But the situation in Qushtab camp, which includes more than two thousand Syrian families, is completely different, as they do not receive sufficient aid from countries and international organizations concerned with helping refugees.

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On a video call, Maryam narrates the details of her daily routine that has remained unchanged in the times of COVID-19.

She wakes up everyday at dawn before waking the rest of her family, to start preparing for work. Collectively, the family starts preparing food in large quantities sufficient for everyone.

Around 1,000 refugees live in the Ahl al Qur’an camp, and after the recent wave of displacement, the number has increased, according to the camp’s director, Muhammad Sheikh Ismail.

“Here, social distancing and preventive measures recommended by the World Health Organization and other associations are not possible,” he said.

“There are no health or service facilities in the camps, and the number of tents is simply not sufficient for the number of people. Consequently, social distancing and self-isolation is not possible.”

“In each tent (two meters wide and three meters long), there are at least five people who share food and drink, while each section (consisting of 40 tents) has a total of six toilets; three for men and three for women,” Ismail said.

Despite the ongoing threat of the virus, residents felt reassured due to the blockade imposed by the Syrian government, and the Turkish government’s closure of three land crossings: Bab al-Hawa, Safety door, and Jarablos.

Airports and other ports have also been relatively empty since the area’s first recorded case.

However, the severity of the situation evolved after July 9 when the first cases were recorded at Bab Al-Hawa hospital, specifically, in a Syrian doctor who recently moved to Turkey.

There was great fear and concern that the cases would continue to spread due to the absence of preventive measures.

A study carried out by the Medicare Health Foundation, in cooperation with the health directorates in northern Syria, set out to assess the number of potential coronavirus cases, and found that the possibility for widespread infection is extremely high if necessary precautions are not taken.

The study indicated that in the first six weeks, cases may reach up to 240,000 (which represent 20% of the internally displaced population), of which 36,000 would be severe, 12,000 would be critical and 14,328 would be fatal.

These areas mostly rely on preventive measures implemented and funded by civil societies and organizations that are already limited in their capabilities and resources.

Director of Latakia (with jurisdiction over the Ahl al-Qur’an Camp) in the Syrian Civil Defense, Muhammad Haji Asaad, sheds light on some of the preventive measures that have been implemented.

“From late April to early September we sterilized 115 camps distributed from Al-Zouf to the village of Badama, including the Ahl al Qur’an camp.

We also sterilized approximately 22 villages in the western countryside of Idlib, and targeted areas with high population densities,” he said.

Dr. Mahmoud al-Hariri, the director of the health information unit in northern Syria (including Hama, Aleppo, the Sahel and Idlib) who works directly with the WHO, told ARIJ that, “[Until September], we only had one laboratory in Idlib equipped with tools for analyzing samples.

It was proposed to equip two new laboratories; one in the city of Jarablus [northeast of Aleppo] and the second in the city of Afrin [north of Aleppo]. Some of the equipment has arrived, albeit late, and included 6,0000 analysis kits and tests, which will be activated very soon.”

Dr. Muhammad Al-Salem, director of the vaccine program and member of the Early Warning and Epidemic Response Network, says that “1,390 tests were conducted for suspected cases by the end of June, all of which were negative.”

According to Al-Salem, the lab in Idlib analyses results from various areas and is not restricted to the governorate alone. Samples collected from Deir Ezzor, Raqqa, Aleppo and Hasaka were analyzed in Idlib, he told ARIJ.

The ACU runs the only laboratory in the opposition-controlled areas of northern Syria. According to Al-Salem, the protocol for positive tests is as follows: in the event of a positive result, a second swab is taken from the potential patient and transferred to Turkey for confirmation.

The confirmation is typically provided 24 hours after the test is conducted. As for the hospitals directly supported by Turkey and located in the northern and northeastern countryside of Aleppo, samples are collected there and then sent to Turkey.

Just two days after the first COVID-19 case was recorded in opposition-controlled areas,  specifically on July 11, the Ministry of Health of Syria’s interim government announced that the number of cases had risen to three – two of which belonged to doctors working in the Azaz City Hospital who had recently entered from Turkey.

As of 23 July, the number of confirmed cases had risen to 22 out of 3,111 tested, according to Dr. M. Ram Al-Sheikh.

On September 5, the Early Warning Network announced an additional 14 recorded cases — the highest since the pandemic reached the north, bringing the total number of cases to 112.

The accelerated rate at which COVID-19 cases were being recorded, only increased fears in light of already extremely difficult living conditions.

An Exhausted Medical Sector

“Currently, Northern Syria does not have a unified health system, and only a few limited health institutions are operating at maximum capacity to fulfil the needs of more than 4 million people in an unstable and unprepared area,” says Dr. Yasser Najeeb, Executive Director of an Immunization Group in Syria.

The group consists of a medical team that provides vaccines for children under the supervision of the WHO, and is one of several working to tackle the crisis in northern Syria, with support from the WHO.

The ARIJ reporter attempted to contact Dr. Munther Khalil, the Director of the Idlib Health Directorate and responsible for coordinating medical support in the governorate, who did not respond.

Al-Salem describes the medical sector as “exhausted”.

“In northern Syria, there are only 600 doctors serving over 4 million people, a third of which live in overcrowded camps on the border with Turkey. We need at least four times the current number of doctors, and qualified laboratory technicians are very rare. Moreover, the infrastructure has been completely destroyed, and most of the hospitals currently operating are relatively rudimentary,” he told ARIJ.

Dr. Mahmoud Al-Hariri added that, “we fear there will be a great number of casualties among medical staff. As of September 8, we recorded 10 cases among the medical teams, which forced them to remain in isolation for 15 days. For us, it is a big problem for a doctor to be absent throughout this period in light of their scarcity.”

There are only 90-100 respirators available in the entire northern region of Syria, which are meant to serve 4 million people in normal conditions, excluding the pandemic and warzones. Of the total number of respirators, 80 to 85 devices are already being used around the clock, according to Al-Salem, leaving only a few devices available.

In its 2019 annual report, the Syrian Network for Human Rights documented the death of 26 medical personnel and a total of 98 attacks on medical facilities in that year alone. The attacks were also confirmed in a report by Physicians for Human Rights, which recorded 595 attempted attacks on 350 separate medical facilities, with a death toll of 923 medical workers between March 2011 and February 2020.

According to Dr. Hariri, the WHO has formed a working group, under its direct supervision, for local organizations to confront the pandemic since March.

The group operates in coordination with health directorates, and has a budget of $64 million for a period of six months.

Al-Salem also indicated that Global Health provides safety equipment for workers in the medical sector, and more is scheduled to be sent in the coming period. It has also provided both online and in person training for medical personnel.

“Only four quarantine centers were equipped out of 30. Additionally, just four out of nine hospitals were equipped according to the medical plan initially drafted by medical organizations, with the support of the WHO, to confront the virus,” Al-Salem added.

Local Organizations

According to Mustafa Al-Hassan, the Protection Coordinator at the Sadad Humanitarian organization, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) allocated $11 million to support response projects, increase hygiene in the camps and support the water and health sector.

It later announced a $75 million grant that would be allocated to organizations, subject to the OCHA’s approval, and according to their projects and plans. These funding figures have been confirmed and matched by three independent sources, but have not been published by the OCHA itself.

For Al-Hassan, “the problem is that most of the organizations working in the humanitarian field in northern Syria are not committed to pandemic prevention measures, and only a few are implementing the appropriate safety and awareness measures amongst their staff.”

Dr. Hariri insists that “no health system is capable of confronting the pandemic without a societal commitment to preventive measures, which is why it is imperative to equip hospitals and isolation centers.

For example, the cost of equipping an intensive care bed can reach up to $13,000 while the cost of a mask is less than half a dollar, and it provides a large amount of protection and largely reduces the risk of infection.”

“However,” he continued, “the majority of the public does not comply with these simple preventative measures. We have even spotted some health sector workers who are not committed to wearing masks.”

The ARIJ reporter found numerous instances of aid organizations not adhering to minimal preventative measures, such as masks.

Beyond the social media accounts of these organizations, which show staff in masks and adhering to the minimal standards, most of the fieldwork is conducted without the necessary health and safety precautions.

Director of the Maram Relief and Development Organization, Yaqzan al-Shishakli, indicated that since last April, his organization has established an isolation and quarantine center in the village of Sheikh Bahr in the countryside of Idlib.

The center provides services to those affected by COVID-19 in a well-equipped arena, to ensure that the virus is not transmitted. Al-Shishakli said that as of September 1, the center has not received a single case.

“The center has a capacity of 160 people and is designed to double its size within a week in the event of an increase in cases, to accommodate 320 people. The center also aims to relieve pressure on local hospitals and coordinates with Idlib Health so that their work is under their supervision,” Al-Shishakli told ARIJ.

Al-Shishakli confirms that his organization has provided several training sessions and workshops on safety and prevention measures, and that the organization has shifted the schools they supervise to e-learning, especially since most of the schools in northern Syria have completely shut down.

“We tried to complete the school year with our 4800 students online, and deliver all the lessons through WhatsApp. However, we faced some accessibility issues, because some families did not have access to WiFi and blackouts meant that the internet was not particularly reliable,” he added.

Chaos and Clashing Authorities

In a region dominated by chaos and lawlessness, the authorities and military organizations seek to gain from the COVID-19 crisis without considering the dangers and consequences of a virus spread.

All decisions aimed at preventing the spread of the virus and issued by the Salvation Government (loyal to the Al-Nusra Front) which manages the city of Idlib and some parts of its countryside, have been superficial, according to Muhammad Haj Hammoud.

Hammoud, a Syrian journalist and Director of the Idlib Plus network, explains how efforts by the authorities are ultimately driven by ulterior motives. Specifically, authorities aim to use this crisis to strengthen their influence “on the ground” and narrow their grip and power over civilians.

This investigation monitored a number of decisions that have effectively put civilians’ lives in danger.

For example, the decision taken on April 2 to suspend Friday prayers in mosques lasted just two weeks. This was a major issue, especially given the month of Ramadan and the increased amount of prayers in local mosques, which continued despite the ongoing crisis and in the absence of any preventative or precautionary measures.

Then, on May 31, came the decision to grant exemptions for vehicle registration fees within a period of 15 days, “with the aim of encouraging people to go back to normality”.

This resulted in citizens flocking to register their vehicles, causing severe congestion, and forcing the government to extend the initial grace period.

This also led to an increase in the risk of contracting COVID-19. Here, the authorities are criticized for attempting to “return to normality” when their interests are clearly focused on remedying the financial deficit and issues with their treasury, instead of prioritizing people’s lives and their safety.

Furthermore, no decision was issued to limit commercial or industrial activity in the governorate. Instead, the Salvation Government tried to open new crossings and trade routes, which threatened the isolation of Idlib and put it at risk of infection from neighbouring areas.

According to various sources (from the Ministry of Health and other unofficial sources), as of June, the neighboring areas had already recorded at least 204 cases. This is despite numerous warnings from the Doctors’ Union in Northern Syria regarding the dangers of opening these crossings.

On April 15, the Headquarters for the “Liberation of Al-Sham” announced the opening of a commercial crossing with areas near the city of Saraqib, due to pressure from the business owners and traders trying to compensate for their losses after the crossings with Turkey were closed. However, the authorities stood to gain from taxes imposed on all vehicles using the crossing, in either direction.

Demonstrations quickly spread in northern Syria, and several popular parties issued statements rejecting the decision and demanding that the crossing be closed. In response to the protests, the authorities simply opened a crossing in a different area in the western countryside of Aleppo on April 30.

Tahrir al-Sham published a video of the crossing’s activities and the entry of trucks from regime-controlled areas. Once again, the people protested by organizing a sit-in to express their opposition to the authorities’ decision. However, the authorities retaliated by shooting at protestors, killing some.

A worker in a local organization speaking on the condition of anonymity, indicates that “the most dangerous thing for humanitarian organizations operating in the northern regions is the interference of the Government through the Office of the Displaced Administration and the Office of Organizations Affairs.

It would be impossible for an organization to operate in those areas or in the camps without their approval, and obstructing these organizations prevents aid from reaching those who need it.”

Due to deteriorating economic conditions, the collapse of the Syrian currency, the threat of the pandemic, and the implementation of the Caesar Act, the suffering and needs of civilians have increased, thereby increasing their dependence on relief and humanitarian organizations.

Ahmed Abdel Hakim, a displaced person who lives in a camp on the Syrian-Turkish border in the western countryside of Idlib, explains how the aid he receives is crucial in sustaining him and his family.

He told ARIJ that if the aid provided to him is cut for just one month, he and his family face starvation and food insecurity, as he is unemployed and without a source of income.

On July 11, after great difficulty, the UN Security Council voted on Resolution No. 2533, which stipulates the renewal of the mechanism for the introduction of cross-border humanitarian aid, specifically through the Bab al-Hawa border crossing that connects northern Syria and Turkey, for a period of one year.

The resolution also called on the UN Secretary General to submit their report on the functioning and progress of the aforementioned mechanism to the Security Council at least once every 60 days.

This investigation was completed with support of Arab Reporters for Investigative Journalism (ARIJ).

SIRAJ —Syrian Investigative Reporting for Accountability Journalism

The post COVID-19: A Ticking Time Bomb in Northern Syria and its Refugee Camps appeared first on SIRAJ.

“We better die from the virus, if it spreads to the camps, than starve to death, since it is particularly difficult to obtain detergents in the camp,” the mother said, weary of the long arduous day on the farm.  

With the money she and her daughters earn, she gets to buy as much vegetables and crops as possible. These, she then turns into food storage for winter. 

Displaced from the al-Ghab Plain, the family today lives in the al-Safsafe Camp, near Salqin city. As COVID-19 prevailed, Rama’s brothers, like the rest of the camp men, yielded to unemployment after they lost their jobs in construction. 

With the significant spread of the virus, the camps’ people had to grapple with major challenges, most importantly their severely affected jobs. Furthermore, they are toiling to make a living, considering their long stay at the camps, lacking job opportunities and humanitarian aid, which before amounted to food shares and a few healthcare services at best, provided by organizations and civil society associations, the camp’s residents said. 

It is dangerous and horrifying, a number of despondent displaced persons at the camps in north Syria said, describing their life there. 

“We almost have no food. The aid we get every now and then is insufficient. We are not even getting enough water, drinkable or for household uses,” said Hind Malaki (33 years), a woman displaced from Mount Zawiya to rural Idlib with her three-member family. “My husband was a day labourer, and we struggled only to get bread. Our life in the camp has grown worse than ever.”

The larger proportion of the camps’ residents are displaced from areas in Hama, Aleppo and Idlib, fleeing the military operations launched by the regime and Russian forces. They, thus, sought refuge in less hostile areas, which incubate over two million civilians, the Syria Response Coordinators Group (SRCG) said, adding that IDPs live in 1277 camps, 366 of which are informal. 

Shortfall in Humanitarian Response within Camps under COVID-19:

Livelihoods and food security sector 49%

Water and sanitation sector  66%

Healthcare and nutrition sector 79%

Non-food items sector 54%

Shelter and housing sector 54%

Education sector 74%

Protection sector 70%

– Source: Director of the Syria Response Coordinators Group

In a statement, the Syrian Civil Defense, a volunteer civil defense organization that helps people affected by the war in Syria, said that the viral outbreak is haunting over four million Syrian IDPs in Idlib province and western rural Aleppo, as well as those in the camps spreading along the Turkish border strip, particularly day labourers, who are stuck in a state of anticipation and are obsessed with the pandemic and infection.  

Furthermore, people’s suffering has hit new extremes, for over a million persons live in camps that lack life essentials, according to statistics reported by the Syrian Network for Human Rights (SNHR).

“In the camps, people struggle to earn themselves a single day’s living, particularly with the widespread virus, which cost a large proportion of people their source of income,” Dima al-Hak, a member of Idlib Province Municipality, said.  

Even though a COVID-19 outbreak in the Syrian displacement camps in rural Idlib and Aleppo will be a disaster, to apply social distancing inside the tents is out of question. However, many people are not scared of the pandemic, as much as they are concerned for their lives and safety. 

As the Syrian pound’s value crashed before the dollar, reaching an exchange rate of about 2500 Syrian pounds per dollar in July 2020, according to one currency conversion website, most of the markets were closed down, while prices spiked. Consequently, complaints increased among workers in camps and north Syria, who are tormented by economic and living crises alike.  

“My two daughters and I are coerced to work in the fields, getting 500 Syrian pounds each. We are trying to earn our bread money, after my husband and son lost their jobs at the olive factories due to the COVID-19 spread, which devastated our lives to the roots. Both my husband and son had jobs, and our finances were acceptable. However, after they stopped working, we had to work for a low wage that does not exceed 500 Syrian pounds. If the virus continues hitting us hard, we might even consent to work in return for 100 Syrian pounds a day,” Rama’s mother said, who is forty-something. 

On the same regard, a Humanitarian Situation Overview in northwest Syria, conducted by REACH Initiative in September 2019, scanning 1051 local communities, villages and towns in north Syria, stated that the majority of the Syrian families’ monthly income amounts to a staggering 50,000 Syrian pounds (about 25 dollars), while the income of 941 of the target communities does not suffice to cover the family’s food-related needs. 

To make do, the overview further reported, 80% of the families borrow money, 56% send their children to work, 22% reduce the size of  meals, 11% skip meals, and 10% offer their household assets for sale. 

Yousef Osman, a Syrian young man and a day labourer who sells vegetables in the city of Idlib, shares the demands of other workers: “We need some entities’ support to help us through these wretched conditions, caused by the spread of the virus and death.”

A report, published by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) on 13 July, stated that the COVID-19 impact was added to the repercussions of repeated displacement, persistent security threats, and instability due to local currency depreciation. These concerns boosted the burdens of the area’s population, amounting to 4.1 million persons, 2.8 of whom primarily depend on relief aid to live.    

The listed factors, the report claimed, induced a rise in the food parcel’s cost by 68% over a single month, thus threatening to push the rest of the area’s population below the poverty line, who would not be capable of affording their needs unaided.  

Concerns and challenges

Muhammad Da’boul (12 years) lives with his family in an informal camp in Atme, rural Idlib in north Syria. The family is extremely concerned over the precautionary measures adopted by the local authorities in Idlib province. 

As a wage earner, Muhammad used to make a daily 1000 Syrian pounds, with which his five-member family managed to get along. “I would shuck corn husks every day, boil them and then sell them in the camp. However, with the COVID-19 outbreak, people are no longer willing to buy. My customers went missing, for people are afraid of contracting the virus from vendors,” Muhammad said, his face overcome by confusion. 

An estimated 83% of Syrians are below the poverty line, according to the United Nations (UN) 2019 annual report, which assesses major humanitarian needs in Syria. 

Muhammad is one among thousands of Syrians who are now in desperate  need of assistance amidst  the rising prices of commodities in the market and the spiralling COVID-19 crisis. 

Local councils in Idlib, responding to the first positive COVID-19 case announced on 9 July 2020, made several statements, providing for banning weekly bazaars in al-Dana, Binish, al-Fu’a and Atme areas “until further notice”, seeking to prevent civilians from gathering. Nevertheless, the area, where three-quarters of the population are on relief aid, is now facing a reality no less threatening than the virus itself. 

Major Sources of Income in North Syria

Borrow money from family/friends 80%

 Reduce meal size 56%

 Children sent to work 22%

 Skip meals 11%

Sell household assets 10%

 

– Source: Humanitarian Situation Overview in Northwest Syria

– REACH Initiative / September 2019

Day labourers left to their own devices

Five months ago, Fatima Muhammad spent long hours behind a sewing machine in her tent in rural Idlib. That was her job for about three years, which she said made her the most happy. 

Sewing was Fatima’s source of income, but she is devoid of all resources today, as she cannot continue working. “I am a tailor. I made a living for the family; we asked no one for help. However, due to COVID-19, less customers are showing up. I am no longer capable of affording my needs or sewing tools and materials, such as needles and threads. I am also a heart and hypertension patient. The doctors have cautioned me against seeking another job,” Fatima said.  

Relating to sources of income, the Humanitarian Situation Overview in northwest Syria indicated that 85% of the people do not have stable jobs, depending thus on day labour, 84% work on the farms they own, 60% work in business and trade, 14% depend on remittances from outside Syria, and only 13% count on stable salaried labour. 

“In the camps, displaced workers, whose main source of income is day labour, are facing a living catastrophe today. Those, however, who work in workshops might be severely affected in two months, if the crisis inflates further,” lawyer Youssef Qadour said, who works with a local team to document violations against the rights of workers in north Syria. 

For her part, Dr. Dulama, SRCG director in northwest Syria, listed the key professions in the camps in north Syria: “The majority of the people are day labourers. Others, however, are either tailors or barbers, or work in sell-buy businesses.”   

Reporting on the purchase power index in Syria, Numbeo stated that it hit extremely low, scoring only 9.30 points out of a hundred.    

Further, the investigative unit interviewed a number of displaced day labourers, who lost their jobs due to the COVID-19 outbreak. They addressed the measures adopted in response and the ensuing repercussions, which aggravated unemployment and poverty rates among IDPs, who were already enduring dire humanitarian conditions before the outbreak and its consequences, which had a catastrophic negative impact on the camps, particularly. 

Residents of IDP camps in north Syria face challenging living conditions, in the absence of minimum resources and services, including water, electricity, sanitation and housing, according to the SRCG.

Eight families in the camps, selected randomly by the investigative unit, reported that despite losing their jobs, no organizations came forward to help day labourers, covering neither of their needs, especially ones related to relief and healthcare.   

 In the camps, key professions are farming, sewing, vending, building, shop keeping, transporting people,  hairdressing or selling commodities on stalls.

Dreading haunger

Under the COVID-19 crisis, the IDPs challenging condition effected a great shortfall in the humanitarian response within the camps, which amounted to 49% in livelihoods and food security sector, 66% in  water and sanitation sector, 79% in healthcare and nutrition sector, 54% in non-food items sector, 54% in  shelter and housing sector (providing tents to informal camps), 74% in education sector, and 70% in the protection sector, the SRCG reported. 

Over 5000 persons live in the al-Safsafe Camp in rural Idlib, north Syria, most of whom sought the camp in batches coming from al-Ghab Plain in 2013. They know no other profession but farming, given the nature of the area they fled.  

“Before the COVID-19 outbreak, over 40% of the camp’s residents had day jobs at olive and canned food factories. Their daily wages, however, did not exceed a 1000 Syrian pounds, which was acceptable and sufficient to support the family, for all the members worked in these factors. As the virus started spreading, the factories were shut down,  boosting unemployment and poverty rates in the camp, which already lacked healthcare and food aid,” the camp manager Wael al-Jasim said, describing the suffering endured by the day labourers. 

Mostly covered in blue tarpaulin, several informal camps rest between fields and hills, such as those in western rural Idlib, near the Syria-Turkey border in Jisr al-Shughur area. 

Set up in 2014, these camps shelter families that fled from rural Latakia and western rural Idlib. They all live in low-quality dwellings that turn into swamps in winter, while unbearable during the scorching summer.   

“We live in this tent, the eight of us,” Ahmad al-Barhou said, a thirty-something man, who lives with his family, while also taking care of his sister and her children. 

He pauses, and then adds: “My sister lost her husband during a Syrian regime air raid on our town in the Turkmen Mountain, rural Latakia. I made a living for my family, my sister and her children. I had a modest vegetables stall. My work stopped due to the coronavirus outbreak and the people’s inability to purchase as the Syrian pound crashed.”

Addressing purchase power, several financial overviews indicated that the living costs of a five-member-family is 300,000 Syrian pounds, or 200 to 250 dollars. Nevertheless, these figures are eight to 10 times less than the actual costs. 

Delivery

Before the outbreak, the camps’ people suffered from long-term unemployment, lacking money and job opportunities. But still, many of them are trying to forge themselves a chance and make a living to improve their life. 

To earn his living, Ghadeer al-Hamwi (29 years) transported passengers and delivered commodities aboard his motorcycle in the Atme Camp on the Syria-Turkey border. However, there are no errands to run these days. 

Standing next to his motorcycle, Ghadeer said: “I transported customers between the camps and to marketplaces for a bit of money, aboard my motorcycle that consumes little oil. The transportation fee is also less compared to cars. So, I had many customers before COVID-19. With the restrictions, preventative measures, and the distancing rules, as well as the rising concerns which accompanied the virus, the people stopped seeking my services. I ended up jobless.”

On 28 July, the Idlib Healthcare Directorate reported new cases, which brings the total case number to 29 in the area. 

The new confirmed case is in Idlib city, the directorate stated, while larger case numbers are in the two cities of Sarmada and Sarmin in rural Idlib, as well as near the camps in Azaz city, rural Aleppo.  

“Inside Syria, over 11 million people need humanitarian assistance, of whom over four millions are children,” Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mark Lowcock, said in early March. 

In north Syria, Ghadeer and fellow day labourers wait for the COVID-19 crisis to end, to resume their jobs after a two-month interruption. 

Ghadeer, who by now sat on the ground near his motorcycle inside the camp, stressed that the condition of his family, consisting of four children, is tragic, while he is unable to meet their needs, or even make a living. “Work has stopped. Unfortunately, we are offered no assistance or food aid. A disaster is looming, a lot more dangerous than the virus. It is starvation,” he said.

The Syrian Investigative Reporting for Accountability Journalism (SIRAJ)

The post “We Fear Hunger, Not Coronavirus”: The Syrian Camps’ Tragedy  appeared first on SIRAJ.

Using the trick successfully, Aiysha convinced her son (5) to keep the preventative rules. Nonetheless, the trick failed to mitigate the negative impact the measures addressing the virus, the ensuing lockdown and curfew, had on his life. Hussain’s personality was a lot different. He was psychologically shaken, turned irritable, and demanding. With a restless sleep, Hussain was less active at home and withdraw into his world on the second month of the lockdown.

Aiysha’s trick proved a successes at her home, but it failed to help Abu Rida, who lives with his sex children at a three square meter tent, surrounded by jammed tents at every side. The forty-something man heard that COVID-19 has arrived in Northern Syria; however, he could do nothing to protect his family.

1/3 of Syria’s children were deprived of education due to war; a larger proportion has been even denied necessary healthcare services.

UNICEF

In Syria, COVID-19 cases started to surge, while real case numbers were kept a secret amidst poor protective and preventative measures, as well as treatment efforts. Thus ominous, the situation threatens Syrians with a scenario that might bear a striking resemblance to the one suffered by Italy.

With its symptoms, the many people it rendered dead, the following closure of schools, curfews and bans on leaving home, COVID-19 had affected children in ways of dire consequences, which psychologists believe might be of a long-term.

Medically speaking, international studies concluded that infected children might show COVID-19 symptoms, including fever and high temperature. Even though children are less vulnerable to testing positive, Syria is currently witnessing large outbreaks. To date, there are no clear estimates of the pandemic’s spread, nor reports of child infections throughout the country, which might be attributed to the fragility of the healthcare system and shortage for diagnostic tests and laboratory equipment, which absence plays a key role in the underdiagnosis of cases.

Furthermore, interviews conducted with families throughout Syria point out the wide lifestyle gap between children from various geographical backgrounds. Children in the capital Damascus, for instance, have a different life from their peers in Northern Syria’s camps, where they are subjected to unmatching economic and social conditions, as well as different housing and living modes, let alone the environment-related discrepancies.

Given the current situation, psychologists are actually urging parents to maintain their calm and low stress levels, for children do mimic their actions.

2.6 million children have been forcibly displaced. About two million children are out of school. 3 out of 10 schools in Syria are destroyed or unusable.

– Human Rights Watch, 13 March 2020

 

“We know the poorest, most marginalised children who were already the furthest behind have suffered the greatest loss, with no access to distance learning – or any kind of education – for half an academic year,” Save The Children chief executive Inger Ashing said.

On the whole, this applies to all children around the world, but it, particularly, does not pertain to Syrian children, whose living conditions are largely different from children in other countries, as they have been doomed to lose a lot during the conflict.

According to a UNICEF report, one-third of Syria’s children were deprived of education due to war; a larger proportion has been even denied necessary healthcare services.

The Syrian Network for Human Rights, on its turn, documented the death of 29,296 children at the hands of main actors in Syria between March 2011 and last June.

Moreover, in a report entitled “They have erased the dreams of my children,” the Commission of Inquiry for Syria outlined multiple blatant right violations children have been subjected to, including death, miming, injury, orphaning, deprivation of education, and enduring the myriad violations by warring parties, as well as the displacement of over five million children, internally and abroad, over the course of the war.

The report, including interviews with more than five thousand children, witnesses, relatives of survivors and medical staffers conducted between 2011 and October 2019, states that “pro-Government forces have also deployed cluster munitions, thermobaric bombs and chemical weapons, claiming dozens of children casualties.”

Rape and sexual violence have been also used against men, women, boys and girls as a tool to punish, humiliate and instil fear among affected communities. On top of this bitter reality, which Syrian children are coerced to endure, here comes COVID-19 to rub salt in their wounds.

It is necessary to block rumours and inform children only of facts available on the Internet and social networking sites, to help them resist stress, particularly with the criticism aimed at governments that announce the daily number of cases, a thing that boosts anxiety and tension.

 “On top of displacement,” here comes COVID-19

Ibrahim (13) was displaced a few months ago from the city of Saraqib, rural Idlib. Fleeing the shelling and the battles, he sought refuge in a small village east of Idlib. As if it was not enough that he lost his home, school and friends, cases of COVID-19 started emerging, destining him for heavier losses. Once again, Ibrahim was deprived of school and playing football, among many other things.

“As the coronavirus hit Idlib, my son’s life changed drastically. He was not allowed leaving home, going to school or the park, and playing with his friends,” Hussain’s father Jihad al-Ibrahim said, adding that it was displacement first, and then came the virus. Both have changed the child’s lifestyle.

Before COVID-19, his son went to school, had fun with friends and moved around freely. All of a sudden, everything stopped.

Of the most critical psychological effects that Ibrahim suffered were excessive irritation, spending long hours on the Internet and video games, according to his father, who added that: “He was awake till five in the morning, playing video games and surfing the Internet and slept for most of the daytime. He also asked me to by him an up to date cellophane so he could play PUBG.”

Ibrahim said that he used to meet his friends after school every day. They would gather somewhere and then play football. Nonetheless, he cannot do this today, while also robbed of the chance to spend summer at the town of Darkoush, western rural Idlib, expressing his great desire to enjoy all these activities when COVID-19 risk disappears.

In a report published on 13 March 2020, Human Rights Watch stated that 2.6 million children have been forcibly displaced. About two million children are out of school. Three out of 10 schools in Syria are destroyed or unusable.

Furthermore, the report noted that four out of five people in Syria live below the poverty line, leading to recruitment into fighting, child labor, and child marriage.

Horrified Children

When the Coronavirus pandemic first took over the world, Jana (11), from Suwaida province, was not scared. Nevertheless, she was grabbed by fear when the first case was reported in Damascus, especially because her grandparents are old and her father works at a shoe store, forced to get into contact with countless people, which makes them vulnerable to greatest risk from COVID-19.

All that Jana knows about the disease is that its symptoms resemble the flue, causing people to lose their sense of smell. Once the lockdown was enforced, Jana started doing sports, eating healthy food that boost the immune system, and washing her hands constantly to protect herself from the disease. This information, she got from TV, for she always joined her father as he watched the news.

“When the first case was reported, I was so scared for my father. When he stayed with us at home, since all the stores were closed, I was not as afraid as before. Upon reopening, fear struck me again, because my father gets into contact with many people,” Jana said.

The virus deprived Jana of leaving home and seeing her beloved friends. Her heart ached when schools were closed, she said, because she misses her friends, who were all forced to stay home.

“Fear, anxiety, and tension initially controlled my daughter, and the virus became all she talked about,” Jana’s mother said, referring to the negative impact the lockdown had on her daughter’s psychological health. The mother, however, cooperated with the child to smooth things down, helping her to do sports at home and other similar activities.

Summarizing the most critical behavioural and psychological disorders suffered by the girl, the mother pointed out to fear, heightened tension, and anxiety, as well as obsessed mentioning of COVID-19 and an intense interest in the quality of food.

The mother also noticed that Jana’s headaches went worse because she had excessive brain electrical charges, while she stayed up at night, turned more irritable and regularly bored.

“I believe that being afraid and the quarantine were the principal reasons that her headache seizures worsened,” the mother added, concluding that anxiety and tension badly affect Jana’s illness.

29,296 children died at the hands of main actors in Syria between March 2011 and last June.

– Syrian Network for Human Rights

Assessing the situation, psychiatrist Muhammad Abu Hilal said that the quarantine increased “socially unacceptable behaviours” among children to varying degrees, such as bullying those who cough, aggression, shouting, hyperactivity, sabotaging furniture, no to mention relentless complaining.

“The reason is that there are not enough child-friendly spaces in Syria. Then, there was the outbreak which complicated the situation for the children. Consequently, they became less active and further isolated from their peers at home,” he said.

The pandemic also gave rise to tension and fear of the disease, the signs of which were shown buy children, as they turned “obsessive” and confused about the appropriate manner of behaving, while many became less trusting of others.

“In general, the children’s language changed from one concerned with playing and studying, to one dominated by virus-related terms, mask and quarantine, which resulted in a new behavioural pattern among them,” the psychiatrist added.

The new pattern, the psychiatrist said, is represented by isolation and lack of social contact, the child’s loss of opportunities to learn from peers and play with them, hyperactivity, violence towards others at times, unjustified crying, mood swings, refusal to obey parents and negative feelings towards them, in addition to irregular sleep that corresponds to changing daily habits and spending long hours on cellophanes and video games.

Upward trajectory

This fear syncs to the mounting coronavirus cases that are recording an unprecedented upward trajectory across the country.

On 10 March 2020, the Syrian Ministry of Health announced the first COVID-19 positive case, confirmed as coming from abroad. The infection then started spreading, and cases ascended on the upward trajectory of the disease, both in regime-held areas and others out of its control.

Abu Firas, a Damascus-based father, has four children, the eldest is 13 and the youngest is only five months old, who turned more demanding amidst the outbreak. The more the pandemic lingered, the more the man and his wife were unable to keep up with the social and psychological condition of their children.

Umm Firas is a retired nurse; she left her job five years ago. Her husband, however, works in the healthcare industry.

The family’s life was organized, but it somehow drifted towards disorder as children stopped going to school, lacked any sense of obligation or definite activities to keep them busy.

“My children used to wake up at eight, go to school, return to do their homework, and then play with their friends. They slept at eight, having their play, computer and TV time all scheduled. Today, because these duties are absent, their life is no longer organized,” Umm Firas said.

“We tried to fill the spare time with at-home activities. Nevertheless, the Coronavirus measures have been going on for months, not a week or two. Therefore, following upon their day to day activities turned somehow tedious,” the husband added.

The eldest son, Firas, was crazy about football, and he waited impatiently for Friday to go with his friends to the stadium, taking the by way of the Sharia School where he studied before the outbreak. He almost had no spare time.

The parents attempt to provide their children with a breather. They visit their grandfather every Friday at his house in Damascus countryside. There, the place is less jammed, and the children get a safe opportunity to come into contact with people and meet relatives.

Sarah (11) is Firas’ younger sister. She was all about paper crafts, spending an hour or two everyday creating things. The girl, however, says that the hobby bored her during the quarantine, and it no longer helped her pass the time.

The family came across a volunteer teacher, who posted video lessons on Telegram, while other family members overcome the long unfilled hours by watching historical drama. “I reached the stage where I stopped keeping a track of their daily schedule. At one point, I even grew irritable. I returned home from work needing to rest and fearing that I could pass them the virus, for I get into contact with dialysis patients, while my children had a lot of energy, being at home,” Abu Firas said.

As a result, the children quarrelled increasingly, jabbed at each other and turned more irritable. The family is also concerned over the worst case scenario — a further spread of the virus with the daily rise in positive cases in Syria. Despite the increase, the family began to allow children to go outside, while maintaining tight preventive measures, for keeping them at home all the time has become impossible.

Age-based response

Psychologist Taher Laila, head of the psychosocial and social support team at the Syrian American Medical Society (SAMS), said that: “Children differ according to their age groups.”

“Those under the age of six can understand the anxiety surrounding them, but it is difficult for them to comprehend quarantine, the virus and its consequences,” he added, stressing that the parents’ duty, in this context, is to advise them and find simple ways to communicate ideas to them, explain the importance of social distancing, and the reason for staying home.

He pointed out that, at this age, children tend to develop feelings of guilt when they are not allowed out to play or are not hugged by their father when he is home from work. Children, thus, blame themselves, which necessitates that they get all these ideas explained.

Furthermore, he stressed the need to block rumours and inform children only of facts available on the Internet and social networking sites, to help them resist stress, particularly with the criticism aimed at governments that announce the daily number of cases, a thing that boosts anxiety and mental strain.

Dealing with children amidst the outbreak, Lila stated, demands that parents maintain low levels of concern, because children imitate their parents’ personalities, becoming stressed, as well. Parents, therefore, must keep their composure and address the pandemic with scientific preventative measures.

Moreover, Lila explained that the story was made rather complicated for children, because they need free and safe spaces to move around. With numerous families living in camps, while others are impoverished, capable of affording the costs of small houses only, due to displacement in Syria, in addition to lacking electricity, Internet and recreational activities, the space dedicated for children was subjected to restrictions with excessive energy that needs to be let out.

The unchanneled excessive energy, the psychologist added, causes children to be sad, depressed and isolated, and renders them anxious, becoming not only demanding, but also vulnerable to other symptoms such as intense anger, and stubbornness at times. This pressure, in fact, affects children’s social skills, through which they manage to integrate into society and communicate with their surroundings. These effects might, in turn, influence their social intelligence, making them shy, lacking in spirit and withdrawn.

In case of primary-school-age children, Lila stated that prolonged confinement to home might affect their linguistic skills.

The post Surrounded by Horror: COVID-19 Increasing Syrian Children’s already Multiple Losses appeared first on SIRAJ.

Hammado lives in Hanbushiyeh, a village located in the countryside of Jisr al-Shughur District, Idlib, northern Syria. She is worried that her adult siblings might contract the virus, since they spend most of the day outdoors and come home in the evening. According to her, they know it is time to return home when they feel hungry, but the news of the coronavirus outbreak has raised her concerns, and disrupted her plans. “We are worried about their health more than ours. I have taught them how to clean themselves, what and how to eat,” explains Hammado.

It is worth mentioning that Hammado communicates with her siblings through words and gestures, as well as repeating her words more than once, so that they would understand her and carry out what she told them to do. The spread of the virus across the world, and the fear of its outbreak in Syria with its deteriorating medical conditions, and the destruction of its infrastructure, are all factors that add salt to the wounds of a vulnerable sector of Syrians, namely, those with mental disabilities. Most of them are young people with ages ranging between 18-35 years old, who are unfortunately suffering in despair, as they fail to attract the attention of social and medical services providers. Hence, their burden rests solely on their relatives amid an acute shortage of aid facilities to combat the epidemic.  

“Unfortunately, people with special needs and mental disabilities have no access to medical facilities to save them from being infected,” commented the head of a treatment and psychological support center based in the countryside of Aleppo.

With the COVID-19 outbreak, specialists and doctors have repeatedly reported a surge in levels of violence against people of special needs, which leaves them in a very vulnerable situation and exacerbates their sufferings, according to the facts revealed in this report.

Flawed Laws

One of the challenges faced by disabled people, including those with a mental disability, mental illness, and others who have psychological and mental disorders, is the flawed laws concerning their conditions. Some cases aren’t necessarily a mental disorder, but legal texts occasionally use inadequate medical terms, resulting in a confusion between mental incapacities and psychological disorders. For example, the Syrian Personal Status Law stipulates that “a madman is fully incapacitated. In other words, all his actions shall be deemed null and void. He has no free will and all his actions are illegal, namely, buying and selling.”

Rahada Abdoush, a Lawyer from Damascus, pointed out that the current legal texts were drafted in the 1950s, and contain outdated terms that must be changed, such as the phrase “insane” and “imbecile.” Therefore in court, deciding on a matter, in practice, depends on the medical expert report. “The law does not determine the nature of the mental illness, but the medical expert report does. It distinguishes between the incompetent, the simpleton, the mentally ill, and the insane. It identifies all sorts of mental incapacities, as well as defining the aim of the law, the competence of a patient to manage his possessions and control his actions, and determines whether he needs a guardian and a curator. It also predicts the duration of his/her custody whether it is permanent or for a limited time,” Abdoush tells Daraj.

As of 2016, more than 10 thousand people were interdicted of their legal capacity in the five years that past, due to their incapacity and mental abnormality that were deemed to be “insane” or “imbecile,” according to Mahmoud al-Marawi, the first sharia court judge in Damascus, and according to the current legal characterization in Syria.

“To interdict a mentally disabled person of his legal capacity as well as the seizure of his money, upon the request of one of his relatives, the patient must undergo a medical examination that confirms his mental disorder,” explains the lawful judge.

It’s worth mentioning that no such cases of coronavirus have been reported, neither in other Syrian regions under the control of the opposition, Northern Syria, or in the Autonomous Administration of East Syria.

However, the Crnic institute has recently published a study in the scientific journal Nature revealing that Down syndrome patients are more susceptible to autoimmune diseases, and therefore more likely to be infected with COVID-19.  

Acute Shortage of Doctors

The situation of those who are mentally challenged has become increasingly complicated, with an acute shortage of specialist doctors and care centres. Doctor scarcity rates have surged, and the medical centres’ readiness for treatment and diagnosis have decreased as a result of the conflict. The official figures have estimated that the number of psychologists in Syria is only around 70 psychologists, which would cover around 9% of the needs. “There are three doctors for every one million people, while the acceptable global rate is one doctor for every 10,000 people,” explains Dr. Mazen Haydar, President of the Syrian Association of Psychiatrists.

During her long working day from the morning until late at night, Maha Jawad, the Psychiatry specialist, who works at “Al-Nafs Al-Mutmainnah” centre, an affiliate of the Syrian American Medical Society, SAMS, in Al-Dana village in Aleppo’s rural areas, raises awareness about the necessity of preventing their relatives and family members who suffer from mental disabilities and psychiatric disorders from participating in gatherings because their susceptibility of contracting the virus is higher than others, due to the lack of sufficient information to face the pandemic .

The employees working in the centre, which provides services in the field of mental illness and chronic diseases for nearly 4,000 persons varying between existing and new cases, are currently reinforcing health awareness to patients and their families on personal hygiene, sanitization and regular hand washing, in light of the outbreak of the COVID-19 pandemic. Muhammad Bassam Abdul-Kareem (17 years), is among the patients regularly visiting the centre to receive medical services and counseling. According to his father (Bassam), the young man suffers from physical and mental disabilities, and often endures painful convulsions and seizures.

Muhammad lives with his family in the Hazano region in Idlib’s countryside. These days, his father is mainly concerned about the fear of the spread of the pandemic following its outbreak in Syria, and the lack of tranquilizers and neurological medications in the region. Even if they were to be available they were often overpriced.

“We suffer from the lack of medicine, and we must be very cautious with our son, we give him disinfectants and face masks, and we prevent him from being exposed to others to protect his health,” explains Bassam.

One of the doctors in Idlib has noted that the Sharia Court in Damascus reported that ‘insanity’ and ‘imbecile’ cases, which are the terms that the Syrian law uses to refer to people with mental disabilities, account for 50 cases only in Idlib governorate in 2014, 250 cases in Aleppo and around 3,000 cases all around Syria. He added that it has recently become hard to count the cases due to the repetitive displacement and intermittent military attacks that hinder the work of specialised organisations and medical centres.

According to the agreement on the rights of people with disabilities ratified by Syria, the state should be committed to provide people with disabilities with forms of human aid. The official website of the Syrian ministry of health has estimated that the number of beneficiaries of mental health services in 2019 amounted to 135,242 people. 

One Quarter of the Village Residents are “Disabled”

Mariam complains about everything, starting from the lack of social and medical support to her four brothers, and the lack of support for people with mental disability in general, to the fact that no one is helping them in facing COVID-19, to the family’s weak purchasing power. She noted that her family needs 2500 to 3000 Syrian liras per day ( US$ 1) only to buy bread, given that 1 kg of bulgur wheat costs 1,000 liras and 1kg of lentils costs 1,300 liras.

Shaker Abdou, the local council representative in “Al-Hanbousheh” village in Jisr Al-Shaghour countryside, stressed that the council is unable to provide aid or support for disabled people due to the lack of support by humanitarian organisations, the lack of expertise and the absence of medical centres in the village.   The local council official has estimated that the number of disabled people in the village accounts for 25% of the residents, around one quarter of the village residents. This is attributed to the frequent marriage among relatives, which often complicates the situation further. This reality has affected Mariam, and people like her, as she tries hard to protect her siblings from contracting the Coronavirus, even though she also suffers from a disability in her right foot as a result of around 9 surgeries to be able to walk on her feet again.

Fear of the Unknown

Not only do the special needs people living in northern Syria not receive adequate support and aid, but also those in other regions, particularly areas that have been witnessing military action and airstrikes in eastern Syria during the battles against ISIS.

Continuous cleaning and the fear of infection of people with mental disabilities and those with fragile physical structures, compel the mother of the young Khedr Issa, 30 years, from the village of Qara Qoy, a town of Darbasiyah in Hasakah, to be close to him day and night.

Young Khedr, registered with the Directorate of Social Affairs and Labor in Hasakah, as a person who is suffering from mental retardation, with deformities in the head and eye, needs a caregiver, and has not received any official assistance. No one has ever inquired about his health status before, neither during quarantine periods, nor during the peak global spread of the disease, nor after the spread of the virus in Syria.

His mother is fully in charge of taking care of his health, and protecting him from the pandemic, despite her severe poverty status.

“We have not received help from anyone,” she says, sitting in her rural home’s court, “He washes his hands daily with soap, I don’t allow him to go out and mix. I have been taking care of him since he was a young boy. I don’t know who will take care of him when I am gone… I love him a lot.”

On the other hand, some medical centers in the Hasakah region provide services, in the fields of educational support and child protection, including the “Smart” Center in al-Qamishli, established in 2012 and with projects extending to al-Hasakah, Deir al-Zour, and Raqqa. As the Coronavirus epidemic began to spread, there were no plans to target people with mental disabilities with awareness programs, according to the psychologist and director of the center, Mohammad Ali Uthman.

“There is no special support for people with disabilities to protect them against COVID-19, the projects are related to education and child protection, but we are working on spreading awareness and printing posters for prevention,” he added.   Safety instructions targeting about 500 people, including children, include maintaining social distancing, at a distance of at least one meter, disinfection, as well as wearing gloves and masks.

Violence During Coronavirus

People with special mental needs are living with the consequences of COVID-19, whether they are adults or children, a large part of them remaining home to avoid mixing, according to the director of the Smart Medical Center.

Staying at home can be a positive factor, protecting them against the disease, and against being affected by other factors, such as violence towards them; for specialists began to record levels of violence against them during the Coronavirus pandemic in Syria. This was demonstrated by the results of a questionnaire prepared by the Syria Bright Future (SBF) foundation for psychiatric health, social support, and protection, to measure levels of violence toward people with special needs, and the levels at which they have access to adequate information about COVID-19 in Syria.

The survey revealed, according to psychiatry consultant Mohamed Abu-Hilal (44 years old), that 20% of the respondents believe that “there is an increase in violence against people with disabilities during this period, and that 25% of those who answered the questionnaire believe that people with disabilities do not have sufficient information about the disease.”

“Violence has increased in general because of increased friction among people throughout the day, and due to the stressful atmosphere affecting families and special needs people, and thus the ability to understand their behavior has declined,” he explained.

Moreover, a report concerned with psychological and social support during the period of Coronavirus, issued by IASC-Inter Agency Standing Committee, shows that disabled people face obstacles during the spread of COVID-19, such as the cost of health care that limits their access to services, as well as prejudices, stigma and discrimination against them, including the belief that they cannot contribute to the response to the outbreak of the Coronavirus. This leaves them and their caregivers with additional pressure.

In Syria, the Coronavirus pandemic has been putting additional weight on an already-exhausted people, and the more fragile segments seem to be forgotten models of daily Syrian suffering.

The Syrian Investigative Reporting for Accountability Journalism (SIRAJ)

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