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Northwest Syria: “COVID-19 adds another layer of complexity to an already catastrophic situation”

MSF’s mobile clinic in a camp for internally displaced people in northwest Syria. March 2020. © OMAR HAJ KADOUR/MSF
Cristian Reynders - MSF field coordinator for northwest Syria
Cristian Reynders, field coordinator for MSF operations in northwest Syria, explains what the potential spread of COVID-19 would mean in Idlib and how MSF is preparing for it.

    Not so long ago, COVID-19 was not yet making headlines worldwide. On the TV news, you’d watch reports on various non-pandemic-related topics. Many of these concerned the humanitarian situation in Idlib province, in northwest Syria.

    The Syrian war has just entered its tenth year and Idlib is currently the area most affected by the conflict. Daily bombing and shelling have displaced almost one million people from their homes in the space of just a few months. Since the start of the year, the fighting has put more than 80 hospitals out of service.

    Not so long ago, Idlib was a humanitarian emergency. Today it still is. The COVID-19 pandemic has added another layer of complexity to a situation that was already catastrophic.

    Last week, Syria confirmed its first case of COVID-19. Since then, the number of cases has risen slightly, but so far, no positive cases have been identified in Idlib. However, our teams do not want to wait for this to happen before bracing themselves for it, because we know how concerning a spread of the disease in such place could be.

    In developed countries such as Italy, Spain and the US, we are seeing public hospitals on the verge of collapse because of the spread of COVID-19. How, then, will Idlib’s health system cope? Healthcare in northwest Syria has been badly affected by the conflict and was already stretched to its limit before the spread of the new coronavirus was declared a pandemic.

    Even if COVID-19 hasn’t yet spread in northwest Syria, people are already faced with a series of unanswered questions and impossible choices. Indeed, most recommendations for protecting people against the virus and slowing down its spread simply cannot be implemented in Idlib.

    How can you ask people to stay at home to avoid infection? Where even is their home? We are talking about almost one million displaced people – at least one-third of Idlib’s total population – most of them living in tents in camps. They no longer have a home.

    Healthcare is of course key, but it is not the only need in Idlib. People still need food, people still need shelter, people still need sanitation. When facing a pandemic, all of these things are essential.
    Cristian Reynders, field coordinator for MSF operations in northwest Syria

    In the camps, we’ve started implementing measures of social distancing when providing our regular services. When running mobile clinics, we now only allow small groups of people to gather around our trucks while waiting for consultations.

    During distributions of essential items, we ask people to keep a certain distance between each other. This way, we are still helping displaced people, but we are also decreasing the risks of them getting the virus when coming for assistance.

    Of course, we also want to protect our own teams and have equipped them with protective equipment, so they can continue working in the camps.

    We’ve been working on getting ready at hospital level too. The medical facilities that remain open in Idlib province play a vital role for the population and we need to focus on supporting them in getting prepared.

    We’ve set up hygiene committees in three different hospitals already supported by MSF. We’ve also set up new triage systems in these facilities to better identify and isolate suspected COVID-19 patients. And we are conducting training in patient-flow management in coordination with local health authorities and the World Health Organization (WHO).

    We are putting everything we can in place, but pragmatically speaking it probably won’t be enough if COVID-19 starts spreading tomorrow in Idlib province. What is happening in northwest Syria today is a humanitarian emergency. A public health emergency in the midst of all this could quickly become catastrophic. Unless…

    …Unless there is immediate international mobilisation. Unless medics and humanitarian organisations are given the means to tackle this potential catastrophe properly before it happens. Unless hospitals are given the supplies and equipment they need to face this ‘crisis on top of a crisis’.

    But the answer to this situation cannot only be medical. Healthcare is of course key, but it is not the only need in Idlib. People still need food, people still need shelter, people still need sanitation. When facing a pandemic, all of these things are essential.

    COVID-19 is touching everyone around the world. Whether people are in Syria or in Italy, they are all connected. This virus affects everybody, no matter their nationality or the colour of their skin. And just as this virus has no borders, I hope that solidarity will have no borders either.

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