When the raging COVID-19 relegated students and parents worldwide to their homes in late March, teens turned to social media to publicly mourn their morning cappuccinos, their upcoming golf tournaments, banter with department-store cashiers and gossip spilled over a fresh haircut. Lamenting the loss of these daily luxuries to comply with state-sanctioned quarantine measures, they begrudgingly retreated from beloved universities to “shelter-in-place” in their hometowns.
But what do “shelter-in-place” mandates signify for the shelter-less, refugee populations of the world? How can one practice self-isolation measures in cramped environments with little to no sanitation practices, let alone reliable healthcare systems? For the refugee communities in Northwest Syrian Province, Idlib, coronavirus represents far more than cancelled plans and coffeeless mornings; it embodies a nightmarish extension of nearly a decade of devastation and extreme destitution.
The Idlib Governorate, positioned adjacent to Turkey’s Hatay province in the northwestern region of Syria, has been under control of anti-government forces since the inception of the Syrian Civil War in 2011. Regarded as the final locus of rebel-control in Syria, Idlib has weathered numerous attacks from the Syrian-Russian military alliance in the Northwestern Offensive, beginning in April 2019. In this nearly year-long drive to reclaim the rebel-controlled region, Syrian-Russian forces targeted critical community infrastructure throughout the province, including hospitals and other healthcare centers, forcing over a million people to flee their homes. In fact, Misty Buswell, regional policy and advocacy director for the International Rescue Committee, comments that “the devastation that coronavirus will cause in Idlib is unimaginable”, estimating that around eighty-five attacks occurred on health facilities in Idlib within the past year. [1] This political violence directed at critical healthcare resources has left the majority of hospitals “unable to cope with the needs that already exist”, according to Buswell, let alone the demands of the virulent COVID-19.
Displaced populations confined to makeshift settlements and camps such as Al Hol camp, in which 70,000 people reside, suffer from severe malnutrition, dehydration, and pneumonia—all health conditions that place these communities at greater risk for requiring hospitalization if infected with COVID-19. Regional director for the Near and Middle East at the International Committee for the Red Cross recalls that when tuberculosis ravaged these regions in years prior, isolation was nearly impossible—“so forget social distancing.” [2] Humanitarian organizations familiar with the area have described it as dangerously overcrowded and under-resourced; testing kits, ventilators, and sufficient medical personnel, sources of unease even for the United States, are impossibly scarce in Idlib. Only 1 of 16 hospitals within the region is fully functional, and the two hospitals delegated to quarantining and treating patients have only 28 beds for intensive care, 11 ventilators, and two doctors trained to use them, according to the IRC’s estimates. [3]
In response to these evident shortages, the World Health Organization has allocated as many as 300 test kits, 10,000 masks, 500 respirators, and 1,000 healthcare workers for the city and surrounding areas. [4] This donation will temporarily halt the spread of the disease, but the dire situation in Idlib requires extensive multilateral support that currently appears politically impossible. The ensuing crisis thereby becomes one of accessibility for NGOs as Turkey restricts traffic through the critical UN Cross Border Assistance Pipeline and Syria closes the border from Kurdish-led administration.
Ultimately, the volatile situation in Syria is one of political entanglement and cross-border alliances, which makes the instrumental work of humanitarian organizations such as WHO, IRC, and others, ever more complicated in the region. As the initial cases of coronavirus emerge in Syria, it appears as though the disaster-stricken country will suffer further unrest as COVID-19 inevitably surges through the millions of displaced peoples across the region. The only solution is ironically one Syria has been searching for ever since the civil war erupted in 2011—multilateral alliance and the resolution of political unrest in the region.
References
[1] “COVID-19 in Syria Could Lead to One of the Most Severe Outbreaks in the World, Warns IRC.” International Rescue Committee (IRC), March 23, 2020.
[2] “Virus Fears Spread at Camps for ISIS Families in Syria's North East.” Crisis Group, April 8, 2020.
[3] “COVID-19 in Syria Could Lead to One of the Most Severe Outbreaks in the World, Warns IRC.” International Rescue Committee (IRC), March 23, 2020.
[4] Marks, Jesse. “Analysis | Syria's Civil War Will Make Fighting Coronavirus Particularly Difficult.” The Washington Post. WP Company, April 2, 2020.