The conflict in Syria has led to a country-wide devastating healthcare crisis that has 2 important and connected components. The first is that healthcare facilities have been at the center of targeted airstrikes—from January to September 2017 there were 218 attacks on healthcare facilities in Syria, and 302 attacks occurred in the previous year. These combined attacks have resulted in nearly 600 deaths and over 730 injuries. The second component to the healthcare crisis is a result of the first: Syria is the most dangerous place on Earth to be a healthcare provider. Those who have not been killed, imprisoned, or had to flee for their family’s safety, are putting their own lives at risk to save the lives of others. As a result, the number of healthcare providers in Syria has reduced drastically over the past 7 years. This makes access to quality healthcare the greatest area of humanitarian need in the country.
In the conflict’s early stages, SRD’s focus was on immediate first aid and trauma relief through Mobile Medical Points. Later, we established regional hospitals offering a variety of trauma, inpatient and outpatient services. In response to the rise in morbidity and mortality rates due to a lack of quality primary and reproductive healthcare, SRD further-established both stand-alone and integrated primary and reproductive health clinics and an integrated focus on public health through community health programs that complement the multi-level healthcare network in place.
SRD’s healthcare system operates on a holistic, preventative continuum of care, ensuring that each patient receives follow-up care and access to comprehensive services that address both the physical and mental well-being of each patient from the initial visit onwards. Without addressing health concerns on every level of the medical spectrum, neglected conditions affect other components of health and, ultimately, plague a once-thriving society. This has been the case with the shortage in physical therapy and rehabilitation programs, leading to mental health conditions such as depression, despondency and isolation from peers, requiring later intervention in the form of psychosocial support or advanced psychiatric care.
In 2017, SRD provided comprehensive reproductive and pediatric healthcare through numerous service sites including 10 Sexual and Reproductive (SRH) Care Clinics, 60 SRH Outreach Sites, and 4 Maternity and Pediatric Hospitals throughout Northern Syria.
At the 10 SRH clinics, specialized reproductive and pediatric care—including OB/GYN, antenatal, postnatal, neonatal, labor and delivery, emergency obstetric, family planning and referral services—have made quality care easily accessible for women and children. Additionally, clinic staff members have been trained in the recognition, treatment and prevention of Sexual and Gender-Based
At SRD’s 60 SRH Outreach Sites in Idleb and Aleppo, trained staff members conduct awareness sessions focusing on critical family planning issues including pregnancy, contraceptives (such as birth control pills, condoms and IUDs, all available on-site), breastfeeding, postnatal care, the recognition, treatment and prevention of SGBV, the prevention and treatment of Sexually-Transmitted Infections (STIs) and the promotion of routine OB/GYN visits. For added comfort and privacy, community members can request individual time with the instructors to discuss personal issues. And as part of the program’s informational outreach, a reproductive health publication, Balsam, that contains information on family planning, pregnancy and motherhood, is produced in Arabic and widely distributed in local communities.
SRD’s 4 Maternity and Pediatric Hospitals provide specialized care through OB/GYN services in addition to labor and delivery, antenatal, natal and postnatal care and lactation support. Staff members are also trained in the Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC). The hospitals receive women and children with a wide range of needs and use a comprehensive, holistic approach to addressing each patient’s individual needs. Many of the women are conflict-affected and a central part of care remains the recognition, treatment and prevention of SGBV and, in some cases, the Clinical Management of Rape (CMR).
SRD’s Primary Healthcare (PHC) services extend to men, women and children alike through 15 fixed and 3 mobile health clinics that emphasize the prevention and management of acute and chronic conditions, in addition to 7 pharmaceutical distribution sites. Primary health care facilities offer a wide range of services, including:
Outpatient Delivery Services (OPD)–
same-day services that include consultations and follow-up visits with primary, secondary and tertiary healthcare providers offered to the patient.
services that must be offered to children to ensure immunity and resistance to infectious diseases. SRD has committed to providing immunizations—such as Measles, Polio, Rubella, Hepatitis, Tetanus Vaccine, and others—at its facilities or ensure referral pathways in coordination with other immunization bodies in line with the World Health Organization (WHO) recommendations and guidelines.
Communicable Diseases (CD)Management –
poverty, collapsed Water, Sanitation and Hygiene (WASH) systems, crowded living spaces, poor health and hygiene education and an overall lack of PHC services available in communities have increased the prevalence of CDs in Syria. Given their severe implications and consequences if left untreated, contagious nature and ability to transform into an epidemic in a short amount of time, the CDs that SRD has prioritized through prevention, diagnosis and treatment include Leishmaniasis, Cholera, Measles, Tuberculosis, Upper/Lower Respiratory Infections (RTI), Acute and Watery Diarrhea and Sexually-Transmitted Infections (STI).
Non-Communicable Disease (NCD) Management –
SRD is focused on the prevention, diagnosis and treatment of NCDs which are chronic in nature, or long-term and slow to progress. The 4 main types of NCDs are cardiovascular diseases, diabetes, cancers and respiratory diseases.
Other Services –
Nutrition and Infant and Young Child Feeding (IYCF)
Reproductive Health (RH)
Psychosocial Support Services (PSS)
SRD’s Trauma and Emergency Hospitals in Northern Syria, situated in Aleppo and Idleb, are vital life-saving facilities that play an integral role in SRD’s healthcare programs: they are our longest-running healthcare facilities and serve as referral points for follow-up care in local clinics, many of which are also part of our healthcare network. Both hospitals provide trauma, emergency services, and health services in a range of specialties as part of their outpatient and inpatient services. The locations of the two facilities reduce hurdles in accessing free quality healthcare in Northern Syria.
Aleppo Hospital has been hit by aerial strikes several times since 2013, but its staff has persevered each time and continued to provide essential life-saving services at great risk to staff members. The hospital provides essential services in internal medicine, pediatrics, general, orthopedic and vascular surgery, OB/GYN, urology, ear, nose and throat (ENT), psychiatric care and other vital components of critical care. Aleppo Hospital also provides trauma care to internally-displaced persons (IDPs) and host communities in Northern Syria in the western countryside of Aleppo, making healthcare more accessible to people who would otherwise have been forced to travel toward the Turkish border in search of quality care.
Idleb Hospital is a life-saving facility for civilians deprived of healthcare options as aerial bombardments have destroyed many medical facilities in the region since the conflict began. The hospital offers services in inpatient and outpatient care, ENT, internal medicine and orthopedic and general surgery. Idleb Hospital also has a Radiology Department to perform x-rays, CT scans and Doppler Ultrasound procedures.
Trauma and emergency healthcare is also provided through SRD’s 21 Ambulance System, a network of ambulances in Northern Syria that ensure access to emergency healthcare and trauma services region-wide. The network provides patients in critical emergency care with transportation to trauma facilities while Emergency Medical Technicians (EMTs) provide life-sustaining treatment during transport.
Injuries sustained during conflict often include those that require follow-up rehabilitative care. In 2013, SRD established rehabilitation services to meet the demand for such care. SRD’s rehabilitative services include a Physical Therapy & Rehabilitation Clinic housed within one of our Primary Health Care Clinics, which also houses an internally operating Dialysis Unit. The Physical Therapy & Rehabilitation Clinic consists of the following specialized rehabilitative departments for adults and children: musculoskeletal injuries, cerebral palsy, amputation cases, brain/spinal injuries and burn wounds. In addition to these, the clinic also provides speech and hearing therapy, treatment for congenital abnormalities and deformities and the creation of splints and casts for injuries.
The Dialysis Unit provides dialysis service, a life-saving treatment that prevents the build-up of waste, salt and extra water in the body by removing them. With a shortage of access to treat two of the leading causes of kidney failure—diabetes and high blood pressure—in Syria, SRD has recognized the priority of maintaining dialysis service at our health clinic.