Shattered health care system causes Syrian refugees to suffer eradicated diseases, preventable amputations
GWEN IFILL: This week marks three years since the start of the civil war in Syria. One segment of the population has been particularly hard hit, the children.
JEFFREY BROWN: At the outset of the war in 2011, rebels seemed to have the initiative, but President Bashar al-Assad’s forces have fought back hard. And infighting among rebel group has led to even more bloodshed.
All told, the Syrian Observatory for Human Rights estimates more than 140,000 killed as of February and, according to USAID, more than eight million displaced within Syria, as well as in neighboring countries. Now comes word of a major cost of this war: a growing health care disaster.
In a new report, the international charity group Save the Children says some 60 percent of Syria’s hospitals have been damaged or destroyed, production of drugs has fallen by 70 percent, and nearly half of Syria’s doctors have fled the country. The crisis has hit children especially hard, with 10,000 deaths and many more suffering from serious injuries and diseases.
And I’m joined now by Michael Klosson, Save the Children’s vice president for policy and humanitarian response.
And welcome to you.
MICHAEL KLOSSON, Save the Children: Thank you for having me.
JEFFREY BROWN: From the beginning of this report, it says: “It’s not just the bullets and the shells that are killing and maiming children. They are also dying from the lack of basic medical care.”
MICHAEL KLOSSON: Right.
JEFFREY BROWN: That is the main message here?
MICHAEL KLOSSON: Right.
It is the case that bullets and bombs have killed 10,000 children, but that the health system in Syria is collapsing. And, as a result of that, we’re seeing all kinds of knock-on effects, where children are not getting immunizations, so you see the rise of childhood diseases.
You have cases where, for example, children need sort of a surgery or something, and they’re — and instead of the surgery being provided, their limbs are being amputated because they just don’t have the equipment and the facilities and the services that you need to save their limbs. I mean, it’s really horrific.
JEFFREY BROWN: The — the equipment, the facilities, the doctors, the medicine, what — is there — they’re just not there?
MICHAEL KLOSSON: What’s happening is, is that I would say maybe 60 percent of the hospitals have either been damaged or destroyed.
So, even if you get to a hospital that hasn’t been damaged or destroyed, you know, the chances of finding doctors — half of them have left the country — or, you know, proper medicine and stuff is increasingly remote.
So you have a case where one of the large cities in Syria, Aleppo, it had — before the fighting started, I think it had on the order of, say, 5,000 doctors. It’s down to 36.
JEFFREY BROWN: Thirty-six?
MICHAEL KLOSSON: Right.
JEFFREY BROWN: For a major city.
MICHAEL KLOSSON: For a major city.
JEFFREY BROWN: Are some of these health facilities being specifically targeted? Do we know?
MICHAEL KLOSSON: Yes, I think so. That is my understanding from U.N. reports, that people, you know, probably all sides, are targeting health facilities. They’re targeting ambulances.
I mean, the — you are putting your life at risk often to go to a hospital, because — and we have examples in the report where people — mothers are, for example, opting for Caesarean section, rather than sort of natural delivery, because they want to be able to control a safer time to go to a health facility.
JEFFREY BROWN: But the dangers also clearly suggest why a lot of doctors have fled.
MICHAEL KLOSSON: Right.
JEFFREY BROWN: For their own safety.
MICHAEL KLOSSON: Right, right.
But it’s — it’s a free-for-all. And, sadly, if you are a parent in Syria, what do you want for your children? You want good health. You want an opportunity to learn. And you want, you know, protection from harm. And on all three counts, you know, those hopes that parents have for kids are being shattered, and children are at risk in all those areas.
JEFFREY BROWN: So what kinds of diseases are more prevalent now?
MICHAEL KLOSSON: Well, a lot of the childhood diseases that had been pretty much eradicated in the past are starting to come back. So Measles, for example, is increasingly prevalent.
There was a case — I think, a couple years ago, the reported number of cases of measles was on the order of, say 25, 30, something in that order of magnitude. And what we have been understanding, for the first week of this year, in a limited number of places in Syria, the report is 84 cases. So you are seeing measles ramping up. Polio has come back. I mean, polio was pretty much eradicated, and it’s coming back as well.
JEFFREY BROWN: Well, I was curious about that, because the report cites that. I guess there is some question about how much it’s back, that it’s…
MICHAEL KLOSSON: Yes. I think it’s in a — in a country that’s convulsed in fighting like Syria is, it’s tough to get comprehensive and accurate data.
So, what we understand to be the best estimate is around — I think there’s around 80-some confirmed cases. And then there’s reports of up to maybe 80,000 kids who are possibly infected.
JEFFREY BROWN: But it is clear from the report that the children, especially those born just before or during all this, they’re not getting…
MICHAEL KLOSSON: And that is the challenge.
Right. And we have — I mean, this has been recognized by the WHO and U.N. agencies. And there’s been a real effort over the last number of months to say, you know, everything else being equal, we have to figure out ways to resume immunization, at least for polio.
And what we want to see is — I mean, and there is some good news. There have been cases where very brave Syrians sort of at the community level are passing out the immunization for the children.
What we want to see is that to be expanded, so you also restore immunization against measles and mumps and rubella and these other childhood diseases, because those are — those are coming back.
JEFFREY BROWN: You have cited statistics before all this. Just for perspective, this was a country that had a fairly good health system previously?
MICHAEL KLOSSON: Right. It is a middle-income country. And it was known — I mean, it produced much of its drugs, I think 70 percent or so of its medicine was produced in country.
I think it has — was known to have competent health facilities, competent doctors. And, in a space of three years, you know, sadly, this has all been blown to smithereens, if you will.
JEFFREY BROWN: So how much are you — if at all, are you and other aid groups able to talk to the government and insurgent groups about the situation? And of course, how much are you able to get any relief?
MICHAEL KLOSSON: Well, we have — we have certainly — I think, first and foremost, it is the responsibility of the — you know, the parties in Syria to allow humanitarian assistance to come in.
And we have certainly been calling that out, the need for that to happen. There was a statement by the Security Council last fall. That didn’t result in a meaningful change on the ground for assistance coming in, particularly medical assistance.
And so the Security Council a couple of weeks ago passed a resolution that sort of underscored that there has to be humanitarian access. So, we’re — part of it is for a real push to provide that kind of Security Council backing for access that needs to be obtained.
On the ground, we are able — we are — we have reached probably maybe 900,000 people inside Syria, maybe half of whom, 500,000 or so, are children, with various kinds of support. So we are working on the ground. We’re supporting some of these immunization efforts.
We’re supporting rehabilitation or the — or the running of sort of some basic health facilities, among other kinds of things. So, that’s — that’s the way we’re trying to contribute, you know, call out the need for humanitarian access, and also, where we can, provide assistance that needs to be ramped up dramatically.
JEFFREY BROWN: A lot happening, but not enough, you’re saying.
MICHAEL KLOSSON: Absolutely not enough.
JEFFREY BROWN: All right, Michael Klosson of Save the Children, thank you so much.
MICHAEL KLOSSON: Thank you.