Corona in Syria… The Ball of Life in the Fragile Health Court

While the Corona virus was invading many countries of the world from east to west, the state of emergency was announced in some countries, and war was declared against this hidden enemy that crept into them, and the need to confront it with all their energy; Syria was silent as an expression of its absence of the Coronavirus.

Until now, the numbers reported by the Syrian Ministry of Health indicate that the situation is under control, as the Ministry of Health published on its official Facebook page the daily update on Thursday, June 18, 2020. The total number of registered cases of the Coronavirus in Syria reached 187, according to the following 102 active cases, while the number of cure cases reached 78 cases, and 7 cases of deaths.

A type of seriousness has begun to take place in the health sector’s work in Syria, after the World Health Organization announced (23 March 2020) that "this country is one of the most vulnerable countries to the outbreak of the new Corona virus, due to the war that erupted there for years, the fragile health system, and the least-immune individuals in the face of this disease".

The story started... How did the virus enter?

Despite the irony that prevailed in the Syrian atmosphere due to the relatively late entry of the virus into the country, on March 10, 2020, Pakistan announced the registration of 9 new infections with the Corona virus, noting that 6 of the new infected people arrived in Karachi from Syria through the Qatari capital, Doha, while The Syrian government denied the existence of any cases of coronavirus in the country until March 22, when the Ministry of Health announced the first infection coming from abroad, according to Health Minister Nizar Al-Yaziji, without further details. On March 25, the Ministry announced the registration of 3 new cases. On the 29th of March, the announcement of the first death of a woman after her admission to the hospital in an ambulance, which, after a test, appeared she was positive with corona virus, just 6 days after the WHO announcement, so that the seriousness turns into fear and anticipation.

Between the declaration of the health organization and the death of the first Syrian citizen, health ministry was in front of a theory worthy of study of the health situation and the infrastructure that suffers before the epidemic in the first place, although government hospitals and clinics offer their services for free, which distinguishes them from many countries, but with the entry of a malicious guest, the economic and social standards have changed, where the proportion of public hospitals fully operating in Syria is 64%, while there is a severe shortage of trained medical staff, according to the Health Organization.

Corona's case in Syria was discussed in reports, considering that the reason is due to the Iranian shrines in Damascus, which the Iranians visit by the thousands, and that the infections were fatal in Iran in the first days of the virus attack. the Syrian government denied the matter as is the case with the spread of polio from the middle of 2013. However, the United Nations and the World Health Organization sent medical supplies and equipment to aid the official medical sector in Syria.

Robert Ford, the former US ambassador to Syria, detonated a bomb when he wrote an article entitled ("Corona" Risks in Edleb more than in Damascus), in which he said that the Syrian government has a bad record on the misuse of medical supplies and equipment not for the benefit of civilians, but for the security apparatus of the system. This is confirmed by Dr. Annie Sparrow, a doctor in public health and specialized in Syrian health affairs, when she wrote in the "Foreign Affairs" magazine, the issue issued in September of 2018, that the World Health Organization used donor funds to purchase blood supplies for the Syrian Ministry of Defense; given that the Ministry has full control over the reserves of national blood banks in Syria".

In the area out of the Syrian regime's control "Edleb", the health organization delivered the required supplies and equipment, where the Edleb Health Directorate (the Syrian Opposition Interim Government) said that it intends to provide 60 beds in 3 of its hospitals, and allocate them to those infected with the Corona virus. "Although the number mentioned is very small when compared to the population of the province, which amounts to 3 million people.

In northeastern Syria, the Health Authority of the autonomous administration of Northeastern Syria issued a statement confirming the death of the first citizen in the National Hospital in Qamishli after being infected with the Corona virus, blaming the World Health Organization, which did not inform the relevant authorities of the health aspect of the autonomous administration, at a time The Syrian government does not cooperate with this administration.

What did the Syrian government do?

the Syrian government has formed what is called the "governmental team concerned with measures to tackle the emerging coronavirus," which issues data and decisions from time to time on the pages of the Syrian Ministry of Health, and its departments on social networking sites, such as news that distributes medical teams and mobile clinics, their dates, locations, numbers of injuries and deaths, numbers of the laboratory tests, etc., while activists released a hashtag called #Government_Action_Conventions_Corona.

The Syrian government confirms that it has 5 laboratories distributed, by 2 in Damascus and 3 in Homs, Aleppo and Lattakia, so that it will be able to accomplish the required tasks within a shorter time, and this means that it is facing 14 governorates, and these laboratories are located in 4 governorates, with 100 tests per day.

In this regard, an official at the Syrian Ministry of Health, who refused to be named, points to the occurrence of many cases of corona infection to hospitals every day, whose cases range from light, to medium, severe, and critical, "and we confirm our ability to provide the medicines included in the treatment plan, and set the therapeutic protocol and awareness and prevention handbook for Health Workers in Health Institutions" he said.

The health official added to the "Suwar" that the Ministry of Health have a map plan includes 19 quarantine centers and 14 medical isolation centers in all governorates, in addition to the presence of quarantine centers equipped by official bodies and NGOs in case of need.

He explained that the ministry faces a challenge to the Corona epidemic due to the economic sanctions imposed on the country, as there is an urgent need to secure the medical supplies and equipment needed to handle patients and meet their needs, calling on the countries of the world and international organizations to look at the health situation regardless of political conflicts.

While a study by the Damascus Center for Research and Studies "Medad" considered that the Syrian government faces a challenge, which is measures and policies taken against the health and non-health threats from the virus, and a commitment to secure an adequate flow of goods, services and needs, such as medical and food materials, and to control the manipulation of their prices, and hospital, transport, communication, education, work and security, etc., and if the threat of the virus lasts for a long time, or has spread in one way or another in the country".

Corona ... and then what?

At the end of March 2020, Mark Lockook, the UN Under-Secretary-General for Humanitarian Affairs, warned that all efforts to detect and respond to cases of Covid-19 will be obstructed by the fragile health system in Syria, noting that about half of the country's hospitals and health care facilities were fully operational at the end of 2019, and warning that the first ten cases are affected and one death is nothing but "the tip of the iceberg" and that there may be a devastating impact on vulnerable communities.

UN figures indicate that with the Syrian conflict entering its tenth year, more than half of the population has been forced to flee their homes, more than 11 million people inside the country, including nearly 5 million children in need of humanitarian assistance, and about 8 million people without access to food reliably, which is more than 20 percent from last year, and 500,000 children suffering from chronic malnutrition".

Given the infrastructure of the health sector in Syria in particular hospitals and their spread in the Syrian governorates, we find that there are major challenges as some regions lack hospitals, and according to 2017 statistics there are 505 hospitals across Syria distributed among public hospitals, private hospitals, hospitals of the Ministry of Health, and hospitals of the Ministry of Higher Education.

"Given the security and political situation in Syria and the deterioration of the health system as a whole, the Syrian government does not have enough to conduct surveys and checks sufficient to count the actual numbers of confirmed injuries, but rather is trying to obfuscate the numbers for political and social reasons, given the current deterioration of the situation," said economic analyst Muammar Awad".

Awad added to the “Suwar” magazine that “the health sector’s infrastructure is in a shabby state, whether at the level of the medical or nursing staff, as well as the lack of adequate equipment and devices, as well as the lack of foreign exchange to import what the sector needs of medicines ... Therefore, there are great concerns from The epidemic is widening because the medical sector is not prepared to deal with the pandemic”.

It is worth noting that the health sector in Syria is facing the difficult and most likely situation of the spread of Corona in the east of the Euphrates and in the vicinity of Al-Tanf, where humanitarian assistance cannot be delivered to those areas densely packed with internal displacement camps and also contains more than 10 thousand detainees from ISIS, according to a spokesperson for the Russian Ministry of Foreign Affairs Maria Zakharova.

Popular discontent

Clear popular discontent reigns in the Syrian atmospheres amid media blackout, as Samah (the nickname) tells “Suwar” magazine that “hospitals before Corona warned people against colds and flu, at a time when doctors were diagnosing pneumonia and severe bronchospasm that continues until now. But in the end, we are as a people (don't need intimidation)".

A Syrian citizen from Damascus countryside called for the necessity of checking on informal areas, such as "Dov Al-Shouk", which suffers from a lack of commitment at all, according to a post on Facebook, adding that "the children and their families are still outside their homes all the time, such as the sitting in front of the homes. Most shops do not adhere to the ban, just as garbage is everywhere, and there is no sterilization for the area ... Please take our voice to those concerned".

Another questioned the numbers issued by the Syrian Ministry of Health, saying: "God knows, how many cases are confirmed in Al-Tabaki and no one is talking about them. And the cars of the Damascus Countryside Health Directorate are transporting patients of hospitals to Zabadani".

5 stages of the Corona examination in Syria

Significant health challenges noted by observers in Syria, including the lack of protective equipment and industrial respirators and the difficulties of isolation in the overcrowded camps for displaced persons and sanitation services, but the Syrian government confirms that the examination of suspects infected with the Corona virus is carried out in five stages, namely:

• Laboratory of emergency diseases and epidemics in Damascus; It includes five PCR analyzers capable of conducting more than 100 daily analyzes of samples from people suspected of being infected with the new Coronavirus, in addition to laboratories in Lattakia, Aleppo and Homs.

• Samples are taken by the surveillance teams in provinces, hospital staffs and health centers, which are nasopharyngeal or oropharyngeal swabs.

• The swab remains valid for analysis after taking it from the suspected person for up to 12 days, and a swab can also be taken from a deceased person.

• The duration of the analysis to detect when infected with the virus takes more than five hours.

• If the result is positive (there is an infection), the analysis is repeated at another stage called the confirmation stage to confirm the accuracy of the result.