International aid cuts create serious ‘health crisis’ in northwest Syria

Dwindling international aid to northwest Syria over the past year has left an estimated 3.1 million people, including 2.8 million internally displaced, facing a health crisis as hospitals and other medical facilities are struggling to operate with scant resources, Amnesty International said today.

Medical facilities in this part of the country, which is under the control of the armed opposition group Hay’at Tahrir al Sham, are entirely dependent on funding from the international community to provide free health services and medicines. Over the past ten months, international aid to the health sector has dropped by more than 40% due to the overall reduction in international aid to Syria.

“It goes without saying, and especially after two years of the pandemic, that health systems are essential services that people need to survive. Last year’s massive cut in funding immediately resulted in the closure of hospitals and vital services, and left millions of Syrians – who have already suffered from conflict and violence – struggling to access medicine and other essential healthcare,” said Lynn Maalouf, Deputy Regional Director for the Middle East and North Africa at Amnesty International.

“The meeting of international donors in Brussels next week should prioritize adequate funding for health and other essential services, as millions face the dire prospect of being denied access to basic healthcare. health in a context of worsening crisis Everyone’s right to health must be protected, which means being able to access health services when needed, without worrying about the financial cost.

Amnesty International interviewed eight doctors and health workers, four people who had recently sought medical care and four aid workers, each of whom described how budget cuts had led to a shortage of resources and medicines, leading to a reduction in operations and services.

The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported that only 25% of funds required for the Syrian health sector had been secured in December 2021, compared to 67% in July 2021. According to the health directorate of Idlib, 10 out of 50 hospitals, including six gynecology and pediatric hospitals, 12 primary care centers and three specialized medical centers lost their funding in 2022. Other health facilities that have longer contracts for next months or years, will also be at risk of closure if their contracts are not renewed.

Reduced capacity and supplies put health and life at risk

Shortages of staff, medicines, equipment and reduced operational capacity have prompted hospitals to cut services, putting people’s lives at risk. Four hospital directors have told Amnesty International that their facilities are at imminent risk of closure if funding is not secured urgently.

“Before the December 2021 budget cuts, we were seeing around 500 outpatients and inpatients a day. Today we can receive 10% of that number because we have suspended all services except basic emergency care,” said the director of an obstetrics and pediatrics hospital.

The director of another obstetrics and pediatrics hospital said he had to close the neonatal intensive care unit and operate only four out of eight incubators. He described a harrowing incident that occurred shortly after budget cuts earlier this year, when he was unable to provide respiratory support to an infant who needed a ventilator: “His parents begged me to help her, but I had no choice but to return them. a way.”

Her parents begged me to help them, but I had no choice but to send them away.

Director of the Northwest Syria Obstetrics and Pediatrics Hospital

Another doctor told Amnesty International that the shortage of health services was threatening lives: “Once this year, a heart attack patient was rushed to our emergency department. We had no oxygen for a ventilator, so we tried to transfer him to another hospital by ambulance, but he died before we got there.

A doctor working at another hospital who lost funding in August 2021 shared a similar story, saying, “In January [2022], we received a five-month-old baby in the emergency room suffering from severe malnutrition and respiratory failure. He needed intensive care, but we had no room for him due to lack of capacity and staff. We intubated him in the ER and gave him manual breathing support for four hours as we tried to find him a place in another hospital. Unfortunately, we couldn’t find any and he died.

All doctors and users of the health system interviewed by Amnesty International said they had noticed a shortage of essential medicines, especially for chronic diseases. A doctor said his hospital even struggled to get anesthetics.

A midwife said the lack of medicines and supplies deterred women from seeking antenatal care. She said: “The women told me that they would not go to a health center that would not offer them the necessary drugs free of charge. Sometimes even the most basic supplements for pregnant women, such as folic acid, are not available.

A woman who had just given birth told Amnesty International: “I couldn’t afford the medicine the doctor prescribed, so I didn’t buy it. The hospital provided us with these drugs for free before they lost their funding.

A lack of funding also means that health workers, whose salaries were covered by aid contracts, now work in several facilities simultaneously to ensure sufficient income. Other health workers have not been paid due to lack of funding. Seven medical workers told Amnesty International that they had been working without pay for months.

Inaccessible and unaffordable health care

Hospital closures, coupled with reduced services and the high cost of private health services, are making access to health care extremely difficult for many people in northwestern Syria. Patients now have to travel longer distances to find a hospital or medical center. Public transport is often limited and for many the cost of transport is unaffordable.

The father of an asthmatic child says: “Some time ago, my son had an asthma attack. As usual, I rushed him to a nearby hospital, only to find that the hospital had lost funding… The only doctor available in the ER told me that the child needed to be hospitalized immediately. ’emergency. I had to borrow some money and take it in a private car to a hospital in Idlib, about 60 kilometers away.

A pregnant woman was receiving antenatal care at a local hospital but struggled to find a hospital to give birth to after the local facility suspended operations due to funding cuts.

She told Amnesty: “I was in a lot of pain. My husband asked around until someone told him there was a place available at Jisr Al-Shughour, an hour away. We went all the way. But then it turned out that there were only midwives available, not an obstetrician, and I needed a caesarean. Finally, I had to go to a private hospital. We borrowed money and paid every penny we had to cover the costs.

“Donors have the power to change this devastating situation. Their decisions have a direct impact on people’s access to healthcare at a time when they are suffering more than ever. What is happening in northwestern Syria right now is a terrible humanitarian crisis,” said Lynn Maalouf.

What is happening in northwestern Syria right now is a terrible humanitarian crisis.

Lynn Maalouf, Amnesty International

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