The Syrian conflict: a case study of the challenges and acute need for medical humanitarian operations for women and children internally displaced persons

Abstract

BackgroundAfter 7 years of increasing conflict and violence, the Syrian civil war now constitutes the largest displacement crisis in the world, with more than 6 million people who have been internally displaced. Among this already-vulnerable population group, women and children face significant challenges associated with lack of adequate access to maternal and child health (MCH) services, threatening their lives along with their immediate and long-term health outcomes.DiscussionWhile several health and humanitarian aid organizations are working to improve the health and welfare of internally displaced Syrian women and children, there is an immediate need for local medical humanitarian interventions. Responding to this need, we describe the case study of the Brotherhood Medical Center (the “Center”), a local clinic that was initially established by private donors and later partnered with the Syrian Expatriate Medical Association to provide free MCH services to internally displaced Syrian women and children in the small Syrian border town of Atimah.ConclusionsThe Center provides a unique contribution to the Syrian health and humanitarian crisis by focusing on providing MCH services to a targeted vulnerable population locally and through an established clinic. Hence, the Center complements efforts by larger international, regional, and local organizations that also are attempting to alleviate the suffering of Syrians victimized by this ongoing civil war. However, the long-term success of organizations like the Center relies on many factors including strategic partnership building, adjusting to logistical difficulties, and seeking sustainable sources of funding. Importantly, the lessons learned by the Center should serve as important principles in the design of future medical humanitarian interventions working directly in conflict zones, and should emphasize the need for better international cooperation and coordination to support local initiatives that serve victims where and when they need it the most.

Responding to health needs of women, children and adolescents within Syria during conflict: intervention coverage, challenges and adaptations

“…The Syrian conflict started in March 2011 when a popular uprising in the South of the country was met by a security response that resulted in further unrest and escalation within the country [3]. The ensuing deadly war led to the division of the Syrian territory among conflicting political factions, and the fragmentation of the country's governance between the Government of Syria and opposition groups [4,5]. The evolution of the conflict has been marked by constant shifts in political boundaries as a result of the volatile security context [6].…”

“…Considering the dynamic shifts in conflict lines, the number of internally displaced persons (IDPs) increased as Syrians were forced to move multiple times before reaching a safe region [18]. The IDPs live in informal settlements 2 [16], and their health needs are exacerbated by poor living conditions [5,18], and their limited access to humanitarian aid [4]. In 2018, an estimated 11.3 million people in Syria were in need of humanitarian assistance in health, of whom 1.3 million were children under 5 years of age [16].…”

A Qualitative Research Study Which Explores Humanitarian Stakeholders’ Views on Healthcare Access for Refugees in Greece

“…Information about the KI’s place of work and experience was obtained. The interviews explored the following aspects of healthcare access for refugees: [ 1 ] changes to the healthcare response for refugees in Greece between 2015 and March 2018, [ 2 ] barriers or facilitators to accessing healthcare, [ 3 ] role of NGOs and international agencies in the health response and [ 4 ] gaps in healthcare provision for refugees in Greece.…”

“…Externally, 5.6 million Syrians are now refugees hosted mainly in neighbouring countries including Lebanon, Jordan and Turkey [ 2 ]. The protracted nature of the conflict, poor labour market opportunities and increasingly uncertain political climate in these countries has driven many Syrians to seek refuge in Europe [ 3 ]. Though the journey from the western coast of Turkey to the Greek islands is short, it can be dangerous with smugglers using unfit-for-purpose, overcrowded vessels and sometimes fake life jackets to maximise profits [ 4 ].…”

Universal health coverage for refugees and migrants in the twenty-first century

“…Internally displaced persons often suffer equally adverse consequences without the protection and rights sometimes afforded to refugees. In Syria, in the context of the challenges of the ongoing conflict, Aburas et al [ 12 ] describe a case study based on a health center providing maternal and child healthcare in collaboration with the Syrian Expatriate Medical Association, illustrating the potential impact of local groups to complement wider international efforts. Additionally, tackling mental health issues in refugees requires both psychological and pharmacological measures; Ostuzzi et al [ 13 ] describe the UNHCR guidelines on pharmacological interventions for non-affective psychosis which, while limited by the quality of underlying evidence, provide robust practical guidance.…”