Logan Reid
Syria's health system has been in a state of crisis since the civil war began in 2011, with hospitals and medical workers on all sides of the conflict being deliberately targeted. According to the World Health Organization, 57% of Syria's public hospitals were damaged during the war, and 37% were no longer functioning as of 2016. Physicians for Human Rights corroborated reports of 566 separate attacks on 348 medical facilities from March 2011 to May 2019, with nearly 900 medical workers losing their lives. The Syrian government has denied these claims, but the UN and humanitarian data have documented dozens of airstrikes on hospitals in insurgent-controlled territories. This has led to a situation where, as of 2019, only half of public hospitals were functioning, and many of them were operating at minimum capacity with severe shortages of staff, medicines, and supplies.
| Characteristics | Values |
|---|---|
| Number of hospitals in Syria | Unknown, but the World Health Organization reported that 57% of Syria's public hospitals have been damaged, 37% are non-functional, and 50% were not functioning in 2012. |
| Number of attacks on hospitals | 566 attacks on 348 medical facilities from March 2011 to May 2019. |
| Number of medical workers who lost their lives | Nearly 900 |
| Number of hospitals in insurgent-controlled territories that have shared their GPS coordinates with Russia | At least 2 dozen |
| Infant mortality rate in 2019 | 17.9 |
| Under-5 mortality rate | 21.5 |
| Percentage of low birth weight newborns in 2009 | 10% |
| Maternal Mortality Ratio in 2009 | 26 maternal deaths per 100,000 live births |
| Adult prevalence rate for obesity in 2017 | 27.8 |
| Percentage of children under 5 who were obese in 2009 | 10% |
| Percentage of the population with access to sanitation in 2015 | 95.7% |
| Percentage of the population with access to clean water in 2015 | 90.1% |
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What You'll Learn
Systematic destruction of medical facilities
The ongoing civil war in Syria has had a devastating impact on the country's health infrastructure, with reports of systematic attacks on hospitals and medical facilities. According to the World Health Organization (WHO), the conflict has resulted in the destruction or damage of more than 50% of the country's health infrastructure. This includes the partial or complete destruction of hospitals, clinics, and other medical facilities, rendering them inoperable and leaving civilians without access to essential healthcare services.
Physicians for Human Rights, an NGO, has corroborated reports of 566 separate attacks on a total of 348 medical facilities in Syria from March 2011 through May 2019. These attacks have resulted in the deaths of nearly 900 medical workers. Furthermore, the United Nations (UN) and humanitarian data have documented more than two dozen airstrikes on clinics and hospitals in insurgent-controlled territories, despite the strong protections enjoyed by medical facilities under international humanitarian law.
There are indications that the Syrian government and its allies may be deliberately targeting medical facilities. OCHA's Mark Lowcock, in a briefing to the Security Council, noted that many sites on the no-strike list that were not hospitals had not been attacked, suggesting that health-related targets were being selectively targeted. While the Syrian government has denied these allegations, the Commission of Inquiry has concluded that the government's airstrikes on hospitals constitute war crimes if the targeting is intentional.
The systematic destruction of medical facilities in Syria has had severe consequences for the country's healthcare system, exacerbating the challenges of providing essential healthcare services to the population. It has also led to the displacement of medical professionals, with approximately 70% of health workers leaving the country, further compromising the availability and accessibility of healthcare for Syrians.
The targeting of healthcare facilities and personnel in war zones has become a growing concern, with reports indicating that it is a strategy rather than an accident. The Safeguarding Health in Conflict Coalition documented a 25% rise in assaults on healthcare facilities and personnel globally in 2023, with nearly half of the incidents attributed to state forces. Syria is among the countries where systematic attacks on healthcare have been documented, alongside Gaza, Myanmar, Somalia, Sudan, Ukraine, and others.
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Hospitals functioning at minimum capacity
Syria's health system has been in a state of decline due to the ongoing civil war, which has resulted in the destruction of hospitals and medical equipment, shortages of drugs and medical supplies, and the displacement of health workers. The situation is further exacerbated by attacks on hospitals and medical personnel, with reports of over 500 attacks on medical facilities and the disappearance or killing of doctors.
In 2012, the World Health Organization (WHO) assessed that only 50% of hospitals in Syria were fully functioning, and the situation has barely improved since. By 2019, over half of public hospitals were operational, but many were functioning at minimum capacity with severe shortages of staff, medicines, and supplies. Hospitals in Aleppo, Dar'a, Homs, Idleb, Rural Damascus, and northeast Syria were among the worst affected.
The lack of resources and staff has had a significant impact on the quality of healthcare provided. Trauma patients often occupy the limited beds in intensive care units, and many hospitals lack specialized services for cancer and kidney disease patients. The equipment required for orthopedic and reconstructive surgery is often outdated or malfunctioning. The shortage of medical professionals is due in part to the dangerous working conditions, with hundreds of doctors killed and many more leaving the country.
To address the gaps in secondary healthcare, the WHO has provided treatments, medicines, and equipment to referral hospitals and trained health workers in a variety of specialties. They have also delivered cancer medicines and diagnostic equipment to the Ministry of Health and supported referrals. Despite these efforts, the Syrian health system continues to struggle, and the ongoing conflict and insecurity hinder the provision of essential healthcare services.
The targeting of medical facilities and personnel by all sides in the conflict has been widely condemned as a violation of international humanitarian law and a war crime. Despite the protections afforded to medical facilities under the Geneva Conventions, hospitals continue to be bombed and attacked, with impunity for the perpetrators. The Syrian government has denied the allegations, and the UN's ability to intervene is limited due to disagreements among its permanent members.
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Shortages of staff, medicines and supplies
Syria is facing a severe humanitarian crisis, with a shortage of staff, medicines, and medical supplies. The ongoing civil war has resulted in the destruction of hospitals and medical facilities, with nearly 900 medical workers losing their lives. The war has also led to the collapse of the Syrian economy, surging prices of basic necessities, and food insecurity.
The shortage of medical staff in Syria is a critical issue. The country has witnessed an exodus of healthcare professionals, with around 70% of health workers leaving since the war began. This has resulted in a lack of qualified nurses and allied health professionals to provide essential care to the population. The high turnover of skilled staff and leadership further exacerbates the problem, impacting the quality of healthcare services.
The conflict has also disrupted the pharmaceutical industry, with substantial damage to plants in rural Aleppo, Homs, and Rural Damascus, where 90% of the country's pharmaceutical production was based. Prior to the war, Syria produced 90% of its medicines and drugs locally. Now, the country faces critical medicine and pharmaceutical shortages, with the World Health Organization (WHO) reporting that Syria is experiencing substantial shortages of essential drugs and medical supplies. This has had devastating consequences, particularly for those with chronic diseases that have become terminal due to the lack of treatment and medicines.
The shortage of medical supplies in Syria is also dire. Hospitals and clinics lack access to basic medical equipment, such as infant incubators, CT scans, Doppler, echography, anaesthesia equipment, and ambulances. The ongoing violence and insecurity have further restricted access to medical supplies, with some areas facing physical and political barriers to receiving aid. The targeting of humanitarian workers and blocking of humanitarian assistance have exacerbated the situation, hindering the delivery of essential medical supplies to those in need.
The shortage of staff, medicines, and medical supplies has had a devastating impact on the health and well-being of Syrians. The civil war has not only caused direct injuries and deaths but has also indirectly affected the population by disrupting the healthcare system. The lack of access to essential medicines and medical care has turned manageable chronic diseases into terminal conditions and has compromised the quality of life for many Syrians.
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Attacks on deconflicted targets
The Syrian Civil War has resulted in the collapse of the Syrian economy, surging prices of basic needs, the destruction of many hospitals, and shortages of drugs and medical supplies. During the war, there have been almost 600 attacks on healthcare facilities, with more than 50% of the country's health infrastructure damaged or destroyed. Physicians for Human Rights, an NGO, has corroborated reports of 566 separate attacks on a total of 348 medical facilities in Syria from March 2011 through May 2019. Nearly 900 medical workers are reported to have lost their lives in these attacks, with 509 of the incidents (90%) traced to the Syrian government or its allies.
Despite strong protections enjoyed by medical facilities under international humanitarian law, hospitals in insurgent-controlled territories have been subjected to dozens of airstrikes. Many hospitals voluntarily shared their GPS coordinates with Russia under a UN-run system called "humanitarian deconfliction," which seeks to prevent attacks on relief facilities, units, and personnel. However, this does not appear to have been effective, with OCHA's Mark Lowcock noting that many sites on the no-strike list that "are not hospitals have not been attacked," implying that health-related targets are deliberately chosen for destruction.
Western diplomats have criticized the behavior of the Russian and Syrian governments, pointing to attacks on deconflicted facilities as incriminating evidence. The Syrian government has denied the criticism and has never acknowledged bombing a hospital. The UN Security Council strongly condemns attacks on healthcare facilities, but disagreements among its permanent members over Syria limit its ability to act.
The conflict in Syria has resulted in mass displacement, with around 270,000 civilians fleeing their homes in the northwestern Idlib region due to attacks by Russian-backed forces on insurgents. Israel has also been accused of launching bombing raids in Syria, targeting government forces in the south and Hezbollah targets in Lebanon. These strikes were allegedly intended to enforce demilitarization and protect minority groups, but leaders from these sects have denied these claims.
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Underground field hospitals
The ongoing conflict in Syria has had a devastating impact on the country's healthcare system, with hospitals and medical personnel being targeted by both government and insurgent forces. As a result, many field hospitals have been driven underground, into basements and caves, in an effort to protect medical staff and patients.
Syrian doctors and engineers have developed three main models of underground hospitals: basement hospitals, cave hospitals, and fully underground hospitals. These underground facilities have proven to be much safer than their above-ground counterparts, with no reported deaths of health workers in fully underground hospitals due to direct attacks. The fortification of medical facilities is now considered standard practice in Syria, with sandbags and cement walls providing additional protection.
The need for underground hospitals is immense, especially in areas outside of government control. It is estimated that 50% of hospitals in opposition-held Syria lack any form of reinforcement or fortification. The Idlib governorate has been identified as a priority area for fortification due to the escalation of attacks using advanced weapons.
Despite the effectiveness of underground hospitals in saving lives, there are challenges in terms of funding. International donor governments often view the reinforcement and construction of underground medical facilities as long-term aid or development work, rather than emergency funding. This creates a funding gap for projects that bridge the divide between emergency humanitarian aid and development assistance. As a result, medical organizations operating in Syria may not have access to the necessary long-term funds for infrastructure building.
The protection of medical personnel and facilities is crucial, and the international community must step up its support for Syrian health workers and patients. Underground field hospitals have emerged as a creative and innovative solution to the brutal urban military conflict in Syria, allowing medical staff to continue providing life-saving care despite the ongoing dangers and challenges they face.
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Frequently asked questions
It is difficult to give an exact number, but in 2012, the World Health Organization (WHO) reported that only 50% of hospitals were fully functioning. This was due to destruction, lack of staff, equipment, and medicine. As of 2019, over half of public hospitals were functioning, but many were operating at minimum capacity and facing severe shortages.
The Syrian Civil War has caused mass displacement and violence, with hospitals being directly targeted by air strikes. The Syrian government has been accused of deliberately targeting medical facilities, which is considered a war crime.
Syrian Field Hospitals have been established in hidden places like basements, farmhouses, deserted buildings, mosques, churches, and factories. These provide basic trauma care and surgery to those who need it. The World Health Organization has also delivered medical equipment and training to hospitals and health workers in Syria.
