Syria's humanitarian crisis.

Abstract

The United Nations has called the conflict in Syria “the greatest humanitarian tragedy of our times.”1 What started as a peaceful protest in March 2011 has led to three years of an escalating conflict in which over 100,000 people have been killed2. Over 10 million Syrians—one-half of the country’s population—will need humanitarian aid in 20143. Over 5 million children are currently in need of aid, according to UNICEF (the United Nations International Children’s Emergency Fund)4. Innocent, noncombatant civilians are paying the largest price, and humanitarian workers—including orthopaedic surgeons—have been risking their lives to help them. Both government forces and extremist militias have committed atrocities and crimes against civilians and civilian infrastructures5. The decimation and starvation of civilian populations, the denial of medical care and humanitarian aid, the murder of doctors and nurses, and the destruction of schools, bakeries, and hospitals—all of these actions have been systematic and deliberate6. They have been conducted as a matter of policy and military strategy to achieve a tactical advantage. A collapsed health-care system further complicates the situation. Sixty percent of public hospitals and 78% of public ambulances are damaged or out of service7. Thousands of health-care personnel have fled the country for their safety, and hundreds have been arrested or kidnapped. As of July 2013, only 250 of 6000 physicians remained in Aleppo, Syria’s largest city, to serve a population of 2,500,0008. Over the past two years, sustained bombardments and intense fighting have transformed the civilian and residential neighborhoods of Aleppo into a battlefield. As a result, medical work in these areas has been driven underground where doctors and nurses operate in secret, makeshift, provisional facilities such as caves, farms, and apartment buildings. They do so under the threat …