Four hospitals inside Syria and 100,000+ consultations for Syrian refugees
May 1, 2013
MSF Syria-Crisis April 2013 Update
The conflict in Syria is extremely intense, with moving front-lines, enclaves of people cut off from assistance, an estimated 6.8 million people in urgent need of humanitarian assistance and a collapsed health system. Despite the very real challenges of operating in the country, MSF now has four hospitals, increasing mobile clinic activities around some of these hospitals, and a strategy of actively seeking to open new projects where it is safe to do so. In order to be entirely independent of all political positioning around the Syria crisis, MSF only uses private donations for its work in Syria.
Some 1.4 million Syrians have fled to neighbouring countries that are overwhelmed and where the humanitarian response has so far been unable to meet their needs. MSF is carrying out medical consultations and distributing relief items to refugees in Iraq, Jordan, Lebanon and Turkey.
Activities inside Syria
Within Syria, the MSF operations are scaling up as fast as is safely possible, but are still limited to four pockets where MSF is able to have teams on the ground running high quality medical activities. While MSF continues to negotiate for access through Damascus, for now it is only possible for MSF to work in opposition-controlled areas.
=> Near Aleppo an MSF hospital provides more that 1,500 consultations and around 70 surgical operations per month. Another MSF team set up a blood bank (now handed over to Syrian doctors) to supply the hospitals in Aleppo area, and then started providing vaccinations for children as the war had brought normal vaccination activities to a halt.
=> In Idlib governorate, MSF has two hospitals. “We’re on permanent stand-by for mass casualty influxes but on a day-to-day basis this is not our core activity,” says Alex Buchmann, recently returned project coordinator of one of the hospitals. “Any medical services that are still somehow operational in this area are focused on war wounded, so for people with difficult pregnancies, chronic diseases, fevers or general illnesses, the only options are our hospital and mobile clinics. Sometimes there are wounded, but all the time there are other illnesses that need treatment.”
The other MSF hospital in this area has a highly specialised trauma and surgical department, where so far more than 1,160 surgical operations have been performed mainly for violence related injuries and more than 2,800 patients have received emergency care, including many patients with extensive burns sustained from accidents with home heaters or when using home-made crude oil refining kits. Physiotherapy care is also provided to patients after surgery, in the hospital or in a post-operative unit.
To improve the water and sanitation situation in an IDP camp, MSF is building 50 latrines and 50 showers. A vaccination campaign was organized for children under five; 3,300 were immunized against polio and 2,000 against measles.
=> In Al Raqqah governorate, fighting and bombing in and around Al Raqqah town has led tens of thousands to flee to already-struggling villages in the area. MSF has already seen some 300 measles cases (a clear sign of the collapse of the healthcare system). The MSF team has started providing out-patient consultations in a health centre and is shortly to start a maternity service, treatment for chronic diseases, an Emergency Room and an in-patient department.
Most of the MSF teams are also engaged in mobile clinic activities and some of the projects have introduced a mental health service, which is critically needed after two years of intense conflict. MSF also has an extensive activity of supplying medical and emergency relief supplies to hospitals and clinics on both sides of the conflict in Syria, including Al Raqqah, Damascus, Deir Ezzor, Deraa, Hama, Homs and other areas.
Activities inside Syria in numbers (to end March 2013):
- Surgical procedures – 1,794
- Consultations – 32,784
- Deliveries – 499
Activities for Syrian refugees
The neighbouring countries are doing a huge amount to assist refugees, but the sheer numbers ― more than 1.3 million and rising fast ― are overwhelming the humanitarian response capacity.
=> In Iraq, an estimated 133,000 refugees are registered or awaiting registration, many in the north of the country. Domeez camp, in Duhok province, was initially designed to host 1,000 families, but is now hosting more than 35,000 refugees. As many as 1,000 people have been crossing from Syria into this part of Iraq every day but there are not enough services in the camps to keep pace with the increased demand.
Lack of shelter is especially critical and newly arrived refugees must share tents, blankets, mattresses, and even their food with other families. Water and sanitation services are poor, and access to water will remain difficult with summer approaching.
MSF is the main healthcare provider in Domeez refugee camp, providing general health care, mental health care, and reproductive health care. The teams have provided more than 64,800 consultations and have carried out a measles vaccination for 31,000 people.
=> In Jordan, over 450,000 Syrians refugees are registered or awaiting registration and around 1,000-3,000 people continue to arrive daily. It is estimated that if arrivals continue at this rate then 1 million refugees may have arrived by the end of 2013. The Jordanian health system is overburdened with the continuous influx of refugees and wounded from Syria, leading to the terrible situation where some patients die while waiting for referral.
Zaatari camp has become a makeshift home to more than 100,000 Syrian refugees. Access to water is a growing concern with the upcoming summer, as Jordan normally has to deal with water shortages even without a refugee influx.
MSF is running a 24-hour paediatric 30-bed hospital in Zaatari camp and an emergency room with three beds for children from one month up to 10 years old. By mid April MSF had hospitalized 72 patients and carried out 277 emergency consultations. In addition, MSF was already running a reconstructive surgery hospital in Amman. Major surgical cases are referred from the camp to this MSF hospital where they are offered physiotherapy, psychosocial support and post-operative care, as well as technically advanced surgical procedures.
=> In Lebanon, the main identified needs for over 450,000 refugees are primarily accommodation, food, primary and secondary health care, and mental health care.
MSF is assisting refugees through primary health care including immunization, treatment of chronic diseases, antenatal care, and mental health care, as well as distributing relief items. MSF’s project locations are in Tripoli, North Lebanon, where the biggest number of Syrian refugees is staying, as well as in the Bekaa valley, the main crossing point for people fleeing Syria. Teams have also carried out activities in northern Akkar district and in the southern town of Tibnine.
=> In Turkey, the number of people fleeing from the area around Aleppo keeps increasing. Official figures of Syrians registered and accommodated in 13 camps in Turkey amount to 177,387, reaching the capacity of these camps. But there are also many refugees ― estimates range from 70,000 to 100,000 Syrians ― without passports who are not taken into account for any distributions or relief services.
MSF is working in an out-patient clinic in Kilis and is providing mental health support to unregistered refugees not living in the camps as well as for refugees in Kilis and Islahiya camps.
Activities for Syrian refugees in numbers (to end March 2013):
- Consultations – 110,019
- Emergency vaccinations – 31,000 people for measles in Domeez camp
- Post-operative rehabilitation – 2,517 patients in the hospital in Amman