Proposal to integrate emergency medical services in north-western Syria

Impacts of Russian and Syrian regimes’ attack on the village of Sfuhen in the southern countryside of Idlib - 26 May 2019 (Enab Baladi)

Impacts of Russian and Syrian regimes’ attack on the village of Sfuhen in the southern countryside of Idlib - 26 May 2019 (Enab Baladi)


Abd al-Sattar Salloum rushed to drive the ambulance to the stricken market of Maraat al-Numan after it was bombed on 22 July. Salloum’s primary concern was to get to the scene to rescue civilians injured in the bombing. In his rush, Salloum forgot to keep the walkie talkie channels open, which meant he didn’t receive warnings of a second imminent raid.

Salloum, in an interview with Enab Baladi, shed light on the fact that paramedics ignore their natural instinct to escape danger as they think of children, women and men who must save their lives. This, in return, puts them at risk of losing their lives. Salloum argues that “any person could face the same situation. In other words, if your family is bombed, or your child or even your brother is wounded, then the first thing that comes into your mind is who is going to save them.”

Operations coordination room

The Emergency Medical Services (EMS) of the Idlib Health Directorate has begun operating since June 2018, with 50 ambulances distributed in 16 points, to provide ambulance services to various hospitals and health facilities. The EMS is aimed at meeting the emergency needs at the time of bombings as well as responding to the demands of families in need to transfer emergency cases from homes to hospitals and health centers.

The Referral Care and Emergency Head of the Idlib Health Directorate, Mustafa Manna’ told Enab Baladi that the EMS, within a scientific protocol adopted since its inception, has managed to transfer 60,000 medical emergency cases. Most of which were critical.

The Idlib Health Directorate pitched the idea of unifying the work of the humanitarian organizations’ EMS operating in the region to “integrate health services and unify efforts.”

The directorate also signed a memorandum of understanding with organizations such as Violet Organization and al-Sham Humanitarian Foundation to form the “unified operations room.” The room will be under the supervision and management of  the health directorate; the directorate will direct the movement of ambulances and prevents inconsistencies in their response.

The establishment of the unified operations room requires setting up a unified communication system which helps the EMSs to communicate with each other. Therefore, seven cell towers were installed in various parts of Idlib governorate to provide full wireless coverage to the Hytera radios.

Manna’ pointed out that the directorate seeks to include the remaining medical service systems within the unified operation room, putting forward the idea of unifying efforts with the Syrian Civil Defense to ensure the integration of EMSs in time of peace and war.

Difficulties and shortcomings

The most common challenges the EMSs face, at the discretion of Manna’ , is the systematic targeting of its vehicles and medical personnel working to rescue the wounded.

This targeting, along with the military escalation that southern Idlib regions are still suffering, has negatively affected the shortage of medical services experienced in some areas, the Paramedic Emergency Response Coordinator of the al-Sham Humanitarian Foundation, known as “Abu al-Walid Salmu” told Enab Baladi.

According to Salmu, a number of remote villages in addition to areas in Zawiya Mountain and on the coast lack ambulances that facilitate and improve the emergency response and reduce the costs.

Salmu considered the interesting feature of the unified operation room is that it saves time and cost. The EMSs were wasting time and cost especially when more than one ambulance was responding to the same emergency condition.

Salmu added that the communication system is not limited to the EMSs but goes beyond them to communicate with hospitals in the province of Idlib and in Turkey. Thus, it coordinates the transfer of medical cases across the border crossings.

Ambulance drivers rely on the guidance of observatories and the operations coordination room, to avoid snipers and rockets, and to reach the wounded as quickly as possible, whether at night or in broad daylight.

However, the driver of the ambulance of the “al-Sham Humanitarian Foundation”, Abd al-Sattar Salloum, was not connected. Thus, he was not able to receive the warnings and therefore he did not turn way and kept standing among the victims of the market massacre in the city of Maarat al-Numan when the second raid occurred.

The raid actually took place close to the area that he was with his fellow-medics. Luckily, they were not being hit.

However, not all the paramedics of the al-Sham Humanitarian Organization were lucky enough to avoid being targeted by the Russian and Syrian regimes’ warplanes while they were helping the wounded. The second raid, in fact, led to the deaths of 11 paramedics while 16 ambulances were bombed.

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