An injured Syrian man on the Syrian side of the Bab al-Hawa border crossing between Syria and Turkey waits with his child outside a hospital on December 16, 2016. Photo: AFP / Bulent Kilic

A particularly disturbing feature of the Syrian civil war, now more than six years old, has been the systematic targeting of medical facilities and personnel. Amid the extreme chaos, the country’s medical infrastructure has been among the worst hit.

Even though the Geneva Convention explicitly requires granting protection to personnel assigned to medical duties during conflicts, Syria’s healthcare infrastructure has been targeted deliberately throughout. Perhaps more shocking is that a 2015 report published by Nobel-winning NGO Physicians for Human Rights (PHR) held the regime’s Syrian Armed Forces responsible for more than 88% of recorded hospital bombings and 97 percent of medical personnel casualties, making theirs the worst concerted attack on healthcare in living memory.

Elise Baker, PHR’s chief Syria researcher, reveals that beyond the documented attacks on medical infrastructure “many more hospitals have closed due to insecurity or lack of support and many more medical personnel have fled the country in fear of their lives.”

Avi D’Souza, global communications director for the Union of Medical Care and Relief Organizations agrees, pointing out that medical staff are under constant fear of attack from all sides. Even civil defense emergency centres have been deliberately decimated, leading to delayed response times.

D’Souza is adamant, however, that voluntary rescue workers, having saved thousands of lives, will not be cowed down by the relentless onslaught. “They do extraordinary work and are used to improvising in order to save lives.”

Syrian activists claim their nation’s medical facilities were targeted more than 250 times in 2016, while a whopping 13,467 civilians were killed, including 2,577 children and 1,554 women. According to the World Health Organization (WHO), sustained bombing of Syria’s medical infrastructure has led almost two-thirds of its health professionals to leave the country, while domestic production of medicines has dropped by two-thirds and vaccination coverage has dipped by half, resulting in rising deaths from otherwise preventable diseases.

With over half the country’s public hospitals and primary healthcare centers either fully or partially closed, according to the WHO’s Syria Representative Elizabeth Hoffe, Russia’s 60-bed mobile emergency hospital capable of serving up to 200 outpatients is in great demand, in addition to services rendered by UN agencies and other NGOs.

However, without adequate healthcare Syrians will continue to suffer for a long time to come. The country is faced with a gigantic health crisis, the consequences of which are likely to last beyond the current generation.

“Most worryingly, a generation of Syrian children are at the risk of developing mental health disorders, as they will grow up knowing nothing but conflict”

As Baker puts it: “It will likely take decades to fully rebuild Syria’s collapsed medical infrastructure and retrain a generation of doctors, nurses and other medical professionals. But most worryingly, a generation of Syrian children are at the risk of developing mental health disorders, as they will grow up knowing nothing but conflict. Exposed to extreme violence and instability, and without sufficient access to healthcare, children in Syria will not only be left to suffer from treatable and preventable conditions, but also bear deep and permanent psychological scars.”

The psychological state of many refugee children currently living in Syria’s neighboring countries is a major concern for the UN Refugee Agency’s senior mental health specialist Pieter Ventevogel. While most feel distressed, disturbed and disoriented, many also suffer from anxiety and insomnia, unable to get over the horrors of the conflict they have endured.

While some children will continue to be affected psychologically, not everybody requires psychotherapy says Ventevogel, adding that “what is needed is a more comprehensive response that does not uniquely focus on counselling but on a range of mental health and psychosocial interventions, from simple ones like child-friendly spaces and support groups for parents to more specialized services.”

Seema Sengupta is a Calcutta-based journalist and columnist

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