BackgroundHealthcare is under attack in Syria with repeated air strikes on hospitals and ambulances and the largest death toll of health workers in any recorded conflict.1 Ambulances in Syria have been bombed, shot at, stolen, looted and obstructed, significantly impeding their ability to safely evacuate the wounded and provide medical aid.MethodsThis article presents the summary of a literature review on attacks against ambulances in Syria from 2011 to 2018, as well as a descriptive secondary data analysis on individual attacks reported by the Syrian Network for Human Rights from January 2016 to December 2017. A peer-reviewed literature search included three databases (PubMed, ProQuest and Embase), and a grey literature search included reports from groups involved in the Syrian health response or human rights monitoring.FindingsFrom 2016 to 2017, there were 204 individual attacks involving 243 ambulances. Half (49%) were either heavily damaged or put out of service. The main perpetrators were the Syrian regime (60%) and the Russian armed forces (29%). Half (52%) of ambulances were directly targeted. The peer-reviewed literature search yielded 18 articles, from which the following themes were drawn: targeting of ambulances, ‘double-tap’ attacks, delays to care, obstruction and other forms of violence, and long-term consequences.InterpretationAmbulances have been intentionally and repeatedly targeted throughout the Syrian conflict as part of a war strategy. Real challenges in monitoring and systematically tracking attacks on ambulances exist, but as a result, they are understudied and likely under-reported.

Suicide is a public health issue that impacts a nation’s resident and non-resident populations alike. Singapore has one of the largest non-resident (work permit holder) populations in the world, yet very little attention has been given to examining suicide in this population. The current study examined the case materials of all 303 non-resident completed suicides in Singapore in the period January 2011 to December 2014. Their basic profiles were compared with that of the 1,507 resident cases in the same period. A sample of 30 death notes written by non-residents were randomly selected and thematically analyzed to supplement the descriptive findings and discussion. Results showed that suicides were highest among males, those aged 21–35 years old, and South Asians. Most non-resident suicide cases did not have known physical or mental health issues, prior suicide attempts, or suicide notes. Suicide decedents from South Asia and Europe most frequently used hanging, while jumping was most common among decedents from other regions. Relationship and health problems emerged as the top two suspected triggers for suicide based on our analysis of the suicide notes. The unique situation of working abroad may increase non-residents’ vulnerability in general, while adverse life events such as relationship and health issues may be too overwhelming to bear, especially when support services are not readily available and accessible. The results have implications for suicide prevention among this neglected group of people who choose to work in foreign lands.