In the face of severe underfunding, the vital medical referral system funded by the World Health Organization (WHO) from 11 refugee camps in northeastern Syria, including Al Hol camp, has stopped. This will lead to a marked increase in the number of preventable deaths.
“The lack of financing of the WHO means that by the end of March, referrals for patients requiring specialized or complex care are no longer funded. This decision shows how WHO is having to make difficult decisions in an environment where humanitarian funding is being reduced across the board. This funding cut essentially eliminates the possibility for the population in Al-Hol camp, where MSF works, and other camps in northeastern Syria, to access secondary and specialized healthcare. It leaves lives hanging in the balance, most of them boys and girls, dying, sometimes with treatable and preventable diseases, and other times needing urgent specialized care such as surgery,” says Allen Murphy, MSF head of mission in Syria.
As of January 2024, 93% of those detained in Al Hol camp are women, girls and boys. 62% are under 18 years old and 43% under 12 years old.
In 2023, MSF will help in the external referral of 1,446 patients. However, at least 22% of referrals were rejected, either because necessary services were not available, or due to security restrictions. Now, since the latest series of service cuts, there is little or no option for even life-threatening cases to be referred to a hospital outside the camps.
Even before the complete cessation of WHO support for medical referrals, there were an estimated 1,000 patients categorized as “chronic cases” (not emergencies, although they may deteriorate into life-threatening emergencies without this treatment) across the 11 fields, including more than 800 cases in Al-Hol alone.
These patients need specialized health services only available outside the field. These conditions include endocrinology, neurology, general surgery, chronic diseases, ophthalmic surgeries, reconstructive surgeries, gastroenterology, and skin diseases.
Patients we have spoken to have described the devastating impact of the cuts:
- “My daughter has been fighting kidney failure since 2023. Despite monthly referrals to hospitals in Hassakeh, I was unable to accompany her due to security restrictions. Recently, I received the devastating news that she can no longer be referred to hospitals in Hassakeh for treatment, and in just 5 days, she will run out of medication. Witnessing her suffering is more distressing than the horror we endured in the Al-Hol camp. The feeling of helplessness when a loved one is suffering is truly overwhelming.”
- “For more than five years, I have called Al-Hol camp home. Despite the immense challenges and hopelessness of country life, I persevere to ensure that my children receive the love, care and attention they deserve… Two years ago, my son was diagnosed with an illness that shattered our world. His small frame suffered relentless nosebleeds and incessant bouts of vomiting, suffering that eclipsed even the horror we witnessed during the conflict and our time in the camp. Two years have passed since his diagnosis, and I am still asking for urgent treatment for him. Recently, my son’s suffering intensified when he began to experience vision disorders. Although it took more than six months for him to be referred to Hassakeh for medical consultation, he has still not been provided with treatment, and my son lost his sight. For the past two years, my son has been denied treatment. His bleeding persists and every day, he screams in agony. Our faith in humanity has diminished; “Within the confines of the Al-Hol camp, compassion finds no refuge.”
“My daughter was diagnosed with a chronic gastrointestinal infection in 2023, a condition for which she needed to be referred to a hospital for essential treatment, as the necessary medications remain inaccessible within the camp. Unfortunately, her last referral, a month ago, in March 2024, brought her no relief. Since then, she has exhausted her medications, and her health has worsened significantly. Despite her excruciating pain, no one within the camp can alleviate her suffering. Now, my daughter is on the verge of fatal consequences… desperate, I begged to be repatriated to my home country where she could once access medical care. However, my pleas went unanswered; “They tell me that my country has abandoned us.”
“With the growing humanitarian needs in northeastern Syria, it is crucial that donors, especially member countries of the Global Coalitionl to combat ISIS, led by the United States, increase funding for health care services rather than reduce it.
This is especially vital for external medical referrals. The capacities of local medical facilities that serve as referral centers for Al-Hol camp and other detention camps and for internally displaced people in northeastern Syria must be improved. “Immediate funding is needed to fill the current gaps in this system.”
“More than 40 thousand people, most of them women and children, remain detained in the Al-Hol camp, coming from countries such as Syria, Iraq and more than 50 others. Many of them have been there since 2019 and some, who “They were born there, they have never known life beyond the confines of the camp,” concludes Allen Murphy.
