Medical Evacuation in Besieged Areas of Syria

In July 2016, twins Moaz and Nawras were born in Eastern Al Ghouta, one of the largest besieged areas in the Syrian countryside, with congenital heart defects. This rare condition required specialized treatment to save the infants’ lives, and doctors both in Syria and beyond called for the evacuation of the twins. Numerous international hospitals offered to treat the children, organizations were willing to finance the cost of the trip to these hospitals, and some countries even proposed receiving the twins without visas or other documentation to accelerate their transfer.

After calling on the United Nations and other organizations, such as the International Syria Support Group, doctors succeeded in attaining security clearance for the twins and their mother to cross into Damascus. Once there however, they faced another challenge: passports were required for international travel out of Syria. The Syrian regime long ago stopped issuing new passports, and Moaz and Nawras eventually passed away. The twins’ case highlights the challenges of accessing healthcare in times of war, and the plight of many children in Syria who require urgent medical treatment, but are unable to be evacuated from besieged areas.

In Eastern Al Ghouta, where more than 400,000 civilians have been trapped since 2013, doctors, nurses, and medics work to treat civilians in “field hospitals,” facing challenging conditions such as the ongoing risk of attack and widespread lack of medicine. This situation reflects the military tactic of blocking access to food and medical supplies, forcing civilians to resort to unsafe roads and tunnels to enter and leave besieged areas.

Since 2012, the need for medical evacuations in Syria has been a key area for humanitarian intervention. Yet, such measures have been neglected on the political negotiating table, with the human right to life turned into merely another agenda item.

Syrian activists,  international NGOs, and opposition groups all accuse the Syrian regime of blocking access to besieged areas for humanitarian convoys sent by the UN. When such convoys are granted entry, security forces confiscate supplies and completely hinder medical and surgical assistance.

Dr. Mohamad Katoub, Advocacy Manager at the Syrian-American Medical Society, confirms that there are more than 300 cases requiring immediate evacuation, 80 of which involve children, 35 of whom are under the age of five. This number increases every day, along with the depletion of medical stocks. According to Dr. Katoub, every medical case in need of urgent evacuation requires multiple appeals and communications between medical teams, activists, the UN, other international organizations, and representatives of ISSG member states. According to Firas, a human rights activist, “It’s unimaginable that evacuating each patient requires all this effort and correspondence, which fails most of the time because regime forces procrastinate and waste time until the patient passes away. The siege is not only a weapon of war—it’s also a collective rule on all people who are in besieged areas, trapped by various types of death.*”

Activists from inside and outside besieged areas in Syria recently launched an advocacy campaign to address the need for medical evacuations in times of war. Such action is necessary to stop the suffering of civilians who face daily bombardments despite the announcement of a ceasefire. Jan Egeland, Secretary General of the Norwegian Refugee Council, further stressed this call to action in his recent press conference in Geneva.

Between negotiations, intervention plans, and statements of condemnation, the medical needs of patients and the right of Syrians to life should no longer be hindered by the lack of action to address the siege in Syria.

Author’s Note:

As a result of the continuing siege on Eastern Ghouta, on October 22 a one-month-old baby, Sahar, passed away. Because of malnutrition, Sahar’s weakened mother was not able to breastfeed her.

*Editor’s Note: This quote is translated from an Arabic conversation between the author and Firas.