The Syrian civil war is now in its fourth year and continues to be defined by brutal violence that does not distinguish between civilians and combatants.
An estimated 200,000 people have been killed, and half the population is displaced either within Syria or in neighbouring countries.
Entire communities are besieged and cut off from any outside assistance and people are trapped between the ever-shifting frontlines.
Thousands of doctors, nurses, pharmacists and paramedics have been killed, kidnapped, or displaced by violence, leaving a massive gap in medical expertise and experience.
With millions of people in need of assistance, Médecins Sans Frontières/Doctors Without Borders (MSF) – who has worked in the country since 2009 – should be running some of the largest medical programmes in its 44-year history, but it is prevented from doing so.
Violence and insecurity, attacks on health facilities and medical workers, the absence of government authorisation and the reneging by armed groups on guarantees of safety for our teams have been some of the main obstacles to a more extensive programme of medical humanitarian aid.
MSF in and around Syria
A man who brought his sister to an MSF field hospital
“We heard the sound of explosions… I told my sister to move and find shelter, as it was close. She was behind me, about five metres. A bomb landed near her. She was covered in rubble. I shouted: “Are you hurt, sister?” She replied: “Yes, I am!” I ran towards her and saw that shrapnel had hit her face. Blood was coming out of her neck … We shouted for a car. Thankfully there was one nearby. We took her to the hospital, where they stopped the bleeding. Her situation is stable now.
If there were no hospital, she’d have died. We need medical care. In my sister’s case, she needs doctors, care, drugs. As you know, we have nothing here. We need support in medication, doctors, ambulances capable of transporting patients immediately, everything.”
An MSF-supported hospital director describes the horror of a mass-casualty influx in northwest Syria.
“The planes circled above us in the late afternoon and we waited. Would we become casualties? Would we become numbers?
“At around 3pm we heard a deafening sound as a result of three rockets exploding in a town nearby. A town overwhelmed, desperate locals living alongside many displaced people from other areas in Syria…
“There was blood everywhere, but we were running out of blood bags. Men and women donated their own blood to strangers.
“With the descent of night it became impossible to find people alive under the rubble. We will continue to find dead bodies in the next few days.
“As a medical team, the only choice we have is to replenish our supplies, gather our hopes, and prepare for the next tragedy.”
Hover over the image below for an interactive guide to MSF in Syria
MSF’s work in Syria: 2014
In January, so-called ‘Islamic State’ gunmen abducted 13 MSF staff. While eight Syrian colleagues were released hours later, five international staff members were held for five months.
Because of the insecurity, we had to withdraw international teams and close a field hospital in Jabal al-Akrad, in Idlib governorate, and two nearby health centres.
We were able to keep open a different 15-bed hospital in Idlib, where our teams treated some 5,800 patients in the emergency room, treated 1,800 burn victims, and performed more than 3,800 surgical interventions.
We also vaccinated more than 11,000 children from displaced families against measles and provided routine vaccines for children younger than three.
In 2014, we ran three health facilities in Aleppo governorate, an area of intense fighting.
One has 28 beds and offers emergency, maternity, and outpatient care, along with vaccinations, , orthopedic services and chronic disease care.
A second was closed in August for security reasons. It had provided healthcare for adults and children, including surgery, burn care, maternity services, and ante and postnatal care.
MSF’s other hospital in Aleppo governorate carried out around 22,000 outpatient consultations, more than 12,300 emergency room consultations and more than 500 surgical interventions, while also offering vaccinations, antenatal care, and mental health support.
In Ar-Raqqah, where health centres struggle to maintain supplies and staff, MSF ran a clinic and supported a paediatric ward in Tal Abyad Referral Hospital. Our teams conducted more than 5,200 outpatient consultations and vaccinated 7,000 children against measles.
In northeast Syria, MSF provided staff, drugs and supplies – all of which are in short supply – to support pre and postoperative care in a hospital’s trauma ward, rehabilitated the maternity ward, and ran two clinics offering outpatient consultations and mother-and-child care.
Near the Iraq border, we ran clinics for mothers and children as well as running polio vaccinations.
MSF also continues to support more than 100 Syrian-run medical programmes with drugs, supplies, technical support, and, in some cases, ambulances, in government- and opposition-controlled areas in six governorates, including besieged areas outside Damascus.
Find out more in our 2014 International Activity Report.
At the end of 2014, MSF had 729 staff working in Syria. MSF first began working in the country in 1999.
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