Translating Humanitarian Emergency into Medical Aid in Syria

Claire Glasscoe


Medical & Paramedical Practitioners

At the start of the conflict in 2011, educated estimates at the time claimed half of the 30,000 medically qualified personnel left Syria rather than practice with compromised medical ethics. This was because the antiterrorist laws proscribed against treatment solely on the basis of need; providing medical assistance to anyone who opposed the Assad regime was considered a criminal offence with severe penalties. Many of those who stayed worked secretly or moved to an area that was controlled by the opposition.

This included students who abandoned their training. Consequently, many healthcare personnel are now practicing under fire in 'Free' areas without a qualification. Those that are qualified still need to keep up to date with new developments for their professional development those that are not qualified need access to medical training at an internationally recognised standard to progress their status to "licensed practitioners" both for now and for the future of Syria. The Nott Foundation aims to provide surgeons practicing in warzones with hands-on and remote guidance in the complex surgical procedures required to manage severe injuries inflicted by explosive weapons. The Union of Medical Care and Relief Organisations (UOSSM) which coordinates medical relief and healthcare to Syrians also supports specialised medical training for doctors, while the Medical Education Council trains anaesthetists to practice inside Syria.

Here I talk with trainers and students about what motivates them, the challenges they face and achievements they have made.

Health Education

The urban landscape for Syrians has changed beyond all recognition with new threats to be faced such as the risk of cholera, the recurrence of polio, the upsurge in cutaneous leishmaniasis and the lack of resources to manage non-communicable diseases (NCD) like diabetes. As a consequence, new information and strategies are needed for citizens of all ages and situation to keep themselves safe, well and free from disease.

However, since an earlier fact finding report by the International Rescue Committee (IRC) it is acknowledged that women are particularly vulnerable to violence and abuse yet they are the ones caring for the young and frail. A subsequent report advocated women's protection and empowerment services through safe spaces for displaced women and girls inside Syria and across the border in refugee camps.

Dr Munzer Al Khalil, Director of Primary Healthcare in Idleb talks with me here about the public health education programme in Idleb’s free Syria and how it has responded to the environmental hazards involved as well as the strengths of this community.

Allied Healthcare

An estimate In January 2015 Handicap International that 80,000 Syrians had lost a limb or it’s functioning as a result of traumatic injury during the Syrian conflict . The implications of this statistic are immense and there is a colossal need to restore both mobility and independent living for those affected. But few are technicians are qualified to fit amputees with prostheses. Injuries that damage the nervous system result in paralysis, which requires complex interventions after surgery – orthotics to support reduced functioning and physiotherapy to coax the body into regaining movement and all these interventions require specialist training. Many Syrians are responding to this burgeoning need by retraining as orthopaedic technicians. The National Syrian Project for Prosthetic Limbs (NSPPL) makes this possible through training apprenticeships in prosthetics and orthotics with funding from Germany, expert trainers sourced from Spain and academic hosting from Ankara University.

Emotional and psychological damage affects the vast majority of the population because of the relentless violence, trauma, devastation of communities under siege and death of family members, humiliation, summary detention and torture. While the need here is boundless the number of qualified practitioners is tiny. Building service capacity in mental health from scratch starts with psychological first aid in primary care. Yet plans are afoot to deliver a better service than there ever was in Syria, which is a breath-taking initiative given the circumstances.

In this section I hear about and discuss these positive developments with the organisations, trainees and trainers involved.