"Healthcare Strategy that shook the World"

Syrian Arab Republic is a country in western Asia, a land of fertile plains, high mountains and deserts, which is a host to a diverse ethnic and religious groups. Syrian health care system is relatively decentralized and focuses on offering primary healthcare at 3 levels: village, district and provincial. The ongoing civil war in Syria has been a very visible and is a heavily discussed conflict. However, one of the more obscure facets of this war is the toll it has taken on Syria’s public health system. One of the biggest losses in the war is that Syria’s healthcare system, which once was boasted of as the best in the Middle East is now in shambles. Health is a basic human right designed to cater to people in sickness and need, but the people of Syria are deprived even of the basic health care facilities despite of it being the need of the hour . The Syrian Arab Republic had been improvising on the health sector drastically before the war but now has been destroyed at a great level . According to WHO July 2017, Syria's population was an estimated 18,028,549. In 2017, the average life expectancy for Syrians is 75 years, 72 for males and 77 for females, compared to the average life expectancy in 1960, which was 52 years. Key health indicators in Syria show that infectious diseases and illnesses related to environmental pollution remain a serious problem. The rate of prevalence of HIV/AIDS in 2001 was 0.01 percent but has drastically increased over years.

Nevertheless, the issue is of growing importance. A country cannot be rebuilt if its inhabitants are sick and dying of treatable diseases, injuries or malnutrition. In my interview with Mr.Oliver RENCH (who is a Pilot for boeing 777, neurosurgeon, academician & Pathologist) who is heading the health care team in Syria by WHO, mentioned in our talk that all hospitals were turned into a graveyard in the country . He even spoke about the strategy used during the war by the opponent was to destroy all the hospitals and health care units first ,before bombing the city’s, so the plan was to refrain from giving aid to the injured citizens leading to slow death and also giving rise to diseases and infections.

ACCORDING TO WHO ANNUAL REPORT of 2017 of Syria : The data about hospitals is - 51% were reported fully functioning, 23% hospitals were reported partially functioning (i.e., shortage of staff, equipment, medicines or damage of the building in some cases), while 26% were reported non-functioning.

Access - according to, February 2018 statistics , 66% hospitals were reported accessible and 10% were hard-to-access.

Damaged hospitals - By the end of February 2018, 46% hospitals were reported damaged [15% fully damaged and 31% partially damaged], while 54% of public hospitals were reported intact.

As compared to the reports as of 1990 the system has extreme difference, the report is as follows :

According to the World Health Organization (WHO), in 1990 Syria had 41 general hospitals (33 public, 8 private), 152 specialized hospitals (16 public, 136 private), 391 rural health centers, 151 urban health centers, 79 rural health units and 49 specialized health centers; hospital beds totaled 13,164 (77 percent public, 23 percent private), or 11 beds per 10,000 inhabitants. The number of state hospital beds reportedly fell between 1995 and 2001, while the population had an 18 percent increase, but the opening of new hospitals in 2002 caused the number of hospital beds to double.

WHO reported that in 1989 Syria had a total of 10,114 physicians, 3,362 dentists,

14,816 nurses and midwives; in 1995 the rate of health professionals per 10,000 inhabitants was 10.9 physicians, 5.6 dentists, 21.2 nurses and midwives.

While the side-effect's of the war is typically declining public health, Syria’s healthcare system has seen devastating damage in comparison to many modern-day conflict zones. So, what leads to the annihilation of the Syrian public health systems? 

The military forces are targeting and destroying Syrian hospitals, clinic workers, and medical suppliers in direct violation of the Genevan Convention, the laws that govern’s war, which condemns attacks on civilians through the destruction of water supply, food, and health care . 

This has hindered the flow of health facilities and made the system non-functional. Many of the health care workers who remain in Syria are facing daily threats to their lives and they are forced to work in shift in hospitals with bare minimum supplies to treat the patients. Medical supplies are severely limited and despite of UN’s humanitarian efforts, the ground forces are preventing the convoys from reaching the target of 12.8 million people that require medical assistance.

Mr. Ranch in his interview also told us some insides of the country which are heart throbbing , he said, “Syrians are normal people who wants to live and have a family, in their house like any other nationalities in the world, but there is something like a ghost that is taking away everything that is needed for surviving and they could not expect whats going on there and could not understand whats happening because everything is happening so fast with so much of mass destruction, "I fail to understand how anybody is willing to take away health and so many innocent lives so ruthlessly and easily". When asked a syrian about wanting to survive the only thing that he said with tears in his eyes was ,“The world has forgotten us” . "These lines gave me an adrenaline rush down my spine and my hands shook while taking his words down ".

Health is a basic right for everyone.

During a war you noticed that even the basic disease which can be cured with just simple medications are causing death of people.

WHO is now organizing emergency support by trying to provide pharmaceutical, vaccinations and to train people to have mobile hospitals.

The next step is to look to the future. Although, there are still areas of conflict and the country is not yet stable enough for reconstruction , it is time for the world to think about the major efforts that will be required to rebuild the Syrian public health and healthcare infrastructure. This rebuilding effort will, after all, require years of work by local and international communities. After the conflict, Syria will need a development process designed to examine and assess the health situation using a holistic approach. This process will need to be undertaken by international organizations in collaboration with the national government of Syria. In developing these processes, Syria and international organizations will need to look up to other countries which have faced similar conflicts and situations and managed to rebuild or even advance their public health infrastructure. Syria will also need to focus its efforts on rebuilding its economy if it wishes to restore its once prosperous health system.

Health Should be acceptable, affordable, accessible, available, equal & quality delivery systems should be incorporated.

Health has evolved over the centuries as a concept from an individual's concern to a worldwide activity. Healthcare has also been improving in government-held areas with many public and private hospitals , still we should all try and contribute in our little ways to help our fellow brothers in need, the world is an unsafe place now and every country is sitting on a ticking time bomb. We should be considering and obliging to countries in need because we can be in that situation next .

Ali