Syria: COVID-19 puts millions at risk

A girl from a displaced Syrian family who received shelter support from CARE partner organisation Ihsan Relief and Development

Nine years of conflict have displaced millions of Syrians – and now COVID-19 puts them at further risk.

There are currently over 16,000 confirmed COVID-19 cases and more than 160 deaths in northwest Syria, with new cases being registered every day. CARE is concerned that displacement camps will soon experience a spike in cases, given the crowded and dire living conditions in these camps.

At least 80 percent of those displaced in northwest Syria are women and children.

CARE’s concern also extends to the impact of COVID-19 on health care workers, with almost 15% of all new cases being registered among doctors, nurses, and midwives. Nirvana Shawky, CARE’s Regional Director for the Middle East and North Africa, says:

With many health care professionals having either left the country or become displaced, providing sufficient medical assistance at scale is nearly impossible.

Many Syrian hospitals and health care centres have been decimated. There were 85 attacks on health care facilities in northern Syria in 2019. The attacks have continued this year, with several more hospitals and health care centres across Idlib and Aleppo governorate reportedly shutting down, suspending their work or reducing operations due to the hostilities.

An incubation room at a hosptal in Syria
A nurse, surrounded by incubators, works at the CARE-supported Hope Maternity Hospital, known in Syria as Amal hospital

After repeated air strikes earlier this year, the CARE-supported Amal hospital had to close and relocate from Ariha city in Idlib to Azaz city in Aleppo.

This hospital is one of the few maternal and pediatric facilities that remain fully operational. It provides life-saving interventions and is a glimmer of hope for the people of Idlib and Aleppo.

A patient being moved on a trolley bed in a hospital corridor in Syria
Medical personnel at the hospital move a patient

As part of COVID-19 mitigation measures, triage and quarantine tents have been set up at the hospital’s entrance, and staff are equipped with personal protective equipment and digital thermometers. In response to the spread of the coronavirus, CARE is providing clean water and sanitation services in northwest Syria, where needs are immense and the health system is already fragile.

Amid the coronavirus pandemic, existing facilities are ill-equipped to respond to outbreaks.

Sherine Ibrahim, Country Director of CARE in Turkey, says:

COVID-19 has compounded the immeasurable suffering experienced by displaced people. CARE, our partners and many humanitarian actors working in northwest Syria are raising the alarm that the spread of the disease will soon outstrip our collective ability to curb its spread.

Tents in a muddy field in northwest Syria
A tent camp in a muddy field in northeastern Idlib

“With winter at our doorstep, displaced people will naturally seek protection from the harsh cold weather, in overcrowded and ill-equipped tents, unfinished buildings, or reception centres. Hospitals continue to struggle to test, and provide medication and basic health needs for those who need it the most.”

There is an urgent need to provide shelter for some 2.7 million displaced people, to enhance testing capacity, and to support health facilities with medical supplies and equipment.

Aerial photo of Al Aman displaced persons camp in Syria
An aerial photo of Al Aman camp

Of the 6.2 million Syrians who are internally displaced, 450,000 live in camps, sleeping in tents, unfinished or destroyed buildings, or even out in the open.

Winter conditions exacerbate the vulnerability of those affected by the conflict. In some parts of Idlib in northwestern Syria, temperatures can drop as low as 12 degrees Fahrenheit, making living conditions unbearable.

Syrian children playing in snow at displaced persons camp
Syrian children playing in snow at a displaced persons camp (photo take in February 2020, showing typical winter conditions)

What the humanitarian crisis means for Syria’s people

All names have been changed

Young girl in a kitchen in Syria

Lina (above) and her family are among those displaced by bombings in northwest Syria. She dreams of a large kitchen equipped with supplies.

Children like Lina are struggling to access education amid the conflict. Nearly 300 schools in Idlib and the countryside have reportedly been closed until further notice, impacting 160,000 students.

Together with partners, CARE is repairing the damaged homes of displaced families, to provide adequate shelter.

Jawhara inside her tent at a displaced persons camp in Syria

Jawhara (above) was forced to flee her village five years ago when bombing intensified. The widow and mother of five rode on a motorbike with her children to the nearby city of al-Bab with only the clothes on their backs.

The family was forced to relocate seven times before finally arriving at a camp for internally displaced people. She says:

When we came, we had nothing, but one night the other displaced people in the camp gathered some blankets for us, so that we could live in the tent.

Although her son works in agriculture, he does not earn enough for the family to buy bread. Syria is experiencing the sharpest rise in inflation in its history. As the value of the Syrian pound has sharply devalued, families like Jawhara’s can no longer afford the basics.

Abdullah and family outside tent at displaced persons camp in Syria

When aerial bombs began dropping in Abdullah’s town in 2015, he had no choice but to flee. Abdullah (above), a farmer, helped his family escape to a nearby village on a tractor. The father of nine children — some his own and some adopted — lost one child during the displacement. He says:

At first we thought we would be able to quickly return so we went to a nearby village, but that was not the case. With every displacement I have left more belongings behind.

Abdullah and his family relocated to a camp and were provided with a tent. With the harsh winters and dusty summers, it quickly wore out, and so they built a stone and mud home, using the tent fabric as a roof.

When he first arrived in the camp, Abdullah worked as a vegetable seller, but camp residents were unable to afford his produce. His family sometimes goes to bed hungry, unable to afford bread. They rely on support from humanitarian organisations. He says:

How I wish to return to my home. [I would] leave everything here behind and go back there.

Maram reading a school book in Syria

When her father died and her mother remarried, Maram (above) moved into her grandparent’s house. With a busy household of 22 children — all cousins and orphans — Maram, the eldest, stepped in to support her grandparents with household chores and caring for the younger children.

Although she enjoyed school, she dropped out because of the increasing duties at home. Shouldering major responsibilities, and coping with the death of her father and forced displacement, Maram experienced psychological distress.

CARE partner organisation Shafak visited Maram at home and informed her grandparents of the importance of receiving an education and the link to psychological well-being. With their blessing, Maram returned to school and now helps her siblings and cousins with their schoolwork. Maram says:

Every day I study for a maximum of one or two hours. I do not have much time because I am the oldest girl in the house. I have to help my grandmother and take care of my brothers and cousins. I help them in their lessons and homework, and I also teach the younger ones the alphabet and writing.

Maram helping her family member with his schoolwork, in Syria

Due to the pandemic, Maram has stopped attending school in person, and has been learning remotely through social media apps on a mobile phone. She says:

I feel sad because I no longer meet my friends, whom I used to play with every day in the yard. I want to tell my friends and all other children that school is important and that they should continue their education, whatever the circumstances.

CARE’s response

In northwest Syria, the crisis requires urgent action. CARE calls on all parties to adhere to their obligations under International Humanitarian Law and to protect the lives of 3 million-plus civilians living in the area.

CARE has been working in Syria since 2014 and has reached more than 5 million people with emergency support including shelter, clean water, and health and sanitation services. Along with humanitarian partners, CARE also addresses hunger, helps rebuild livelihoods, and provides psychosocial and gender-based violence programming.

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