We are not afraid of the disease, in these words Hajj Amer al-Khatib, an internally displaced person in “al-Falah” camp, in the northern countryside of Aleppo talked about the virus. His words reflect the degree of indifference by many in northern Syria regarding the newly registered infections of the novel coronavirus (COVID-19).

Despite from the fact that Hajj Amer is not afraid, there are attempts to join efforts and unify work between organizations operating in northern Syria, the health directorates and the “Syrian interim government” (SIG) along with the Turkish Ministry of Health, the World Health Organization (WHO) and the “Support Coordination Unit” (ACU), according to what the head of Primary Health Care Department in Idlib Health Directorate, Anas Dghaim, and the director of the media and advocacy department at Watan organization, Ziyad Hatim, have told Enab Baladi.

A joint plan of eight axes

A plan was set to counter the spread of the novel coronavirus (COVID-19) in northern Syria by the aforementioned authorities, according to the head of Primary Health Care Department in Idlib Health Directorate,  according to Anas Dghaim. He also said that the plan consists of eight axes namely:

1^st: Coordination, planning and monitoring axis, which is a joint team between all collaborators.

2^nd: Communicating axis about the virus risks and community awareness. This axis’ mission is to spread awareness about the dangers of the virus and spread messages to people.

3^rd: Surveying and investigating cases by the Support Coordination Unit (SCU).

4^th:  This axis tackles the issue of entry points into the region (opposition controlled areas), which includes crossings like “Bab al-Hawa”, “Bab al-Salama”, “Jarabulus”, “al-Hammamet”, “al-Rai” and “Tell Abyad” with Turkey, and their administration by the de facto authority and the Turkish government.

5^th: Laboratories axis, the main mission of this axis is to analyze samples and detect infection cases, and there is only one laboratory in the city of Idlib.

6^th: Cases management axis, is based on screening process in all health facilities and providing them with a protocol to operate, as well as screening patients from the Health Directorate.

7^th:  infection control axis through providing the necessary equipment and materials, as well as training medical workers in facilities to control the infection.

8^th: the axis of logistical and operational support; this axis cooperates with the logistics sector in the World Health Organization (WHO) and the interested Turkish authorities to secure coronavirus logistics.

Early warning in Aleppo .. isolation is key

The coordinator of Early Warning, Alert, and Response Network (EWARN) in al-Bab city, doctor Muhammad al-Saleh, told Enab Baladi that the current plan of action constitutes of several steps, the most important of which is to break the chain of transmission of the virus, by reducing secondary infection between infections of close contacts and health-care workers in the region.

Preventing events which may increase the virus spread in the community and investigating all suspected and detected coronavirus infections, and collect samples of them.

All close contacts of known positive cases are being tracked and they must be quarantined for a period of 14 days from the date they had close contact.

Al-Saleh added that work is underway to coordinate with organizations and partners in the process of tracking COVID-19 cases of close contacts and map the geographical distribution of infections.

Al-Saleh added that ” isolation is key” for anyone who suspects being infected or had close contact with positive cases. If symptoms develop, patients must contact the Early Warning, Alert, and Response Network (EWARN) to run tests on them, through a set of numbers published by the “EWARN” distributed starting from Idlib to Jarabulus in the east Aleppo.

Awareness campaigns and volunteer teams

Idlib Health Directorate, in cooperation with the “Syria Civil Defence” (SCD), launched a volunteer campaign to curb the virus spread. More than 120 organizations have participated in the campaign while the number of volunteers reached about four thousand.

With the start of high school exams, “Syria Civil Defence” (SCD) conducted disinfection campaigns for all schools, and distributed teams in front of schools, whose mission was to check students’ temperature, sterilize their and distribute masks.

Since mid-March, “Syria Civil Defence” (SCD) conducted disinfection campaigns for vital facilities, including universities, mosques, camps and government facilities. In his talk to Enab Baladi, the director of the media office of “Syria Civil Defence – Aleppo branch”, Ibrahim Abu Al-Laith, said that the team has sterilized more than 17 thousand sites in northern Syria.

Most organizations operating in the region launched awareness-raising campaigns through road boards were in addition to affixing and distributing brochures in mosques, roads, camps and markets, in addition to campaigns to raise awareness about the threats of the virus and ways of preventions.

However, Hajj Amer al-Khatib, an internally displaced person in “al-Falah” camp, in the northern countryside of Aleppo, thinks that these awareness campaigns should be accompanied by health support for camp residents, so that they would interact positively with them to pay off.

He justified this by saying that living in camps requires securing basic services, such as baths, portable water and spacing between tents. The absence of such factors makes most of these instructions and directives meaningless for the population due to the difficulty of applying them on the ground.

The number of people living in camps, who were forced to displace from the areas like Hama, Aleppo and Idlib due to the military operations of the regime forces and Russia towards safer places, reached about one million and 41 thousand people, distributed on one thousands and 277 camps, including 366 random camps, according to the “Syria Response Coordinators” team.

According to a report by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) issued on 13 of July, more than 2.8 million people out of 4.1 million (76 percent of the overall population are women and children) rely on humanitarian assistance to meet basic needs such as food, water, shelter, healthcare and education. While the number of internally displaced persons amounted to 2.7 million face difficulties in securing to personal protective equipment to fight the virus spread because of poverty.

Medical sector readiness in Idlib to face COVID-19

There are currently three hospitals in Idlib governorate to treat patients of coronavirus, including “al-Ziraa Hospital” in Idlib, which was equipped by the “Syrian-American Medical Association” (SAMS) in cooperation with the World Health Organization (WHO), last June.

In addition to “Kafar Takharim Hospital” which was equipped by the Syrian Medical Association for Syrian Expatriates “SEMA”, a medical relief organization, northwest of Idlib, there is “al-Sham Hospital” located in Tal al-karama village, in Ad-Dana district northern Idlib and one other specialized hospital in Kafr Karmin in the northwestern countryside of Aleppo, according to the head of Primary Health Care Department in Idlib Health Directorate, Anas Dghaim.

Meantime, there is a community isolation unit in Arihah prepared by the “Violet” organization with a capacity of 70 beds, in al-Sheikh Bahr and Kafar Takharim. In a previous interview with Anas Dghaim, he said that work is underway to equip and prepare the rest.

In the coming period, these medical facilities will be equipped with 200 ventilators and about 1500 community isolation beds will be ready to receive patients. Currently, there are only 50 ventilators and 200 community isolation beds.

Opposition-held areas have registered its first confirmed case of coronavirus on 9 July of a doctor working in “Bab al-Hawa” hospital, who is 39 years old, and entered Syria from Turkey on 25 last June.

The number of infections rose to 13 on 18 July, after two thousand and 841 samples were tested, according to what the minister of health in the “Syrian interim government” (SIG), Dr. Maram al-Sheikh, has tweeted on his “Twitter” account.

Abdul al-Salam Majaan, and Youssef Gharibi, Enab Baladi’s correspondents in Aleppo and Idlib, contributed in the preparation of this article.