LONDON (AlertNet) - More than half Syria's 88 hospitals have been damaged in the country's bitter civil war, and nearly one third are out of service, making it difficult for people to get medical care, Syrian and U.N. health officials have reported.
December data from Syria's health ministry, released by the World Health Organization (WHO) on Wednesday, shows that 48 hospitals have been damaged, of which 27 are no longer operating. Syria's 1,919 public health centres have been less severely affected - around 10 percent are damaged and 6 percent closed.
Parts of the country hit by the fiercest battles between government and government-backed forces and opposition fighters are the worst affected. In eastern Deir al-Zor governorate, only one of the six public hospitals is functioning, while in Homs, just seven of 13 public hospitals are in service. In Deraa, three of nine public hospitals are operating but the rest are offering only partial services.
WHO spokesman Tarik Jasarevic said the situation is deteriorating. "Some hospitals and health centres are still functioning, even in Homs, but the problem is that there continues to be more damage, a shortage of drugs and fewer health workers," he told AlertNet from Geneva. "The solution for this is to stop the fighting."
A U.N. humanitarian bulletin, also issued this week, said medical supplies are "severely low" in many places, leaving people without access to proper care and forcing surgeons to carry out complex operations under local anaesthetic.
"Many people in conflict areas are seeking medical care in informal clinics, fearing that hospitals will be subject to attacks," it said, adding that international humanitarian law prohibits attacks on medical facilities.
Jasarevic from the WHO said the risk of outbreaks of disease is rising, though no major outbreaks have yet been detected.
The agency said nearly all deaths reported in the first week of this year were due to influenza-like illness, almost 40 percent of them children aged between 5 and 14. The unusually cold winter has made the problem worse, as many Syrians use electric heaters, but some areas experience daily power cuts.
Around 1.5 million children were vaccinated against measles and polio late last year, but the joint immunisation campaign could not reach children in some conflict-hit areas, including Deir al-Zor governorate and districts of Homs. Further efforts are planned for April.
The WHO is working with 16 NGOs inside Syria to provide medical supplies to healthcare facilities, including kits to treat serious injuries and medication for chronic illnesses. It is also collecting data on deaths and disease, and recently sent an emergency support team to Jordan to help its offices in Syria and other countries in the region that are hosting Syrian refugees.
Fighting, the threat of violence and government restrictions have made it extremely tough for U.N. agencies and international NGOs to carry out humanitarian work on the ground in Syria. Most are providing aid through the Syrian Arab Red Crescent (SARC) and local groups, and a few are running clinics and field hospitals.
Another major - and growing - health problem for Syrians is the psychological toll taken by the armed conflict, with which "a great number of people in Syria require support to cope", according to the U.N. bulletin.
Psychosocial support services are being offered on a very limited scale to several hundred displaced people and children through clinics and community centres. But 2 million children who are affected by the war - around half the total - are suffering from witnessing violence on a daily basis and being deprived of their education, the U.N. children's fund (UNICEF) says.
"Some children have been out of school for almost one or two years. With the destruction of the infrastructure, 25 percent or 3,900 schools have been damaged, destroyed or (are) being utilised as shelters," Ted Chaiban, UNICEF’s head of emergency operations, told reporters this week after a visit to Syria.
UNICEF and its partners are stepping up provision of chlorine tablets to prevent water contamination, which can cause diarrhoea and other bacterial infections. Meanwhile, cases of scabies and other skin diseases are on the rise, it noted.
"Another important issue relates to the lack of chlorine as local industries have been destroyed," said Chaiban. "Internally displaced people now have access to one third of the water they used to have," he added.
The impact on civilians of the 22-month-old revolt against Syrian President Bashar al-Assad has been catastrophic. The United Nations says more than 60,000 lives have been lost, at least 664,000 people have fled the country, and 2 million are displaced inside Syria.
Four million Syrians, nearly one in five of the pre-crisis population, need humanitarian assistance. Roughly half of those are located in the three most-affected governorates of Aleppo, Homs and rural Damascus, the U.N. humanitarian bulletin said.