Lacking hygiene products and medical care, the refugee camps of northwestern Syria could witness the most tragic scenes of the coronavirus crisis.
The novel coronavirus had swept through most parts of the world before finally arriving in Syria on Sunday, when a 20-year-old woman who had entered via Lebanon was confirmed as the country’s first case.
There have been just four more cases of Covid-19 reported in Syria, but if there is one thing we have learned from the rapidly growing pandemic it is how quickly the coronavirus can spread and overwhelm healthcare sectors from Mumbai to Milan.
Saudi Arabia, for example, reported its first case of the virus on 2 March. Three weeks later, and the country has over a thousand cases with a strict nationwide curfew enforced to halt its spread.
It means that the current figure of five cases in Syria is likely to skyrocket in the coming days and weeks, and nowhere could this prove more deadly than in opposition-held Idlib province.
Hit by months of air strikes on medical facilities, and with more than a million refugees living in overcrowded camps and lacking the connections with international global health bodies, Idlib could be the worst tragedy of the coronavirus crisis.
On Thursday, Syrian NGOs and activist groups appealed to the UK government and UN to urgently respond to the threat of coronavirus in Idlib province – which the region’s health directorate warned could kill tens of thousands of people.
The signatories said coronavirus would likely spread with speed among Idlib’s hundreds of thousands of refugees and quickly overwhelm the opposition province’s already under-resourced healthcare facilities.
Batol Abdulkareem, from Syria Solidarity UK, said that as the threat of the deadly Covid-19 threat inches closer to Idlib, the situation in the camps appears grim.
“Over a million people living in overcrowded makeshift IDP camps in north Syria have no access to soap and running water, no medical facilities, no ventilators, and social distancing is impossible,” she said in a statement.
“We are writing to the WHO, DFiD, and ECHO to urgently mobilise resources to provide these basic necessities to avert an imminent catastrophe. This pandemic is a threat to all of us and unless we stand together to protect the most vulnerable, humanity will suffer.”
In a joint letter signed by Syria Solidarity UK, Kesh Malek, the Syrian Network for Human Rights and other groups, the NGO workers and activists called on the UK government, the World Health Organisation, and others to immediately respond while there is still time.
“[We] are writing to you to express our grave concern over the dire situation of the IDP camps in the north of Syria especially in the current COVID-19 pandemic,” the letter, addressed to the UK Department for International Development (DFiD) read.
Healthcare workers and NGOs are already struggling to cope with a mass exodus of around one million people from southern Idlib towards the Turkish border, following a major Russian-backed regime offensive which began in December.
Medical facilities there have been decimated after repeated Russian and Syrian regime air strikes, which have not only destroyed dozens of clinics but also killed urgently needed doctors, nurses and emergency responders.
There is also a shortage of essential hygiene products such as soap, clean running water, and even tissues.
“Basic measures recommended by the WHO to halt contagion such as frequent, thorough handwashing, using hand sanitisers, catching coughs and sneezes in a tissue, social-distancing, and self-isolation for symptomatic individuals are all impossible for Syrians living in IDP camps,” the letter continues.
It makes the current WHO guidelines of how to avoid the coronavirus – such as washing hands regularly and avoiding contact with other people – moot for the refugees living in overcrowded camps in Idlib, where 35 people often share a single tent.
Healthcare workers also lack the necessary medicine and equipment needed to protect themselves from the virus, let alone the necessary tools to treat others with the disease.
The letter called on the UK government to provide emergency supplies to help medical workers cope with the crisis, including clean water and soap, more tents, Covid-19 test kits, ventilators, ICU units, and training for medical workers.
Activists have started a Twitter campaign to highlight the fact that the global advice to “#StayHome” is not an option for Syrians in Idlib, lacking the basic healthcare and safety enjoyed by others in the world.
Idlib’s health authority has estimated that as many as 100,000 people could lose their lives in an outbreak of the coronavirus.
Idlib Health Directorate said that due to air strikes on medical facilities, the province has only 105 intensive care beds and 30 ventilators to cater to a population of more than three million civilians.
“Our ventilators are always 100 percent occupied and we don’t have one single bed ready for a corona case today,” Dr Munzer Al-Khalil, head of the directorate, said in a statement.
“Camps are the perfect breeding ground for the virus and 400 percent overcapacity, with ten or more people sharing one tent. People don’t have enough water for drinking, let alone washing their hands.”
Al-Khalil said that over the past year, northwest Syria has seen 76 health facilities destroyed or lost to regime forces, adding further strain to healthcare facilities.
“Donors have cut their funds and medical staff have been killed, arrested or displaced. The health sector in Idlib cannot cope with the inevitable outbreak and we fear 100,000 people could die unless we get supplies immediately,” he said.
The only glimmer of hope for the people of Idlib is a shaky ceasefire put in place after a Russian and Turkish agreement earlier this month.
Yet even this hangs by a thread with Idlib villages destroyed in regime rocket fire this week and threats against Turkish and Russian troops by shadowy Islamist groups forcing joint patrols along the M4 highway to be put on hold.
Russia’s Defence Minister Sergey Shoygu made a surprise visit to Damascus this week and met Bashar Al-Assad. He reportedly instructed the Syrian president to end regime attacks on Idlib province and abide by the terms of a Russian-Turkish ceasefire agreement.
If the coronavirus spreads from regime areas or Turkey into Idlib, then the situation will be inexplicably worse than what other Middle East countries have endured and mark another tragic chapter of the Syria war.