Revival of basic health services in Syria
Authors: Mohamed A Sekkarie, Lina Murad, Zaher Sahloul
Journal: The Lancet Global Health (2015)

Waleed Al-Faisal and colleagues (July, 2015)1Al-Faisal W Sen K Al Saleh Y Syria: end sanctions and find a political solution to peace.Lancet Glob Health. 2015; 3: e363Summary Full Text Full Text PDF Scopus (5) Google Scholar call for an end to sanctions in Syria. Sanctions do have unintended consequences for innocent citizens, but those imposed on Syria have been mostly on weapons and items of dual use, many of which were imposed years before the onset of the present conflict,2Human Rights FirstSyria sanctions fact sheet.https://www.humanrightsfirst.org/wp-content/uploads/pdf/Syria_Sanctions_Fact_Sheet.pdfGoogle Scholar including the period of the positive achievements in health care mentioned by Al-Faisal and colleagues. Furthermore, humanitarian items and drugs were exempted from the sanctions. We believe that the reasons behind the present health-care crisis in Syria are much more complex. Since the beginning of the crisis, there were systematic attacks on health-care professionals and targeting of health-care facilities by the Syrian Government and to lesser extent some armed groups, as a tactic of warfare. According to the most recent report of Physicians for Human Rights,3Physicians for Human RightsAnatomy of a crisis: a map of attacks on health care in Syria.https://s3.amazonaws.com/PHR_syria_map/web/index.htmlGoogle Scholar 633 health-care workers have been killed and 271 health-care facilities attacked since the beginning of the conflict. Of these, 611 and 243, respectively, were by Syrian Government forces. Another factor is the improper distribution of available resources. For example, immunisation coverage for poliomyelitis in 2013 was 100% in Tartous Province but only 36% in Deir Azzor province, which is where the first case of the recent epidemic occurred.4Sahloul Z Coutts A Fouad FM et al.Health response system for Syria: beyond official narrative.Lancet. 2014; 383: 407Summary Full Text Full Text PDF PubMed Scopus (13) Google Scholar Aid agencies are essentially prohibited from sending materials to opposition-controlled areas, the assumption being that they could be used to treat rebel fighters.5Parker B Humanitarianism besieged.http://www.odihpn.org/humanitarian-exchange-magazine/issue-59/humanitarianism-besiegedGoogle Scholar Furthermore, civilians' access to health care in certain areas that are under complete siege is almost impossible. The UN's April, 2015, report6UN Security CouncilImplementation of Security Council resolutions 2139 (2014), 2165 (2014) and 2191 (2014): report of the Secretary-General.http://www.un.org/en/ga/search/view_doc.asp?symbol=S/2015/264Google Scholar on the implementation of Security Council resolutions 2139, 2165, and 2191 cited that 440 000 Syrians live in areas besieged by government forces, non-state armed groups, and ISIS. The UN was able to reach a mere 0·3% with health assistance. Improving health care for all Syrians and abiding by principles of medical neutrality should be a priority for humanitarian organisations and the UN, but lifting sanctions alone without providing measures for fair distribution of resources and protection of health-care workers and facilities would be futile and might have its own unintended consequences. We declare no competing interests. Syria: end sanctions and find a political solution to peaceFurther attempts were made last month to initiate peace talks in the Syrian conflict, and in the context of the devastated economic, social, and health systems, such a political solution aimed at halting all fighting must be given priority over blaming one side or the other. There is evidence to suggest that a revival of basic health services can act as a trigger to bring together warring sides.1 Full-Text PDF Open Access