Syria poised for polio outbreak due to regime blockades, rebel chaos

November 5, 2013

By Nuha Shabaan and Kristen Gillespie

SARMADA, SYRIA: The lack of medical supplies and vaccines in rebel-controlled areas of Syria combined with malnutrition and the coming winter are setting the stage for an outbreak of tuberculosis and polio, the latter of which is already appearing in Deir e-Zor province, doctors and medical professionals say.

“We are on the brink of a humanitarian disaster because we have few medicines and no vaccines,” says Khalid, 30, a doctor in Deir e-Zor, who declined to say where specifically out of concern for his safety. Most of the province is ruled by competing rebel groups, he said, with aid unable to reach areas in need, whether due to regime blockades around them or other safety risks.

Khalid was one of the doctors who alerted international medical organizations about the outbreak of polio in the eastern Syrian province, a tribal area that residents say has long been neglected by the regime. Still, before the rebel takeover, vaccines were available. But no longer.

“Ten cases of polio have been documented in Deir e-Zor,” Khalid said, adding that these patients live in rebel-controlled areas. “We are at the beginning with polio; we can solve it now, but if we do not get vaccines, it will be a disaster.”

Last week, the UN’s World Health Organization (WHO) confirmed the existence of 10 polio cases, adding that it is investigating 12 more. There is a “high risk of it spreading across the region,” a WHO spokesman said.

Doctors inside Syria say the crowded, unsanitary conditions displaced Syrians are living in make them ripe for an epidemic, particularly polio, which can be transmitted by direct contact and through saliva, food and water.

Khalid said he is seeing a resurgence of diarrhea in children as those living in tents face colder weather. “There is a serious possibility it will be more intense this year,” he said.

Combined with persistent malnutrition, the doctor warns that “tuberculosis is now knocking on Syria’s door.”

Feras, 29, is a nurse working in a Deir e-Zor hospital in a rebel-held area, who says the arrival of medication is “rare.” He echoes the sentiments of Khalid the doctor, saying that malnutrition is affecting children across the province.

Feras says that the vast majority of the Deir e-Zor’s 600,000 have left as rebels fight amongst themselves for Syria’s oil-rich province. The result of the chaos? “Civilians face true misery; prices are high and food shortages frequent.”

Schools are closed amidst internal battles and “people are starving,” he said.

Elsewhere, in the the FSA-controlled town of Sarmada, near the Turkish border, Mohammed Farij opened a pharmacy last year. He says that the border provides opportunities for a free flow of goods, but high prices and taxes are prohibitive for many internally displaced Syrians.

“We get medicine from Aleppo but pay a lot of taxes to get it here,” Farij said. “We can’t get medicine from Damascus because the regime won’t allow it, so we get the rest from Turkey.”

Farij, himself internally displaced following battles in his village, Tah, also in Idlib province, says Syrians fleeing their towns also face overcrowding and a lack of humanitarian aid.

Syrians from Sarmada, Farij says, discriminate against their rural compatriots, perceived as uneducated and undesirable.

“There is a school filled with homeless Syrians now, and town citizens want to remove them so their children can go to school,” Farij said.

Winter is coming as the war drags into its third cold season, prices are high and the displaced people have few options, he added. Residents “just want to get people out.”

Still, Farij says he does not regret the fact that the revolution grinds on.

“If the revolution had ended after only a few months, we would not have discovered who people really are.”