Warood Muhammad, a resident of Raqqa city, does not know if there are confirmed or suspected cases of the novel Coronavirus disease 2019 (Covid-19) in her city, for the laboratory test kits to detect the virus are not available yet, and the residents are only spreading rumors about Coronavirus. 

Muhammad told  Enab Baladi that she was committed to self-isolating at home, just like many people in the area, during the ongoing curfew imposed as part of the fight against Coronavirus. She noted that streets and markets across the city are empty except for some gatherings in some popular neighborhoods. 

Muhammad considered that the prevention and control measures against the Coronavirus pandemic taken by the Kurdish-led Autonomous Administration of North and East Syria (NES) and civil society organizations—including spraying the streets and institutions with disinfectant and distributing Coronvirus leaflets among people, imposing financial penalties on curfew violators—relatively good.

However, she complained about the high prices of medical face masks, hand sanitizers, disinfecting wipes/sprays because some pharmacists exploit the Coronavirus crisis and the high demand for the protective personal equipment and sanitizers, amid the absence of clear price control measures supposed to be set by the concerned authorities. 

The north-eastern regions of Syria have caught up with the areas that geared up to stem the novel Covid-19, such as taking precautionary measures, in light of significant challenges facing them and local and global warnings about the difficulty of curbing further spreading of this deadly disease. Northeastern Syria has been ravaged by nearly a decade of war, weak health care system, limited humanitarian aid in addition to the repeated interruption of water supplies. Not to mention the critical situation of the squalid and overcrowded IDP camps in the area where social distancing is almost impossible

Preventive actions and further appeals for international support

Joan Mustafa, the joint head of the Kurdish-led NES’s health authority, revealed that the health authority has not received coronavirus test kits so far to examine cases suspected of being infected with the disease.

He pointed out that there is only one medical center with the Coronavirus test kits, which is located in Damascus, complaining about the difficulty of sending samples to the Syrian regime.

The health authority announced in an urgent appeal that it lacks “the essential pharmaceutical and medical supplies to treat people infected with Coronavirus, such as ventilators and supplies for the initial disease containment.” The authority also expressed  its “urgent need for preventive equipment and sterile supplies.”

The Kurdish-led NES took a series of precautionary measures to arrest the “Coronavirus,” as it set a curfew in all areas of its control, starting from 6:00 am on Monday, 23 March, for 15 days, which can be extended. The administration also banned population movements between the main cities and between “civil and administrative institutions.”

Moreover, the Kurdish-led NES shut down public places: restaurants, cafes, open markets, public parks, private medical clinics, wedding halls, condolence tents. In addition, the NES’s local councils carried out sterilization campaigns for spraying streets and institutions.

Journalist Izz al-Din Saleh, from the city of Qamishli, pointed out that the people of the city do not leave their homes except for essential activities and to purchase necessary items.  All grocery stores are closed at 6:00 pm, so the streets are almost deserted and empty of the population.

In his speech to Enab Baladi, Saleh highlighted that the security forces and health workers are intensively deployed in all areas. “Health committees” conducted disinfection campaigns for streets and public centers. 

Saleh affirmed at the same time that north-east Syria suffers from a shortage of pharmaceuticals and basic medical supplies for treating people infected with the Covid-19. The area sees high prices of sterilizers, disinfection sprays, and medical face masks; the price of a pack of protective face masks reached about nine dollars.

Emergency preparedness of the Kurdish Red Crescent

Farhan Ali, a board member of the Coronavirus management committee, spoke about the precautionary medical measures taken by the Kurdish Red Crescent, to combat the spread of the Coronavirus in the regions of north-eastern Syria.

Ali explained to Enab Baladi that 13 ambulances were distributed throughout the al-Hasakeh region, with trained healthcare workers in cooperation with the NES’s “Medical Doctors’ Union.” Three ambulances are equipped with modern medical devices for complicated cases, pointing out that they will remain functioning for 24 hours. 

He added that seven health centers were equipped to receive people sickened by the Coronavirus disease. Triage and infection prevention and control strategies are followed, and they are critical to identifying potentially infectious or acutely ill people. 

First of all, if there are patients with suspected Covid-19 with mild symptoms, they are required to undergo home quarantine with tight monitoring and analysis for them regularly.

 As for Coronavirus patients with moderate symptoms, they are placed in health isolation centers, where they are given oxygen and precise medical care. They are also tested on a regular basis.  

Regarding novel coronavirus patients with severe symptoms, they are triaged in intensive care units. 

Ali referred to the provision of nine isolation centers spread over all regions of north-eastern Syria, and a plan to equip 100 intensive care unit beds in each city, in addition to the international intervention centers.

An “Operations Room,” consisting of health institutions, and municipalities, was formed and will be ready for assisting around the clock.

Its members have been trained to wear necessary protective gear ( a surgical gown, gloves, respiratory protection, eye protection or a face shield) in addition to identifying the designated sites for waste disposal, according to Ali. 

Poor infrastructure

Dr. Firas Mamdouh al-Fahd, the head of the humanitarian foundation “Makers of Hope for Human Rights (SHM), considered in his speech to Enab Baladi that the infrastructure in the regions of north-eastern Syria is not well-prepared to receive a large number of handle COVID-19 cases.  in the event of the spread of the virus.

He pointed out that the preventive measures, though significant, remain insufficient in light of the inadequate medical facilities and public hospitals, the limited intensive care units, and the scarcity of ventilators—an essential machine used to ease breathing for Coronavirus patients because the virus attacks the respiratory system.

The NES’s health authority did not cooperate with the “Ministry of Health” of the Syrian regime to eliminate the threat of the Covid-19. However, they both operate in the same areas, including al-Hasakeh and Qamishli. 

Al-Fahd also told Enab Baladi that there are many individual initiatives undertaken by private hospitals in Raqqa. They announced that they are ready to offer free medical treatment. Several doctors, with different specialties, will also receive and treat patients for free. 

Crisis unit in Raqqa… but

Media figure in the Civil Raqqa Council, Osama al-Khalaf, confirmed that since the beginning of March, the council has announced about the establishment of a crisis unit to confront the threat of the Coronavirus and eradicate the root causes of its spread.

The “health committee” has worked to set up a preventive quarantine center as a first step, in addition to rehabilitating health and medical cadres in the city of Raqqa and its countryside.

As a second step, the committee cleaned and disinfected surfaces of public places, schools, institutions, and mosques.

In the third phase, the “Self-Administration” announced the imposition of curfews, the closure of institutions, markets, and crossings, the allocation of emergency numbers, and the distribution of masks and gloves to workers in sterilization, hygiene, health, and extinguishing workshops.

The NES imposed a curfew and shut down all establishments, markets, and crossings. The NES assigned emergency contact numbers, distributed face masks, and hand gloves to health workers, firefighters, and medical personnel.

Many civil society organizations operating in Raqqa, such as “the Makers of Hope” conducted media campaigns and drew murals to increase the awareness of families about the importance of commitment to stay in their homes, and to clarify the seriousness of the disease.

However, the protection measures appear to have a limited positive impact because the north-eastern regions experience a shortage of advanced medical preventive equipment.

Al-Khalaf sheds the light that most sterilization products used in the precautionary measures and campaigns do not contain viable chemicals; the medical substance of these products is a derivative of diluted chlorine and pesticides. 

Raqqa does not have an accurate medical laboratory to detect Coronavirus cases. There are only thermometers to detect the temperature of people at the entrances of hospitals and institutions; this is not effective because an elevated body temperature might be a symptom for other diseases other than Coronavirus disease.    

Conditions of IDP camp amid the Coronavirus infection

North-east Syria includes nearly about one million and 27 thousand displaced people, spread over several camps, the most prominent of which is al-Hol camp, which houses more than  69 thousand people.

In addition to the severe overcrowding, these camps experience poor humanitarian and living conditions, which makes the implementation of preventive measures to protect against the Covid-19 very difficult, increasing the chances of the rapid spread of the virus. 

Joan Mustafa, the joint head of the Kurdish-led NES’s health authority, told Agence France-Presse about the protection measures taken in the camps of north-east regions of Syria, noting that he “prevented entry and exit from these camps except in special circumstances.”

He added that if the Coronavirus struck the area, “the health authority will set a mobile quarantine tent in each camp. Otherwise, we have no possibility.”

The International Rescue Committee (IRC) warned in a statement that “north-east Syria is at high risk. The United Nations (the UN) is no longer able to provide medical supplies through border crossings, and the healthcare needs to be provided by many humanitarian organizations to those in camps such al-Hol are essentially threatened to be suspended.”

Last January, the UN Security Council allowed aid operation to continue from only two places in Turkey without the need to get approval from the government of the Syrian regime:  Bab al-Hawa and Bab al-Salam border crossings but dropped crossing points from Iraq (al-Yaarubiyah crossing in north-eastern Syria)and Jordan (The Ramtha crossing) due to opposition by China and Russia. Therefore, a gap between the humanitarian response and needs was created in north-eastern Syria.

Frequent water cuts spark fears among residents of north-eastern Syria

Residents of north-eastern Syria suffer from frequent water shutoffs, which make them more vulnerable to the “Corona” virus, according to the United Nations Children’s Fund (UNICEF).

A few days ago, the Alok water station, placed near the border city of Ras al-Ain with Turkey, stopped pumping water for the second time in a month, to about 460,000 people from the cities of al-Hasakeh and Tel Tamer, and the camps of al-Hol and al-Arisha.

The UNICEF warned in a statement, saying, “the water supply interruptions during the current efforts to limit the spread of the Coronavirus disease  expose children and families to an unacceptable risk because washing hands with soap is vital in combating the disease.”

The UNICEF highlighted that having access to  safe and reliable water is essential to ensure that children and families in the region are not infected with diseases, adding, “Clean hands save lives.”