Exodus of doctors and health workers leave sick and ailing Syrians out on a limb

Sanctions, isolation, earthquakes and a grinding civil war have devastated Syria’s health system, leaving medical personnel underresourced and overwhelmed, forcing many to leave for Europe. (AFP)
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Updated 13 June 2024
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Exodus of doctors and health workers leave sick and ailing Syrians out on a limb

  • Sanctions, isolation, earthquakes and a grinding civil war have devastated Syria’s health system
  • Overwhelmed, under-resourced, and often unpaid, medical personnel are leaving for Europe in droves 

LONDON: More than a decade of civil war, economic sanctions, regional tensions, and a devastating earthquake have left Syria’s healthcare system in tatters and, according to a top World Health Organization official, forgotten by the international community.

Hanan Balkhy, WHO’s regional director for the Eastern Mediterranean, said last week that almost half of Syria’s health workers had fled the war-torn country. She called for innovative approaches to halt the exodus of Syrian medical staff abroad.

In an interview with the AFP news agency, she said that young doctors needed to be offered better prospects than practicing “fourth-century” medicine amid dire conditions, “where you cauterize people and send them on their merry way.”




An injured man receives emergency treatment at the Samez hospital following bombardment by pro Syrian regime forces in rebel-held northwestern city of Idlib on October 6, 2023. (AFP)

The International Rescue Committee highlighted in a 2021 report that about 70 percent of the medical workforce had fled the country, leaving one doctor for every 10,000 people.

Balkhy told AFP that in addition to earning extremely low wages, if any at all, Syria’s medical staff faced a severe shortage of resources and equipment, including operating rooms, sterilization units, and medications.

However, according to Dr. Zaher Sahloul, a Syrian-American critical care specialist and president of the medical NGO MedGlobal, every young Syrian physician he knows either plans to or dreams of leaving Syria and pursuing opportunities in other countries, “especially Germany, other European nations, or the US.”

“The flight is across the board and not related to war or conflict,” he told Arab News.

According to data released by the German Medical Association earlier this year, 6,120 Syrian doctors work in Germany without holding a German passport. These doctors account for 10 percent of the EU country’s foreign medical staff.

INNUMBERS

• 70 percent Proportion of Syria’s medical workforce that fled the country, leaving one doctor for every 10,000 people. (IRC, 2021)

• 6,120 Number of Syrian doctors working in Germany, accounting for 10 percent of the country’s foreign medical staff. (GMA, 2024)

• 65 percent Proportion of Syria’s hospitals deemed fully operational, making access to healthcare heavily constrained. (WHO, 2024)

• $80 million Funding needed by the WHO for 2024 to ensure access to health services and prevent further deterioration in Syria.

Balkhy said many young doctors in Syria are learning the German language on the side “so that they can be ready to jump,” which she believes is a significant concern for the region and its population.

But she also believes that finding creative solutions may encourage Syrian doctors to stay or return to their country — a choice she says many would make “willingly” with access to adequate support.




A man stands at the entrance of Adnan Kiwan hospital that was hit during reported airstrikes by pro-regime forces in the town of Kansafrah, in the south of Syria's Idlib province on November 25, 2019. The patients of the hospital were reportedly evacuated shortly before the strike took place. (AFP/File)

Sahloul says the main reasons behind the exodus of medical workers “are the economic collapse, hyperinflation, corruption, the collapse of the healthcare system due to long years of war, the regime’s policies of destroying what is left and pushing away anyone who wants to leave, and the lack of a viable political solution.”

Following a brief visit to the country between May 11 and 16, WHO’s Balkhy described the healthcare situation as “catastrophic,” warning that the number of people in need is “staggering, and pockets of critical vulnerabilities persist in many parts of the country.”

In a statement published on May 18, the WHO official wrote that intensifying tensions in the region, including the Israeli operation in the Gaza Strip and the Iran-Israel shadow war, have exacerbated this catastrophic situation.

The civil war has forced more than 14 million Syrians to flee their homes and seek refuge both within the country and beyond its borders. Among them, more than 7.2 million remain internally displaced, while about 70 percent of the population needs humanitarian assistance, according to UN figures.




Dr. Hanan Balkhy, WHO’s regional director for the Eastern Mediterranean. (Supplied)

Balkhy said in her statement that she was “extremely alarmed” by the increasing malnutrition rates among children under 5 and nursing mothers as a result of rising poverty.

The UN warned last year that 90 percent of Syria’s population lived below the poverty line, with millions facing a reduction in food rations due to a shortfall in funding for aid agencies.

According to the WHO regional director, almost three-quarters of all deaths in Syria are caused by chronic conditions, including cancer, cardiovascular diseases, diabetes, and mental health disorders, many of which are going untreated.

She also noted the number of burn injuries in Syria has been disproportionately high, especially among children, as people, deprived of traditional means of heating and cooking, burn unsuitable materials, such as tires, plastics, and fabrics.




In this picture taken on May 2, 2023, male patients receive treatment at the Haematology and Oncology department run by the Syrian American Medical Society (SAMS) at Idlib Central Hospital in the rebel-held northwestern Syrian city.(AFP/File)

Fumes produced by burning these substances also result in respiratory issues.

With just 65 percent of hospitals and 62 percent of primary healthcare centers fully operational, combined with a severe shortage of essential medicines and medical equipment, access to healthcare is constrained.

Before the war erupted in 2011, Syria’s pharmaceutical industry covered about 90 percent of the national needs of medicines, according to a 2010 paper by academics from the University of Medicine and Pharmacy in Romania.

In 2013, WHO reported that the country’s local drug production plunged after the fighting caused substantial damage to pharmaceutical plants in the governorates of Aleppo and rural Damascus.




A picture taken on February 21, 2018 shows a view through the wall of a destroyed hospital's pharmacy after it was hit in a regime air strike in the rebel-held enclave of Hamouria in Ghouta near Damascus. (AFP/File)

Poverty also creates significant barriers to accessing medical services and affording essential medicines, said Balkhy.

What concerned her most was “the fact that almost half of the health workforce, which forms the backbone of any health system, has left the country.”

An investigation by Arab Reporters for Investigative Journalism last year found that although the exact number of Syrian physicians who left the country remains unknown, the true extent of this exodus is larger than the NGOs and the Syrian government have reported.

“Retaining a skilled health workforce and ensuring sufficient medical supplies in Syria and across the region is a key priority,” said Balkhy.




Members of the Syrian Civil Defense, also known as the White Helmets, carry the body of a woman recovered from the rubble of a building at the site of a reported airstrike on the rebel-held town of Ariha in the northern countryside of Syria's Idlib province early on January 30, 2020. (AFP/File)

She proposed engaging young Syrian physicians on research projects with a pathway to publishing so they can “feel that they’re doing something worthwhile,” in addition to ensuring they “at least have the equipment” to perform operations.

For Sahloul of MedGlobal, fostering a belief in a brighter future is essential to retaining both new and seasoned doctors.

“What will encourage young and old doctors to stay in Syria is believing in a better future — a new leadership that respects its human capital,” he said.

Sahloul said that international and Arab actors need to devote more attention to finding a genuine solution to the Syrian conflict — “one that ensures respect for human rights and dignity, and focuses on rebuilding.”




A man and woman carry malnourished children at a camp for Syrians displaced by conflict near the town of Deir al-Ballut by Syria's border with Turkey in the Afrin region in the northwest of the rebel-held side of the Aleppo province on September 28, 2020. (AFP/File)

He added: “The current Arab normalization with the regime is flawed because it gives no hope for any meaningful change.”

Sahloul said normalization’s priorities, including refugee repatriation, curbing the manufacture of and trade in the amphetamine drug Captagon, and limiting Iran’s influence, “are not the most important priorities to the young graduates and aspiring doctors in Syria.”

Balkhy emphasized that the decline in humanitarian funding for Syria was a “central and troubling concern.” 

For instance, Al-Hol camp in Syria’s northeast — home to the wives and children of Daesh militants captured in 2019 — has grappled with many significant challenges since funding shortages forced WHO to halt medical referrals, prompting camp administrators to revoke its access.

Talks with donors in the capital Damascus during her five-day visit revealed that while they acknowledge the extent of gaps and needs, they are hampered by competing regional and global agendas.

Medecins Sans Frontieres warned on April 29 that the severe lack of funding for a vital WHO-funded medical referral system in 11 camps in northeast Syria “will lead to a marked increase in the number of preventable deaths.”

WHO said in March that it required $80 million in funding for the year 2024 to ensure the continuity, quality, and accessibility of health services and infrastructure in Syria, and to prevent a further deterioration of the already precarious situation.


 


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Houthis blame Israel for Yemen port strike

HODEIDAH: The Houthis blamed Israel Saturday for a series of strikes on a fuel depot in the militia-held Yemeni port city of Hodeidah, adding that the strikes caused casualties.
“The Israeli enemy’s raids on oil storage facilities in the port of Hodeidah” have led to deaths and injuries, the militia’s health ministry said in a statement carried by Houthi-run media, without specifying a toll. Israel has yet to comment on the strikes.

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UAE launches investigation into Bangladeshi expats arrested for alleged riots

DUBAI: UAE Attorney-General Hamad Saif Al-Shamsi has ordered an investigation into the arrest of several Bangladeshi nationals who were apprehended for inciting riots across multiple streets in the UAE on Friday.

A dedicated team from the public prosecution has promptly begun investigating the arrested individuals, Emirates News Agency, WAM, reported on Saturday.

Preliminary findings suggest that the suspects engaged in criminal activities, including assembling in public spaces and protesting against their home government, WAM added.

These actions were allegedly intended to incite unrest, obstruct the enforcement of law, disrupt individual interests, endanger others and violate their rights, impede traffic, and cause damage to both public and private property.

It is alleged that the suspects deliberately disrupted transport networks, organized and promoted these demonstrations, and recorded and disseminated audiovisual footage of their actions online.

Such activities are considered offenses against state security and public order in the UAE.

The public prosecution has ordered the pre-trial detention of the suspects pending further investigations. Al-Shamsi has also directed that the suspects be referred to an expedited trial.

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Police have fired tear gas to scatter protesters in some areas while the government has banned public gatherings, imposed communications restrictions, deployed the army in some parts and imposed a curfew. Dozens have been killed in the past week.


Jordan sends 83 aid trucks to Gaza

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Jordan sends 83 aid trucks to Gaza

  • Contents of the trucks include food parcels, blankets, clothes and health care supplies

AMMAN: Jordan announced that a convoy of 83 trucks containing humanitarian aid was headed to Gaza on Saturday, Jordan News Agency reported.

The contents of the trucks, including food parcels, blankets, clothes and health care supplies, will be distributed to Palestinian civilians via partner associations and organization in the Strip.

The convoy was sent by the Jordanian Armed Forces-Arab Army and the Jordan Hashemite Charity Organization. It was sent in collaboration with the World Food Programme and funded by the Helping Hand Society and Human Appeal.

JHCO Secretary-General Hussein Shibli highlighted the scale of Jordan’s aid initiative to Gaza, noting that the substantial donations from local, regional and international bodies underscored the trust Jordan commands globally and its capability to deliver aid effectively to the region.

Shibli said that to date, the number of trucks to have entered Gaza had reached 2,694, in addition to 53 planes via El-Arish in Egypt.
 


Emirati market opens in Qingdao to celebrate 40 years of UAE-China relations

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Emirati market opens in Qingdao to celebrate 40 years of UAE-China relations

  • Market includes pavilions selling dates, traditional handicrafts, and popular Emirati cuisine

DUBAI: The UAE opened an Emirati market in Qingdao on Saturday as part of the UAE-China Friendship Festival, which ends Sunday.

The festival marks 40 years of diplomatic relations between the two nations, showcasing a diverse array of Emirati products and arts to the Chinese public, the Emirates News Agency (WAM) reported.

The market includes pavilions selling dates, traditional handicrafts, and popular Emirati cuisine. There is also an exhibition chronicling the development of relations between the UAE and China.

The festival also features a “comprehensive cultural program” that includes performances of traditional arts “celebrating the UAE's national identity,” as well as workshops.

This event is part of a broader series of activities in both countries aimed at “enhancing mutual understanding and fostering new opportunities for cooperation across various sectors,” according to WAM.
 


UAE, GCC welcome ICJ ruling on Israeli settlements in Palestine

Updated 20 July 2024
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UAE, GCC welcome ICJ ruling on Israeli settlements in Palestine

  • ICJ had reinforced the Palestinian people’s legitimate rights under international law, Albudaiwi says

DUBAI: The UAE and the Gulf Cooperation Council have welcomed a ruling by the UN’s top court that Israeli settlements on Palestinian territory break international law.

The International Court of Justice issued the judgment, which is non-binding, on Friday.

The court ruled that “the transfer by Israel of settlers to the West Bank and Jerusalem as well as Israel’s maintenance of their presence, is contrary to article 49 of the Fourth Geneva Convention.”

The UAE Ministry of Foreign Affairs said the country rejected all measures aimed at altering the historical and legal status of occupied Palestine.

The ministry condemned practices that contravene international resolutions, warning that such actions “threaten further escalation and instability in the region, and hinder efforts to achieve peace and stability.” It also emphasized the importance of supporting initiatives to advance the peace process in the Middle East as well as bringing an end to “Israel’s illegal practices that undermine an independent Palestinian state.”

GCC Secretary-General Jassem Mohamed Albudaiwi said that the ICJ had reinforced the Palestinian people’s legitimate rights under international law and UN resolutions to reclaim territories occupied by Israel. He asserted that the settlement activities and geographic changes imposed by Israeli forces are “illegitimate and lack regional or international recognition.”

Albudaiwi reiterated that the Occupied Territories remain “the inherent right of the Palestinian people” and reaffirmed the GCC’s steadfast support for the Palestinian cause, advocating for the establishment of an independent Palestinian state within the borders of June 4, 1967, with East Jerusalem as its capital.

The ICJ’s ruling comes against the backdrop of Israel’s devastating bombardment on Gaza, following the Oct. 7 attack by Hamas on Israeli settlements adjacent to the Palestinian enclave.

Israel captured the West Bank, the Gaza Strip, and East Jerusalem in 1967, but Palestinians consider those areas to be an integral part of any future independent state.

The ruling was also welcomed by Saudi Arabia and the Muslim World League.