Translating Humanitarian Emergency into Medical Aid in Syria

Claire Glasscoe



In areas that are besieged by the Assad regime, the opposition or ISIS, military checkpoints are set up to restrict or completely prevent the flow of people and basic supplies, such as food, clean water and medicine. This is where a corrupt siege economy thrives. Enab Baladi newspaper describes a situation evolving now where trade crossings between the regime and the opposition within the country have become more like border crossings.

Being caught while trying to leave a regime-controlled area under siege without permission would be met with arrest or summary execution. Umm Zohour requested to leave Homs with her daughter Gharam who suffered an injury to her eye and jaw in 2012 when the Assad regime fired rockets at their home before the blockade was imposed. Surgery in a field hospital resolved the injury to this girl’s jaw at the time but the injury to her eye was not treated and remains problematic. She and her mother describe three options they had of leaving the city to access more complex medical care: through sewage tunnels; by requesting a permit to leave, which resulted in this mother’s imprisonment; and, by a negotiated agreement between the UN, the regime and the Free Syrian Army to evacuate wounded people. Here Um Zouhour and Gharam describe their three-and-a-half year quest to reach Turkey to obtain ophthalmic treatment.

Explosive & Incendiary Devices

As the conflict in Syria developed, so too have the methods of mass destruction: rockets and mortars quickly spiralled into barrel bombs, elephant bombs, vacuum bombs, bunker busting bombs, cluster bombs and incendiary devices which contain thermite and other highly flammable substances. Indiscriminate use of such weapons contravenes International Humanitarian Law when they are used in populated areas, endangering civilians and civil society.

The 2008 Convention on Cluster Munitions provides an international framework for eradicating these weapons but principle state actors involved in the conflict in Syria are not members or signatories to the convention; namely Syria, Russia and the US-led Coalition (excepting UK).

According to Physicians for Human Rights, hospitals inside Syria’s opposition held areas were targeted with explosives devices more than 465 times up until June 2017, killing 809 healthcare personnel; 91% of these attacks were carried out by the Assad government and Russia. The Syrian medical community has responded to this onslaught by retreating to safer places to practice – in basements, caves and by building hospitals deep underground. At an international level the Syrian regime’s offensive strategy is conceptualised as a 'weaponisation of healthcare' in a paper published by the Lancet–American University of Beirut Commission on Syria: Health in Conflict, and they believe this is a precedent that needs to be robustly challenged.

I talk here with those who have been on the receiving end of excessive explosive weapons’ use inside Syria’s healthcare and hear from those who continue to provide a medical service despite the risks and are now capacity building underground.

In regime controlled areas families worry about their fighting aged men (18-42 years) being conscripted because of the depletion in SAA forces through desertion (400,000 in 2011 to 180,000 now) and anyone perceived to support the opposition is prone to arbitrary arrest and disappear into the prison system. The Syrian Network for Human Rights (SNHR) document 74,607 enforced disappearances from 2011 – 2016. Loyalist militia and criminal gangs also operate in regime controlled areas with reports that the majority of kidnapping cases in Damascus are young men and women who belong to families known for their wealth, with the aim of demanding ransom.

Amnesty International exposes the extent of abductions, torture and summary killings by extremist militias in opposition held areas of in the NorthWest of Syria where summary arrest and a Sharia court ruling may settle a charge of wrongdoing. But the climate is ripe for bartering and while funds for weapons may be at a premium, abduction is also an opportunity for prisoner exchanges.

I speak with those whose families have been adversely affected by this seemingly lawless free-for-all environment Syria has become.