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Rising COVID-19 cases put additional pressure on medical facilities in northern Syria

The COVID-19 treatment department at the Ziraat Hospital in Idlib - 14 June 2020 (Enab Baladi, Youssef Gharibi)

The COVID-19 treatment department at the Ziraat Hospital in Idlib - 14 June 2020 (Enab Baladi, Youssef Gharibi)

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Enab Baladi – Khawla Hefzy

The suffering endured by the residents of northern Syria doubtless increases after many coronavirus positive cases have been recorded, particularly since the medical facilities in the region, although few, are considered “fragile.”

The increasing number of coronavirus cases in northwestern Syria have caused the temporary suspension of several hospitals in the region with the aim of disinfecting them, including the hospitals of “al-Noor” in Taftanaz,  the hospitals of “Kafr Takharim,” “Salqin,” and “ “al-Quds,” in addition to the medical centers of “Koren” and “Korknia.”

“The Scientific Advisory Committee to confront coronavirus in northwestern Syria” recommends that the departments of the hospital, which receive coronavirus cases, must be disinfected for two hours effectively with chlorine (when the pH is 5.0 %.)

Hospital sterilization 

Deputy director of Idlib’s healthcare directorate, Mustafa al-Eido, highlighted to Enab Baladi that if one of the hospitals has confirmed cases of COVID-19 among its staff or patients, the infected person and the one who has been in close contact with the person with COVID-19 are quarantined. 

Al-Eido added that the hospital will be closed for one day only to carry out disinfection. That was what happened in Salqin Hospital, which recorded the COVID-19 case. 

Coronavirus prevention and control measures in medical facilities

Medical facilities in northern Syria have adopted procedures to deal with the presumption of recording coronavirus infections, whether among medical personnel or patients. 

Dr. Anas Daghim, responsible for primary healthcare at the Idlib health directorate, told Enab Baladi that “the cadres working in medical facilities and hospitals are trained to apply infection control protocols, as well as to fully educate and familiarize themselves with information about the epidemic,” adding, “Every medical facility is equipped with two tents; one for sorting and one for isolating patients.

 According to al-Daghim, all workers in medical facilities are equipped with personal protective clothing (masks, gloves, sterilizers, outer protective clothing, and eye shields). They are also trained on the use of protective equipment.

Regarding the time required for the results of nasopharyngeal swab PCR for COVID19 to appear, as speed is necessary to confirm cases in medical facilities, al-Daghim denied that there had been a delay in the appearance of the examination results, explaining that the impact of the swab takes hours. It is impossible to show each result separately because the test device needs 30  to 50 samples to work.

Al-Daghim explained the working mechanism of the COVID-19 test apparatus. First, all the swabs are picked up and then placed all together in the apparatus. He indicated that picking up swabs takes time, so are the results, because they depend on how many swabs can be put in the apparatus. 

He warned that there is a decrease in the number of the available coronavirus testing kits, explaining that the “Early warning alert and response network” is the body responsible for bringing the tests.

He speculated that there will be a massive shortage of “testing kits” due to the widespread of  COVID-19 infections, explaining that the number of swabs has reached more than eight thousand for people suspected of being infected with the coronavirus. Besides, there has become a “greater need for swabs,” and the early warning system is trying to secure them.

Recommendations of the scientific committee of medical facilities

“The Scientific Advisory Committee for Hospitals and Health Centers” published its recommendations to health centers if a positive case of the COVID-19  appears in those facilities.

In a statement, on 15 September, the committee identified several items to deal with the registration of any confirmed coronavirus case, namely:

1- If one of the medical personnel gets infected with the COVID-19 disease in the health center or hospital, the infected person must be suspended from work for ten days and another day for making sure if he does not have any symptoms.

2- The management of a health facility shall restrict the close contacts of the patient who meet the conditions of close contact, which are: Contact for a distance of fewer than two meters for more than 15 minutes without wearing a face mask, or close contact such as hugging and kissing.

3- For non-accidental contact, he should be subjected to a quarantine period of 14 days, and if symptoms appear, a swab for COVID-19 testing should be taken.

4- A swab is taken from accidental contact, and isolation is applied to him for ten days and an additional day for making sure that he does not have symptoms, regardless of the result of the swab.

5-  Appropriate penalties are taken against those in contact with medical cadres for neglecting infection control precautions.

6- Hospital departments must be sterilized with chlorine for two hours and then reopened.

Hospitals in Idlib for treating COVID-19 patients

 There are currently three hospitals in Idlib governorate dedicated to treating COVID-19 patients:  first, al-Ziraat Hospital in the city of Idlib, which was equipped by the Syrian American Medical Society (SAMS) Foundation in cooperation with the World Health Organization last June, Second, Kafr Takharim Hospital is serving COVID-19 patients in northern Idlib, which was equipped by the Sima Medical Association in addition to Sham Hospital in the village of Tell al-Karama, which is linked to Dana sub-district, north of Idlib. 

There is also a specialized hospital in the town of Kafr Karmin in the northwestern countryside of Aleppo, the head of the primary health care department in the Idlib health directorate, Anas al-Daghim, said in a previous interview with Enab Baladi.

There is one community isolation unit in Ariha that was prepared by the “Violet” organization with 70 beds, and units in Sheikh Bahar and Kafr Takharim, and work is underway to equip the rest.

SIG’s health minister appeals to the World Health Organization

In an attempt to control coronavirus case and enhance preparedness further, the minister of health in the SIG, Dr. Maram al-Sheikh, appealed to the World Health Organization and partner organizations leading the response process to complete their procedures and to be fully aware of the seriousness of the situation inside Syria after the increasing number of daily confirmed coronavirus cases.

On 14 September,  al-Sheikh said, “It is noticeable that the number of COVID-19 infections has increased sharply,” adding that the number of infections has not yet reached the peak.

Al-Sheikh denied the possibility of imposing a lockdown in these areas without the cooperation of other executive authorities, indicating that this is what the ministry of health is thinking.

The SIG’s minister of health added that his government is determined to establish a hospital to treat COVID-19 cases, including 25 ventilators and their accessories. Also, the ministry will set up two community isolation centers, and the project will be funded by the Syria Recovery Trust Fund (SRTF).

Al-Sheikh pointed out that the number of coronavirus cases constituted a tremendous pressure on the capacity of the health system to absorb, and he referred to the great challenge facing them and to the reports received, which indicated that citizens did not comply with the recommendations and warnings given in the awareness campaigns at home.

The minister directed the necessity of adhering to protective measures to prevent COVID-19 transmission more dramatically, wearing a mask, and abide by social distancing measures. 

The first case of coronavirus was recorded in northwest Syria on 9 July, for a male 39-year-old physician at Bab al-Hawa Hospital, who entered Syria from Turkey on 25 June. 

As of  19 September, the number of coronavirus cases reached 496, while the number of total recoveries amounted to 149, according to what was published by the minister of health in the SIG through his Twitter account

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