Civil War Complicates Fight Against COVID-19 in Syria

Syria reported its first case of COVID-19 on March 23, 2020, while its first death was confirmed on March 29. As of April 9, the number of confirmed cases in the country stood at 19.1 Some reports do note that the spread of the infection is more widespread than acknowledged by official agencies.2 Syria has imposed a lockdown and a nationwide night curfew to check the spread of COVID-19 since the first case was reported. Businesses, schools, universities, mosques, government offices and public transport have been shut. The movement of people between governorates has been sealed and only army vehicles and essential services are allowed to move. While commercial flights at Damascus Airport have stopped, the government has ordered the closure of main border crossings with neighbouring states.

Speculations are rife that Iranian militias operating inside the country are the primary sources of infection. Iranian pilgrims also visit the Sayeda Zainab shrine in Damascus. Iranian airlines, Mahan Air, still has regular flights from Tehran to Damascus, despite Iran reporting nearly 40,000 cases and over 2,500 deaths due to coronavirus. In addition, the presence of Turkish troops, Russian military, and foreign aid workers increase the chances of COVID-19 transmission.

Unequipped Health Facilities

Syria is not equipped to handle the spread of coronavirus as the health facilities have undergone massive degeneration as a result of the civil war and access to health care is severely restricted. As per the World Health Organisation (WHO), only fifty per cent of public hospitals are fully functional in Syria, with private hospitals mainly confined to the major cities.3 The head of the UN Office for the Coordination of Humanitarian Affairs (UNOCHA) noted that given the frequently moving population, along with complexities in acquiring medical supplies and protective equipment and the challenges of practicing social distancing in crowded refugee camps, Syria’s fragile health system poses a grave hurdle in battling the virus.4 70 per cent of the total worldwide attacks on healthcare facilities have taken place in Syria, leading the WHO to create a Surveillance System of Attacks on Health Care (SSA) in January 2018.5 The extent of attacks on health facilities is such that the Red Cross and the Red Crescent have been forced to remove their symbols from health facilities run by them.

The Precarious Case of Idlib

While the situation in the whole country is precarious, the areas under rebel or opposition forces, especially Idlib in the northwest, the three small pockets held by Turkish forces and their Syrian allies in the north (Idlib, Afrin, and Tal Abyad) and the area east of the Euphrates River up to the border with Iraq controlled by the United States (US)-backed and Kurdish-dominated Syrian Democratic Forces, are at greater risk from the pandemic. For instance, a major regime offensive in Idlib since December 2019, codenamed “Dawn of Idlib 2”, has led to massive displacement of people, forcing the rebel leaders to establish 200 refugee camps with inadequate sanitation facilities.

Lack of adequate aid from the international community, constant air bombardment and the absence of the formal presence of the UN, makes it extremely difficult to handle any health emergency in Idlib. The UN has confirmed that a total of 51 medical facilities have been damaged as a result of attacks since the offensive began in Idlib.6 Attacks on the national hospital of Jisr al-Shughour, south wing of health centre in Maarat al-Numan and the facilities at Saraqeb are the cases in point. The condition of internally displaced people in Idlib has worsened with fears of unimaginable loss of life, as flagged by the UN Special Envoy for Syria, Geir Pedersen, who has called for an immediate nationwide ceasefire in Syria to enable an all-out effort to combat the corona pandemic.7

Regional and International Response

Syria is receiving regional and international support in its fight against coronavirus but it might not be sufficient. The US committed an additional $16.8 million for humanitarian programming for Syria under the US Agency for International Development’s (USAID) $274 million  fund for countries affected by the coronavirus.8 The WHO has shipped 300 test kits to Idlib, and promised to supply an additional 2,000 tests, while deploying an additional 1,000 health personnel, 10,000 masks and 500 respirators to the city and the neighbouring areas.9 The United Arab Emirates (UAE) has assured Syrian President Bashar al-Assad that Syria will not be left alone during these critical times.10 China has called for the lifting of sanctions on Syria. While the international support for Syria is a positive development, given its highly deficient healthcare system and the ongoing conflict, the coronavirus situation in the country could take a turn for the worse sooner than later. The COVID-19 pandemic adds another layer to Syria’s continuing misery.

Views expressed are of the author and do not necessarily reflect the views of the Manohar Parrikar IDSA or of the Government of India.

• 1. “Coronavirus Disease 2019 (COVID-19): Situation Report 78”, World Health Organisation (WHO), April 07, 2020.
• 2. Ali Cina, “What’s the truth behind the Coronavirus spread in Syria?”, TRT World, March 27, 2020.
• 3. Tarik Jasarevic, “Seven years of Syria’s health tragedy”, WHO, March 14, 2018.
• 4. “UN: Syria coronavirus cases just ‘the tip of the iceberg”’, Middle East Monitor, March 31, 2020.
• 5. “Impacts of Attacks on Healthcare in Syria”, ReliefWeb, UNOCHA, October 19, 2018.
• 6. “Syria 2019”, Amnesty International, 2019.
• 7. “UN calls for total ceasefire in Syria to focus on coronavirus”, Al Jazeera, March 24, 2020.
• 8. “The United States is leading the humanitarian and health assistance response to COVID-19”, US Department of State, March 27, 2020.
• 9. “War-torn Syria braces for lockdown after first virus case”, Al Jazeera, March 23, 2020.
• 10. “UAE offers to help Syria counter coronavirus threat”, The National, March 28, 2020.