Shortages Force Aleppo Medical Centres to Close

Medical care becomes especially vital when a nation is enduring protracted conflict. In Aleppo in northwest Syria, health centres have operated under dire conditions in the last four years, with little funding, the daily threat of aerial bombardment, and dangers posed by local armed groups.

Clinics and hospitals are run by a handful of specialised doctors, undergraduate medical students, and volunteers with some basic nursing training.

Facing multiple pressures, many have been forced to close down.

Paramedic Hassan Fatuh told Damascus Bureau that health services in Syria were slowly collapsing. He said the number of doctors had fallen by 90 per cent compared with 2010, and domestic production of pharmaceuticals had plummeted.

Another paramedic, Safi, described a typical day at the clinic where he worked.

“We treat injuries caused by barrel bombs, snipers and shells,” he said. “Sometimes we attend to as many as 30 emergency cases a day. We also offer consultations and surgeries for the sick and poorly.”

Safi’s health centre is forced to transfer some patients to Bab al-Hawa hospital near the Turkish border, and to hospitals inside Turkey. He recalled one incident at the beginning of May when the government bombed a school in Seif al-Dawla. Many of the wounded people brought into the centre were sent on to Turkey, especially those suffering head injuries.

“First, there’s the shortage of staff, especially surgeons and neurologists,” he explained. “Then there’s the scarcity of vital medicines like anaesthetics, antibiotics and cancer treatment medication. And finally, there is a lack of equipment like X-ray, scanning and dialysis machines. Not to mention rehabilitation equipment like crutches and wheelchairs.”

Mohammed Arab, a 35-year-old barber from Aleppo’s al-Ansari neighbourhood, told Damascus Bureau he had taken his mother to Turkey several times for liver examinations.

“There isn’t the equipment for this in Aleppo,” he said, “So I have to take her to Turkey to do the tests required, and then we come back to Aleppo, where she receives treatment.”

A report by the Violations Documentation Centre in Syria says that in opposition-held parts of Aleppo, there are ten general practitioners, four paediatricians, three orthopaedic surgeons, two urologists, one A&E doctor, one anaesthetist and one ophthalmologist.

These doctors are scattered around at least ten medical centres plus a number of small clinics.

Healthcare provision in Aleppo is supported by a number of aid organisations including the Syrian-American Medical Society, the Union of Medical Care & Relief Organisations, Islamic Relief Worldwide, Medical Relief for Syria, the Shafak Organisation, Physicians Across Continents, and the International Patients Helping Society.

“These organisations provide medical centres with equipment, medical supplies and salaries,” said Dr Hamza al-Khatib, adding that healthcare provision was hampered by other, unpredictable risks.

“The shortage of medical expertise, and the lack of electricity and fuel to run machinery, are additional burdens,” he said, “not to mention the damage done to equipment by the bombing”.

At the end of April 2015, aerial bombing of Aleppo’s al-Sakhur health centre devastated both the building itself and the equipment and medical supplies it contained. The following day, a second round of airstrikes targeted ambulances, putting the centre out of service.

The Violations Documentation Centre has repeatedly called on all parties to the conflict, especially the Syrian government, to observe international conventions and refrain from bombing hospitals and medical staff.

Hussam Kuwaifatiyeh is the pseudonym of a Damascus Bureau contributor living in Aleppo, Syria.