Northwest Syria: Hospitals full of wounded, while vital needs grow after earthquakes

"On February 6, we quickly understood that we were facing a catastrophic situation," explains Mohammad Darwish, deputy director of the MSF hospital in  Atmeh. "The destruction was massive in the area, we launched our emergency plan less than 3 hours after the first earthquake and put our staff on alert."

The MSF hospital in Atmeh, which specializes in caring for severe burns, has made numerous donations of medical and non-medical equipment and seconded its surgeons as reinforcements to several hospitals in the region after the earthquakes. Additionally, numerous donations have been made from MSF projects to 30 hospitals locally.

Atmeh teams have started to send medical equipment to around ten hospitals in the region, to Bab al-Hawa, Darat Izza, Idlib, and even to Atarib. “All the hospitals were overwhelmed, including ours,” explains Samih Kaddour, director of the Aqrabat hospital, specializing in orthopaedic and reconstructive surgery. “The MSF teams were the first to help us and to share their resources. They gave us materials, including making casts and sterilizing wounds. We received 800 people in the emergency room, 250 of whom needed surgical treatment. Even today [Saturday, February 11], the wounded continue to flow in.” Since then, unfortunately, the time window for emergency lives saving has closed.

MSF surgeons from the hospital were also sent to certain health facilities in the region to help their colleagues who were dealing with a large number of injured. 

"I went to a hospital located near Turkey," explains Dr Mohammad Zaitoun. "Due to the closure of the border and the impossibility of receiving external support or transferring the wounded, this put immense pressure on us. There were many wounded, the medical staff was exhausted. We did our best together with the MSF teams in Atmeh. As a surgeon, I was in the operating room. We had never witnessed such an influx of wounded, except perhaps during the bombardments or massacres that took place in the region."

Ambulances from the Atmeh hospital were also involved. They made it possible to transfer patients between hospitals. As for the MSF mobile clinics, their intervention plan was adapted to the situation and they were dispatched to places where victims of the earthquake were flocking. The teams that make up these mobile clinics have been working regularly for several years, providing health care to people living in the many camps in the region, which host war-displaced people. They are currently visiting the places where people who have lost their homes are taking refuge daily, whether in Sarmada, Kammouneh or Al Dana.

"We still do not have a clear vision of the situation in the wider area of Atmeh," continues Mohammad Darwish, speaking last Saturday. “We just know that the hospitals are full of wounded and dead people and that the needs are immense. The people of the region need everything. We immediately opened our logistics warehouses and distributed hundreds of essential items, but it is not enough. 2,500 blankets have been donated to hospitals for their patients, and hundreds of kits of necessities have been distributed to families, among others."

^{Trucks en route to distribution of essentials by MSF - 11 February 2023 [© Abdul Majeed Al Qareh]}

In the immediate future, MSF teams in the region are drawing on their emergency stock, while waiting for an international supply, which has been hampered by the political tensions surrounding this landlocked region. Until the earthquakes, Bab al-Hawa was the only crossing point for humanitarian aid from Turkey to this landlocked region of northwestern Syria.

"Almost a week after the earthquakes, we have not received any help from outside," deplores Moheed Kaddour, director of a hospital in Atmeh, and brother of Samih Kaddour. "Support only came from other hospitals, local communities or organizations already present before the disaster. In this, the MSF hospital in Atmeh played an important role. However, this responsiveness, built through regular support for a network of around twenty health structures, is now facing certain limits, such as the impossibility of transferring patients in serious condition to Turkey." 

"Usually, we can transfer our most severely burned patients to appropriate health structures in Turkey," explains Mohammad Darwish. "The MSF hospital in Atmeh provides essential care, but also has its limitations and can only adequately care for people with moderate burns. Today, there are no more specialized hospital beds in the governorate of Idlib and one cannot cross the border."

In northwestern Syria, these earthquakes are disrupting a region that already has more than 2 million displaced people living in camps and where access to health care is lacking. "Nine days after the earthquakes, we are still mobilized by the care of our patients, says Moheeb Kaddour. We are still performing life-saving surgeries on crush syndrome victims. This pathology, which results from a prolonged compression of the muscles, can be fatal by causing saturation and renal failure. The situation is indescribable and for now, we are alone."