Northwest Syria Covid-19 crisis

Dr Halim Boubaker, MSF medical coordinator for Northwest Syria reports Ten-fold increase in coronavirus cases adds new challenges in northwest Syria

Northwest Syria is currently witnessing a sharp increase in the number of patients with COVID-19, which is now ten times higher than what it was just a month ago. As of 22 September, 640 people had tested positive for the new coronavirus in the region, almost 30 per cent of them health workers.

Eighty new cases were recorded on 14 September alone, the highest one-day total since the first case was recorded in early July. Furthermore, testing has remained limited throughout that time, which raises doubts about the real rate of transmission and the true number of infections.

Coronavirus increasing among displaced people

This increase in the number of people infected with COVID-19 in the region is adding more challenges to an already-dire situation in northwest Syria. More than two million people, over half of the population, have been displaced by conflict.

Most of them now live in overcrowded camps with scarce access to water and poor sanitation. Control measures, such as physical distancing, hand-washing and isolating are challenging, if not simply impossible, for most camp residents.

“More and more COVID-19 cases are being recorded among displaced people living in camps and this is worrying,” says Dr Ammar, MSF medical activity manager in northwest Syria. “We’re trying to help the camps’ inhabitants protect themselves against the virus, but we can’t change the overall situation and the fact that they live in such a place. We need to adapt constantly to provide solutions for these people who already are living in incredibly difficult conditions.”

We’re trying to help the camps’ inhabitants protect themselves against the virus, but we can’t change the overall situation and the fact that they live in such a place.

MSF teams raising awareness and distributing soap

Since April 2020, MSF teams have distributed more than 63,000 hygiene kits, including items such as soap and detergent, to over 26,000 displaced families in several camps across Idlib governorate and northern Aleppo governorate.

“We put in place different measures to prevent creating crowds of people coming to pick up their kits during these distributions,” explains Osama, a logistician supervising one of the distribution campaigns. “People are asked to maintain a safe distance between each other and to regularly wash and sanitise their hands. We ask each family to only send one person to the distribution site.”

Our health educators also conduct awareness-raising sessions about the virus, especially how it is transmitted and how they can prevent this, with people queuing to receive the kits.

“Understanding COVID-19 and knowing more about it is a big step towards avoiding catching it,” says Osama.

Helping to manage isolation to manage the pandemic

Many health facilities were already struggling to meet existing medical needs in northwest Syria before the COVID-19 pandemic. To help them, MSF teams are also working in health facilities to treat patients with COVID-19 or that have other medical needs. For example, we have set-up a triage system in each the hospitals that we support, co-manage or run in Idlib governorate. These ensure fast detection of suspected COVID-19 cases, while maintaining continuity of care for patients in the wards.

“A few days ago, a young girl came to one of the hospitals we co-manage. She was still at the entrance when she was screened as a potential COVID-19 case,” says Dr Halim Boubaker, MSF medical coordinator for northwest Syria. “She was referred to another health facility where she tested positive for COVID-19.”

“However, one major issue we are currently facing is that most patients who test positive isolate at home with their families, rather than in isolation centres,” says Dr Boubaker. “This increases the chances of creating new clusters of infections and has certainly contributed to the recent rise in the numbers of COVID-19 cases.”

Northwest Syria was already an unstable region and we were used to overcoming uncertainty to provide assistance to people… But COVID-19 has added an extra challenge to our work.