Jordan + 1 more

There is nothing left

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Amman, 28 March 2013 – As Syrian refugees continue to pour into Al Zaatari refugee camp, WHO talks with Syrian women receiving medical treatment and the dedicated team who administer it.

“There is nothing left.” It was a unanimous answer. The eight women inside a field hospital tent in Al Zaatari refugee camp, Jordan, all agreed on one thing: health services in Syria are almost non-existent. “We are all from Dar’aa [a city in the south, near the Jordanian border]; we had almost no choice but to escape. Our local hospital has been closed to the general public; only military personnel use it now.” These words are from Umm Amal (real name censored), a women in her 60s. “I was shot in both feet as I left my house, and needed urgent medical attention. I went to the public hospital, but they turned me away. I tried to call for a local doctor to come to my house, but he said it was too dangerous. I decided then to head for the only other place that could help me, Dar’aa’s private hospital. They took good care of me there, but I knew it wouldn’t be cheap. It cost me 270 000 Syrian pounds (approximately US$ 3800). I am not a rich person; this was almost everything I had. Once I was better, I paid my bill and left for the Jordanian border. It was all I could do.”

Umm Amal’s story is not unusual. Each of the eight women had an equally distressing story. Several had left their homes heavily pregnant. “Yesterday we had five caesarean sections, the day before that we had four,” states the specialist epidemiologist at the field hospital. “These numbers are very high, we are struggling to cope.”

People come here in desperation; they come because they have nowhere else to go. Though a lucky few can afford private health care in either Syria or its neighbouring countries, the majority of citizens, like these women, have no choice but to flee. “Health care in Al Zaatari is completely free. Free for all Syrians, men and women, pro- and anti-government. We never ask questions, we never discriminate. But every day the situation is getting worse and worse and demand is constant. We have the supplies and are fortunate to have regular stock top-ups directly from Morocco. Insulin however is in short supply. It is the same in Syria; we are being told that it’s extremely difficult to get it over there.”

The field hospital is very impressive. The doctors are dedicated, hardworking and professional. They have a trauma surgery, consultation room, laboratory, X-ray machine, ophthalmology ward, dental surgery and pharmacy. But they are becoming overstretched. One example is in the ophthalmology ward (for issues to do with the eye). They were prepared for regular cases such as viral conjunctivitis and eye trauma. However, according to the young ophthalmologist in the field hospital, they are now seeing a lot of cases of a certain rare disease. “Thinned corneas” exclaims the doctor “We’re treating dozens of cases a day. This is not a common issue; it’s a specific genetic disorder. We are facing so many, it is now a significant part of our day. We would never have been able to plan for this.”

“In Al Zaatari we have cases of war trauma, of course – but it is not our major concern,” explains the director of the field hospital, an experienced field hospital manager. “Children mainly suffer from diarrhoea and the adults mainly suffer from lung infections. The majority of our problems are not directly linked to war traumas. One of our most pressing issues is sanitation, particularly when it comes to women. Toilet facilities are limited. Some women are not even allowed to use them, forced by their male relatives to stay in their tent. I have seen cases where they will defecate in tins inside their own tents. This is what we face; this is something that is not portrayed in the news.”

The situation outside the refugee camp is also difficult. Limited international support for the Jordanian health facilities has meant that they are now overstretched, and the Jordanian Ministry of Health resources spread across both Jordanian and recent Syrian beneficiaries.

As we leave the medical tent, Umm Amal screams “They burnt everything: our homes, our cars, our animals.” It is a stark reminder of the situation just a few dozen kilometres from Al Zaatari camp, across the border inside the areas from which they were forced to flee.

As is the incident that occurs as we leave. A minor scuffle breaks out in front of the children’s vaccination tent; a man holding a young child argues with the members of the medical team. The director just shrugs “It happens here every day, people fight to be first – they’re just worried.”

What they are worried about he did not say. But it could be that they are worried for their sick wives or children; worried about their unborn babies; worried that the medicine will run out and the support will stop; worried for their husbands across the border; worried for their own future; worried that they will never go home.

Syrians in Al Zaatari refugee camp have a lot to worry about.