Milestones :: Perspectives :: Featured Journal Content
WHO: 6 years into the conflict, hero vaccinators in northern Syria brave danger to protect children from disease
This month marks a tragic milestone: 6 years since the conflict began in the Syrian Arab Republic. This ongoing crisis has led to 5 million refugees, more than 6 million internally displaced people and 13.5 million people in need within the country.
A number of WHO partners in the north of the country collectively form what is known as the Syria Immunization Group (SIG), an immunization cluster coordinated by WHO staff in the field office in Gaziantep, Turkey. The work of this group is carried out under what is known as the “whole-of-Syria” approach, which brings together humanitarian actors both within the country and from neighbouring countries to provide access to health services across lines and borders.
The SIG is made up of individuals who often put their own lives at risk to bring vaccines to children in hard-to-reach and besieged areas. These courageous health workers take boats when bridges are destroyed. They walk through farmland carrying coolers of vaccines. They provide vaccinations to communities while bombs fall nearby. They brave tremendous danger to protect children from deadly diseases.
Read the stories representing just a few of the many hero vaccinators working in partnership with WHO to keep children in northern Syria safe from vaccine-preventable diseases…
Mar 18, 2017 Volume 389 Number 10074 p1075-1164
Syria suffers as the world watches
March 15, 2017, marks the sixth anniversary of the civil war in Syria, a conflict perhaps unprecedented in its apparently shameless disregard for international law. The world has stood by in horror, watching the death toll rise and the humanitarian and refugee crises spread their indelible stain on the world map and human history. The Syrian conflict has been marked on the one hand by immense suffering and on the other by a stunning lack of adequate condemnation or action from governments, international agencies, or the medical community.
The first output from the Syria Commission launched jointly by The Lancet and the American University in Beirut (AUB) shows the credibility, urgency, and importance of the Commission’s work. Detailing events in both government-controlled and non-government-controlled areas, the article strengthens the concept of the weaponisation of health: the targeting of health workers and facilities as a weapon of war. The strongest independent analysis of the Syrian health worker crisis published so far, it collates data from multiple sources in a compelling four-part analytical approach, analysing the formidable challenges health-care workers in Syria face now and in the future, and carefully offering policy options and lessons for public debate.
2 weeks ago, the UN published its Inquiry on the Syrian Arab Republic, finding that multiple war crimes had been committed by both sides. Powerful in its concentrated nature, the report dispassionately describes deliberate attacks on schools, hospitals, markets, water supplies, humanitarian relief personnel, and civilians; use of civilians as human shields; arbitrary arrests, forced conscription, reprisal executions, and forced displacement; withholding of humanitarian aid; use of chemical weapons including probable chlorine attacks; and intentional targeting of medical workers, facilities, and transport, including double tap attacks—deliberate targeting of those already harmed. The UN also calls for action, and although some conclusions might not seem feasible, its recommendations to the international community are irrefutable.
Together, these reports highlight grievous failings by the global health community and international governance. Although many medics have shown extraordinary bravery and solidarity in the face of this war, the 6-year conflict has been marked by insufficient cooperation among health professionals and, as the war has raged, fatigue. Journals too have been guilty of turning away from the conflict to focus on more immediate wins.
This is a moment to think carefully about how we renew our solidarity, particularly as the tectonic plates shift elsewhere in politics. The efforts of the Obama administration to seek a ceasefire and a political process might have been incomplete, but the USA was there. Donald Trump’s speeches so far do not instill confidence in the USA’s ongoing commitment to resolving the Syrian conflict. The proposed USAID budget cuts will have a more serious impact for Syrians in future development and humanitarian assistance.
At WHO, the focus for the past 12 months has been on the elections, rather than the world’s health crises. By their own definition, WHO’s commitment to meeting the health needs of Syrians has been inadequate. The summits and intergovernmental meetings organised in the face of Ebola have not been matched by a response to this very different human catastrophe. If the USA is withdrawing from its role as a champion for a peaceful and democratic Syria, it is even more important that multi-lateral organisations step in to fill the vacuum and show leadership. WHO must now focus every effort on supporting the health structure and health workers in Syria, raising the finances needed to meet this challenge, and mobilising international support to resolve the humanitarian crisis in Syria, as they acknowledge in a Comment.
On March 30, the World Bank will host a meeting in Marseille, France, to discuss the integration of Syrian health-care workers into OECD countries. This is also an opportunity for the international community to face up to the situation in Syria and shoulder responsibility. The Syrian civil war, which started as a popular uprising and became a battleground for the great world powers, is not just a Syrian crisis but a global crisis. An entire region and its people have been decimated while the world has watched. For Syria and its neighbouring countries the effects will last lifetimes. Health and development will take decades to catch up with themselves, and it will take generations to survive the loss of lives and livelihoods, structures and infrastructure. The Lancet-AUB Commission is ongoing and is much needed, but it is only a tiny part of the commitment that Syria needs.