Enab Baladi – Idlib

On 19 August, Idlib’s health directorate announced the first coronavirus (COVID-19) death in northwestern Syria, of a woman in her eighties from the al-Tamania village in the countryside of Khan Shaykhun. The woman lived in a house adjacent to a camp established between Sarmada city and al-Dana in the northwestern Idlib countryside.

Among the reasons that led to the woman’s death are chronic renal failure, for which she had dialysis, in addition to her old age, diabetes, blood pressure related problems, respiratory failure, and pulmonary edema.

The head of the primary health-care department of Idlib’s health directorate, Dr. Anas al-Dogheim, told Enab Baladi that the elderly woman had been put on a ventilator after she had been hospitalized two days before she died because of respiratory failure.

Al-Dogheim added, the deceased woman had a swap test, that came positive, meaning that she was carrying the coronavirus, and she died from a COVID-19 infection added to her renal failure.

“Coronavirus” in the camps

The deceased woman was reported as the first case of coronavirus death in the northwestern areas of Syria, specifically in its camps, for the woman’s place was adjacent to a camp for internally displaced people (IDPs).

Before the woman’s death, two cases of coronavirus infection were reported in the “al-Salama” camp on the Syrian-Turkish border, for two patients who were isolated at “Azaz National Hospital,” according to what the minister of health in the “Syrian Interim Government” (SIG), Dr. Maram al-Sheikh mentioned on his “Twitter” account on 10 August.

Al-Sheikh discussed with the camp’s management and the World Health Organization (WHO) the possibility of a complete isolation for the camp and confirmed the necessity of increasing community awareness and disinfecting campaigns.

The Syria Civil Defense (SCD) team in Azaz has disinfected the camp, distributed flyers to raise the residents’ awareness, sterilized other camps in the Syrian north, and other temporary shelters for the displaced persons, and every area where coronavirus infections are reported, according to the director of the SCD in Idlib, Mustafa al-Hajj.

Al-Hajj added, disinfecting and awareness campaigns on the coronavirus organized by the SCD team in general, and for the IDPs camps in particular, have been continuing since the beginning of the spread of the COVID-19 pandemic worldwide.

He pointed out that campaigns became limited to awareness posters only after the suspension of flyers’ distribution for being one means of transmission. The authorities were also unable to gather civilians because overcrowding and gathering in one place or closed place are contrary to the world health recommendations.

Tents adjacent to each other

Dr. al-Dogheim recommended the camp residents to adhere to the public preventive measures of social distancing, wearing facial medical masks, and avoiding social gatherings unless necessary.

Other recommendations by the al-Dogheim included wearing medical gloves when heading to a place suspected of having positive coronavirus cases and sterilizing the hands and washing them properly and repeatedly.

Nevertheless, many camp residents cannot comply with these measures, owing to their living and economic conditions.

The manager of the “Sheikh Idris Gathering” camp in Khirbet Ma’ez (between Kafr Daryan and Kafr Aruq), Mahmoud Nayef al-Sayed, said to Enab Baladi, “I cannot comply with the coronavirus protection measures, nor the camp’s residents, because it is an impossible thing within the camp’s overcrowding and lack of preventive qualifications.”

Al-Sayed added that the inability to adhere to the coronavirus preventive measures is due to the absence of medical masks and disinfecting materials, besides the absence of authorities that supply the camp with protective supplies in light of the spread of the COVID-19 virus, and the camp residents’ lack of money to buy these supplies.

He asserted that the tents’ residents’ commitment to limit the spread of infection is “impossible” because the tents are placed next to each other, and the residents cannot stay inside the tents because they lack heat insulation. The residents suffer from temperature fluctuations of heat and cold in summer and winter; therefore, there will be social gatherings outside the tents.

Al-Sayed hopes that the camp residents can isolate themselves amid the spread of the coronavirus pandemic or any other infection, or that the patients stop socializing to prevent the virus transmission; however, he realizes that the camps’ conditions do not allow this.

Placing blame on organizations

The “al-Rayan” camp manager in Harbanoush town, northern Idlib, Qaddour Ramadan, justifies the camp residents’ failure to comply with the prevention measures and blames the organizations for the absence of their role and their non-distribution of any protective requirements to the camp’s residents.

Ramadan said to Enab Baladi that “the residents are left on their own, and the competent and responsible authorities were not up to the responsibility.”

He pointed out that the organizations that visited the camp only directed and conducted awareness campaigns, contrary to the camp’s needs for medical materials such as medical masks and disinfectants, that people are unable to buy.

Ramadan said, “people will die without work for there are no salaries or pensions offered to them.” He added that “the camp’s residents’ economic conditions, and their search for a living, prevent them from staying in their houses, they need to work to secure their needs.”

As for al-Dogheim, he indicated that the residents could wear facial masks by buying them from the private sector or made them free of charge at home; thus, facial masks become cheap and available for everyone.

Humanitarian crisis

Officials of the medical sector in northern Syria fear a humanitarian crisis and a deterioration at the sector level, as it cannot accommodate the patients in the event of an explosion and a rapid outbreak of the pandemic in the camps of northern Syria.

Al-Dogheim referred to the “danger” of the virus spread in the camps, being overcrowded, where about a third of northwestern Syria’s population lives in them, besides the living conditions that prevent the residents from home isolation or social distancing.

Mohammed Hallaj, the director of the Syrian Response Coordination Group (SRCG), confirmed to Enab Baladi that there is a “problem” in the camps. He said the camps’ tents are adjacent to each other and separated by about one meter only. Meanwhile, the camp residents are asked to comply with “social distancing” and leave one meter or a meter and a half between each other, which is “impossible,” as per Hallaj’s expression.

As for wearing facial protective masks, Hallaj said that the price of one mask is 1,000 Syrian pounds (SYP) or two Turkish liras (TL) (1 TL = 289 SYP). He wondered, how can they afford to buy a mask on a daily basis for personal use, while their daily wage is less than 3,000 SYP.

On 13 August, The SIG released a statement, in which it announced a series of preventive measures to curb the spread of the pandemic, as the number of coronavirus infections increased in northwestern Syria. These measures included the imposition of medical masks wearing under penalty, provided that the SIG will secure the masks free of charge and in batches.

Hallaj believes that the distribution of medical masks by organizations and associations or having an effective response to the people’s needs makes it logical for the SIG to impose a penalty on not wearing masks; However, this is not the case.

He added that about four million people in northwestern Syria need a minimum daily amount of one million medical masks, which is why people will not abide by wearing them.

As for al-Hajj, he believes that the percentage of camp residents’ commitment to preventive measures is “very low,” and requires greater awareness and commitment to protection procedures.

He added, the camps’ residents must not have all the burden because of their poverty and lack of financial ability as they own nothing but the tents they live in.

Al-Hajj continued saying that displaced people living inside or outside the camps cannot be blamed because their income is very low amid the high prices of disinfectant materials, face masks, and lack of prevention supplies.

Instead, al-Hajj pointed the blame towards the key actors on the ground of humanitarian associations and organizations.

Meanwhile, al-Dogheim talked about projects sent to several organizations to provide medical masks for the IDPs in the camps in particular and for hospitals and medical facilities’ patients and reviewers in general.

Al-Dogheim also mentioned a project that has been sent to the United Nations (UN) to provide medical protective masks for people in northern Syria.

For al-Dogheim, the blame is on the camp residents for not adhering to the preventive measures. People outside the camps are also not committed to wearing them, for they do not believe or take the coronavirus pandemic seriously, as per his expression.

The SIG’s health ministry has reported 59 coronavirus infections in northwestern Syria and announced that 46 persons were cured, while one person died.

This report was prepared with the contribution of Enab Baladi’s correspondent Iyad Abdel Jawad