Coronavirus: First death in northeast Syria highlights region at risk, warns MSF

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The first death from the new coronavirus in Syria’s contested northeast highlights the region’s inability to deal with a potential COVID-19 outbreak, warned Doctors Without Borders (Médecins Sans Frontières – MSF) on Tuesday.

Northeast Syria has been a site of conflict during the country’s nine-year-long war. Kurdish-led forces, Turkish-backed opposition groups, and the Iranian-backed Syrian regime all control territory in the region, with US and Russian troops also present.

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On top of nine years of conflict, Syria is now bracing for an expected outbreak of coronavirus in the country, with many areas housing thousands of refugees in makeshift accommodation with little or damaged healthcare facilities. The Damascus government has implemented a 12-hour curfew, but does not control all of Syria's territory.

In the northeast, MSF warned that a weakened healthcare system due to conflict and a delay in testing due to border closures means the region is ill-prepared for an outbreak – with more deaths likely to follow.

“We are deeply concerned about the lack of laboratory testing, the absence of contact tracing, inadequate hospital capacity to manage patients and limited availability of personal protection equipment (PPE),” said Crystal van Leeuwen, MSF Medical Emergency Manager for Syria.

“The response in northeast Syria at this time is not nearly enough. A significant increase in assistance from health actors, humanitarian organisations and donors is essential,” she added.

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A photo taken looking into the Al Hol camp in northeast Syria. (MSF)
A photo taken looking into the Al Hol camp in northeast Syria. (MSF)

Cramped conditions in camps put residents at risk

MSF said it was particularly concerned about the risk of outbreak in refugee camps across the region.

Many camps house refugees in cramped spaces with no access to clean water or medical services.

MSF said that the Al Hol camp was “overcrowded” and now housed 65,000 people who are not allowed to leave.

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The MSF report echoes similar reports from camps elsewhere in Syria.

Al Arabiya English reported in late March that Idlib province, the main opposition stronghold in northwest Syria, had only one COVID-19 PCR test machine and 2,000 tests kits for a population of over five million. Hospitals in the region were already overwhelmed due to the conflict.

Likewise, the isolated Rukban camp in southern Syria faces similar threats. The settlement has been cut off from the rest of the country and has not received a major aid delivery since 2019. There are no trained doctors in the camp, forcing a handful of nurses to set up a makeshift clinic with minimal supplies.

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Lack of testing, access

Across Syria, one of the key problems faced by healthcare workers is a lack of testing facilities. Without sufficient testing, it is difficult for medical teams to keep track of the virus and protect patients.

According to MSF, the patient who died of coronavirus in northeast Syria had been tested for the virus, but the results were not shared for two weeks. By the time the results were published, the person had already died.

“The lack of reliable and timely testing capacity in the region makes it nearly impossible to detect cases at an early stage, significantly hindering the ability to slow transmission within communities early on, when it is most important,” said van Leeuwen.

Supplies are distributed at the Al Hol camp in northeast Syria. (MSF)
Supplies are distributed at the Al Hol camp in northeast Syria. (MSF)

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MSF has also called authorities in Iraqi Kurdistan, across the border from northeast Syria, to increase timely access for humanitarian workers to enter the region.

“We respect the COVID-19 measures put in place by the authorities in Iraqi Kurdistan; however, exemptions and facilitation must be granted to humanitarian workers to ensure that appropriate levels of support reach northeast Syria,” said Will Turner, MSF Emergency Manager.

“Much of the humanitarian support to northeast Syria is reliant on passing through Iraqi Kurdistan. We have much needed additional supplies and medical staff ready to travel, but we lack the guarantees that they can enter Iraqi Kurdistan and move on into northeast Syria,” he added.

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