The Syrian conflict that began in 2011 has created the biggest displacement crisis since the Second World War

Millions of people are in desperate need of lifesaving humanitarian aid.

Map of MSF's activities in Syria, 2015

Some 4.8 million people have fled the country and an estimated 6.5 million have been internally displaced as government troops, opposition forces and insurgent groups battle for power and control of territory.

The complex war has been characterised by extreme violence: civilian areas have been routinely bombed – often in ‘double-tap‘ attacks in which the initial strike is followed by a second on rescue teams or on the healthcare facility receiving the wounded; and there have been attacks resulting in symptoms of exposure to chemical agents.

In east Aleppo, since the siege began in July 2016, functioning hospitals have been damaged in over 35 separate attacks. Some hospitals have been hit multiple times and have been forced to close as a result.

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The Syrian government continues to deny repeated requests by Médecins Sans Frontières/Doctors Without Borders (MSF) to access government-controlled areas. In a country where we should be running some of our largest medical programmes, the opportunities to reach people and to respond in a timely manner to the enormous needs remains extremely limited.

This is a forceful reminder of how access to medical care is by and large not respected and is in many cases directly targeted by those involved in the conflict and used for political purposes.

Following the Islamic State (IS) group’s abduction and release of MSF staff in 2014, and the impossibility of obtaining the necessary guarantees from IS leadership that MSF patients and staff will not be taken or harmed, the difficult decision was taken to withdraw from IS-controlled areas.

MSF’s activities have consequently been limited to regions controlled by opposition forces, or restricted to cross‐frontline and cross‐border support to medical networks.

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MSF’s work in Syria: 2015

In 2015, MSF continued to operate six medical facilities in different locations across northern Syria and saw an increase in the number of people with medical complications caused by delayed medical care, and in infections and deaths due to shortages of antibiotics.

MSF also increased its support programme to around 70 healthcare facilities run by Syrian doctors, with a particular focus on besieged areas. MSF provides technical advice, medical supplies, salaries and fuel, and helps rebuild damaged buildings.

MSF also gives ad hoc support such as medical donations to around 80 other medical facilities in emergency situations, for example massive influxes of casualties. No MSF staff are present in these supported facilities.

During 2015, 23 MSF-supported Syrian health staff were killed and 58 wounded. Furthermore, 63 MSF-supported hospitals and clinics were bombed or shelled on 94 separate occasions in 2015; 12 of these facilities were completely destroyed.

Aleppo governorate

The situation deteriorated significantly in Aleppo city in 2015, with targeted attacks on civilian infrastructure such as markets, water supplies and health facilities throughout the year. The intensification of the conflict in Hama and Idlib forced thousands of families to flee to Aleppo governorate.

MSF staff at the 28-bed MSF-run hospital in Azaz district conducted over 32,500 outpatient and 17,000 emergency consultations, and performed 1,200 surgical interventions. The teams also saw 6,000 patients for antenatal, postnatal and family planning consultations and delivered 409 babies.

MSF received reports of attacks on nine health facilities around Aleppo in May, including six hospitals – one was the MSF-supported al Sakhour hospital in Aleppo city, which was forced to suspend activities after being bombed at least twice on consecutive days.

In June, MSF had to close its field hospital in Maskan due to ongoing insecurity – the hospital had performed 5,834 outpatient and 2,495 emergency consultations, and assisted 51 deliveries.

Hassakeh governorate

Fighting between armed groups intensified in north east Syria in 2015. MSF worked in a maternity hospital in the area, where 1,559 births were assisted, including 393 caesarean sections. Regular medical equipment and supplies were also donated.

Idlib governorate

MSF continued to run the Atmeh burns unit in Idlib, where over 6,800 medical consultations and 5,500 surgical interventions were conducted, and 3,100 patients were enrolled for mental health services. More than 7,000 children were vaccinated against measles and over 3,500 newborns against hepatitis B.

Besieged areas in Homs and Damascus governorates

More than a million people in opposition-controlled neighbourhoods have been under military siege in Damascus and Homs governorates, plus several hundreds of thousands more in Deir ez-Zor and other areas where MSF has not been able to organise support activities.

On average, more than 300,000 patient consultations were carried out per month in MSF-supported health facilities in besieged areas.

"In 10 documented mass-casualty influxes, such as after the bombings of schools or playgrounds, between 60 and 90 percent of the victims were women and children."

Dara’a governorate

MSF provided medical donations, relief items and technical support to six hospitals and health posts across Dara’a governorate, helping Syrian medical networks undertake 118,000 outpatient consultations, admit 5,800 patients for care and assist more than 2,000 deliveries.

These hospitals also treated more than 8,000 victims of violence.

Documentation of war-wounded

A report compiled by MSF and released in early 2016 showed that 154,647 war-wounded patients were received in 2015 in MSF-supported hospitals and clinics in north west, west and central Syria (Aleppo, Homs, Hama, Idlib, Lattakia and Damascus governorates), and 7,009 war-dead were documented.

Women and children accounted for 30 to 40 percent of the victims. In 10 documented mass-casualty influxes, such as after the bombings of schools or playgrounds, between 60 and 90 percent of the victims were women and children.

Find out more in our 2015 International Activity Report.

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