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Coronavirus: Damascus’ rosy statements clash with facts on the ground

The Syrian government has reassured citizens that they ready to meet Coronavirus head on; however, the realities of Syria's public healthcare system begs to differ.

6 April 2020

AMMAN — Despite officially having only 19 cases of Coronavirus and two resulting deaths, the Syrian government has taken a series of steps to prevent its spread, including “expanding the number of quarantine centers at a rate of two per province, providing them with necessary equipment and personnel, and designating medical staff for each center,” according to a statement by the state-run news agency, SANA. 

In contrast to the reassuring tone from official sources, however, photos of a quarantine center in al-Duwayr, in Reef Dimashq province, showed unhygienic and dirty rooms, provoking anger and ridicule by many on social media. 

How many isolation and quarantine centers are there really?

Due to Damascus’ general lack of transparency on even the most basic issues, it has only given piecemeal information on the capacity of the isolation and quarantine centers thus far and has not specified the number of available supplies and personnel. Public information is limited and consists solely of statistics and data provided by pro-government media.

In Aleppo for example, SANA News quoted a statement from the Ministry of Health, saying that a 50-bed quarantine center had been prepared at Ibn Khaldoun hospital. “It is equipped with everything necessary in the event that the need arises.” The Ministry also announced the readiness of an isolation center with a “12-bed capacity, and resources for intensive care, in addition to the similarly-equipped isolation centers at hospitals run by the Directorate of Health and the Ministry of Higher Education.” 

To further bolster the Ministry of Health’s capacities, the Ministry of Education has turned its training centers over to the directorates of health in all provinces for use as quarantine sites. According to its own press office, the Ministry of Education also allocated 12 residential centers, which have a capacity of 668 people, in addition to 28 schools, in the event of an emergency. 

The government also announced the transformation of a housing unit in “Martyr Basil al-Assad University City” with 240 rooms and 400 beds in Damascus into an isolation facility in the event of an emergency.

However, the situation is quite different in the government-controlled areas south of Raqqa, where “there is no place for isolation, because there are no sterile places, lodging or restaurants,” the head of Raqqa’s Directorate of Health, Jamal al-Aisi told Syria Direct. “If any cases are suspected, they will be reported to Aleppo or Damascus province, whichever is closer,” he added.

The situation is even grimmer for those areas outside of government control—such as displacement camps in the northwest and northeast—where population density and lack of adequate infrastructure means that even if they wanted to, residents could not isolate themselves. 

Hospitals destroyed, doctors gone

On March 13, the Syrian government announced that the Ministry of Health would begin to “prepare senior undergraduate students, as well as postgraduates in medical school, in all specializations to be involved in hospitals” in the case of a coronavirus outbreak.

Though no official figures have been published regarding the number of doctors and nurses in Syria, a March study by the Damascus Center for Research and Studies revealed that 15,000 doctors left the country before 2015 alone, which was equivalent to 50% of the 30,000 doctors registered in the country in 2009.

Further, according to the study, 23% of the country’s medical centers and clinics were partially or completely damaged, in addition to 11% whose fate was unknown because they were located outside of Damascus-controlled areas. Also, over a third of all public hospitals were partially or completely damaged, in addition to a further 17% whose status could not be determined due to their location outside of government-controlled areas. 

As a result, Syria’s public health system can only handle a maximum of 6,500 Coronavirus cases, after which “the healthcare system is likely to collapse,” according to a recent study by the London School of Economics and Political Science (LSE). 

The level of care that can be provided also varies significantly throughout the country, as Damascus can handle over 1,920 cases while Deir e-Zour has zero capacity for Coronavirus cases.

Source: The London School of Economics and Political Science, March 2020

Even where testing machines and staff are available, connections and hefty sums are required to get testing. According to the LSE study, hospitals are charging between 50,000-300,000 Syrian Lira (SYP)—$39-233, at the black market exchange rate of 1,275 SYP per US dollar—for a test. The testing fee is far higher than the average monthly salary in Syria, which ranges between SYP 30,000 and 40,000 in the public sector and does not exceed SYP 65,000 in the private sector

The healthcare system also faces financial constraints. The Ministry of Health was allocated SYP 76 billion in the 2020 general budget, which is about $59 million at the current black market exchange rate of SYP 1,275 per dollar. The amount needed to repair the damage to the country’s hospitals alone, according to the Damascus Center for Research and Studies, is SYP 759 billion at the 2017 exchange rate of 515 SYP per dollar. 

It remains unknown whether Damascus will receive any significant cash infusions from Tehran as Iran grapples with its own Coronavirus outbreak at home—one of the worst in the world. 

A version of this report was originally published in Arabic and translated into English by Calvin Wilder and William Christou.

This article reflects minor changes made on 07/04/2020 at 12:59 pm.

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