’s Country Director stated.

Access the report 

This year 15 March marks seven years of war in Syria: the parties to the conflict, together with their allies, are killing with complete impunity, while the international community flounders impotently. 

So much has already been said about the scale of the conflict: 350,000 deaths, a country bled dry and over half the Syrian population in exile or internally displaced.

Médecins du Monde – Doctors of the World (MdM) is calling on the international community to assume its responsibilities: to do everything possible to ensure access to humanitarian aid and to take action to end seven years of war crimes. A stop must be put to the impunity.

“For seven years, access to healthcare has been used as a weapon of war. Destroying hospitals just as the bombings drive civilians to these places where they should find refuge and receive care is an assault on the physical integrity of the population and shows that the attacks will spare nothing and no one, not even children. In the last three weeks, 1,000 people have died in Eastern Ghouta, and one-third of them were children” , says Dr Françoise Sivignon, President of MdM. “During this conflict, medical staff have been decimated; medical centres have been attacked almost systematically.”

11.3 million Syrians – the largest number of refugees since the Second World War – are in need of medical assistance and are subsisting in difficult conditions. United Nations Security Council resolutions are passed one after another and are violated as soon as they are adopted. The supposed de-escalation zones established by the Astana Agreement only exist on paper, as this war demonstrates the failure of an international system which has run out of steam.

Finally, MdM demands that humanitarian truces are properly observed, to allow aid teams to respond to the most pressing health needs of the civilian population resulting from the escalation of violence, and calls for an end to impunity.

A coalition of medical and humanitarian organizations, some working inside besieged Eastern Ghouta, have urged the United Nations Security Council to vote for an immediate cessation of hostilities to allow urgent humanitarian assistance to all areas in need in Syria.

The Security Council is expected to vote today on a resolution aimed at implementing the cessation of hostilities and lifting sieges on areas like Eastern Ghouta. More than 300 people have been killed there by Syrian government and allied forces since Sunday while more than 20 health facilities were subject to bombardment. The resolution would also prevent further indiscriminate attacks from armed opposition groups in Damascus, where at least 15 have been killed since Sunday.

The coalition, which includes organizations like Save the Children, Care International and Physicians for Human Rights (PHR), are making themselves heard loud and clear in New York today by deploying three billboards to circle the United Nations building, calling out the Security Council and demanding answers for their inaction.

Mirroring a tactic from the Oscar-nominated film Three Billboards Outside Ebbing, Missouri, the billboards say “500,000 dead in Syria / And still no action? / How come, Security Council?”

“The situation inside Ghouta is catastrophic. So many people are dying that the numbers of the dead keep flowing into each other, we can’t keep count,” said Dr Hamza, a doctor with the Syrian American Medical Society (SAMS) in Eastern Ghouta. “The amount of terror we are going through cannot be described.”

He said that families are “holed up in basements terrified of the strafing planes and bombardment.” Because of the lack of medical attention and poor living conditions, skin diseases such as scabies are rampant and chronic diseases continue to be exacerbated.

In their joint call to the UN Security Council, the coalition calls on all members to support the passage of a humanitarian resolution and use their influence to make the cessation a reality. They are asking for:

1. A humanitarian pause/cessation of violence throughout Syria;
2. Sustained humanitarian access through weekly UN humanitarian aid convoys to all areas in need, including those in opposition-held areas;
3. Emergency medical evacuations with necessary safety guarantees to patients in need of urgent treatment outside of besieged areas;
4. Commitments from all parties to the conflict to comply with their obligations under international law to prioritize the protection of civilians and guarantee the protection of hospitals and other medical facilities;
5. Lifting of the sieges, most urgently on eastern Ghouta, the largest Syrian city under besiegement. Around 400,000 have been living under siege there since 2013, leaving residents starving and many close to death.

Dr Hamza continued: “I just treated a woman in her twenties who spoke her last words just three hours ago. She was seven months pregnant and we couldn’t save her. There is a huge shortage of medicines and equipment to treat patients in Ghouta. None of those being killed are military targets, they’re all civilians.”

Refusal to deliver medical supplies prevents doctors from fulfilling their duties. Trauma drugs and surgical equipment are non-existent, and in Syria they are systematically removed from humanitarian convoys without any justification.

One of the biggest challenges doctors face is the refusal of medical evacuation requests for critically ill patients, including those with tumors and serious heart problems. In the rare cases where they can evacuate patients, many die while waiting for a medical evacuation out of Syria or treatment inside the country. Currently, more than 700 patients require medical evacuation.

The recent onslaught of violence comes on top of one of the worst hunger crises since the beginning of the Syrian conflict, with the UN reporting that 12 percent of preschoolers in eastern Ghouta are suffering from acute malnutrition.

• The coalition consists of: CARE International; CCFD-Terre Solidaire; International Rescue Committee (IRC); Independent Doctors’ Association (IDA); Médecins du Monde (Doctors of the World); Mercy Corps; Physicians for Human Rights (PHR); Syrian American Medical Society (SAMS); Save the Children; and Union of Medical Care and Relief Organizations (UOSSM).

Noelle is the mental health manager of the Lebanon Mission, and has been with MdM for almost five years. She started off as a psychologist in the field, working with Syrian Refugees in the Bekaa. Here, she relates her experience since the beginning of the Syrian Crisis.

“Five years already in the field…. I feel I’ve been living in a movie. Every day, I go back home and recall the day’s events, the people I’ve met, the stories I’ve heard, and the pain and joy I shared with my patients. Sometimes, I feel I am out of touch with reality.  Some stories are too painful to even look back on. But at the same time, thinking about these people’s resilience keeps me going. I would like to share two stories that really touched me.

The first is one of a 38-year-old Syrian woman. She was tortured and had to endure the worst in Syria, so she escaped to Lebanon, desperate to put painful memories behind her. She was subjected to continuous harassment in all forms and wanted freedom above all. She was able to find work and earn a living. She fought for her rights. When I met her, she had already developed her own coping mechanisms. She refused to be a victim, determined to be a survivor. It was very easy for me to continue from where she started.

Another story impressed me. I feel the responsibility of raising his voice after he is gone. Mahmoud, in his late 50s passed away last year from lung cancer. He had to flee Syria with his family, leaving his house and his job behind. As his family was tight-knit, they stood by him, trying to improve his new life. His health started deteriorating when he arrived in Lebanon. Having had to leave Daraa for an unsettled environment took its toll and his mental health affected his physical wellbeing. He came to the clinic where we work to get medical assistance. Our case manager met him and transferred him to me. Mahmoud was suffering from a severe depression. At first, he was reluctant to talk, but after several attempts he visited me a few months later. He entered my office all by himself although, by then, he was already very ill. He told me that he wanted to talk and needed help, so I listened, deeply touched by his presence. He had been diagnosed with lung cancer one month before his visit. He was heartbroken to be away from his homeland.

We talked for two hours… He told me about his beloved Syria, his daily life there. In those two hours, he was able to smile again. When I asked him what pushed him to come talk to me, he told me that he felt the need to share his people’s plight, but what he didn’t know was that, by speaking out, he was able to alleviate his own pain. We set a date for our next meeting, but one week later I found out that he had lost the battle against cancer. His son was the one to give me the sad news, as it seems his father had insisted that he come see me. His son was very curious to know who I was, and why I mattered so much to his dad. He told me that he was happy to see his dad smiling again, and regain a glimmer of hope… I explained to him that I had only listened to his father in an attempt to ease his pain, understand the difficulties he was facing and help him find ways to cope with his new reality. I still follow up with his family.… They even mobilize to talk about mental health in their community. It is their way of keeping Mahmoud’s memory alive … “

Since the end of 2017, Médecins du Monde – Doctors of the World (MdM) has faced a deteriorating situation in Idlib and Hama Governorates in north-western Syria.

Although the ongoing diplomatic negotiations imply that the war is over, continued bombing is killing civilians, deliberately targeting hospitals and resulting in major displacements of people. MdM calls on the parties involved to respect International Humanitarian Law and to put an end to the suffering of the civilian population.

This is our report from the ground at the end of the first week of January 2018:

–          On 2 January a hospital in Kafr Zeita (Hama Governorate) came under fire from the air. The building has since been unusable.

–          On 3 January a paediatric hospital in Ma’arrat An Nu’man (Idlib Governorate) was hit by bombing, killing four civilians and injuring two healthcare workers. The building has been unusable since the bombing.

–          On 7 January a primary healthcare centre supported by a local NGO was targeted by an aerial attack, which damaged a storage facility, a waiting room and a vaccination room.

–          On the evening of 7 January an explosion in the city of Idlib resulted in 30 casualties and 100 people being injured, including a surgeon. The health centre providing paediatric, gynaecological and internal medicine services to the west of the city was affected.

The virtually daily shelling of north-western Syria has led to the displacement of tens of thousands of people. The MdM teams are organising to respond to the health needs and the humanitarian crisis.

Dr Françoise Sivignon, President of MdM, said: “We call on the parties involved in the conflict to declare an immediate ceasefire and to find a lasting solution for the civilian populations who are suffering and fleeing the fighting. We remind them that International Humanitarian Law is not optional. We are particularly alarmed by attacks targeting hospitals and healthcare workers. We demand that access to healthcare as well as the safety of civilians and healthcare workers be guaranteed in all circumstances.”

A group of leading NGOs expresses grave concern about the plight of civilians in Eastern Ghouta, where violence has escalated in recent weeks, and Syrians are experiencing a severe lack of food, medical, and other supplies. We are calling on parties to the conflict to deescalate violence and urgently increase access for humanitarian purposes.

The organizations call on the parties to the conflict to fulfill their obligations under international humanitarian law. We also call on member states with influence over the parties to fulfill their humanitarian commitments as mandated through the humanitarian task force of the International Syria Support Group (ISSG) and through the de-escalation agreements brokered through the Astana process. The following commitments made during the Astana process must be immediately implemented:

– Rapid, safe and unhindered humanitarian access
– Delivery of medical and food aid to local populations
– Unhindered movement of unarmed civilians
– Lasting ceasefire between conflicting parties

The ceasefire announced on 28 November only momentarily decreased the violence, which immediately intensified once the two-day period had ended. In November, only two humanitarian convoys entered the area, the most recent of which provided food baskets, flour, and medical supplies for 7,000 of the 400,000 civilians who remain trapped in Eastern Ghouta. This provided crucial temporary life-saving assistance but is not enough to sustain the civilian population as long as the siege continues. As of early December, food prices are still at least 200% higher than prices in August.

According to Syrian humanitarian workers based in Eastern Ghouta, food, when available, is prohibitively expensive; fuel shortages and high prices will continue to increase as winter comes; access to drinking water is threatened; and cases of malnutrition are on the rise. Other local organizations have reported difficulties in procuring necessary goods, and the increase in shelling and airstrikes has led to a suspension of their programs. This situation is exacerbating the impact on an already vulnerable population, specifically female-headed households, people with disabilities, children, and elderly people, and this is likely to worsen with winter fast approaching.

The 400,000 civilians in Eastern Ghouta represent nearly 95% of the total besieged population in Syria, according to UN statistics. According to UNICEF, 11.9% of children under five in Eastern Ghouta are acutely malnourished. This is the highest level that has been recorded in Syria since the conflict began. Over 400 people are awaiting urgent medical evacuation.

Parties currently involved in the Geneva process have the ability to avert further humanitarian catastrophe in Eastern Ghouta. They must immediately allow unhindered humanitarian access and movement of civilians as well as ensure a credible and lasting ceasefire is implemented.

CARE
Finn Church Aid
International Rescue Committee
Médecins du Monde – France
Mercy Corps
Oxfam
Save the Children
Syria INGO Regional Forum (SIRF)
Syria Relief & Development

In Lebanon, the Department of Psychology at the American University of Beirut in collaboration with Medecins du Monde-France, are organizing a one day forum on the 18^th of December, 2017 from 9 a.m. to 5:00 p.m. on “Research on Mental Health & Psycho-social Support (MHPSS): Focus on the Syrian Humanitarian Crisis”.  Through a shared platform composed of different stakeholders (academics, humanitarian aid organizations, policy makers), the forum will aim to provide an open space to share MHPSS research findings, experiences, challenges, best practices as well as encourage new opportunities to foster further MHPSS research collaboration within the humanitarian context.

A major component of the forum will be a focused discussion on strengthening collaboration between humanitarian agencies and academic institutions for MHPSS research as well as setting forth the MHPSS research priorities for the field.

For more info, check out the MHPSS Forum Program 2017-

Amid the intense diplomatic activity over the Syrian crisis, Médecins du Monde (MdM) points out that the war is far from over and the humanitarian situation remains extremely critical, with thousands of people still being trapped, killed or wounded and displaced. Regular targets of relentless airstrikes, hospitals and health workers are also paying a heavy price. Yet again, Médecins du Monde wishes to alert opinion to this truly catastrophic situation and urge respect for international humanitarian law.

Prior to the resumption of peace talks to resolve the Syrian conflict to be held in Geneva on 28 November, a summit is underway in the presence of the presidents of Russia, Iran and Turkey in Sochi. Meanwhile, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) has provided an extremely grim overview of humanitarian needs in Syria which show no sign of abating: “13.1 million people require humanitarian assistance,  5.6 million of them urgently due to limited access to essential items and services.”

In spite of the Astana agreement that provides for the setting up of de-escalation zones, a deluge of bombs continue to pound all of Syria—Idlib, Aleppo, Raqqa and Deir ez-Zor provinces in the north and northeast, Homs and Hama in the centre, Daraa in the south and the region around Damascus. According to the Syrian Observatory for Human Rights (SOHR), 61 people, most of them civilians, were killed on 13 November in airstrikes on a market in Atareb (west Aleppo province), even though the town is situated in an area where government forces and armed opposition groups are supposed to have stopped using all types of weapons.

According to the SOHR, since the 1^st January 2017, unprecedented levels of violence have resulted in the deaths of over 3,000 people—1,000 of them civilians. The fighting is continuing to cause massive population displacements, with around 6,550 people forced to flee every day. For them, the war is far from over.

Hospitals—which international law is supposed to protect—are also attacked and sometimes reduced to rubble. Physicians for Human Rights documented a succession of seven attacks in five days alone in September, the deadliest month to date. And, according to the International Committee of the Red Cross, over half of Syria’s medical facilities are now in ruins, depriving more than 100,000 of its citizens access to medical care.

The task of humanitarian aid workers has become even more complex and dangerous. Médecins du Monde is continuing its support to its local partners who, despite the huge challenges they face, continue with courage and determination to provide assistance to the sick and wounded.

In this dramatic context, Médecins du Monde once again calls for protection for civilians and medical personnel and facilities. International humanitarian law must be respected by all parties to the conflict and the population’s access to medical care and their fundamental rights guaranteed. 

Nada was fond of orange blossom and green fields…

She dreamed to learn piano, she loved the way the music notes could speak to a person’s soul… She believed in another version of reality, a reality far from the sound of war… far from the reality she had to crash in suddenly.

Nada is 25 years old, mother of two girls, and Syrian refugee in Lebanon since 2014 – the beginning of the Syrian Crisis. She comes from a village in Syria called Ghota described as the oasis, formed by the Barada River. Ghota, as she described to us, is “a village that you recall even if you are far away… recall the smell of the earth and the beauty of its blue sky.”

In 2015, she had to move to Damascus. Her nightmare started then, as she told us. She had to escape to Lebanon because her husband was abducted. The last thing she heard from him was to prepare food and hot water. They took him from the house, leaving her traumatized with two little girls, the three years old Sham and the one year old Wajd. In a matter of seconds, she became the only source of shelter and protection for her girls.

Her husband’s family who had to escape to Lebanon asked her to live with them. She followed them with her two little girls to Masnaa village in Bekaa valley, at night. She had to leave her parents behind, respecting the traditions… Her fear from the dark started to develop stronger. From the deadly war she moved to a cold war, a mental war with herself. A war that does not leave apparent bruises behind.

During her first year in Lebanon, she felt that there was no tomorrow. She felt as if she was still stuck while the rest of the world continued moving. Drowning in loneliness, facing continuous harassments, feeling unworthy with her daughters, and losing any hope of return, she tried to kill herself many times. She wanted to have control at least over something in this shaking reality. She only had control over stopping her life. But all attempts failed…

In 2015, during a home visit, she was referred to one of MdM’s case managers, Fatima. At first, she refused to talk, but day after day she started to open up to Fatima. She felt that she can at least talk to someone, someone cared to listen, and that was enough. This is where Fatima discovered that her husband’s family were mistreating her, and her landlord sexually harassed her… At noon, she and Fatima used to meet over a salad, they called it Fatima’s Salad… Fatima then referred her to an MdM psychologist, Noelle, and they provided her with comprehensive support.

Our other case manager, Amani, helped her to get a job through another NGO and within a year she was able to take her girls and rent a two room house in Rashaya El Wadi. She faced her husband’s family and took her daughters with her. The moment she started to confront, she started to live again. She even enrolled her daughters in school. One year later, she still recalls how she was able to breathe again. She never imagined that mental health mattered that much, having lost faith that someone can help her. She learned to cope with her surroundings, create something new from what she has… She told us: “When the war takes away all the colors, mental health support helps in bringing them back”.

Now, she is still struggling with many challenges but she is more resilient and stronger. She wants to go back to Syria once the green fields are back. She plans to visit her parents, but she is afraid to see the colors of Syria now…