In Europe, the so-called “Phase 2” of the COVID-19 pandemic began. It is a first attempt to gradually reopen after the end of the lockdown due to a slow decrease in the number of infections among populations. At the same time there are areas of the world where the fear of a forthcoming spread of the virus continues to alarm about the already highly unstable and precarious health, political and economic conditions.
Syria has been a country in conflict since March 2011. Nine years of complex humanitarian crisis have forced over 6.8 million people to leave their homes, leave without knowing when to return. COVID-19 arrived before they returned, spread throughout the Middle East and today there are 47 affected people in Syrian territory (of these, 3 victims and 29 people recovered).
But it is necessary to consider numbers in relation to the context they are related to. 47 infections in a country like Syria – where just half of the hospital facilities are functioning and the remaining part was destroyed by bombing during the conflict years – can be considered a condition of high health risk.
11.7 million people still need humanitarian assistance today and 6.2 million are internally displaced. The humanitarian needs in Syria are large and complex, and the health sector is undoubtedly among the most fragile. The lack of clean water, which is essential to put in practice correct hygiene measures, is a problem common to many parts of the country.
The pandemic, in a conflict scenario, is a drama in the drama. There is an immediate need to increase road transport and the supply of hygiene products such as soap, which is fundamental for the banal although decisive hand washing. “A large part of the Syrian population lives in high density urban centers, informal settlements or overcrowded camps, making the application of the spacing measures almost impossible“, says Giulia Campigotto, INTERSOS program manager in Syria, “since the beginning off the emergency, we started a project in collaboration with SARC (Syrian Arab Red Crescent), to prevent and contain the possible spread of the virus”.
INTERSOS’s intervention is aimed at supporting the national response plan to COVID-19 implemented by the Syrian ministry of health and the SARC response plan, intervening in the densely populated areas of Damascus and Hama, characterized by the presence of a high number of displaced persons (one in three people in these areas was forced to leave their usual place of residence).
The humanitarian response of INTERSOS is articulated on different fronts: prevention of the infections (called IPC, prevention and control of infections) through the training of medical-health personnel, distribution of medical material, monitoring of the proper functioning of medical screening, community awareness by the dissemination of prevention messages via radio and, finally, the training of health and non-health community workers, creating a “sentinel” system in the community for the early detection of suspected cases.
“The training of local communities becomes an essential element to face the risk of contagion”, says Giulia, “through the training of some members of the communities, we are able to inform people about good hygiene practices and the risks of the disease“, a job of prevention that starts from knowledge.
Through specific trainings on prevention and response to the COVID-19 virus, INTERSOS operators are training 50 people including health workers and SARC volunteers. The public health system is fragile after years of conflict. There is a general shortage of qualified personnel and adequate facilities for treatment: if in the Damascus governorate only 18 hospital beds are available for 10,000 people, in many other governorates there are none. In rural Damascus there are 5 beds per 10,000 people, Homs and Dar’a both have 3, which is well below the normal standard indicated by the Interagency Standing Committee (IASC) which provides a minimum of 10 beds per 10,000 people.
The global emergency of the pandemic requires each state to be able to deal with it with measures suitable for the safety and health of the populations, but to date it is estimated that the Syrian health service has a maximum capacity to handle 6,500 cases.
If the COVID-19 contagion were to increase over the next few weeks, Syria, already suffering from one of the most serious humanitarian crises on the planet, could enter a dark phase with no possibility of an exit. Civilians live in conditions of survival with a high risk of exposure to the virus, such as in the north-west of the country where over half a million of those who have recently been displaced due to the escalation of the conflict of last December, sleep in tents or makeshift shelters.