“I started borrowing money to meet my needs, which prompted me to resign from Azaz National Hospital due to the low and late wages,” said the head of the cardiology department at Azaz Hospital in the northern countryside of Aleppo, Dr. Abdul-Qader al-Yassin, justifying his resignation.

Delayed salaries and low wages are one of the problems of most of the medical staff in the areas controlled by the Turkish-backed Syrian Interim Government (SIG), which has recently returned to the fore.

An issue that prompted a number of medical staff in several cities and towns in the northern and eastern countryside of Aleppo to strike on 10 October.

The protests and partial strike of the medical staff have returned to the hospitals of Azaz, al-Ra’i, Afrin, and al-Bab, due to the delay in their salaries for more than two months and the old demands they hold amid the intransigence of the local authorities to meet them.

The demands for fairness and improving the monthly salaries were met with threats to the medical staff, represented by summonses, investigations, and threats of dismissal from work, in addition to the threat of fabricated charges.

Resignation, request for investigation

Cardiologist al-Yassin announced on 11 October that he resigned from his job in the hospital due to the low and late wages, adding to Enab Baladi that the hospital administration (which is headed by a Turkish director) requested his presence for investigation because of the protests that took place months ago.

Al-Yassin insists on his resignation despite the request of the hospital director ( Syrian) to return to work, as he made it clear that due to the low salary, he is borrowing to meet his needs, which forced him to resign and look for an alternative job.

Some workers in the medical sector in the northern and eastern Aleppo countryside were forced to leave their work and search for alternative jobs that meet their requirements and needs or to remain silent about their demands amid the pressures they are exposed to and the lack of response to any demands.

The doctor denied receiving any threats, while a source from inside the hospital told Enab Baladi that the cardiologist had submitted his resignation due to security harassment and his request to attend investigations regarding the protest stands organized by medical staff.

Doctor al-Yassin explained that he did not attend any investigation, although he was summoned twice. On 7 October, the doctor posted on his social media page about the delay in salaries, so the hospital director asked him to come for an investigation in person.

The Demands

Doctor Hassan Bard, a general internal medicine specialist at Azaz National Hospital, says that with every protest, demands are repeated to change the nature of contracts signed with medical personnel from forced labor and voluntary contracts to contracts like any contracted employee with the Turkish Red Crescent and the EU and to improve salaries.

Bard told Enab Baladi that the movement organized by the medical staff in Afrin, al-Ra’i, and Azaz hospitals and the rest of the hospitals is a continuation of the old movement that started with a protest stand in which the same demands were raised, without any response from the responsible parties.

The strike is not general, as the hospital receives emergency cases and war injuries, and the strike will not expand further in all hospital departments to respond to the urgent needs of patients, but it will continue until the demands are fulfilled, according to Dr. Bard.

Turkish and Syrian medical cadres oversee the management of hospitals operating in the northern and eastern countryside of Aleppo and the cities of Ras al-Ain and Tal Abyad, but the Turkish cadres have the upper hand.

One of the nurses at Azaz Hospital, who refused to give his name for fear of being fired, said that the demands of the medical staff are to achieve equality between the Syrian employee and the Turkish employee, and delayed salaries is one of the problems, even though the Turkish employees receive their salaries at the end of each month.

Medical sector employees in hospitals have not received their salaries for more than two months, amid promises of getting them soon.

The nurse said that the Syrian employees’ contracts are voluntary or forced labor contracts, denying the cadres’ knowledge when signing them.

He added that the Turkish nurse’s salary is about 15,000 Turkish liras, while the Syrian nurse’s salary reaches 1,300 Turkish liras.

The salary of a Turkish doctor is 40,000 Turkish liras, and the salary of a Syrian doctor is between 3,500 and 4,900 Turkish liras.

Threats, pressure

The administration of some hospitals began calling the protesting medical staff and conducting internal investigations with them, threatening them with dismissal, amid a state of anxiety at the moment, according to Dr. Bard.

“This happened especially in Azaz Hospital, where any employee in the medical staff who refrained from working or went on strike was threatened with dismissal,” Bard adds.

The hospital administration summoned five medical personnel, who were photographed and threatened with dismissal from the hospital.

Doctor Bard stated that the threats are serious and have been going on for a week, with the summoning of a number of cadres of Azaz Hospital, including internal medicine doctors, cardiologists, and pediatricians, and threats that these protests are hostile to the Turkish state.

Several threats of dismissal reached Dr. Hassan Bard through personalities from the administration in order to stop the movement, while he pointed out that the medical staff’s demands are right, and they are not enemies of any party, whether the Turkish government or others.

While the nurse said that the Turkish side, represented by the hospital administration, is exerting many pressures on the Syrian doctors.

A number of Syrian doctors hold Turkish citizenship, but this does not negate the disparity with Turkish doctors in wages, but rather adds to them another threat to withdraw it and not to allow them to cross through the border crossings with Turkey, which need an exit and entry permit.

What happened in Azaz Hospital?

A well-informed source from Azaz National Hospital told Enab Baladi that some of the hospital’s workers demanded a strike like in other hospitals, followed by the Turkish administration’s summoning some of them after following up on the conversations that took place between the medical staff, and interrogated them and asked them for the names of those calling for the strike and took copies of their ID cards.

The hospital administration demanded the name of the person who leaked photos of the department’s strike from inside the hospital, and they were threatened with dismissal and taking legal action in the event of a strike.

On the second day, the administration demanded the staff to come to their workplaces, or else strict measures would be taken against them, threatening to dismiss them.

Accordingly, the strike was stopped in exchange for not dismissing the people who were investigated through a voice message sent by one of the translators to the medical staff.

Azaz National Hospital in the northern countryside of Aleppo (Azaz Hospital/Facebook)

Previous “arbitrary” dismissal

On 6 August 2021, The Turkish administration in the Marea Hospital in the northern countryside of Aleppo dismissed Cardiologist Othman Hajjawi.

The text of the expulsion decision, which was translated by Enab Baladi, stated, “Hajjawi is prohibited from practicing his work in all hospitals in the region, whether Turkish or supported by humanitarian organizations.”

The dismissal decision was issued by the Presidency of the Syrian Work Teams of the Turkish state of Kilis, and the decision attributed the reasons for the dismissal to his absence from his shift, his poor treatment of patients, and his failure to perform his duty in the hospital.

The decision was met with widespread anger, and several statements of condemnation from doctors and civil activists, and local medical syndicates submitted objections to what was described as the “arbitrary dismissal” of Dr. Hajjawi and the manner in which he was dismissed, which they considered “unfair.”

The objection also extended to the arguments for which the doctor was dismissed, such as missing his shifts and that he treats patients poorly despite his high morals, according to a statement issued by the hospital doctors.

In their statement, the doctors said that Hajjawi did not accept that the Turkish nurse “Ali Reza” insulted Dr. Rafi Alwan and submitted a regular complaint against the nurse in the presence of several doctors.

The objections and statements did not bear fruit, and Dr. Hajjawi is still banned from working in the hospital. He currently works as a doctor at the university, does not have permission to cross through the border crossings, and lives in a dormitory affiliated with Marea Hospital amid attempts to get him out, but he refuses to leave.

No response

The demands and protest stands of medical staff have been repeated for months.

It began on 1 August, when medical workers in the cities of al-Bab, al-Ra’i, and Afrin held a protest to demand better salaries for doctors and nurses in the hospitals in the area adjacent to the Turkish border and to denounce the mistreatment of administrators in public hospitals.

The protests were preceded by posts circulated by activists on social media, in which they compared the salary scale in hospitals north of Aleppo between Turkish and Syrian employees in the medical sector.

The difference in salaries between Turks and Syrians is very large in the medical sector in northwestern Syria, where the salary of the Turkish employee is sometimes more than eight times his Syrian counterpart north of Aleppo, even though the sector is supported by the EU, according to the leaked photos of the salary lists.

Doctor Hassan Bard confirmed that the medical staff’s demands did not receive any response from the responsible authorities, especially the Doctors Syndicate and the Health Directorate, pointing out that their role was negative in dealing with the medical staff, and their decisions were not in the interest of the medical staff.

Bard expressed his regret at the intransigence in meeting the demands, pointing out that most of those responsible for solving these problems stick to their own interests and privileges, such as Turkish citizenship, residence, and transit permission.

Medical cadres need to establish independent organizations as unions whose goal is to advance the medical reality and not implement agendas, as is the case with the Doctors Syndicate and the Health Directorate in the region, Bard added.

After the military support to the opposition factions, known as the Syrian National Army (former Free Syrian Army), which carried out joint military operations with the Turkish army, Ankara managed the northwestern region economically and in the service sector and organized medical work by building hospitals in several areas, and supervised their management.

 Enab Baladi’s correspondent in Azaz, Dayan Junpaz, contributed to this report.