Translating Humanitarian Emergency into Medical Aid in Syria

Claire Glasscoe


Unexploded Ordnance (UXO)

Handicap International (HI) is an organisation that supports casualties who sustain life-changing injuries and disabilities within armed conflicts. Explosive munitions are doubly dangerous because they don't all explode immediately; instead they litter the vicinity with primed ordnance ready to be detonated by unsuspecting civilians.

In a case study dated May 2015, HI analysed weapons contamination in Syria: 'A time bomb in the making'. Of 77,645 damaging or potentially damaging incidents documented - 83.73% involved explosive weapons and 75% of these occurred in densely populated areas. Landmines, used to control borders caused damage more often in the Syrian countryside where internally displaced people under siege found themselves trapped in some of the most contaminated areas. Indiscriminate use of explosive devices in densely populated areas violates International Humanitarian Law (Additional Protocol 1 to the Geneva Conventions) but that has not curbed their use in Syria. Experiences of those injured by UXO, as well as work being done to reduce the risk of injury to civilians is presented here.

Chemical & Biological Weapons

The Al-Ghouta chemical weapons attack on 21 August 2013 with Sarin nerve gas, a deadly toxin developed in Nazi Germany in 1938 caused international outrage and much talk of 'red lines.' The US government found 1,429 individuals had been killed, 426 of which were children. Many more were expected to have long-term consequences as a result of exposure to this agent.

By 14 September 2013, under pressure from Russia, the Syrian Arab Republic (SAR) acceded to the Chemical Weapons Convention and began dismantling its stockpile of banned toxins under UN supervision. But Sarin as documented by the Syrian American Medical Society in their report 'A New Normal', was then replaced by the Regime with chlorine gas, which converts to hydrochloric acid in contact with water in the lungs and occasionally mustard gas - a toxin more often used as a weapon by ISIS. Turkey is sufficiently worried by these threats to monitor its border with Syria 24/7 while Israel assiduously patrols its borders due to concern over biological weapons they believe the SAR has developed.

What then of the civilian population still inside Syria? Read about their experiences and what is being done to protect them from such hazards.

Infection Control & Immunisation

The collapse of the healthcare system over the last 5 years in Syria has created an environment that promotes the spread of previously well controlled infectious and vector borne diseases. Although there are remnants of an immunisation campaign the delivery of vaccinations has been haphazard, particularly in areas controlled by ISIS and in the north, while in besieged areas immunisation has been actively withheld by the Assad Regime along with other medications.

After its eradication in 1995, Polio has now recurred in opposition-held areas. In her article: 'Syria's Polio Epidemic' for the New York Review of Books, Dr Annie Sparrow, Director of the Human Rights Program in the Arnold Institute of Global Health, Mount Sinai stresses that because of its highly contagious nature, the 90 positively identified cases could fast become 90,000 and it has already spread to Iraq. But that's not all, Dr Issam Raad in his report prepared for the US House of Represntatives, warns of the growing threat of other diseases in the Middle East. A Measles epidemic has been reported in the North of Syria with outbreaks of Hepatitis A detected in the displaced population. Cutaneous Leishmaniasis, a disfiguring disease transmitted by the Sandfly is endemic in parts of Syria but has been exacerbated by malnutrition and poor housing. The conflict and extensive arbitrary displacement has allowed this disease to reach epidemic level and spread to neighbouring Lebanon. Poor sanitation and lack of clean water encourages waterborne diseases such as cholera and typhoid and dysentery is widespread.

How then are these vaccine-preventable and treatable diseases being managed to protect Syrians? The Syrian American Medical Society is one organisation to answer the call to halt the spread of Polio - campaign flyer above.