Health officials have warned that as many as 100,000 people could die as a result of COVID-19 in the governorate of Idlib in Syria where I was born.
This fills me with abject fear as we are pitifully prepared. Countries like Italy and the UK with very developed health systems are struggling to deal with this crisis, but ours have been decimated by nine years of war.
The situation is catastrophic; only a month ago, there were bombing attacks in Idlib. And more than 84 hospitals and medical facilities have been destroyed, damaged or forced to close since the beginning of December last year, many of them deliberately targeted.
This has been a long, ugly and dirty war. Thousands of trained health workers have been killed or have fled for their lives.
I, myself was displaced in July last year, after 8 bombing attacks in my village in Maarat-al Numan claiming the lives of 43 civilians, including three girls and one boy.
I fled at one o’clock in the morning with my wife, mother and two daughters. My youngest daughter, Sana, was two years old and she had a panic attack. These continued for three months afterwards, every time she heard a loud noise.
And now we have the scourge of Coronavirus. Thankfully, there hasn’t been any official cases in Idlib yet, because we don’t have the capacity to deal with a few, never mind an influx.
A week ago, I was feeling optimistic about the plans for testing kits and isolation centres but everything is moving so slowly. Apparently, there are 300 testing kits so far, for a population of 3.5 million people. And more are on their way. But I have no idea how we can access those kits.
There are three major hospitals in Idlib, Afrin and Al Rai who have the capacity to deal with COVID-19 and these hospitals have a total of 260 hospitals beds (32 of which are intensive care unit beds) and only 24 ventilators, for a population of 6 million people. Most of these beds are already occupied by people suffering traumatic injuries as a result of the war.
I cannot even begin to explain my frustration. I was born in Idlib; this is my city, my people.
It’s infuriating, as the costs of ventilators are going up all the time because of the demand. A few weeks ago, they were $8,000 but now they cost anything between $15-25,000.
We have virtually no protective equipment like surgical masks and gloves.
Knowing how ill-prepared we are for this crisis, prevention is paramount but that’s proving highly challenging in the circumstances.
Some people feel that if they have survived nine years of war and almost constant bombings, how could they succumb to COVID-19? Their lives are in God’s hands and he has spared them so far, so it’s unlikely they will lose their lives to a mere virus.
People are struggling to make ends meet and they live a hand to mouth existence, earning a bit of money here and there. They have to go out and earn some money to put food on the table, so it’s very difficult to ask them to stay indoors. They tell me, we’ll die if we stay indoors as we won’t be able to eat. So many families have lost their main breadwinners, so young and old are forced to do what they can to eke out a living.
Life is hard in the camps, with many people forced to live out in the open or in flimsy tents, vulnerable to acute respiratory infections. We are also seeing many cases of acute pneumonia, which we rarely saw before the war. With all the stress and trauma of the conflict, there are also high rates of hypertension in Idlib. And people with low or compromised immunity suffering from these non-communicable diseases are far more likely to contract COVID-19. It’s such a worrying situation, especially for older people who are particularly at risk.
Many of them, especially those with cancer and kidney diseases, need to go for medical treatment, but this is now very difficult when they are being asked to stay in their homes. In my hospital, we have 50 patients who come for dialysis 2-3 times a week, for example.
People around the world are so scared about COVID-19, but over half a million people have died in Syria, so we have a different attitude towards death.
But we have survived so much and I can’t bear the thought of this virus taking yet more lives. The world has stood by while we have been slaughtered. I hope the international community will provide more support immediately, so we can stop yet more needless deaths.
I feel an overwhelming sense of responsibility to protect my people, and like many other health workers, I am working more than 15 hours a day every day.
In addition to my job as a general surgeon, I lead the projects of the Syrian Expatriate Medical Association (SEMA), which is supported by HelpAge International. We are educating people about how they can avoid contracting COVID-19; training hospital staff in infection control; providing tents for triage and procuring personal protective equipment for health workers.
But however hard we work, however much we worry, this Coronavirus pandemic is beyond our control. We urgently need the means to effectively prevent, test and treat this disease. I’m not sure I can take the stress anymore, if this doesn’t materialise.
By Doctor Wasel Aljork, general surgeon at Idlib City Hospital and project manager for Syrian Expatriate Medical Association (SEMA), supported by HelpAge International and Age International