Sudden closure of UN-run medical clinic leaves tens of thousands in Rukban camp without vital care

Rukban camp in March. Photo courtesy of Rukban Camp Civil Council.

AMMAN: A UN-run medical clinic serving tens of thousands of displaced Syrians in a remote camp on the Syrian-Jordanian border remains closed for the fourth consecutive day, cutting off access to life-saving treatment, UN sources and camp residents told Syria Direct on Wednesday.

The UN-run medical point, which provides emergency medical care to residents of the Rukban camp from across the border in nearby Jordanian territory, was first closed on Sunday without explanation, a UN source told Syria Direct, speaking on condition of anonymity because he was not authorized to discuss recent developments with press. The clinic treats thousands of camp residents per month.

This is the fourth day the clinic has remained closed, with next to no information from authorities in charge of the facility about how residents in dire need of medical care will gain access.

The UN medical point is a vital lifeline for the estimated 60,000 people thought to still live in Rukban, where only a skeletal network of poorly served nurses’ clinics operate. The clinics are desperately low on supplies, according to medical staff and humanitarian workers inside the camp, while medicine is prohibitively expensive—when it’s actually available.

Rukban’s makeshift tents and mud homes sit sprawled out across a demilitarized no-man’s land between the Syrian and Jordanian borders known as the “berm.” Following a series of bombing attacks claimed by the Islamic State in recent years, a nearby border crossing into Jordan has been firmly closed to the tens of thousands of displaced Syrians camped out in the remote desert settlement.

Some residents have been allowed through, however—those who sign up on a waiting list are granted temporary entry into the UN medical point, where a smaller number of patients in need of surgeries and more complicated treatment, such as C-section births, are then transferred over to Jordanian hospitals.

‘Where else can we go?’

According to Ruba al-Homsi, a nurse who runs Rukban’s only clinic providing free healthcare, at least three patients have died at her facility since the closure of the UN medical point earlier this week. Syria Direct could not independently confirm the deaths.

As well as providing basic healthcare to camp residents, al-Homsi’s clinic helps coordinate the transfer of patients in need of serious care into the UN medical point for examination and treatment, as she has few medical supplies on hand inside Rukban.

But by this week, she said, those transfers had halted.

“We have many cases in the camp who need specialized hospitals with operating rooms,” al-Homsi told Syria Direct on Tuesday.

Among those impacted by the closure is camp resident Hanan Nader’s two-year-old son, who she says is in “dire” need of surgery for urinary retention.

“Sometimes, he sits for two days without urinating at all,” Nader told Syria Direct on Wednesday.

When she attempted to sign up for entry into the UN medical point earlier this week—a process she’d grown accustomed to following several regular visits since the facility opened last year—rebel fighters turned her away, she said.  

“I couldn’t enter,” Nader said. “They told me it was closed, and there was no getting in.”

Rukban resident Asmaa Talib, who was displaced to the camp from her hometown of Palmyra in Homs province three years ago, said she also attempted to enter the medical point this week—twice—to seek treatment for gallstones.

But Talib was also denied entry, leaving her with few other options for advanced medical care.

“If [the medical point] is closed, where else can we go?” she said.

UN ‘in talks’ to reopen clinic

It remained unclear Wednesday afternoon exactly who was responsible for the ongoing closure of the medical point. Some camp residents blamed nearby rebel faction Jaish Ahrar al-Ashair, which maintains a presence along the border area, for preventing entry to the facility, though Syria Direct could not independently confirm the accusations. A spokesperson for the group denied any role in closure.

A handful of US- and Jordanian-backed fighters maintain a presence in Rukban as well as the surrounding desert.

UN officials were “in talks with the government of Jordan” earlier this week in an effort to reopen the medical point, the UN source told Syria Direct.

A Jordanian government spokesperson was not immediately available for comment on Wednesday.

Medicine in a Rukban donations center in September. Photo courtesy of Hadhar al-Hussein.

Residents of Rukban, thousands of whom fled battles between Syrian pro-government forces and the Islamic State in eastern Syria’s Deir e-Zor in recent years, are left stranded in the desert with scarce food and water supplies. They often depend on sporadic aid deliveries, as well as goods smuggled from elsewhere in Syria to survive.

Soap, cleaning supplies and medicine are in desperately short supply more than eight months after the last official cross-border aid delivery arrived to Rukban in January.

What little medicine remains in the camp typically arrives via smugglers coming into the camp from Syrian government-held territory, before being sold at a nearly 50 percent markup to residents already short on cash after years without steady employment, Rukban resident Hadhar al-Hussein told Syria Direct on Tuesday.

Al-Hussein helps run a small aid distribution center in the camp that hands out basic food and medical supplies to residents who can no longer afford them.

“People who came to the camp with just a few cents to their names have since run out,” al-Hussein said.

Camp residents live in makeshift tents and mud houses built by hand. Cinder-block grocery stores and pharmacies dot the desert settlement, while a UNICEF-funded water pipe that supplies Rukban from Jordan often cuts off, allowing nearby rebel groups to sell water from their own tanks at a premium.

Evacuation from Rukban?

The ongoing closure comes amid talk surrounding a planned population transfer convoy from Rukban to Turkish-occupied northern Syria, sources on the ground in both locations told Syria Direct.

Syria Direct understands that the evacuation has been agreed upon with Syrian government forces and is planned for the coming days. The agreement would see fighters from the now-defunct rebel faction Liwa Shuhada al-Qaryatayn—alongside several thousand civilians—bused north to Jarablus, a city on the Syrian-Turkish border, Emad Ghali, a spokesperson for the rebel group, told Syria Direct on Wednesday.

A source close to the opposition-run Jarablus Local Council in northern Syria also told Syria Direct of a planned convoy from Rukban, adding that local officials were planning a “temporary camp” in the area to receive the incoming displaced.

The proposed evacuation would be the first of its kind in Rukban—and in Syria as a whole.

Over the past two years, pro-government forces have adhered to a strategy of besieging and bombarding remaining rebel-held territories across the country, then bussing out thousands of fighters and civilians as it reasserts control.

Rukban would be the first rebel-held pocket to undergo evacuations without having faced a direct bombing campaign by pro-government forces beforehand.

US Army Col. Sean Ryan, a spokesperson for the US-led anti-Islamic State coalition that controls the border area surrounding Rukban, told Syria Direct via email on Wednesday that Liwa Shuhada al-Qaryatayn were “reported to have negotiated a deal specific to their situation.”

But plans to bus out residents in the coming days “may have now changed with the agreement between Russia and Turkey,” the spokesperson added, referencing a deal announced Monday evening to establish a buffer zone between areas of rebel and government control around Syria’s northwestern Idlib province.

Civilians and humanitarian organizations hope the buffer zone could stave off a pro-government offensive on the rebel-held province, where more than one million displaced people are estimated to live.

With additional reporting by Nour al-Homsi and Muhammad al-Hourani. 

This report is part of Syria Direct’s month-long coverage of internal displacement in Syria in partnership with the Konrad Adenauer Foundation and reporters on the ground in Syria. Read our primer here.