Government attacks on Syria’s health care system

In the New England Journal of Medicine, Michele Heisler, M.D., M.P.A., Elise Baker, B.A., and Donna McKay, M.S., write: In July 2015, a 26-year-old pediatrician described to our team of Physicians for Human Rights (PHR) investigators his experiences in Aleppo, Syria’s most populous city. When he was a medical student in 2012, government forces detained and severely beat him. He now works as an emergency medicine physician and surgery resident in a hospital that has twice been bombed by the Syrian government. He lives in fear of being killed by bombs on his way to work or while there. His family wants him to leave Syria as they did, but he explained, “It’s our country, and if we leave, it will fall apart. At times, I think maybe I will leave and specialize and come back with better skills, but then I see how much the people need me. Maybe that’s the biggest thing that’s keeping me inside.”

Media coverage of Syria has focused on the exodus of refugees fleeing the sectarian warfare and the atrocities committed by the Islamic State. Less attention is paid to the Syrian government’s destruction of hundreds of hospitals and clinics in opposition-controlled areas and deaths of doctors, nurses, and other medical personnel. Since the conflict began in 2011, PHR has documented the killings of 679 medical personnel, 95% of them perpetrated by government forces. Some personnel were killed in bombings of their hospitals or clinics; some were shot dead; at least 157 were executed or tortured to death.

In July, a PHR team investigated the state of the health care system in eastern Aleppo.3 Though Aleppo does not reflect the worst of the destruction in Syria today, conditions there illustrate the consequences of these repeated attacks: the city’s medical facilities have been attacked nearly 50 times since opposition groups gained control of eastern Aleppo in 2012. The government has rained rockets, missiles, and since 2013, “barrel bombs” (100-to- 1000-kg barrels filled with explosives, shrapnel, nails, and oil that are dropped from helicopters and break into thousands of fragments on impact) on homes and civilian infrastructure, including hospitals. The number of barrel-bomb attacks reached an all-time high between April and July 2015. These bombs, which obliterate everything they hit and inflict head-to-toe injuries on anyone in their large blast radius, have had a devastating impact on life in eastern Aleppo. Only a quarter of the city’s 1.2 million residents remain, more than two thirds of the hospitals have stopped functioning, and roughly 95% of doctors have been killed or have fled. [Continue reading…]

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