Reaching the Hard-to-Reach: A Look at the Zogra Camp in Syria
Reaching the Hard-to-Reach: A Look at the Zogra Camp in Syria
By Emma Ackerman, MedGlobal Communications & Advocacy Intern
Conflict in Syria has brought 10 years of near constant threats of violence, destruction of health infrastructure, ongoing violations of international humanitarian and human rights law, poverty and economic crisis, and widespread displacement. The UNHCR reports that 6.7 million internally displaced people (IDPs) living in Syria will need humanitarian aid in 2021, a 600,000 person increase from 2020. Ongoing conflict and destruction of critical infrastructure has caused one the world’s worst, most pervasive humanitarian crises, which has only worsened during the COVID-19 pandemic.
MedGlobal works in Syria to address health and humanitarian needs, and has recently extended operations to support health programs in the Zogra IDP camp. Zogra is located 27 km (or 17 miles) from Jarablus, a town in the Aleppo province of northwest Syria – very close to the Turkish border. The camp first opened in March 2017 to receive residents of the al-Waer neighborhood of Homs City who were forcibly displaced after years of siege and armed conflict. Most had already been displaced within Homs multiple times. Zogra later received waves of IDPs from Eastern Ghouta and Idlib. Despite reports that Zogra was prepared to receive IDPs, the first to arrive found a ‘catastrophic situation’ where most had to spend the first night either on the ground or in the buses they had arrived in. Tents were delivered soon after, but bathrooms and water sanitation services remained nonexistent. According to a resident of Zogra, “If the pain and oppression had a voice, you could hear it in the Zogra refugee camp north of Aleppo.”
From a geographical perspective, Zogra is one of the most difficult camps to reach, resulting in a massive unmet humanitarian need among IDPs in the camp. MedGlobal Turkey Country Director Dr. Hala Alghawi recently travelled to Zogra camp on a trip that took over three hours. Lack of safe roads, lack of available transportation, and expense of travel to the camp from nearby locations such as Jarablus and Azaz contributed to the difficulty of travel to this hard-to-reach area. She estimates that as of June 2021, 15,000 people (or around 3,000 families) are living in Zogra camp. A recent needs assessment of Zogra camp conducted in August 2020 echoes many other accounts of dire humanitarian needs in Zogra, including: insufficient and infrequent distribution of food, unavailability of health care services amid increasing need, chronic unemployment, poverty, scarcity of fuel for heating & cooking, shortage of weather insulators, and lack of warm clothes. Insufficient water sanitation and sewage systems are still grave health concerns in Zogra. The toilets are essentially open pits that facilitate the spread of diseases and epidemics, especially during summer months. Food security remains one of the most pressing needs among IDPs in Zogra. In addition to the 2017 cholera outbreak, 10 cases of poisoning in children due to unclean water were reported in 2019. Despite the acute need for more comprehensive health care, health facilities in Zogra are rudimentary, consisting only of a single pharmacy, pediatric clinic, gynecology clinic, and general medicine clinic. These primary care services are the only form of medical care available in Zogra. If specialized services are needed, residents must make the long, arduous, and expensive journey into Jarablus, where they will then likely be referred to cities such as Al Bab and Azaz, another two-hour trip. Vulnerable populations – such as pregnant women, the elderly, chronic disease patients, people with disabilities, critical care patients, ophthalmic cases, cardiology cases, and other subspecialty needs patients – require the most specialized care, and are therefore at an even greater risk for negative health outcomes during displacement. While observing these hardships, Dr. Alghawi shard a poignant reflection:
“It is not the Syria which I grew up in years ago. It was emotionally very painful to see my people, children and elderly, live in these inhumane circumstances. They have to adapt and fight for a better future. They seek safety and dignity but unfortunately they got the [bare] minimum.”
Existing aid programs and health care services have lessened the suffering of IDPs since arriving in Zogra, but are very far from addressing the many pressing needs of this forgotten population, and do not erase the needless suffering that has already occurred. Dr. Alghawi has highlighted some of the largest gaps in current services:
Medication supply shortages, especially for chronic diseases
Lack of specialized health services less than 1.5 hours away from Zogra
No services or centers for children with learning disabilities
No mental health & psychosocial support (MHPSS) services
No sexual and reproductive health (SRH) awareness or education programs
No rehabilitation centers for physical and mental disabilities
MedGlobal operations in the hard-to-reach Zogra camp aim to build capacity in existing health facilities and address the needs of the most vulnerable. Just this past week, MedGlobal donated a six month supply of medication for acute pediatric cases and provided 650 patients suffering from non-communicable diseases with vital medications. Dr. Alghawi passed on this message from a field manager in Zogra Camp:
“May God reward you and bless you for the great effort made to visit the camp. You made their hearts happy and they felt that someone remembers and takes care of them.”
As of June 1, only 12% of the $628.6 million requested by UNHCR for the 2021 Syria Operation has received funding. The world cannot forget about the displaced people in Zogra. There are numerous opportunities for implementation of advocacy activities and health programs in Zogra, and even a small amount of funding will make a noticeable difference in the quality of care available to Zogra’s most vulnerable IDPs.
Challenges to COVID-19 Vaccination in Syria
By Andrew Moran, MedGlobal Policy & Advocacy Intern.
On March 15, the humanitarian crisis in Syria will enter its eleventh year. A decade of violence and devastation in Syria has led to the deaths of hundreds of thousands of Syrians and engendered the largest refugee crisis in the world. More than 5.6 million people have fled Syria, including 70% of the country’s health workers. Among those that remain, 6.6 million Syrians are internally displaced. The destruction of infrastructure and interruption of services across the country has exacerbated the humanitarian crisis and now 13.1 million people are in need of some form of aid.
The outbreak of COVID-19 across Syria has created new challenges and put additional strain on health systems that have reached their breaking points. Half of all health infrastructure in Syria has been damaged or destroyed from the conflict which, when combined with mass displacement, limited testing capacity, and lack of coordination among local authorities, has hindered efforts to contain the spread of the virus. Though the actual number of COVID-19 cases in Syria is likely significantly greater than official figures suggest, each region has reported evidence of widespread community transmission:
Total Confirmed Cases in Government-Held Areas: 15,981 (Mar 8)
Total Confirmed Cases in Northwest: 21,214 (Mar 10)
Northwest Syria, the region with the most confirmed cases and a positive testing rate of 28%, has only nine hospitals equipped to handle COVID-19 patients. Between them, the northwest has the combined capacity of only 212 ICU beds and 162 ventilators for a population of more than four million people. In response to the health crisis, MedGlobal has worked with partners to distribute tens of thousands of personal protective equipment items and personal hygiene kits to health workers and people in need. MedGlobal has also provided 200 oxygen concentrators and 100 CPAP and BIPAP machines to health facilities and built critical health infrastructure, including two industrial oxygen generators in Idlib and Darkoush.
Syria is expected to receive its initial supply of vaccines in April through the COVAX program, enough to cover 3% of the population. The Syrian government, which will control the national distribution of vaccines, has not clarified whether it will include certain areas, such as those not under its direct control, in its vaccination plan. Concerns over vaccine access have led local authorities in northwest Syria to submit their own formal request to COVAX for a direct supply of vaccines. According to the self-styled regional government, the WHO will provide 1.7 million doses of AstraZeneca vaccine to the northwest starting in late March. Unlike the northwest, which continues to have access to aid through a UN sanctioned border crossing, the northeast is entirely dependent on the Syrian government for aid delivery. The northeast has no mechanism for receiving vaccines in the event that the government decides to delay or halt vaccine delivery.
Access to vaccines is critical, but technical, logistical, and social challenges may prevent successful implementation of vaccination campaigns. Many areas of Syria lack the necessary equipment and continuous access to electricity required for storing certain types of COVID-19 vaccines. In the northwest, where half the population is displaced, identifying and reaching individuals from priority groups and following up with a second dose in three to four weeks will be difficult. Many displaced Syrians lack formal identification and repeat displacement events, such as the massive flooding that affected more than 67,000 IDPs in January, will complicate tracking efforts. Combating widespread misinformation and entrenched stigmas surrounding COVID-19 and vaccines is also necessary for people to participate in vaccination campaigns. In preparation for the arrival of vaccines, local and international health organizations are working together to set up 93 vaccine distribution centers and mobile units in northwest Syria. While this is critical for building capacity, overcoming the other challenges and ensuring the safety of health workers will ultimately require greater support for the northwest, and the rest of Syria, to achieve herd immunity and overcome the COVID-19 crisis.
Field Operations Update for November 2020
Each month, MedGlobal publishes a monthly Field Operation Update, highlighting our humanitarian and health programs around the world. MedGlobal supports healthcare in Bangladesh, Colombia, Ecuador, Gaza, Greece, Lebanon, Sudan, Syria, and Yemen, and has been contributing to the COVID-19 response in the United States. These monthly blog posts provide a snapshot of some of our most notable program updates from the past month. For more frequent updates, make sure to follow us on Facebook, Instagram, and Twitter.
Bangladesh
In collaboration with Prantic and OBAT Helpers, MedGlobal provided a major distribution of personal protective equipment (PPE), medical supplies, and other health and hygiene equipment to health clinics in Cox’s Bazar. This medical distribution is supporting Rohingya refugees in the camps, as well as the Bangladeshi community in Cox’s Bazar town. The medical equipment included the most critically needed supplies to prevent and respond to the spread of COVID-19, including oxygen concentrators, portable ventilators, over 700 PPE sets, infrared thermometers, and more. This distribution also included 7 handwashing stands that went to the host community in Cox’s Bazar. They are stationed at various high-traffic areas, such as outside temples and public toilet spots.
Gaza
The rapid spread of COVID-19 in Gaza continued into November. In partnership with Rahma Worldwide, MedGlobal provided a shipment of 75,400 PPE items as well as sanitizing supplies to the Kamal Adwan Hospital in Gaza in November. MedGlobal’s Gaza Program Manager Raja commented, “As COVID-19 continues to spread so rapidly in Gaza, masks and other PPE are critical to protect the few health workers available to treat those affected.”
MedGlobal also continues to support the salaries of staff in Kamal Adwan Hospital’s Pediatric ICU Department. This month, MedGlobal increased the number of staff we’re supporting to 20 doctors and nurses. This emergency pediatrics department is critical, particularly as the people in Gaza are cut off from external healthcare, and its medical staff have saved over 100 children’s lives. Gaza is home to two million Palestinians, nearly 80% of whom rely on humanitarian assistance and live in overcrowded areas with poor living conditions.
Lebanon
MedGlobal has continued its medical response in Beirut, aimed at supporting overwhelmed health facilities facing increased levels of medical need and a medication shortage in Lebanon. In partnership with Baitulmaal, MedGlobal delivered two rounds of medications to the Rafik Hariri University Hospital in Beirut, which will provide critical treatment for hundreds of patients facing emergency health issues as well as non-communicable diseases. During the distribution, our Lebanon team commented: “They have been out of stock of some of these medicines for quite some time, and they are life-saving.”
Syria
In northwest Syria, there are now between 300-500 new confirmed COVID-19 cases each day. With a health system destroyed from war, local health workers warn that a health catastrophe may be imminent. MedGlobal, alongside our partners Rahma Worldwide and Violet Organization, began the installation of two major oxygen generators: one in Idlib City and one in Darkoush, northwest Syria. These generators will help supply health facilities, especially those leading in COVID-19 treatment, with critically-needed oxygen. Health facilities in northwest Syria have been facing an increasing demand for oxygen cylinders with the rapidly increasing number of COVID-19 patients who face severe symptoms, including difficulty breathing. This oxygen supply will have a lasting impact for local communities.
In addition, MedGlobal continued its distribution of 200 oxygen concentrators and 100 CPAP/ BIPAP machines in partnership with local independent NGOs throughout Syria, including to Aleppo, Damascus, Homs, Latakia, Hama, Zabadani, Bludan, and Safita. The provision of oxygen and these non-invasive ventilators are critical for people with difficulty breathing, primarily those suffering from severe COVID-19 symptoms. MedGlobal is also distributing 2,500 pulse oximeters, devices to measure the level of oxygen in your blood, which were also requested as critical based on local needs assessments.
United States
Domestically, MedGlobal is committed to supporting health facilities that focus on supporting particularly marginalized and underserved communities. These communities are disproportionately affected by COVID-19 with both higher rates of infection and mortality from the virus. In November, Illinois saw a spike in COVID-19, with the daily rates consistently over 10,000 new cases and 100 deaths per day. Hospitals became increasingly stretched then. In November, MedGlobal donated an additional 1,000 PPE items to Saint Anthony Hospital in Chicago to help with their COVID-19 response. Saint Anthony Hospital is a safety-net hospital that primarily treats underserved communities of immigrants, people of color, and those facing economic hardship.
Syria: Displacement in the Last 4 Years
As the year 2021 gets closer, so does the tenth anniversary of the conflict in Syria, which has led to over 500,000 deaths, destroyed the country’s infrastructure, and displaced nearly 13 million people from their homes, leading to the world’s largest displacement crisis. The health sector in particular has been decimated – as much as 70% of the health workforce has been displaced out of the country, there have been more than 600 attacks on health facilities, and at least 923 medical personnel have been killed, over 90% by Syrian government attacks. The targeting of healthcare has been used as a strategy of war from the beginning days of the conflict. Attacks on civilian areas coupled with the destruction of the health facilities and lack of medics that would treat them has been a central driver of overall displacement.
Currently in Syria, there are at least 6.2 million people, including 2.5 million children, internally displaced. From April 2019 through March 2020, an aerial and ground offensive in northwest Syria – during which attacks on civilian areas including schools, hospitals, and markets was frequent – led to the death of at least 1,600 civilians and the forced displacement of around 1.4 million people. Many of these internally displaced persons (IDPs) had been displaced several times over. These figures are just the latest displacement statistics – based on research from the Internal Displacement Monitoring Center, there have been millions of people displaced internally each year over the last four years:
2017: 2.9 million new displacements
2018: 1.65 million new displacements
2019: 1.85 million new displacements
2020: 1.47 million new displacements (through June 2020)
In addition to the mass internal displacement, an additional 5.57 million Syrians are displaced outside the country as refugees. This number has grown significantly from the 4.8 million Syrian refugees registered with the UNHCR at the end of 2016. For the vast majority of refugees, conditions for a safe return to Syria do not currently exist, and the protracted nature of the refugee crisis persists.
At the same time, in the U.S., policies around refugee resettlement have been drastically scaled back over the last four years. The U.S. has historically been the global leader in refugee resettlement, especially since the passage of the 1980 Refugee Act. However, while the world faces the highest levels of displacement on record, refugee admissions to the U.S. have dropped to a historic low over the last four years.
In 2016, the Presidential Determination for refugee admissions was 85,000. Each year since then, the Presidential Determination has hit a new historic low, with a FY2021 refugee admissions cap of only 15,000. During this administration, there have been numerous policy changes – from the refugee admissions cuts to three Presidential Executive Orders denying admission to refugees from specific nationalities, most notably Syrians – dismantling the U.S. refugee resettlement infrastructure.
For Syrian refugees, who make up more than 27% of refugees under the UNHCR’s mandate, the effect in this policy shift has been particularly pronounced. A total of 22,138 Syrian refugees have been admitted to the U.S. since 2012. However, since 2016, the United States has only resettled 7,668 Syrian refugees, a sharp decline from the 12,587 who were resettled in 2016 alone. In 2020, only 481 Syrian refugees have been resettled in the U.S., just over 3% of the 2016 total.
Moving forward, it is critical that the effects of the conflict in Syria and the displacement crisis be addressed at all levels – in Syria, the region, and globally. MedGlobal is proud to have partnered with several Syrian and refugee-led organizations supporting healthcare in Syria and the region, including Violet Organization, Rahma Relief, UOSSM, and Multi-Aid Programs (MAPs). During the COVID-19 pandemic alone, MedGlobal has worked with partners to distribute tens of thousands of personal protective equipment (PPE) and personal hygiene kits; support a 150-person quarantine center in Darkoush, which provides food, hygiene, housing, and daily medical checks for displaced families; and build critical infrastructure, most notably industrial oxygen generators in Darkoush and Idlib City to support COVID-19 patients and others who need breathing assistance. Additionally, in August MedGlobal began to provide 200 oxygen concentrators and 100 CPAP and BIPAP machines, or non-invasive ventilators to help people who are suffering from severe COVID-19 symptoms breathe, to cities throughout Syria in partnership with local independent NGOs.
It is critical that governments and stakeholders step up to support displaced Syrians through increased support and protection programming for displaced civilians inside of Syria, service provision and ample rights for refugees displaced regionally, and increased resettlement of refugees at a global level, including the United States. Each year, the Presidential Determination should be put forth to at least 95,000, in line with historic averages. Direct funding for local and refugee-led humanitarian and civil society organizations should be increased. The displacement crisis for Syrians in the country and refugees outside of the country is far from over, and these communities must not be forgotten.
The Escalating COVID-19 Crisis in Syria: Humanitarian and Health Update
The COVID-19 crisis in Syria is reaching a tipping point as hospitals become overwhelmed, testing remains limited, and cases are surging across the country. The impact of the pandemic is adding to an already dire humanitarian situation in Syria, nine years into an emergency conflict that has led to staggering levels of death and need inside the country, decimated the country’s infrastructure, and led to the world’s largest displacement crisis.
On October 1, MedGlobal hosted the webinar “The Escalating COVID-19 Crisis in Syria: Humanitarian and Health Update” focusing on the COVID-19 crisis throughout Syria, giving a picture of the crisis, response, and key needs in different governorates. Speakers gave insights into the COVID-19 response and updates from medics inside Syria. Below are the highlights from each panelist’s remarks.
Dr. Zaher Sahloul
President and Co-Founder of MedGlobal
“No one knows what the real COVID-19 numbers are, the official numbers are only the tip of the iceberg.”
“This is the only country where I’ve heard that patients need to purchase their own oxygen and ventilators to be treated at home because hospitals are not accommodating these patients. Because 8 out of 10 Syrians are below the poverty line and cannot afford this equipment, many people have died without being treated, they suffocated to death inside their homes.”
At least 50% of healthcare providers have fled due to the targeting of hospitals and health workers. Health infrastructure has been destroyed, especially in the northwest, but even in government-controlled areas hospitals have been poorly managed and faced growing shortages of specialists.
The Syrian government has only reported roughly 4,000 cases of COVID-19 and 200 deaths. However, physicians and experts in Syria believe that the actual number of cases is much higher. Some medical leaders in Syria have estimated that the actual number of COVID-19 cases may be over 110,000 in Damascus alone.
Part of the problem is that testing in Syria remains extremely low. Only 35,000 tests have been conducted in government-held areas since the start of the pandemic. In comparison, Lebanon and Jordan are conducting 12,000 and 16,000 tests per day respectively and have much smaller populations than Syria.
A dire lack of resources has also exacerbated the crisis. Personal protective equipment (PPE) is essential for the safety of both health workers and patients, but many physicians are now having to buy their own. This has contributed to an increase in infections among doctors and according to the Healthcare Union in Syria, at least 61 health workers have died from the virus. As a consequence, some doctors are reluctant to treat patients with COVID-19 and private hospitals closed their doors to protect their other patients.
Each urban area has only 2 to 3 hospitals to treat COVID-19 patients. In Damascus, there were only 2 hospitals dedicated to treating COVID-19 patients, leading to long lines and people dying in crowded emergency rooms. For many Syrians, accessing treatment requires them to purchase their own oxygen concentrators and ventilators – an insurmountable barrier in a country where eight out of ten people live in poverty.
Dr. Naser Almhawish
Surveillance Coordinator for the Early Warning Alert and Response Network (EWARN) of the Assistance Coordination Unit
“To purchase a few thousand N95 masks… we had to wait more than one month.”
“The absence of good governance in the field is a huge issue because you do not have accountability.”
The situation in northwest Syria has been developing rapidly in the last month.
We can divide the COVID-19 response in the northwest into two stages: before the first cases were identified in July, and since COVID-19 cases have been confirmed. The closure of the borders around northwest Syria isolated the area and initially delayed the spread of COVID-19. Now, coordination and surveillance is essential for identifying gaps in the response and efficiently allocating resources.
Expanding laboratory capacity for testing is critical, as is protecting health workers. Nearly 30% of confirmed cases are among health workers and the quarantining of staff for two weeks has devastating consequences for the health sector.
Between July and August, there were only around 100 confirmed cases total in northwest Syria. In September, there have been 990 cases confirmed, and we know this is not all.
Major challenges include the displacement of people, limited lab capacity, overwhelmed staff and shortages of healthcare providers, coordination issues and weak governance, and stigma which lead to people denying potential symptoms and prevents people from getting tested.
The lack of PPE is greatly affecting healthcare providers. It’s also important to note that other safety and protection issues continue to affect healthcare providers, such as attacks on hospitals and airstrikes.
Hazem Rihawi
Senior Programs Manager of the American Relief Coalition for Syria (ARCS)
“This is the time now to increase the funding and the support for humanitarian responses coming into the northwest, the northeast, and government-controlled areas.”
“The health systems even in developed countries were struggling to be able to control this and you can imagine in a conflict zone like Syria it will be a further issue.”
Research from the NWS Modelling Team at the Covid Modelling Consortium estimates that the COVID-19 peak will happen in mid-November if limited interventions happen.
There are only 75 hospital beds in the northwest available for COVID-19 patients, which is much lower than needed. Hospitals in the northwest are already at 90% capacity.
The time is now for countries like the United States and other stakeholders to increase humanitarian funding to all areas of Syria before the number of cases peaks in the coming weeks.
COVID-19 Response Coordinator
Northeast Syria Forum
“Social stigma continues to be a significant issue. People tell us that they don’t ring the hotline because they don’t want the neighbors to see an ambulance… they don’t want the rumor to get out that they might have the virus.”
“Just because we have beds which are currently operational does not mean that the quality of care is necessarily assured.”
“The impact of the UN Security Council Resolution 2533 renewal, or non-renewal you could say, is that to have a predictable supply line in northeast Syria, we do require multiple modalities, whether that is UN cross border shipments under a Security Council resolution, NGO local procurement, NGO cross border procurement, or cross-line assistance from Damascus. We need this because we know that any one of these pipelines can break down.”
As of September 30, there have been 1,670 confirmed cases of COVID-19 in northeast Syria, including 67 deaths and 437 recoveries. At least 200 health workers are in self-isolation or quarantine and 10 health facilities have closed either a section or entirely. There is a gap of 818 hospital beds and 236 intensive care unit beds and virtually all patients who have been ventilated have died. Despite the crisis, which is on track to worsen significantly, there are no movement restrictions or lockdowns in place and there is minimal adherence to personal preventative measures.
One of the key challenges that needs to be addressed in the northeast is the low levels of risk perception among the population. It is important to remember that over the last nine years, the people living in this part of Syria have experienced immense hardship from the Syrian conflict, living under ISIS, and dealing with an economic crisis. Civil leaders have downplayed the danger of the virus and stigmas around COVID-19 keep people from reporting symptoms and seeking treatment. There are low levels of hospitalization as people are dying in their homes rather than seeking medical care and those that do often wait until they are at advanced stages of the virus.
The closure of the Al Yarubiyeh border crossing into northeast Syria has further intensified the crisis by disrupting supply chains. PPE in hospitals is being washed and reused and some health facilities have instituted policies against using PPE unless the patient is confirmed to have COVID-19. Supplies for conducting testing are also in great demand and there is concern that testing capacity will fall to zero by the end of the year.
Key needs for managing the COVD-19 crisis include high levels of funding through 2022 and improved coordination between health facilities and different levels of governance.
Field Operations Update for September 2020
Starting this month, MedGlobal will be putting out monthly Field Operation Updates, highlighting our humanitarian and health programs around the world. MedGlobal supports health care in Bangladesh, Colombia, Ecuador, Gaza, Greece, Lebanon, Sudan, Syria, and Yemen, and we have been contributing to the COVID-19 response in the United States. These monthly blog posts will provide a snapshot of some of our most notable program updates from the past month, though won’t cover the entirety of the health services and humanitarian work MedGlobal provides each month. For more frequent updates, make sure to follow us on Facebook, Instagram, and Twitter.
Lebanon
On August 4, 2020 a massive explosion in Beirut’s port destroyed buildings and infrastructure, killing at least 191 people, injuring over 6,500, and leaving as many as 300,000 people without a home. Following the explosion, MedGlobal launched an emergency response in coordination with local partners. MedGlobal partnered with Banin Charity Organization to establish a medical tent that provides medical and mental health services, medications, hygiene kits, supplies, and referrals to people affected by the blast. The tent is located in the Zqaq El Blat area of Beirut and referral tents are located in Mar Mikhael and Karantina. MedGlobal also provided Rafik Hariri University Hospital, located in Beirut, with medical supplies and medications following the blast. For more information about MedGlobal’s emergency response to the Beirut blast, please watch this video.
In addition to the Beirut response, MedGlobal responded to the COVID-19 crisis alongside our partner Multi-Aid Programs (MAPs) by providing health care support to Syrian refugees, who are particularly vulnerable. MedGlobal supported two medical facilities who primarily serve Syrian refugee communities in Majdal Anjar, a village in Lebanon’s Beka’a governorate. We provided personal protective equipment (PPE), staff salaries, and medications to the facilities. Our recent work in Majdal Anjar has reached 6,000 patients.
Ecuador
In response to the COVID-19 outbreak in Guayaquil, Ecuador’s most populous city, MedGlobal began providing the MUEVE Foundation with supplies for their medical brigades for vulnerable populations in Guayaquil. This included medications for over 4,000 patients, 1,000 surgical masks, and 500 bottles of sanitizer. In partnership with Parametria, Santa Elena Governorate, and the Universidad Estatal Peninsula de Santa Elena, MedGlobal also helped conduct a survey to learn more about socio-demographics and perceptions and knowledge of COVID-19 within the province. In addition to our work combatting COVID-19, MedGlobal, in partnership with Parametria, donated food and hygiene kits to the MUEVE Foundation which will distribute them among 500 families of displaced Venezuelans in Guayaquil neighborhoods, reaching over 2,500 people.
Yemen
In August, MedGlobal scaled up its COVID-19 response in Yemen. MedGlobal distributed over 60,000 items of PPE and 61 oxygen cylinders, in addition to hospital beds, testing equipment, and other medical supplies to hospitals and isolation units throughout Yemen. This health care has served some of the most vulnerable communities in the Hadramout, Al Hudaydah, and Taiz governorates. Only half of all medical facilities in Yemen are fully functioning and 80% of the population relies on humanitarian assistance, so health support is more critical than ever.
Syria
As the COVID-19 crisis escalated in Syria, MedGlobal, alongside our partner Rahma Worldwide, has worked to provide oxygen concentrators, crucial for the treatment of COVID-19 patients, to health facilities and isolation units in Idlib, northwest Syria. Oxygen concentrators are crucial for providing the medical grade oxygen needed for treating COVID-19 patients. The impact of the pandemic is adding to an already dire humanitarian situation in Syria, nine years into an emergency conflict. Additionally, in August MedGlobal began to provide 200 oxygen generators and 60 CPAP machines, or non-invasive ventilators for people suffering from severe pneumonia or COVID-19 symptoms, to cities throughout Syria in partnership with local independent NGOs based on comprehensive needs assessments. These medical supplies will support upwards of 2,000 people, primarily those who are not financially able to access health care, over the next 6 months in Aleppo, Damascus, Homs, Latakia, Hama, Zabadani, Bludan, and Safita.
Press Release: MedGlobal Calls for Foreign Medical Doctors to be Granted Licenses to Help in COVID-19 Response
Washington, DC – MedGlobal thanks Governor Phil Murphy of New Jersey for signing Executive Order No. 112 which grants temporary U.S. licenses to doctors who are licensed and in good standing in foreign countries.
This Executive Order for New Jersey is a critical step in enabling foreign medical professionals to assist in the urgent and extensive response to COVID-19 in the United States. As of April 1, the Center for Disease Control and Prevention reported 186,101 cases and 3,603 deaths from the virus in the U.S.
MedGlobal urges all governors to authorize similar executive orders, granting temporary US medical licenses to doctors who are licensed in foreign countries.
“During times of disasters, it is expected that policy makers modify public policies in order to save more lives. Now, with the U.S. at the epicenter of this global pandemic, we are suffering from a shortage of medical professionals that may get even worse as more patients and healthcare workers get exposed to or infected with COVID-19,” said Dr. Zaher Sahloul, President of MedGlobal. “It is vital that US-based foreign doctors (IMGs) – who are able to use their skills to save lives – are granted licenses to practice medicine across the U.S. during this dangerous pandemic.”
MedGlobal provides free healthcare and life-saving medication to vulnerable communities across the world, including Rohingya refugees in Bangladesh, displaced Venezuelan in Colombia, refugees in Greece, and victims of wars in Syria, Yemen, Lebanon, and Gaza. These communities are bracing for a catastrophic COVID-19 outbreak. MedGlobal is scaling up its work during this time with an international COVID-19 response, including providing medical supplies, ventilators, medical technology for Intensive Care Units, and personal protective equipment (PPE) for healthcare workers in Gaza, Syria, Yemen, Bangladesh, and beyond. Our volunteers and local staff are honored to serve these communities, and we implore all U.S. governors to grant foreign doctors the ability to offer the same care and solidarity to COVID-19 patients here in the U.S.
In the midst of the deadly global COVID-19 pandemic, MedGlobal urges immediate and urgent action to support refugees, displaced persons, and the most vulnerable communities. MedGlobal warns of the potential for a catastrophic impact of the dangerous virus on refugees and other vulnerable communities, and commits itself to adapting programs in the most effective ways to meet their needs.
“While the global health community and countries are busy with curbing the spread of COVID-19, let us not forget the refugees and the displaced,” said Dr. Zaher Sahloul, President and Co-founder of MedGlobal. “It is our humanitarian duty, and the right thing to do, to prevent catastrophic morbidity and mortality in a population that is unable to deal with the pandemic effectively.”
There are over 70 million refugees and forcibly displaced persons in the world. They will be the hit hardest by the COVID-19 pandemic, as many are confined to cramped environments like overcrowded camps or communities in urban areas where disease can rapidly spread. The majority do not have access to basic preventive measures like clean water, soap, cleaning solutions, sufficient sanitation facilities, or the ability to social distance or self-isolate. Refugees and displaced persons are made even more vulnerable by the lack of access to testing, limited access to sufficient medical care like Intensive Care Units in case they contract COVID-19, and damaged or destroyed health infrastructure as a result of conflict. These conditions could easily facilitate the rapid spread of COVID-19, with a mortality rate predicted to be much higher than the general population.
MedGlobal provides free healthcare and life-saving medication to Rohingya refugees in Bangladesh, displaced Venezuelan in Colombia, and refugees in Greece, in addition to local communities in Pakistan and victims of wars in Syria, Yemen, Lebanon, and Gaza. These communities are bracing for a catastrophic COVID-19 outbreak.
The MedGlobal team is acting with urgency to support brave frontline health workers and vulnerable communities during this COVID-19 pandemic. To date, our team has taken the following steps to adapt our operations and respond to COVID-19:
Emergency Needs Assessments: We are working with our teams and partners in Bangladesh, Colombia, Greece, Pakistan, Yemen, Gaza, Lebanon, and Syria to compile emergency needs assessments to understand the current situation locally and respond in the most effective way for each setting.
Emergency Supplies and Triage Programs: Based on local needs, we are ramping up provision of medical supplies to support local health workers and communities, including soap, washing units, personal hygiene kits, and cleaning solutions; medications, ventilators, oxygen masks, and medical technology for Intensive Care Units; Protective Personal Equipment (PPE) including masks, gowns, gloves and eye shields. With top experts around the world, we are developing emergency triage programs in preparation for potential COVID-19 outbreaks.
New Prevention Measures for our Clinics: Our full-time clinics in Bangladesh and Colombia continue to function, with new infection control and prevention measures implemented in coordination with partners.
Clinical Resources: We are designing resources pertaining to COVID-19 tailored specifically to our field operations, including recommendations on infection control and prevention based on CDC, WHO and UNHCR data; clinical management of suspected cases; and emergency planning in the case of an outbreak.
Educational Online Programs: We are planning webinars and educational programs for the general public, which aim to present the potential impact COVID-19 may have on refugee communities. Our first webinar on COVID-19 is Tuesday, March 24 from 9am-11am CST.
Mental Health Response: We are designing a mental health plan in the context of COVID-19, including a webinar for all staff wellbeing on coping with the COVID-19 threat and a webinar for field staff on how to support patients’ mental health during the pandemic.
MedGlobal will continue to prioritize the needs of the most vulnerable and marginalized, primarily communities of refugees, displaced persons, and others facing crises. We will continue to work with brave health workers across the globe to ensure that we are able to reach and support these communities, who must not be forgotten during this global pandemic.
Join us in supporting health workers on the front lines, helping vulnerable communities preparing for COVID-19 outbreaks.
MedGlobal meets with high-level UN officials about Syria
Last week, MedGlobal President Dr. Zaher Sahloul and the advocacy team held a round of high-level meetings with UN agencies, officials, and delegations to discuss the urgent and unprecedented humanitarian crisis unfolding northwest Syria. This included meetings with Ambassador Heusgen, the Permanent Representative of Germany to the UN; Ambassador Sinirlioǧlu, the Permanent Representative of Turkey to the UN; the U.S. Mission to the UN; the French Mission to the UN; the UN Office for the Coordination of Humanitarian Affairs (OCHA); and others.
In the past month, a new wave of displacement in Idlib and the Aleppo countryside has been underway, as a result of the rapidly deteriorating security situation due to airstrikes missile shelling on civilian areas. Towns and villages of the southern and eastern Idlib countryside and western Aleppo countryside are witnessing waves of ongoing displacement. The number of people displaced from these areas since December 2019 is now more than 516,000 civilians. A large portion of those displaced in the past weeks have been displaced before from other parts of Syria. In the 3 days of our UN meetings, over 260,000 people were newly displaced, with more forced to flee each day.
Local NGOs warn that another 650,000 people, mostly children, and women, may also be displaced if violence continues. Most of these IDPs are moving to areas in northern Idlib and Afrin and A’zaz in northern Aleppo, seeking areas less likely to be targeted by attacks and with access to services. These families require humanitarian assistance across sectors, with shelter being a particularly high priority. The vulnerability of IDPs is exacerbated by the winter weather. Heating, winter clothes, and blankets are essential needs. The evacuation of each family has cost between $140-200 in recent weeks.
MedGlobal partners with several Syrian NGOs on the ground like Violet Organization and UOSSM. These and other Syrian NGOs are taking the lead in evacuating families, arranging for much-needed shelter for the newly displaced families, and providing life-saving health services. MedGlobal will continue to advocate for the needs and protection of Syrian civilians.
MedGlobal led a solidarity mission with the displaced civilians in Idlib, Syria
MedGlobal provides hope and healing to the displaced people in Idlib, Syria
MedGlobal, along with a group of humanitarian organizations, stood in solidarity with 1.2 million displaced Syrian civilians in Idlib to highlight the catastrophic conditions. They called on the UN Secretary-General Antonio Guterres to visit the 359,000 newly displaced people.
A local Pediatrician who was displaced with her family from Maarat Al-Noman, Dr. Loubna Saad, described the horrifying conditions of evacuating her city three weeks ago. She also described the dire conditions of people who live in temporary shelters where necessities are not available. Diesel fuel for heating is scarce and expensive – families are burning plastic bags and appliances to warm their children.
Dr. Loubna speaking about the conditions of people who live in temporary shelters.
“Children are traumatized,” Dr. Loubna said, “ I have treated children with severe malnutrition and women who can’t nurse their children due to psychological trauma and lack of good nutrition. It will be very difficult for the displaced children to survive the harsh winter.”
Dr. Zaher Sahloul, co-founder and president of MedGlobal, participated in a press conference at one of the camps for internally displaced civilians in Idlib on January 7 to express solidarity with Syrian humanitarians and doctors.
“I traveled from Chicago to Idlib to stand in solidarity with you and convey the support of the American public. People are sending their prayers and donations to you,” said Dr. Zaher Sahloul. “We call on President Donald Trump to increase the humanitarian assistance to the displaced Syrians and to apply all diplomatic pressure on Russia to stop the bombing in Idlib. The United Nations and its Secretary-General Antonio Guterres have been slow in their response to the catastrophic situation – they should make ending this crisis a priority.”
During the last three weeks over 359,000 civilians, including 165,000 children, have been displaced. Since May 2019, over 1.2 million Syrians civilians have been displaced and more than 70 hospitals were bombed.
Dr. Zaher Sahloul participated in a press conference at one of the camps for internally displaced civilians.
According to Physicians for Human Rights, Idlib has 4 million civilians and half of them are displaced from other regions in Syria. Idlib has 1,150 refugee camps for the displaced, but Idlib is land-locked and there is no place to flee the bombing and violence.
Keeping Children warm in the harsh Idlib winter
MedGlobal, in partnership with the Violet Organization, supported and helped distribute blankets and tents to the newly displaced people from Maarat Al-Noman. More than $100,000 were donated to support the much-needed winterization program.
When a 10-year-old child, Ali, was asked about what he dreams of he said, “ I dream of a warm house once again.” Ali is living in a tent in one of the 1,150 camps in Idlib. He is one of 1.2 million internally displaced people who live in tents. He was displaced with his family from the city of Maarat Al-Noman three weeks ago.
Bab al-Hawa Hospital in Syria
Dr. Zaher Sahloul visited Bab al-Hawa hospital, the largest hospital in Idlib, and met with administration and medical staff. He made rounds in the Intensive Care Unit (ICU) and Dialysis Center and expressed the support of MedGlobal medical volunteers and leadership.
Bab-Alhawa is the largest hospital in Idlib and is reasonably protected because of its proximity to the Turkish border. They have 85 doctors and about 200 medical staff. The hospital serves 240,000 patients every year. The surgeons perform 1,200 surgeries every month, including orthopedics, vascular, plastic, cancer, and neurosurgery. Many of the surgeries cannot be performed anywhere else inside Syria.
The ICU is well equipped with 6 monitored beds and advanced technology, although it needs to be updated. It serves a mix of surgical and medical patients. The Dialysis Center has 6 dialysis units and operates 3 shifts for 24 hours. Some of the dialysis units are outdated and need replacement.
After the visit, Dr. Sahloul said, “the care in the ICU in Bab-Alhawa is equal to the care in my hospital in Chicago, in spite of the limited resources and risk on the lives of medical staff.” Doctors and nurses are targeted in Syria if they work in non-government controlled areas.
Dr. Sahloul with doctors and staff from the ICU in Bab-Alhawa
More than 580 hospitals have been bombed and 910 medical workers have been killed according to Physicians for Human Rights. “These heroes are harassed, targeted, and forgotten. These are amazing humanitarians who deserve our support, respect, and solidarity. We should all support these heroes,” Dr. Sahloul said.
MedGlobal provided $250,000 worth of medical supplies and equipment to Bab-Alhawa.
Outpouring support from the American public
Two pharmacists from Chicago donated free medications and medical supplies for this emergency medical mission. Dema Alzein and Jalal Matarieh often donate free medications to MedGlobal medical missions to Yemen, Colombia, Puerto Rico, Lebanon, Bangladesh, and Syria. They run a small pharmacy in Chicago Ridge.
This time their medications ended up helping newly displaced children in one of the temporary shelters in Idlib city. Whether you are a physician, a nurse, pharmacist or any other medical professional, you can choose to volunteer, donate, and heal through MedGlobal.
Janet Lipner attended a presentation about refugees in Chicago at the Illinois Holocaust Museum. Since then she handmade and sent crochet toys to Rohingya children. MedGlobal runs a clinic at one of the largest refugee camps in Cox’s Bazar in Bangladesh that served so far 100,000 Rohingya refugee patients, 25% of which are children.
Syrian children with crochet toys from Janet Lipner.
Our volunteers delivered the first two batches of fluffy toys to the Rohingya children which made them smile amid their tents. This time, the toys were made for Syrian children. They were hand-delivered and offered some warmth during a harsh winter. Thank you, Janet.
Everyone can do something to plant a smile on the faces of refugees, so make your intention to do so.
Support MedGlobal’s efforts in Syrian to provide hope and healing – donate today!
Co-founder and president of MedGlobal, Dr. Zaher Sahloul, joined a press conference in Istanbul, Turkey on January 10, 2020, with several humanitarian organizations. They stood in solidarity to shed light on the heartbreaking humanitarian situation in Idlib, Syria which left more than 359,000 civilians displaced. The following is the full statement on the humanitarian situation in Idlib, Syria from Dr. Sahloul:
“I traveled from Chicago to Idlib to be with the children of Idlib and convey the humanitarian picture to the American people. The American people care about what is going on and they want their government to end this crisis. Mosques, Churches, and Synagogues are sending their prayers and donations to the people of Idlib. Faith leaders have issued statements in solidarity and send their prayers to the victims. The church of Latter-day Saints donated $150,000 to help in the evacuation and shelter. Many Christian, Jewish, and Muslim-Americans also donated. The Syrian diaspora has been generous throughout the crisis. I have many American doctors who would love to volunteer with MedGlobal in Idlib in spite of the bombings. They want to help give treatment to Syrian patients and to stand in solidarity with their Syrian colleagues.
The children of Idlib are suffering. They are being targeted by Russian and Syrian regime bombs and missiles. They are cold and without shelter – most are unable to go to school. They have no food or medicine, their mothers are suffering, and their futures are bleak. Save the Children released a report which states that 175,000 children were displaced since December 2019. On average, every day there is a Syrian child who is killed by the Russian/Syrian bombing. In one month, more children were killed than that of all of 2018. We want to ring the alarm bells for what is happening.
What is happening is not fair. I have seen a family of mother and 6 small children who ended up in a room that hosts 3 families in a deserted building that is converted to a temporary shelter. I asked her what she needs. She looked at me with tears in her eyes and she said “everything.” She was displaced with her family in the middle of the night from the city of Maarat Al-Noman 3 weeks ago.
I saw a disabled man sleeping on a thin mattress when he needed a special bed for his condition to prevent bed ulcers. We spent part of a night in one of the 1,150 camps. It was a very cold and rainy night. Mud was everywhere and we had to wear long boots to be able to walk. Some children had no shoes. I asked one of the children, 12-year-old Asma Shbeeb, what she needs. She said, “I wish that there is some way to pave the camp with gravel instead of the mud so we can walk to our school which is 3 kilometers away.” Asma is a straight-A student in spite of her ordeal. She was displaced seven times with her family from the village of Jobbin before ending up in that camp tent.
Idlib children who are displaced.
I have been in many disaster zones with my organization, MedGlobal. I participated in medical missions to Yemen, Colombia, Gaza, Greece, Iraq, Lebanon, Jordan, Rohingya crisis in Bangladesh. What is happening in Syria, in Idlib is, by far, the worst. The UN and UNSC have to be ashamed for letting this happen for 9 years.
Dr. Sahloul treating a patient at one of the camps in Idlib.
The international humanitarian law which guarantees the protection of civilians, hospitals, and children is being violated every day – unfortunately, by a member of the UNSC. This should not be allowed to be the new normal, even in war situations.
The humanitarian situation is overwhelming to local Syrian NGOs. The United Nations and its agencies have been absent in action. After 9 years of the crisis and frequent large-scale displacements, it does not look like the UN has a plan to deal with emergency situations such as this. They have left the local NGOs, more or less, to deal with the displacement of 359,000 civilians on their own. Why isn’t there an emergency fund that could have been deployed right away? None of the UN officials visited Idlib or met with the people who they are supposed to protect and provide humanitarian assistance to.
The media has been absent in action. I was watching the TV over the past few weeks and every day there is a coverage of the bush-fires in Australia that led to the displacement of 100,000 people in a continent with unlimited resources. There is a pouring of sympathy and donations from all over the world to the good-hearted Australian people.
One of the Arab countries pledged to donate millions of dollars to Australia to help in the firefighting but at the same time cut its assistance to the largest hospital in Idlib that serves 240,000 every year. We should sympathize with the Koalas but the Syrian children deserve more attention. They are also cute like the Koalas. There is very minimal coverage of the worst displacement of the 21st century, a displacement of a million people, and mounting, in a small area in northwest Syria.
I call on the UN, UNSC member organizations especially Russia to stop the bombing of children, doctors, and women in Idlib. These are not your enemies. I call on President Donald Trump to make Syria a priority and apply all diplomatic pressure to end the Syrian crisis once and for all based on UNSC resolution 2254 and increase humanitarian assistance to Syrian children through the local Syrian NGOs. Syrian children have suffered enough. His legacy, like that of President Obama, will be determined by what he will or will not do in Syria.
I call on the UN Secretary-General Antonio Guterres to make the catastrophe in Idlib a priority. Mr. Antonio Guterres should visit Idlib like he visited other disaster areas. Claiming “deep concerns” in his comfortable UN office in NYC is not enough, he should be in the field, it is his duty. And if he does not want to, then he should resign. What is happening in Syria, in Idlib, is a stain on the United Nations record and utter failure of their rigid and outdated system.-
The UNSC should review the Cross Border aid resolution that is set to expire today. Russia and China should lift their veto and renew the resolution for one more year. The Syrian children are not their enemies. Without this resolution, the lives of 4 million civilians will be affected. The horrible situation in Idlib will be made even worse.
In spite of that, I can tell you that the Syrian children, the Syrian people, the people of Idlib are very resilient. They are dealing with the catastrophe with very limited resources. They are using compressed olive pits to heat their stoves instead of diesel fuel. They are even using plastic bags and other containers to heat the stoves. Winter is cold in Idlib. As a doctor, I know the long term consequences of inhaling plastic vapors – it is our loss if we don’t help them.
I asked the children of the camp what they dream to be in the future. Some wanted to be engineers, some teachers and some wanted to even be a president. But Asma, Huda, and more than half of the children in the camp wanted to be doctors. I hope that the international community gives them the chance to be a source of healing to the whole region instead of being a source of hopelessness.”
Support MedGlobal’s efforts in Syria to provide hope and healing – donate today!
Open your mouth wide My little angel Say Ahhh I brought my little light with me to see What happened to the land Of olive trees I brought my light with me For the world to see What did the beast do to you My light is so small And the darkness is overwhelming I hope it will shine And pierce through their apathy Some hearts may look at your beautiful face And pay little attention To what has been done to you Even if they don’t Don’t worry about them My little angel God is staying Very close to you They are the ones who lost By turning away God is here in the room with you My little angel #WithIdlibChildren
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