Only one coronavirus testing machine for millions in Syria’s war-torn Idlib

As the number of coronavirus cases rise inexorably around the Middle East, Idlib province in northwest Syria is a disaster waiting to happen. Idlib and surrounding opposition areas have only one COVID-19 PCR test machine and 2,000 tests kits for a population of over five million. This makes the province a sanitary ticking bomb, which could reverberate across borders.

Hospitals in Idlib are overwhelmed, under-resourced and lacking essential life-saving tools to face the coronavirus pandemic.

“As of March 24, only 42 people have been tested so far. The province has the capacity for 10 daily tests, which is too little for five million people residing in Idlib and surrounding opposition areas,“ says Nawar Shaaban, a Syria analyst at Omran Dirasat, a independent think tank and policy center.

Members of a humanitarian aid agency disinfect Ibn Sina hospital as prevention against coronavirus in the city of Idlib, Syria, on March 19, 2020. (AP)

So far, three quarantine centers have been set up, a number that could nonetheless grow to 28. Brahim Idilbi, an Idlib journalist, explains nonetheless that many of those are makeshift centers, located in hangars or in rundown building.

“We do not have the capacity to face an enormous pandemic such as the coronavirus, we have only 130 ambulances, 500 doctors and 223 respirators, of which 100 are in use,“ he points out.

There are massive shortages of beds, medicine ventilators, and equipment. More than 84 medical facilities were damaged or destroyed due to violence, with hospitals systematically targeted by forces loyal to the regime of President Bashar al-Assad. More than 90 percent of health centers in Idlib lack drugs to treat chronic diseases, according to Reliefweb.

According to figures provided by Omran Dirasat, 65 hospitals and healthcare centers are currently operational. They are equipped with 3,065 beds, putting the ratio of people to every hospital bed at 1,702. The foreseen number of beds in case of an outbreak, says Shaaban, is 58,000, with at least 14,500 critical care beds needed.

“As many as two to three million could be infected,” warns Shaaban. The number of people who will need treatment could range between 300,000 to 450,000.

“We believe that 100,000 to 150,000 people will have to be hospitalized in intensive care, a capacity that we do not have, with only 201 units available,” says Shaaban.

Besides the lack of resources, virus propagation could be enabled by poverty, unemployment, and poor sanitary conditions. People’s immune systems have been worn down by malnutrition, stress and violence inflicted by years of war.

Omran Dirasat estimates that at least 75 percent of the Idlib and surrounding opposition areas’ population are unemployed and that 80 percent of them live under the poverty line.

An aerial picture taken on February 15, 2020, shows a Syrian man on a motorbike in the deserted Syrian city of Kafranbel, south of Idlib city in the eponymous northwestern province, amid an ongoing pro-regime offensive. (AFP)

Millions of displaced Syrian have sought refuge in the last opposition stronghold. Most live in densely population camps, in unhygienic conditions, with no access to sewage systems, or running water.

“The last offensive pushed over 1.4 million people to the Turkish border,” said Idilbi.

Medecins Sans Frontieres ( MSF) warns that the spread of COVID-19 there could become catastrophic and that the disease would spread very quickly, especially in camp settings.

MSF’s ability to scale-up its assistance will depend on a steady flow of essential relief items, medical supplies and also on its ability to send in international staff to support their Syrian colleagues, the organization says. To be able to scale-up the response, MSF has asked Turkish authorities to facilitate the transit of essential supplies and international staff into north-west Syria.

The conditions are rife for an outbreak that Idlib simply does not have the resources to handle.