© MSF
26 Feb 18 27 Feb 18

Syria: Doctors and nurses collapsing as medical response in East Ghouta reaches its limits

The number of casualties in Syria’s besieged East Ghouta enclave are soaring as the capacity to provide healthcare is in its final throes.

Hospitals and clinics supported by MSF have seen more than 3,700 wounded and more than 700 dead after just seven days of intense bombing and shelling, from the evening of Sunday 18 to the evening of Sunday 25 February.

“Our medical point was bombed. We relocated to another place. That place also got bombed. That second time, the rescuers and others around the area rushed in to excavate people from under the rubble and that’s when a second bombing happened on that same spot, just when the people were all gathered there. We had around 100 people wounded and no working facility.”
Male medical assistantworking in a health clinic, 23 february

However, these figures are certainly an under-estimate, as the number of facilities that were able to report is decreasing, and many facilities in the area that MSF does not support have also received wounded and dead.

Women and children majority of wounded

On Friday 23 February, women and children represented 58 percent of the wounded and 48 percent of the deceased recorded by the nine MSF-supported facilities that managed to report figures.

Over the same period 13 medical facilities, fully or partially supported by MSF, have been hit by bombs or shells.

“Our hospital is full, and we already got hit twice. When the patients started overflowing, we reassigned another location normally used as an outpatient clinic close to us. We are now using it just to have enough space to give whatever care we can to the patients. We are 250 people (between staff and patients) and we have nothing to eat.”
Male doctorworking in a field hospital, 24 February

Medics in East Ghouta who were already pushed to the brink have been working now for seven days straight, without a break, with no realistic hope of being able to adequately treat their patients in such extreme circumstances.

We are calling for an immediate ceasefire to enable the basic human act of helping the sick and wounded.

“As a nurse who has worked through extremely grim conflicts, I am devastated to hear doctors and nurses in East Ghouta saying they have 100 wounded patients and no hospital because it has just been reduced to rubble by bombing,” says Meinie Nicolai, General Director of MSF.

“There is a level of desperation and exhaustion that comes from working round the clock, finding no time to sleep, no time to eat, permanently surrounded by bombing, and simply being in the middle of absolute distress.

"Adrenaline can only keep you going for so long. If doctors and nurses collapse, humanity collapses. We must be determined to not let that happen.”

Supplies urgently needed

On the third day of this offensive, the medics that MSF supports were calling for increased medical supplies.

Now, after seven days of incessant bombardment, they are saying that even with supplies they would have no physical capacity left to keep treating the wounded. They are calling for the bombing to stop.

As the war in Syria has increased in intensity, the frequent calls by MSF and others for International Humanitarian Law (IHL) to be respected have fallen on deaf ears.

MSF is now adding a specific plea: for the medics to be able to do their job. The shelling and bombing by the Government of Syria and the armed opposition groups in East Ghouta must pause immediately - we call on the supporters of these belligerents to use their influence to alleviate this extreme situation.

“It’s getting very difficult to refer patients. Anytime an ambulance leaves the facility, it gets bombed. The only way we have to refer patients is via tunnels.”
male doctorworking in a field hospital, 24 february

With high numbers of medical facilities hit and damaged or destroyed, with roads for transferring patients either impassable because of bomb-rubble or from fear of bombing, with medical supplies limited or entirely lacking, and with extraordinary numbers of patients and exhausted medics, a humanitarian response is urgently required.

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MSF insists the following should be included in the response:

  • Pause the bombing and shelling to allow a reorganisation of the medical response;
  • Allow medical evacuation of the most critical patients;
  • Allow independent humanitarian medical bodies to enter the area to provide hands-on assistance;
  • Provide a massive resupply of life-saving medicines and medical supplies; and
  • Ensure before, during and after any pause in fighting that civilian areas on both sides, including medical facilities, are not hit.

We call individually on the member states of the UN that are militarily engaged in Syria or are supporting warring parties in Syria to acknowledge their complicity in the unfolding medical catastrophe and to urgently exert their influence to alleviate this crisis.

Header image: The last two functional ambulances in the Al-Marj neighbourhood of East Ghouta were destroyed beyond repair in an aerial bomb attack on 5 December 2016.

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