Hand for Syria is a U.K.-based aid agency that takes medical and humanitarian aid into Syria. The group funds one of the few remaining hospitals in the rebel-held areas of the north, in a battered area of Aleppo province. Now, due to a lack of funding, the hospital is being forced to close. Doctors at the facility perform heart surgery, dialysis and provide inpatient care to Aleppo’s most at-risk patients: a rarity in a country where rudimentary field hospitals have become the norm.
Three years ago Syria boasted one of the most advanced health-care systems in the Arab world. Today that system has been decimated by what Physicians for Human Rights calls the systematic targeting of medical personnel and facilities by both the Syrian government and extremist rebels.
As a desperate response, field hospitals have popped up everywhere, from converted rural schoolhouses to the basements of major cities under aerial bombardment. A few modern hospitals have remained functional, but they are increasingly being targeted and remain vulnerable to the same donor fatigue that has left broader aid efforts underfunded (lackluster donations recently forced the U.N. to revise down its Syrian food aid programs for 2014).
Dr. Rola Hallam is one of Hand in Hand’s numerous British-Syrian volunteers. Here, she discusses why aid for facilities like theirs is dwindling, and the impact of the hospital’s closure on Syrians in Aleppo.
Our health care has all but been totally destroyed except for pockets in areas under government control in Aleppo and Damascus. It’s been almost annihilated. The main reason for that has been the specific systematic targeting by the Syrian government of hospitals, health-care facilities and health-care workers. We as Syrian doctors have been saying for nearly three years now that health care is being used as a weapon of war and that the very people meant to be protected by all warring parties are being sought out and targeted.
We’re closing because of a lack of funding. The hospital costs between $60,000 and $70,000 a month to operate, depending on our field costs. This is quite cheap for three operating theaters, an emergency room and 55 inpatient beds, but it’s a lot for a small charity. It has massive repercussions for our Syrian medical staff and for the approximately 5,000 patients we see every month. And, of course, for the greater population around us that knew it had access to our services.
In terms of geography, it’s in an opposition area and there’s no aid going into that area. It’s under daily shelling from the air, and it’s an area that has a lot of casualties. It’s also highly populated because there’s a high level of displacement into these [rural] areas. That’s why we set up the hospital there to begin with. And in addition, a [large] hospital in Bab al-Hawa was damaged a couple of days ago. [With the closure] the options will be even more limited. People will have to go to the border areas, or Turkey, or back into Aleppo, to seek treatment.
The services we provide at this hospital in particular are very important. Lots of the health care has been shifted from proper hospitals to field hospitals, where we can’t do inpatient treatment, mother and baby health care or most surgery. There’s war-related surgery, and then there’s non-war-related surgery. People still need to have an appendectomy. Our hospital has a dialysis unit. It’s one of only a few such units still functioning in Syria, and so its closure has huge repercussions.
We also have outpatient services, we can perform heart surgery and treat heart problems, postnatal care. We have a pediatric ward. And we provide inpatient care, which is such a rarity now compared to field hospitals [which can’t keep you overnight]. We have 55 beds.
The problems we have with funding is that Syrian NGOs like ours are not funded directly by international organizations and governments, because they have very rigid initial criteria, including three years of registration when most, like Hand in Hand, have less than that. We don’t fulfill their requirements and they won’t change them to suit the current need.
International NGOs do not have the expertise to be dealing with the complex medical problems we have in Syria. Generally, they [fund] single programs like mother care, rather than an entire hospital. Other international NGOs have been scared off of working in Syria for security reasons. Medecins sans Frontieres [which has had staff kidnapped] now doesn’t operate in Syria. They’ve been driven out. So people have left and are scared to work until there’s a change in the security setting. And with some international groups, even to this day, there’s a level of distrust and inexperience in working with the Syrian NGOs.