Daraa’s “crumbling” health sector and civil initiatives fail to respond effectively to COVID-19 pandemic

A Syrian Red Crescent worker provides medical supplies to a child in the governorate of Daraa to contain coronavirus- 17 December 2020 (Syria’s Red Crescent Daraa branch)

A Syrian Red Crescent worker provides medical supplies to a child in the governorate of Daraa to contain coronavirus- 17 December 2020 (Syria’s Red Crescent Daraa branch)

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Daraa – Halim Muhammad

“ It is increasingly hard to find vacant respiratory ventilators in Daraa’s hospitals,” noted a nurse working at the National Hospital in the Syrian southern province of Daraa. The National Hospital is one of the three hospitals specialized in treating COVID-19, which has reached 800 patients in Daraa, according to the Syrian government figures.

The General Authority of Daraa National Hospital, al-Basil Medical Training Center, Izra National Hospital, the Suburban Health Center, and Khirbet Ghazaleh Isolation Center are not sufficiently qualified to stem the spread of the virus, according to a report by Physicians for Human Rights (PHR) issued on 8 December. According to the report, Daraa suffers from an acute shortage of hospital beds. Additionally, health care facilities are not well equipped to confront the coronavirus. The governorate has no more than 1.1 doctors per 10,000 people. Together these factors continue to stand in the way of providing the necessary health services to Daraa’s residents. 

With limited health supplies, COVID-19 infection prevention and control campaigns were mostly carried out by Daraa people. These campaigns have not yet succeeded in raising people’s awareness or interest in the coronavirus pandemic and its dangers.  Like the remaining Syrians living in Assad-held areas, Daraa residents believe that the government figures of the coronavirus cases are suspiciously low. According to the PHR’s report, the damage and destruction sustained by the health sector made Daraa “the biggest loser,” unable to contain the spread of the disease. 

“Detained” medical staff and hospitals unprepared for COVID-19 

Daraa has lost “the highest percentage” of hospital beds since 2011. Of 810 beds, only 130 beds remained undamaged in 2019. Out of eight public hospitals, only one hospital operates, with a shortage of qualified medical cadres. Most were forced to flee during the military operation that ushered in the return of the Syrian regime’s control over the governorate in July 2018. 

“The lack of health workers in Daraa is an example of how the Syrian government deals with providing healthcare services in the areas it retook from the opposition, compared to the pro-government ones,” according to the report. 

Another report by the Martyrs Documentation Office in Daraa stated that the Syrian regime forces have arrested four medical workers on the charge of “diagnosing patients with coronavirus infections without referring to the Ministry of Health.” This brought the number of detained doctors and health workers to 21 since the so-called settlement agreement signed in August 2018.

The nurse working at the Daraa National Hospital with whom Enab Baladi met (who spoke on condition of anonymity for security reasons) indicated that coronavirus patients often do not consider going to hospitals in the governorate for treatment.

There are fewer than ten ventilators in the public hospital. Moreover, putting a COVID-19 patient on a ventilator in private hospitals costs 700,000 Syrian pounds per day (242 USD).

The nurse expected that the hospital will not be able to accommodate more COVID-19 patients if another second wave of the coronavirus infection is to hit the area. This is due to difficulties related to the isolation of patients and the lack of adequate medical staff to deal with these cases, especially after the migration of a “large number” of doctors and nurses. The majority of those currently in the hospital are “resident doctors,” as pointed out by the nurse. 

Dr. Ashraf Bermo, the director of Daraa health, highlighted that the isolation centers in Daraa have no more than 250 beds. This number is “not sufficient” to receive the increasing numbers of coronavirus patients, according to the correspondent of Sama TV (a pro-government channel).

Neither the residents of Daraa nor the medical staff within the hospital follow precautionary measures to prevent coronavirus spread.

 Enab Baladi monitored the opinions of several patients who unanimously agreed that health workers do not fully adhere to wearing medical face masks. Besides, patients’ wards, especially toilets, are not being sterilized. 

One patient in the Daraa National Hospital said that she is worried about contracting the virus in light of this “recklessness” and lack of safety measures. She also fears that her mother, a heart disease patient, may get infected with the virus. 

The lack of government support for public hospitals in the governorate led to their lack of basic medical supplies, including medicines, gauze, cotton, and sterilizers. Patients have to purchase medical supplies (such as oxygen ventilators and medicines) at their own expense, the nurse and a twenty-year-old patient told Enab Baladi

The patient added that he had to pay for saline and other medicines out of pocket.

Daraa has no specialized laboratory to detect coronavirus cases as the swabs samples of patients with suspected novel coronavirus are sent to Damascus to be tested. Then, the result is provided to the patient. The swab covid test costs around 80 USD, according to the nurse.

The number of coronavirus cases, which increased last November, prompted scholars and administrators in some areas in Daraa to take measures that would reduce the severity of the pandemic.

Several professionals in the city of Tafas, including doctors, held a meeting at the beginning of December 2020 under the slogan “ an ounce of prevention is better than a pound of cure.” They issued a statement, which calls for social distancing and a ban on large gatherings such as funerals and wedding ceremonies; condolences and congratulations will only be offered via social media. The statement underscored the necessity of wearing face masks and washing hands to prevent the spread of the virus.

Enab Baladi surveyed the opinions of some residents in Daraa about the decision to cancel the funeral and wedding ceremonies. They unanimously considered the new decision as a “positive step,” given people’s “reckless behavior” regarding the protective measures. 

Abdul Karim, a man in his fifties residing in Daraa, said that he suffers from high blood pressure and is afraid of contracting the virus. That’s why he stopped attending weddings and mourning ceremonies.

The experience of Tafas encouraged other areas in the governorate, such as the city of Dael and all areas of the eastern countryside in Daraa, to follow similar steps.

Even the fighters of the Eighth Brigade, which is affiliated with the Fifth Corps—one of the military parties in the governorate who were previously in the ranks of “the Free Syrian Army” before the 2018 settlement agreement —are working to raise awareness about preventive measures against COVID-19.

On 13 December, a patrol belonging to the Russian-backed faction in the city of Busra, east of Daraa, circulated to shop owners, via loudspeakers, the necessity to wear masks and gloves. Those in violation face the threat of shutting down their business. 

The Syrian government also previously announced a set of decisions to tackle the pandemic, including the imposition of wearing masks for clients and workers in public institutions, people using public transportation, and people going to markets, shops, and bakeries.

However, Daraa residents show “almost no” interest or commitment to preventive measures, as described by some people in the governorate to Enab Baladi.  Only a small segment of people within the governorate of Daraa adhere to face mask use, disinfection, and social distancing measures. Daraa residents mostly preserve their customs and traditions that see refraining from visiting friends and family as a “defect” that is worse than disease risk.

 

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