Syria needs $US 78-million to vaccinate 20% of its population against COVID-19 by the end of this year, and its pandemic response is being challenged by a worsening humanitarian crises in the country, including continued attacks on health care facilities.

This is according to Akjemal Magtymova, the World Health Organisation (WHO) Representative in Syria, who told a media briefing on Tuesday that the country had only received half of the funding it had requested for this year and that additional assistance was needed to combat the virus and save lives.  

The briefing comes two days after the Al-Atareb Hospital in the Aleppo area was hit by artillery shelling from Syrian government forces, killing six people and injuring 17, including patients and medical personnel. 

The underground hospital, in an area controlled by forces opposed to the Syrian regime, sustained structural damages, resulting in the evacuation of all patients and staff, and the suspension of health services.  Hospitals and clinics in opposition-held areas have been repeatedly targeted, and destroyed in attacks by government forces – backed by Russia and Iran, according to a recent report by the International Rescue Committee. The attacks have continued despite a Russian-Turkish ceasefire covering rebel-held areas of northwest Syria, in effect since March 2020. Only 58 percent of hospitals remain fully functional, according to UN data.

“Thousands of people who depend on this hospital for basic and lifesaving health care are now deprived of this basic human right. Our thoughts and prayers are with the families of the victims,” said Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean Region. 

Magtymova said funding is needed for creating mobile clinics, services, training, administration of vaccines, surveillance and dealing with side effects in the country whose health system and financial resources have been severely strained by war.

The country is expected to get its first delivery of AstraZeneca vaccines from COVAX within the next two to three weeks, allowing it to kick off a national COVID-19 vaccination programme starting with healthcare and frontline workers. Its immediate need is $7-million to vaccinate 2% of the population before the end of June.

Magtymova said WHO was working with dozens of different international and regional partners to address some of the country’s challenges, including funding, security issues and the fight against COVID-19. 

“We have worked hand in hand with our partners for coordinated efforts for COVID-19 preparedness and response against enhancing laboratory surveillance capacity, infection prevention and control points of the case management,” said Magtymova. “Most importantly is to maintain essential health services…and health care professionals are severely depleted.”  According to the IRC report, following a mass exodus of medical personnel, there remains just one Syrian doctor for every 10 000 civilians. 

COVID Adds To Multiple Healthcare Challenges in a Complex Environment

Describing the situation as “one of the most complex environments”, Magtymova said some of the challenges included “expanding public trust measures and achieving behaviour change, protecting health workers, security and access in ensuring continued use of essential health services, as well as establishing reliable supply chains”.

Some of the challenges at health care facilities include patients being treated in overcrowded rooms with no masks or social distancing and patients with abdominal wounds due to artillery strikes being treated in the same rooms as mothers with children. Some patients had to take detours of about six hours to get medical help due to hostilities and violence in their areas.

Magtymova added that while the pandemic was WHO’s priority, non-communicable diseases remain one of the major causes of mortality and morbidity with COVID-19 making people even more vulnerable. 

“Access to essential medicines have been severely compromised due to economic constraints. WHO sustains provision of life saving medicines to patients with diabetes, kidney diseases and failure, cancer, alongside with COVID-19 patients,” she said.

Giving an update on the situation in the northwest part of Syria, held by opposition forces, Mahmoud Daher, head of the WHO’s Gaza sub-office, said increased attacks on healthcare facilities were impeding the provision of critical health services.

“In Syria in general, and in northwest Syria, we have witnessed the attack on a hospital that was providing 5700 outpatient consultations, 375 hospital admissions and 160 major surgeries per month,” said Daher.

“This situation continues, and shows the fragility of that system that is prevailing in the northwest Syria. We are working with the international community and with the UN system in order to continue to provide health care services to the entire population. We are working under the United Nations Security Council Resolution to ensure that humanitarian assistance can continue despite the current volatile situation,” said Daher.

Syria’s COVID-19 real COVID-19 Numbers Are Much Higher than Official Data

Syria has nine dedicated COVID-19 hospitals, 70 community care treatment centres for moderate to mild cases of the virus. Three laboratories have been established to detect and confirm COVID-19 cases. The country has registered 21, 260 COVID-19 cases, with 411 deaths.

Daher believes that investment from the international community, led by WHO, has contributed to the low numbers. He however warned that: “The situation is in need of all our efforts in order to contribute to humanitarian assistance, including radical services”.

As of 19 March, Syria had 21,000 COVID-19 cases reported in northwest Syria, more than 9,000 in the northeast and more than 17,000 in government-controlled Syria – the highest case fatality ratio is under government control territory. 

I do believe that the real numbers are much, much higher. The virus is not behaving differently in Syria. In fact, we are not aware of what kind of variants of the virus we are dealing with, because of the level of the capacities, but as WHO we have sent samples for sequencing to understand,” said Magtymova, adding that they were seeing a 100% bed occupancy level.

“Our epidemiological curve shows an increase in the new cases…which means that we are working in a very steep curve. And I have no reason to believe that, you know the situation of recorded cases is real. I’ve seen much more people with COVID-19, said Magtymova.

Magtymova concluded that the current infection patterns emerging in Syria and the looming third wave of the pandemic necessitates a more vigorous and urgent response.

Image Credits: Unicef.