Exodus of doctors and health workers leave sick and ailing Syrians out on a limb

Special Exodus of doctors and health workers leave sick and ailing Syrians out on a limb
Sanctions, isolation, earthquakes and a grinding civil war have devastated Syria’s health system, leaving medical personnel underresourced and overwhelmed, forcing many to leave for Europe. (AFP)
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Updated 13 June 2024
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Exodus of doctors and health workers leave sick and ailing Syrians out on a limb

Exodus of doctors and health workers leave sick and ailing Syrians out on a limb
  • Sanctions, isolation, earthquakes and a grinding civil war have devastated Syria’s health system
  • Overwhelmed, under-resourced, and often unpaid, medical personnel are leaving for Europe in droves 

LONDON: More than a decade of civil war, economic sanctions, regional tensions, and a devastating earthquake have left Syria’s healthcare system in tatters and, according to a top World Health Organization official, forgotten by the international community.

Hanan Balkhy, WHO’s regional director for the Eastern Mediterranean, said last week that almost half of Syria’s health workers had fled the war-torn country. She called for innovative approaches to halt the exodus of Syrian medical staff abroad.

In an interview with the AFP news agency, she said that young doctors needed to be offered better prospects than practicing “fourth-century” medicine amid dire conditions, “where you cauterize people and send them on their merry way.”




An injured man receives emergency treatment at the Samez hospital following bombardment by pro Syrian regime forces in rebel-held northwestern city of Idlib on October 6, 2023. (AFP)

The International Rescue Committee highlighted in a 2021 report that about 70 percent of the medical workforce had fled the country, leaving one doctor for every 10,000 people.

Balkhy told AFP that in addition to earning extremely low wages, if any at all, Syria’s medical staff faced a severe shortage of resources and equipment, including operating rooms, sterilization units, and medications.

However, according to Dr. Zaher Sahloul, a Syrian-American critical care specialist and president of the medical NGO MedGlobal, every young Syrian physician he knows either plans to or dreams of leaving Syria and pursuing opportunities in other countries, “especially Germany, other European nations, or the US.”

“The flight is across the board and not related to war or conflict,” he told Arab News.

According to data released by the German Medical Association earlier this year, 6,120 Syrian doctors work in Germany without holding a German passport. These doctors account for 10 percent of the EU country’s foreign medical staff.

INNUMBERS

• 70 percent Proportion of Syria’s medical workforce that fled the country, leaving one doctor for every 10,000 people. (IRC, 2021)

• 6,120 Number of Syrian doctors working in Germany, accounting for 10 percent of the country’s foreign medical staff. (GMA, 2024)

• 65 percent Proportion of Syria’s hospitals deemed fully operational, making access to healthcare heavily constrained. (WHO, 2024)

• $80 million Funding needed by the WHO for 2024 to ensure access to health services and prevent further deterioration in Syria.

Balkhy said many young doctors in Syria are learning the German language on the side “so that they can be ready to jump,” which she believes is a significant concern for the region and its population.

But she also believes that finding creative solutions may encourage Syrian doctors to stay or return to their country — a choice she says many would make “willingly” with access to adequate support.




A man stands at the entrance of Adnan Kiwan hospital that was hit during reported airstrikes by pro-regime forces in the town of Kansafrah, in the south of Syria's Idlib province on November 25, 2019. The patients of the hospital were reportedly evacuated shortly before the strike took place. (AFP/File)

Sahloul says the main reasons behind the exodus of medical workers “are the economic collapse, hyperinflation, corruption, the collapse of the healthcare system due to long years of war, the regime’s policies of destroying what is left and pushing away anyone who wants to leave, and the lack of a viable political solution.”

Following a brief visit to the country between May 11 and 16, WHO’s Balkhy described the healthcare situation as “catastrophic,” warning that the number of people in need is “staggering, and pockets of critical vulnerabilities persist in many parts of the country.”

In a statement published on May 18, the WHO official wrote that intensifying tensions in the region, including the Israeli operation in the Gaza Strip and the Iran-Israel shadow war, have exacerbated this catastrophic situation.

The civil war has forced more than 14 million Syrians to flee their homes and seek refuge both within the country and beyond its borders. Among them, more than 7.2 million remain internally displaced, while about 70 percent of the population needs humanitarian assistance, according to UN figures.




Dr. Hanan Balkhy, WHO’s regional director for the Eastern Mediterranean. (Supplied)

Balkhy said in her statement that she was “extremely alarmed” by the increasing malnutrition rates among children under 5 and nursing mothers as a result of rising poverty.

The UN warned last year that 90 percent of Syria’s population lived below the poverty line, with millions facing a reduction in food rations due to a shortfall in funding for aid agencies.

According to the WHO regional director, almost three-quarters of all deaths in Syria are caused by chronic conditions, including cancer, cardiovascular diseases, diabetes, and mental health disorders, many of which are going untreated.

She also noted the number of burn injuries in Syria has been disproportionately high, especially among children, as people, deprived of traditional means of heating and cooking, burn unsuitable materials, such as tires, plastics, and fabrics.




In this picture taken on May 2, 2023, male patients receive treatment at the Haematology and Oncology department run by the Syrian American Medical Society (SAMS) at Idlib Central Hospital in the rebel-held northwestern Syrian city.(AFP/File)

Fumes produced by burning these substances also result in respiratory issues.

With just 65 percent of hospitals and 62 percent of primary healthcare centers fully operational, combined with a severe shortage of essential medicines and medical equipment, access to healthcare is constrained.

Before the war erupted in 2011, Syria’s pharmaceutical industry covered about 90 percent of the national needs of medicines, according to a 2010 paper by academics from the University of Medicine and Pharmacy in Romania.

In 2013, WHO reported that the country’s local drug production plunged after the fighting caused substantial damage to pharmaceutical plants in the governorates of Aleppo and rural Damascus.




A picture taken on February 21, 2018 shows a view through the wall of a destroyed hospital's pharmacy after it was hit in a regime air strike in the rebel-held enclave of Hamouria in Ghouta near Damascus. (AFP/File)

Poverty also creates significant barriers to accessing medical services and affording essential medicines, said Balkhy.

What concerned her most was “the fact that almost half of the health workforce, which forms the backbone of any health system, has left the country.”

An investigation by Arab Reporters for Investigative Journalism last year found that although the exact number of Syrian physicians who left the country remains unknown, the true extent of this exodus is larger than the NGOs and the Syrian government have reported.

“Retaining a skilled health workforce and ensuring sufficient medical supplies in Syria and across the region is a key priority,” said Balkhy.




Members of the Syrian Civil Defense, also known as the White Helmets, carry the body of a woman recovered from the rubble of a building at the site of a reported airstrike on the rebel-held town of Ariha in the northern countryside of Syria's Idlib province early on January 30, 2020. (AFP/File)

She proposed engaging young Syrian physicians on research projects with a pathway to publishing so they can “feel that they’re doing something worthwhile,” in addition to ensuring they “at least have the equipment” to perform operations.

For Sahloul of MedGlobal, fostering a belief in a brighter future is essential to retaining both new and seasoned doctors.

“What will encourage young and old doctors to stay in Syria is believing in a better future — a new leadership that respects its human capital,” he said.

Sahloul said that international and Arab actors need to devote more attention to finding a genuine solution to the Syrian conflict — “one that ensures respect for human rights and dignity, and focuses on rebuilding.”




A man and woman carry malnourished children at a camp for Syrians displaced by conflict near the town of Deir al-Ballut by Syria's border with Turkey in the Afrin region in the northwest of the rebel-held side of the Aleppo province on September 28, 2020. (AFP/File)

He added: “The current Arab normalization with the regime is flawed because it gives no hope for any meaningful change.”

Sahloul said normalization’s priorities, including refugee repatriation, curbing the manufacture of and trade in the amphetamine drug Captagon, and limiting Iran’s influence, “are not the most important priorities to the young graduates and aspiring doctors in Syria.”

Balkhy emphasized that the decline in humanitarian funding for Syria was a “central and troubling concern.” 

For instance, Al-Hol camp in Syria’s northeast — home to the wives and children of Daesh militants captured in 2019 — has grappled with many significant challenges since funding shortages forced WHO to halt medical referrals, prompting camp administrators to revoke its access.

Talks with donors in the capital Damascus during her five-day visit revealed that while they acknowledge the extent of gaps and needs, they are hampered by competing regional and global agendas.

Medecins Sans Frontieres warned on April 29 that the severe lack of funding for a vital WHO-funded medical referral system in 11 camps in northeast Syria “will lead to a marked increase in the number of preventable deaths.”

WHO said in March that it required $80 million in funding for the year 2024 to ensure the continuity, quality, and accessibility of health services and infrastructure in Syria, and to prevent a further deterioration of the already precarious situation.


 


Hezbollah supporters protest banning Iranian plane from landing in Beirut

Hezbollah supporters protest banning Iranian plane from landing in Beirut
Updated 14 February 2025
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Hezbollah supporters protest banning Iranian plane from landing in Beirut

Hezbollah supporters protest banning Iranian plane from landing in Beirut
  • Young men set tires on fire, leading to scuffles between angry protesters and soldiers
  • The Lebanese army had been deployed at Beirut International Airport

BEIRUT: Supporters of Iran-backed Hezbollah group blocked the Beirut airport road and burned tires on Thursday to protest a decision barring two Iranian planes from landing in the Lebanese capital, state media and an airport official said.
“Young men set tires on fire in front of the airport entrance, raising banners supporting Hezbollah’s former Secretary-General Hassan Nasrallah,” Lebanon’s National News Agency said.
Some of the young men raised Hezbollah’s yellow flag and held pictures of Nasrallah, killed in an Israeli strike in September, as well as Iran’s slain Revolutionary Guards commander Qasem Soleimani, AFP footage showed.
The Lebanese army had been deployed there, the NNA said, with videos online showing scuffles between angry protesters and soldiers.
An official at Beirut’s Rafic Hariri International Airport told AFP that the Public Works and Transport ministry had asked the facility to inform Mahan Air that Lebanon could not welcome two of its Beirut-bound flights.
One flight was scheduled for Thursday and another for Friday, said the official who requested anonymity to discuss sensitive matters.
“The two flights were rescheduled to next week,” he added, without saying why.
Earlier in the day, video footage circulated online showing a Lebanese man stranded at a Tehran airport calling on his peers to block the Beirut airport road.
“We have been waiting here since this morning. We are Lebanese... no one can control us,” the man said, calling on Hezbollah-allied parliament speaker Nabih Berri to secure the return of Lebanese travelers.
A November 27 ceasefire agreement ended more than a year of Israel-Hezbollah hostilities including about two months of all-out war, but both sides regularly accuse the other violations.
Saeed Chalandri, CEO of Tehran’s Imam Khomeini Airport, said “today’s flight to Beirut was scheduled... but the destination (country) did not issue the necessary permission,” in an interview with Mehr news agency.
A day earlier, Israeli military spokesman Avichay Adraee said Iran’s Quds Force and Hezbollah “have been exploiting... over the past few weeks the Beirut International Airport through civilian flights, to smuggle funds dedicated to arming” the group.
He added that the Israeli army was sending information to the committee tasked with ensuring ceasefire violations are identified and dealt with in order “to thwart” such attempts, though some had been successful.
Israel has repeatedly accused Hezbollah of using Lebanon’s only airport to transfer weapons from Iran.
Hezbollah and Lebanese officials have denied the claims, with authorities reinforcing surveillance and inspections at the facility.
In January, an Iranian plane carrying a diplomatic delegation was subjected to inspection, sparking outrage from Hezbollah and its supporters and praise by its detractors.


France says EU working toward ‘rapid’ easing of Syria sanctions

France says EU working toward ‘rapid’ easing of Syria sanctions
Updated 13 February 2025
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France says EU working toward ‘rapid’ easing of Syria sanctions

France says EU working toward ‘rapid’ easing of Syria sanctions
  • Paris conference focused on protecting Syria from destabilizing foreign interference, coordinating aid efforts

PARIS: France’s Foreign Minister Jean-Noel Barrot said Thursday that the EU was working toward swiftly easing Syria sanctions as Paris hosted a conference on the transition in the war-torn country after President Bashar Assad’s fall.

Opposition fighters toppled Assad in December after a lightning offensive.

The new authorities, headed by interim leader Ahmad Al-Sharaa, have sought to reassure the international community that they have broken with their jihadist past and will respect the rights of minorities.

They have been lobbying the West to ease sanctions imposed against Assad to allow the country to rebuild its economy after five decades of his family’s rule and almost 14 years of civil war.

“We are working with my European counterparts toward a rapid lifting of sectorial economic sanctions,” Barrot said, after EU foreign ministers agreed last month to ease them, starting with key sectors such as energy.

Syria’s Foreign Minister Asaad Al-Shaibani is in Paris for the conference, in his first such official visit to Europe for talks after he attended the World Economic Forum in Davos last month.

The French presidency said earlier that the United States, Germany, Britain, the European Union and the United Nations were also to be represented, as were several Gulf nations and Syria’s northern neighbor Turkiye.

French President Emmanuel Macron is due to address attendees.

There has been concern among Western governments over the direction the new Syrian leadership will take in particular on religious freedom, women’s rights and the status of the Kurdish minority in the northeast of Syria.

Shaibani on Wednesday said a new government would take over next month from the interim cabinet, vowing that it would represent all Syrians in their diversity.

German Foreign Minister Annalena Baerbock, ahead of the Paris meeting, emphasized the need for “all actors” in Syria to be included.

“It is essential that women be represented,” she said.

Several diplomatic sources had said the conference also aimed to focus on protecting Syria from destabilizing foreign interference and coordinating aid efforts.

Turkish-backed factions launched attacks against Kurdish-held areas in northern Syria at around the same time as the offensive that overthrew Assad, and have since seized strategic areas.


Syria’s new leaders zero in on Assad’s business barons

Syria’s new leaders zero in on Assad’s business barons
Updated 13 February 2025
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Syria’s new leaders zero in on Assad’s business barons

Syria’s new leaders zero in on Assad’s business barons

DAMASCUS: Syria’s new rulers are combing through the billion-dollar corporate empires of ousted President Bashar Assad’s allies, and have held talks with some of these tycoons, in what they say is a campaign to root out corruption and illegal activity.

After seizing power in December, the new administration that now runs Syria pledged to reconstruct the country after 13 years of brutal civil war and abandon a highly-centralized and corrupt economic system where Assad’s cronies held sway.

To do so, the executive led by new President Ahmed Al-Sharaa has set up a committee tasked with dissecting the sprawling corporate interests of high-profile Assad-linked tycoons including Samer Foz and Mohammad Hamsho, three sources told Reuters. Days after taking Damascus, the new administration issued orders aimed at freezing companies and bank accounts of Assad-linked businesses and individuals, and later specifically included those on US sanctions lists, according to correspondence between the Syrian Central Bank and commercial banks reviewed by Reuters.

Hamsho and Foz, targeted by US sanctions since 2011 and 2019 respectively, returned to Syria from abroad and met with senior HTS figures in Damascus in January, according to a government official and two Syrians with direct knowledge of the matter, who spoke on condition of anonymity.

The two men, who are reviled by many ordinary Syrians for their close ties to Assad, pledged to cooperate with the new leadership’s fact-finding efforts, the three sources said.

Accused by the US Treasury of getting rich off Syria’s war, Foz’s sprawling Aman Holding conglomerate has interests in pharma, sugar refining, trading and transport.

Hamsho’s interests, grouped under the Hamsho International Group, are similarly wide-ranging, from petrochemicals and metal products to television production.

Hamsho, whom the US Treasury has accused of being a front for Assad and his brother Maher, did not respond to a Reuters request for comment. Foz could not be reached. The establishment of the committee, whose members are not public, and the conversations between Syria’s new government and two of the Assad government’s closest tycoons who control large parts of Syria’s economy have not been previously reported.

The new Syrian government’s approach toward powerful Assad-linked businesses, yet to be fully clarified, will be key in determining the fate of the economy as the administration struggles to convince Washington and its allies to remove sanctions, Syrian analysts and businessmen say.

Trade Minister Maher Khalil Al-Hasan and Syrian investment chief Ayman Hamawiye both confirmed to Reuters the government had been in contact with some Assad-linked businessmen, but did not identify them or provide further details.

Khaldoun Zoubi, a long-term partner of Foz, confirmed his associate had held talks with Syrian authorities but did not confirm if he had been in the country.

“Foz told them he is ready to cooperate with the new administration and provide all the support to the Syrian people and the new state,” Zoubi said from the gilded lobby of the Four Seasons hotel in central Damascus, which Foz’s group majority owns. “He is ready to do anything asked of him.”

The two Syrian sources said Foz, who holds a Turkish citizenship, had left Damascus after the talks. Reuters could not ascertain Hamsho’s whereabouts.

The US has sanctioned Foz, Hamsho and others with a prominent economic role, including Yasser Ibrahim, Assad’s most trusted adviser.

Syrian analysts say around a dozen men make up the close ring of business barons tied to the former regime. HTS-appointed government officials consider all of them to be persons of interest.

Syrian authorities have ordered companies and factories belonging or linked to the tycoons to keep working, under supervision of HTS authorities, while the committee investigates their various businesses.

“Our policy is to allow for their employees to continue working and supplying goods to the market while freezing their money movements now,” Trade Minister Hasan told Reuters in an interview early in January. “It’s a huge file. (Assad’s business allies) have the economy of a state in their hands. You can’t just tell them to leave,” he added, explaining the new government could not avoid engaging with the tycoons.

Hamsho International Group is among those put under HTS supervision, according to the sources with direct knowledge.

A Reuters visit in late January showed little work was being carried out at its modern multi-story headquarters in Damascus, where some offices had been looted in the wake of Assad’s fall.

Staff have been instructed to cooperate fully with the new Syrian administration, members of whom regularly visit the company seeking information, said one employee, who asked not to be identified by name.

Some economists say the country’s dire economic situation required major domestic corporations to continue to operate regardless of who they may be affiliated with.

The UN says 90 percent of Syrians live below the poverty line. While basic goods shortages have eased after strict trade controls dissolved in the aftermath of Assad’s fall, many Syrians still struggle to afford them.

“Syrian authorities need to be wary of a harsh crackdown on former regime cronies because this could create significant shortages (of goods),” said Karam Shaar, director of a Syria-focused economic consultancy bearing his name.

Assad’s rapid fall, culminating with his Dec. 8 escape to Russia, left many Syrian oligarchs with no time to dispose of or move their local assets that have since been frozen, giving Syria’s new rulers strong leverage in dealing with the tycoons, according to two prominent businessmen and the government official.


Vatican says Palestinians must ‘stay on their land’

Vatican says Palestinians must ‘stay on their land’
Updated 13 February 2025
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Vatican says Palestinians must ‘stay on their land’

Vatican says Palestinians must ‘stay on their land’
  • Secretary of State Pietro Parolin: ‘This is one of the fundamental points of the Holy See: no deportations’
  • Parolin: ‘The solution in our opinion is that of two states because this also means giving hope to the population’

VATICAN CITY: A top Vatican official on Thursday rejected US President Donald Trump’s proposal to move Palestinians from Gaza, saying “the Palestinian population must remain on its land.”
“This is one of the fundamental points of the Holy See: no deportations,” Secretary of State Pietro Parolin said on the sidelines of an Italy-Vatican meeting, according to the ANSA news agency.
Moving Palestinians out would cause regional tensions and “makes no sense” as neighboring countries such as Jordan are opposed, he continued.
“The solution in our opinion is that of two states because this also means giving hope to the population,” he said.
Trump has proposed taking over the war-ravaged Gaza Strip and moving its more than two million residents to Jordan or Egypt. Experts say the idea would violate international law but Israeli Prime Minister Benjamin Netanyahu has called it “revolutionary.”
Pope Francis this week criticized Trump’s plans for mass deportations of undocumented migrants in the United States — drawing a sharp response.
In a letter to US bishops, the head of the Catholic Church called the deportations a “major crisis” and said sending back people who had fled their own countries in distress “damages the dignity” of the migrants.
Trump’s border czar, Tom Homan, responded: “I wish he’d stick to the Catholic Church and fix that and leave border enforcement to us.”


Israel asserts presence in five strategically significant high points in southern Lebanon

Israel asserts presence in five strategically significant high points in southern Lebanon
Updated 13 February 2025
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Israel asserts presence in five strategically significant high points in southern Lebanon

Israel asserts presence in five strategically significant high points in southern Lebanon
  • Lebanon rejects any extension of Israeli forces’ presence in the border areas
  • Egyptian foreign minister: Resolution 1701 must be implemented by all parties

BEIRUT: Ahead of the scheduled Friday meeting of the five-member committee overseeing the implementation of the ceasefire agreement in southern Lebanon, Israel preemptively announced its decision to maintain a military presence in five strategic points overlooking the southern sectors.

The Israeli announcement — through both its officials and Israeli media — came four days before the extended deadline for withdrawing its forces, which have advanced into Lebanese territory.

On Wednesday night, Israeli warplanes conducted low-altitude flights, breaking the sound barrier over Beirut and several other regions, including the Bekaa Valley.

The maneuver came only hours after Lebanon rejected any extension of Israeli forces’ presence in the border areas, which they had advanced into since Oct. 1.

Political analysts interpreted the aerial incursion as “an act of intimidation designed to pressure Lebanon into accepting the situation.”

Lebanon has rejected any extension of the Israeli occupation of its territory. On Thursday, President Joseph Aoun reaffirmed that “Lebanon is intensifying diplomatic efforts to ensure Israel’s withdrawal by February 18.”

He said that the country was actively engaging with influential global powers, particularly the US and France, to secure a sustainable resolution.

During his meeting with Lebanese Foreign Minister Youssef Rajji in the newly formed government, Egyptian Foreign Minister Badr Abdelatty underscored the need to enforce the ceasefire agreement in southern Lebanon and demanded the immediate, full withdrawal of Israeli forces. He also stressed the importance of enforcing Resolution 1701, ensuring that all parties complied without exception.

On Thursday, Israeli Strategic Affairs Minister Ron Dermer announced that Israel would retain control over five strategic high points inside Lebanon following the expiry of the ceasefire next Tuesday. He emphasized that while the Israeli army would redeploy, it would maintain its presence in these key positions until Lebanon met its commitments under the agreement.

“Lebanon’s obligations do not entail removing Hezbollah from the border, but rather disarming it,” Dermer told Bloomberg.

While the Israeli minister did not specify how long the Israeli army would remain in the strategic high points, he said: “The army will not withdraw in the near future.”

On Wednesday, Ori Gordin, the chief of the Israeli army’s Northern Command, made a call “to solidify Israel’s presence in these positions under American cover and with international support.”

The Israeli Broadcasting Authority quoted senior officials in the Security Cabinet of Israel as saying that “the US has granted Israeli forces permission to remain in several locations in Lebanon long-term beyond Feb. 18.”

Israeli media reported that “the Israeli army has received US approval to establish observation points to monitor Hezbollah’s activities, while the US side rejected postponing the Israeli withdrawal from the villages where it is still carrying out incursions.”

These Israeli positions coincided with a round of talks conducted by US Maj. Gen. Jasper Jeffers, representative of the US in the committee monitoring the implementation of the ceasefire agreement, with Israeli officials on Thursday. As a result, the committee’s meeting in Ras Naqoura was postponed to Friday after originally being scheduled for Thursday.

Lebanon has rejected a joint US-French proposal to take control of these five strategic positions along the border, insisting instead that UN peacekeeping forces — UNIFIL — assume control of these points in coordination with the Lebanese army.

The disputed hills, which the Israeli military refuses to evacuate, include Jabal Blat, Labouneh, Aziziyah, Awida and Hamames. All these positions are strategically located but uninhabited.

According to local media reports in Beirut, Israeli forces have begun constructing prefabricated structures with guard posts along the Markaba-Houla road, adjacent to an existing UNIFIL position near the border.