LONDON (AlertNet) – Healthcare provision for tens of thousands of Syrian refugees living in camps and urban areas in Jordan is inadequate and unaffordable for the large numbers who cannot access free treatment, aid workers say.
As the number of Syrians crossing the border to escape the worsening conflict at home rises, there are fears that hospitals and clinics will be overwhelmed amid a shortage of funding to open new facilities.
The U.N. refugee agency, UNHCR, warned on Wednesday that the refugee crisis is "dramatically worsening". Arrivals in Jordan have increased to an average of 730 people per day in the past month, up from a daily average of 500 over the past six months. Humanitarian agencies expect more will leave Syria as weather conditions ease after recent winter storms, and fighting intensifies in and around major cities.
Medicins Sans Frontieres (MSF), which runs a hospital in the Jordanian capital Amman offering reconstructive surgery, is bracing for a jump in injured Syrians needing intensive treatment.
"We think it is very likely that in the coming (period) we shall be very challenged by the number of people with surgical complications and infection," Antoine Foucher, MSF head of mission for Jordan and Iraq, told AlertNet.
The programme has been taking on about 50 new patients per month, half of them Syrians who have sustained heavy wounds in attacks or are in a serious condition after being treated in clandestine clinics in embattled towns. Foucher said these are cases that other hospitals in Jordan are unwilling to handle, because they usually require treatment for around four months - which is costly and technically difficult.
The general capacity of over-stretched hospitals to take in Syrian refugees is insufficient, Foucher added. This is a problem due to a "huge increase" in respiratory infections, as well as diarrhoea epidemics, in the main camp of Zaatari, after floods and cold temperatures earlier this month, he said.
MSF is monitoring the situation in the camp, home to some 40,000 to 50,000 people, because medical facilities there have not been expanded in line with the growth in its population. The charity may need to start offering services there too, Foucher said.
He is also concerned that further spells of winter weather will bring more chaos due to a lack of robust shelter and drainage in the camp. "It is a permanent catch-up, and we will be in the same situation next time when the bad weather happens again," he said.
FREE HOSPITALS FLOODED
The problem of accessing healthcare is perhaps even more acute in urban areas, where around 80 percent of the 200,000 to 300,000 Syrian refugees in Jordan are living. Many are struggling to pay for rented apartments, and others are staying with host families or even sheltering in abandoned buildings.
In a report released this week, the International Rescue Committee (IRC) said gaining access to medical care is a "major problem" for urban refugees. Many have serious and life-threatening war wounds, chronic illnesses and other medical needs, and have already flooded the few hospitals and clinics where they can receive free services, it said.
Sanj Srikanthan, the IRC's emergency field director, told AlertNet that health is taking a back seat in assessments of the assistance required by Syrian refugees.
"We're far too ready to make the assumption that Syrians can access the Jordanian healthcare system, which I think is not universally true," he said.
The IRC has spoken to refugees who reported having to pay a fee to just see a doctor in Jordan. The aid agency is running two primary care clinics providing free treatment, counselling and subsidised prescriptions for 100 patients a day in the refugee-inundated towns of Ramtha and Mafraq to relieve overburdened local health facilities.
Srikanthan said he had also visited a clinic run by a group of Syrian doctors in Amman who have rented two floors of a private hospital and are averaging 1,500 Syrian outpatients - many of them war casualties - and 150 operations monthly.
But the doctors are worried about how long they can keep functioning without an increase in donations, let alone expand their services, Srikanthan said, adding that the IRC is also unable to open further facilities without more funding. He called for pressure to be stepped up at the international level to drum up more financial support for health centres.
Another area of healthcare where demand is growing is counselling to help people cope with conflict-related trauma, according to both MSF and the IRC.
"It was not like that at the beginning (of the conflict), but for three months now, we are seeing people with a lot of personal despair," MSF's Foucher said.
IRC is running several centres for women in Jordan and Lebanon. One of their key services is to assist women and girls who have been sexually attacked in Syria's conflict, by offering confidential counselling and clinical referral in a way that builds trust and avoids stigmatising them.
"If that is known, more and more cases will come forward because they are definitely out there in the refugee population," Srikanthan said.