A once-enviable system brought to its knees

Syria’s healthcare system is now crippled — with hospitals destroyed and severe shortages of drugs and equipment. Many healthcare workers have been killed or have fled the country. Doctors and their patients are targeted, and a culture of fear prevails. Horrific injuries are going untended; women are giving birth with no medical assistance; men, women, and children are undergoing life-saving surgery without anaesthetic; and victims of sexual violence have nowhere to turn.

Hand in Hand for Syria is one of the few charities able to bring medical aid into Syria. Our medical team offer their time and skills to the sick and injured as well as training Syrian doctors, opening hospitals, and setting up rapid-response schemes and a blood bank. They co-ordinate with Syrian doctors on the ground to assess what’s needed most urgently, and where. That way, we can mobilise aid supplies from our warehouses inside Syria and respond quickly to the rapidly changing security situation.

The following clip is from BBC Breakfast on 20 September 2013, and features Dr Talaat Atassi, an NHS surgeon and a member of our British-based medical team, describing the severity of the situation:

Hospitals are unsafe

According to WHO, 37% of Syrian hospitals have been destroyed and a further 20% severely damaged. This is the result of deliberate and systematic attacks on medical facilities and personnel, not an inevitable or acceptable consequence of armed conflict. Some, in the worst-hit cities, have been taken over by the army and turned into military bases. Others which remain open aren’t safe for injured civilians: reports of torture and medical negligence are widespread.

Doctors are under attack

The Syrian government has made it a criminal offense for medical staff to treat someone deemed to be a member of the opposition, whether an active protestor or an innocent bystander. Health workers have been arrested for doing this, with an estimated 469 now imprisoned and others tortured or killed. Others have had their families attacked to prevent them from providing further care. Many doctors and pharmacies report having their premises ransacked and destroyed. About 15,000 doctors have been forced to flee abroad, according to the Council on Foreign Relations. Of the 5,000 physicians in Aleppo before the conflict started, only 36 remain.

People are afraid to seek help

In some cases, where injured civilians have sought medical treatment for conflict-related wounds, they have been transferred to military intelligence centres to be detained, interrogated and eventually killed. During the worst of the shelling, people are too afraid to leave their homes to obtain medicines or seek medical treatment; in moments of fragile peace, they may quickly venture out to get a prescription or to see a doctor.

Drug shortages

A few pharmaceutical factories still operate sporadically, but at barely a third of their pre-crisis capacities. Production has dropped 75% since 2010, according to the UN’s June 2013 Syria Humanitarian Assistance Response Plan. Stocks of medicines are rapidly diminishing; the most pressing need is for supplies of vaccines, children’s medicines, antibiotics, anaesthetics and painkillers. However, there is also a constant need for medicines to manage long-term conditions like asthma and diabetes.

New health issues to tackle

Besides trying to cope with a devastated health system, Syria’s physicians are faced with injuries and diseases which they never had to deal with before. These include blast injuries from bombs and shelling, blunt trauma from collapsed buildings, malnutrition, diseases associated with poor sanitation (such as hepatitis, typhoid, cholera, and dysentery), hypothermia, and a resurgence of diseases which had previously been eradicated. Polio has re-emerged, with 43 cases reported in Deir AlZour in November 2013; this is a direct consequence of national vaccination rates dropping from 95% in 2010 to 45% in 2013.

Secret field hospitals

A network of small, secret field hospitals has sprung up across Syria — in basements, schools, homes or even in tents. Equipped with only the most basic equipment and minimal medical staff, they offer life-saving operations from treating gunshot wounds to delivering babies by Caesarean section. Despite being severely under-resourced, they provide a vital lifeline to the local community.

How we’re helping

Hand in Hand for Syria has links with over 100 of the field hospitals across the country. We regularly send vital shipments of medicines, consumables and medical equipment to field hospitals, first-aid points and clinics around Syria. In some areas we have set up new hospitals, and we have delivered everything from anaesthetic machines to ambulances. We also provide emergency staff with a blood-clotting agent which stops major bleeds very quickly, and users require no prior in-depth medical training (an important factor when there is a shortage of paramedics). As the conflict has developed, we have expanded our medical supplies to include antidotes to chemical and biological weapons and protective clothing for health workers, as well as training the staff to manage such attacks.

We desperately need your help to continue supporting these brave doctors and nurses provide essential, life-saving treatments.

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