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

Abstract

Background The Syrian conflict has endured for a decade, causing one of the most significant humanitarian crises since World War II. The conflict has inflicted massive damage to civil infrastructure, and not even the health care sector has been spared. On the contrary, health care has been targeted, and as a result, many health professionals have left the country. Despite the life-threatening condition, many health professionals continued to work inside Syria even in the middle of the acute crisis. This qualitative study aims to determine the factors that have motivated Syrian health professionals to work in a conflict-affected country. Methods The research is based on 20 semi-structured interviews of Syrian health care workers. Interviews were conducted in 2016–2017 in Gaziantep, Turkey. A thematic inductive content analysis examined the motivational factors Syrian health care workers expressed for their work in the conflict area. Results Motivating factors for health care workers were intrinsic and extrinsic. Intrinsic reasons included humanitarian principles and medical ethics. Also, different ideological reasons, patriotic, political and religious, were mentioned. Economic and professional reasons were named as extrinsic reasons for continuing work in the war-torn country. Conclusions The study adds information on the effects of the Syrian crisis on health care—from healthcare workers' perspective. It provides a unique insight on motivations why health care workers are continuing their work in Syria. This research underlines that the health care system would collapse totally without local professionals and leave the population without adequate health care.

Conflict, healthcare and professional perseverance: A qualitative study in a remote hospital in an Anglophone Region of Cameroon

“…One participant emphatically expressed her religious inclinations towards patients and the community. Similar coping strategies were identified amongst HCWs in Yemen including fatalism [24] and in Syria participants had both intrinsic (humanitarian) and ideological (religious) reasons for staying at work [23]. Hospital administration has a vital role in ensuring job satisfaction amongst workers and according to our study the hospital administration did not fail in this aspect.…”

“…Behavioral studies have identified factors that promote job satisfaction such as conducive work environment, career progression or promotion, remuneration, adequate working conditions and recognition [22,23]. In conflict setting however, motivations may change such as is the case in our study, where participants' main motivation was their moral obligation to improve lives and reduce suffering and their ability to lead a relatively comfortable life.…”

Exploring healthcare-seeking behavior of most vulnerable groups amid the COVID-19 pandemic in the humanitarian context in Cox’s Bazar, Bangladesh: Findings from an exploratory qualitative study

“…In the world stage, countries with insufficient health systems like Bangladesh are overburdened by pandemic breakouts when health services are desperately required [ 29 ]. Evidence suggests that during the first year of the COVID-19 pandemic, many healthcare workers experienced additional stress, psychological problems, lack of personal protective equipment (PPE), were excluded or stigmatized, lack of sufficient incentives, absence of coordination, and had management issues [ 29 , 30 ], which may have affected their attendance and behavior. Furthermore, studies showed that frontline healthcare workers in humanitarian contexts are particularly vulnerable to COVID-19 [ 31 ] which also added to the stigma and contributed to the absenteeism of healthcare workers during the initial COVID-19 lockdown.…”

“They cannot afford to feed their children and the advice is to stay home. How‥?”: A qualitative study of community experiences of COVID-19 response efforts across Syria

“…In Syria, COVID-19 research is relatively limited, especially related to the experiences and practices of ordinary Syrians that can play a significant role in mitigating transmission in areas with minimal governance or local authority support [20][21][22][23]. The COVID-19 pandemic has exacerbated ongoing socioeconomic challenges [14,24]. The first COVID-19 case was officially reported in Damascus in 22 March 2020 [14], followed by initial reported cases on 2 April 2020 in AACA [25] and 9 July 2020 in OCA [26].…”