Nouran Ahmed – Deir Ezzor
A small building in front of which patients gather daily, not commensurate with the population density and the number of beneficiaries who flock to it in the district of Kasra, located in the western countryside of Deir Ezzor, hoping to have the chance to receive treatment and medicine, where the opportunity to access health care becomes an advantage and not a basic human right.
Abu Omar, 44, who works as a passenger car driver, says, carrying his 6-year-old daughter: “My daughter suffers from tonsillitis and the doctors consulted the need to remove them. I am today in the hospital because the date of her operation has come after I registered for this operation more than a month and a half ago”. As for the reason for the delay in scheduling the operation, Abu Omar explains, “Because of the large numbers of patients who need surgery and who are waiting for their turn before his daughter, the hospital conducts these operations for only two days per week and I had no choice but to wait for the appointment because I couldn’t have the operation in a private hospital. I checked with a private hospital, and they told me that the cost of the operation could exceed 250,000 Syrian pounds”.
Reports[1] issued by the United Nations High Commissioner for Refugees (UNHCR) indicate a marked increase annually in the number of health care seekers, stating in a previous report for 2021 that (80%) of individuals in Syria have not received any form of mental and therapeutic health services.
Reports[2] issued by the World Health Organization indicate that approximately (12.5) million people in Syria will be in need of health care in 2022, including (1.33) million displaced people, after the failure and weak supply suffered by the country by the international community after the COVID-19 pandemic.
High costs force patients to wait for long roles
Private hospitals in Deir Ezzor are the last resort that a patient may go to in performing surgeries, due to their high costs, which are huge relative to the income of citizens in the region.
These reasons force Najah (pseudonym), a resident in her fifth decade of the village of “Hermoushiya” to wait for her turn to perform orthopedic surgery ten days ago and does not have the ability to make it in a private hospital.
For his part, Issa (pseudonym), who works as a nurse in a private hospital, emphasizes the high costs of some uncomplicated surgeries, saying, “The costs of surgeries vary according to difficulty; the cesarean section costs about (450) thousand Syria pounds, approximately equivalent to $100, while general surgery such as appendix, gallbladder and water bags on the liver and in the lung (800) thousand Syrian pounds, which is equivalent to $190. Hernias and varicose veins operations range from (300) to (400) thousand Syrian pounds, or about $90. The costs of performing thyroid surgery rise to one million Syrian pounds and this is more than $220”.
Um Hisham, 55-year-old, a resident of the town of al-Zughair, went to the hospital despite the long time she waits to make the tests requested by the doctor in the private hospital, saying, “I have been suffering for a while from dizziness, fatigue and weakness and I cannot go to the doctor, the test alone costs (10) thousand Syrian pounds and I do not have this amount. I checked with a pharmacy and gave me medicine for my condition that was never useful”.
Support That Does Not Fit the Need
Some civil society organizations support the health sector in Deir Ezzor city, but it is not commensurate with the great and urgent need, especially for such a sensitive and important sector.
The coordinator of the organization “Medical Relief” in Deir Ezzor talks about the support provided by the organization in the health sector, “We provide support to the hospital of Al-Kasra, which includes the monthly salaries of the staff of doctors, nurses and administrators, who number up to (110) staff. We contribute a large percentage to the provision of medicines necessary for the hospital”.
The support services provided by the organization are currently limited to Al-Kasra Hospital only, as confirmed by the coordinator, due to the suspension of support from the clinics of “Harmoushiyah” and “Al-Kubar” because of some breaches and lack of administrative competency. As for the most important challenges they face in providing these services, he says, “The hospital building is small where the number of beneficiaries is increasing, which affects the quality of services.”
Sawsan Association also provides medical services and supports health centers in many areas, Abdul Sattar, a member of the association, says about the services provided by them:
“Sawsan Association supports health centers and primary care centers in Raqqa, Deir Ezzor and Manbij, and these centers contain labor clinics and dialysis centers in Kobani”.
As for the distribution of health centers in Deir Ezzor, Abdul Sattar explained, “We provide our support to the centers of Abu Hamam, Hajin, Harijiya and Sousse, all of which contain pediatric clinics, internal, dental and pharmacist, while the number of beneficiaries in these centers varies according to the geographical distribution and the number of residents benefiting from each center”.
The obstacles they face during their work are limited to some routine while communicating with the Health Committee of the Autonomous Administration.
Physiotherapy Services in the Region
The service of physical therapy and prosthetics in the areas of Deir Ezzor is one of the most important services requested by the population and its surroundings due to the numbers of war wounded and limbless, where the organization ” Humanity & Inclusion” provides a major support for this service. The staff in charge of physical therapy in the organization, who prefers not to be named, saying: “We offer in the countryside of Deir Ezzor a number of services represented in the centers of Al-Basira Hospital, Al-Kasra Hospital and Hajin Hospital, in addition to a field team that provides physiotherapy sessions within the Hospital perimeter (25) km. We also provide prosthetic limbs service after evaluation within the center and referral to the limbs department at Kasra Hospital. We also provide movement aids (crutches, wheelchairs…. etc.), in addition to psychological support sessions for people with disabilities”.
The organization registers (400) treatment sessions per month, an average of (30-40) new beneficiaries on a monthly basis. The service of prosthetics is provided recently and therefore the numbers of beneficiaries are still relatively low. These teams are currently undergoing training sessions to develop the service in the future and increase the number of beneficiaries. According to the person in charge in this organization, while they face some difficulty in providing assistive movement equipment for people with disabilities, he said.
Hajin Public Hospital, 6 August 2022, Source: Author of the article
“Action for Humanity” organization contributes to supporting the health sector at Al-Madina Hospital, which is located in Al-Maamel area, provides services to the eastern, western and northern countryside of Deir Ezzor because of its location, in addition to the hospital “Al-Shuhail”. Amer Al-Nada, Managing Director of Al-Madina Hospital, talks about the services it provides: “The hospital includes the ambulance department, which provides a first aid service for all accidents that need radiography and CT, and also the intensive care department that provides cardiology services and all cases of care for cerebral infarction and others, Moreover, it provides full service of accommodation for patients with medication and meals. There is also a residency department for children with meninges and cases that need to keep the child in the hospital where it provides them with a complete health care service under the supervision of a competent pediatrician. The Covid department provides full care to Corona patients including accommodation, oxygen, meals and the supervision of specialized doctors”.
Speaking about the departments and clinics offered in the hospital, which operate throughout the week, Al-Nada added, “We provide the services of the pediatric clinic, the inpatient clinic, the digestive clinic, the chest and the heart, in addition to the endocrine glands️, the urinary clinic and is affiliated with the dialysis department. There is also a department for the laboratory, pharmacy, and CT instrument, not to mention ambulances to transport patients and emergency cases and a center for the treatment of burns. The hospital provides its services to about five thousand patients per month”.
He explains some of the difficulties they face: “We suffer from the lack of specialized doctors in Deir Ezzor governorate. There are many cases of malnutrition of children without a special center in Deir Ezzor, and also lack the presence of a specialized center for eye treatment in the city.”
The Role of Local Authorities in Supporting the Health Sector
As for the role of local authorities in supporting and supervising this sector, Dr. Mohammed Al-Salem, Chairman of the Health Committee in Deir Ezzor, talks about the conditions of health services and the future plans of the Committee:
“It is no secret to anyone the damage done to the infrastructure of the health sector in Deir Ezzor during the years of war. Before 2021, the health sector was a primitive sector that provides simple services and with weak capabilities. One of the priorities of the Health Authority was the advancement of the health sector. The work was done on three levels, the first is the infrastructure such as establishing hospitals and clinics, the second is securing equipment and instrument, and the third is the staff.”.
The health services provided in Deir Ezzor are limited to three hospitals, according to Al-Salem. There are 31 clinics distributed to the sectors of Deir Ezzor region. Recently, the hospital of “Hajin” became functional. The distance of (10) kilometers between the clinic and the other was specified. As for the equipment, Al-Salem explains, “We will provide the hospital of “Hajin” after the completion of a tender in this regard to secure stone fragmentation device, an arc device, a gastrointestinal endoscopy device and a radiology device. In “Theeban”, a catheter device will be secured, which is the first and only one in northeastern Syria”.
