Abstract
ABSTRACTDespite lacking capacity and resources, the health system in the northwest Syria is using innovative approaches for the containment of COVID-19. Lessons drawn from previous outbreaks in the region, such as the polio outbreak in 2013 and the annual seasonal influenza, have enabled the Early Warning and Response Network, a surveillance system to develop mechanisms of predicting risk and strengthening surveillance for the new pandemic. Social media tools such as WhatsApp are effectively collecting health information and communicating health messaging about COVID-19. Community engagement has also been scaled up, mobilizing local resources and encouraging thousands of volunteers to join the ‘Volunteers against Corona’ campaign. Bottom-up local governance technical entities, such as Idleb Health Directorate and the White Helmets, have played key leadership role in the response. These efforts need to be scaled up to prevent the transmission of COVID-19 in a region chronically affected by a complex armed conflict.
Highlights
As of 1 May 2020, the COVID-19 pandemic has hit 214 countries around the world with 3,175,207 confirmed cases and 224,172 deaths.[1]
Attacks on health workers and facilities, collapse of central governance, lack of resources and supplies, and a rapidly changing humanitarian, political and military environment have contributed to a weak health system in a region of around 3.5 million population.[6,7,8,9] Currently, the health system of northwest Syria has around 1.4 doctors per 10,000 people, about 0.625 hospital beds per 1000 people, about 5.7 Intensive Care Unit (ICU) beds per 100,000 people – but with only 47 functioning adults-ventilators for the whole region
The health system is neither prepared nor capable to deal with the current increasing health needs, let alone the predicted spread of the COVID-19. This health system has survived nearly a decade of civil war but faces a new kind of enemy as the impact of a possible spread of COVID-19 in northwest Syria will be catastrophic.[10]. Factors that put the estimated 3.5 million population at a higher risk include: [1] the presence of more than 2.8 million Internally Displaced Persons (IDPs); [2]overcrowding in all urban and rural areas as well as in the 500+ arbitrary camps in the region; [3] the extreme poverty rate with about 83% of Syrians living below the poverty line; [4] the intense social mixing; and [5] the large average household size.(4,11
Summary
- Despite lacking capacity and resources, the health system in northwest Syria is using innovative approaches for the containment of COVID 19. These efforts need to be supported to scale up the capacity of the health system shall the virus spread in this region. - Protection of health workers should be a core principle in designing the COVID response in northwest Syria. - WHO should mobilise more resources to scale up the capacity of the health system in northwest Syria. Authors' contributions: The theoretical framing, initial analysis and drafting, and multiple rounds of edits were carried out by AE. COVID-19 response in northwest Syria: innovation and community engagement in a complex conflict
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