Caught in crossfire: health care workers’ experiences of violence in Syria

Abstract

Health care is attacked in many contemporary conflicts despite the Geneva Conventions. The war in Syria has become notorious for targeted violence against health care. This qualitative study describes health care workers' experiences of violence using semi-structured interviews (n = 25) with professionals who have been working in Syria. The participants were selected using a snowball sampling method and interviewed in Turkey and Europe between 2016-2017. Analysis was conducted using content analysis. Results revealed that the most destructive and horrific forms of violence health care workers have experienced were committed mostly by the Government of Syria and the Islamic State. Non-state armed groups and Kurdish Forces have also committed acts of violence against health care, though their scope and scale were considered to have a lower mortality. The nature of violence has evolved during the conflict: starting from verbal threats and eventually leading to hospital bombings. Health care workers were not only providers of health care to injured demonstrators, they also participated in non-violent anti-government actions. The international community has not taken action to protect health care in Syria. For health workers finding safe environments in which to deliver health care has been impossible.

I don't leave my people; They need me: Qualitative research of local health care professionals' working motivations in Syria

“…This approach is not primarily tied to their profession but rather an expression of their world views. Among other Syrians, medical professionals and students participated in and organised anti-government rallies [ 12 ].…”

“…Local Syrian HCWs working in highly stressful conditions are exposed to severe mental trauma, such as secondary traumatic stress and burn-out [ 15 ]. We have shown earlier that HCWs in Syria have specifically experienced violence due to their profession and may have lost relatives or even close family members [ 12 ].…”

“…The violence in Syria has been so intense that more than 70% of HCWS have migrated from the country. The figure is equal regardless of whether HCWs worked under ISIS rule in parts of Syria or NSAG controlled areas [ 12 , 19 , 22 – 24 ]. Our recent study points out that reasons for HCWs to leave to leave Syria were all related to security concerns [ 25 ].…”

“…The situation in Syria differs from many earlier conflicts because some of the HCWs operate from Southern Turkey, where they live with their families. They have obtained permission to enter Syria and perform humanitarian work there [ 12 ]. This delivery of humanitarian aid cross-border to Syria was authorised by UNSC in resolution 2165 and the mandate since then regularly renewed.…”

Public health consequences after ten years of the Syrian crisis: a literature review

“…Moreover, less than 64% of hospitals and 52% of primary healthcare facilities in Syria are operational. According to the United Nations, this fact put greater pressure on the remain active healthcare workers inside Syria [ 66 – 68 ]. The international organization has tried to protect the healthcare workers on both sides of the Syrian conflict; however, those attempts have failed to achieve any significant protection for health workers and facilities.…”