Idlib Medical Facilities Targeted as Humanitarian Situation Deteriorates

Syrian regime forces captured significant parts of the countryside east of Idlib, and the Abu Duhur military airport, exposing the route between Aleppo and Hama. In doing so the regime has been able to isolate the city of Idlib from its eastern countryside, and from the southern Aleppo countryside. In response, the Syrian opposition and Hay’at Tahrir al-Sham (HTS) regained a number of areas, yet clashes are still ongoing. Fighting has occurred regardless of the fact that Idlib falls under the fourth de-escalation zone as denoted in the ‘De-escalation Agreement’ that was signed by Turkey, Iran, and Russia in Astana.

In the wake of this attack by the regime, HTS, Ahrar al-Sham, and other opposition factions launched a counter-attack named “Responding to Tyranny” to retake areas recently lost to the regime, as well as open other strategic fronts. As part of the counter-operation, armed opposition have held the Abu Duhur military airport, and instigated a period of back-and-forth fighting with the regime, who is supported by Russian airpower.

The progress made by the regime has coincided with a vicious air campaign targeting these areas. Aerial bombardment has not spared medical facilities, many of which have been badly damaged by air strikes. It appears that the targeting of medical facilities in the Idlib countryside is another example of a tactic employed during military campaigns waged on cities under opposition control. Air strikes targetting public hospitals are intentional, as the regime is aware of their locations, since they formerly controlled the facilities, such as Idlib Central Hospital, the Maarrat al-Nu’man Hospital, and others. The regime has also targeted a number of healthcare centers, while others have been affected due to their proximity to the bombings.

The regime has been gaining significant ground, aided by Russian aerial support. The Syrian American Medical Society (SAMS) has documented the targeting of hospitals and medical centers in Idlib and its countryside, as well as in Aleppo’s countryside. SAMS confirmed that the al-Salam Hospital in Maarrat al-Nu’man is no longer functional since the attack, while patients in Abu Duhur Hospital had to be evacuated before regime troops arrived in the area. The al-Tahh Hospital also sustained serious damage, while a blood bank in Saraqib recently sustained damaged after an air strike.

Omar al-Masri, a doctor at the SAMS hospital based in Maarrat al-Nu’man said: “Most hospitals in the countryside south and east of Idlib have been destroyed, and the regime and Russian air forces intentionally target civilian areas and gatherings of displaced persons, leading to dozens of victims and casualties, especially amongst women and children.”

Russian war planes also bombed and destroyed the al-Kahf Hospital, which was built underground by SAMS’. After such an action, it is undoubtable that the regime is intentionally bombing medical facilities, yet the regime still claims that it strictly targets armed individuals and unintentionally strikes hospitals. The al-Kahf Hospital is protected and invisible due to its underground location, and signs of its existence are not clearly visible, as compared to hospitals such as al-Ma’ar Hospital and Idlib Hospital.

The regime’s most recent attacks led to dire consequences. Ibrahim al-Shamali, a news reporter from Idlib said: “The first loss is the vast areas controlled by the opposition in eastern Idlib and Hama to the regime, resulting in the displacement of eastern Idlib.” He added, “the second loss is the reduced areas of opposition control; making it easier for the regime to launch an attack on Idlib. There is a huge burden that has been placed on humanitarian organizations, which are unable to deal with meeting the needs of the large number of internally displaced people.”

The healthcare system has also been subjected to significant damage in the Idlib countryside, placing organizations and groups that support medical facilities in Syria on high alert. There are large numbers of internally displaced peoples (IDP), and as the battles rage on, more people are forced into displacement. A rapid response team has documented the displacement of over 300,000 individuals as a result of the recent fighting, with people dispersed to over 379 locations within the Idlib province.

The regional humanitarian coordinator for the Syria crisis, OCHA, stated yesterday that the “ongoing attacks on hospitals and other medical facilities in northwestern Syria have deprived hundreds of thousands of people of their basic right to health.”  

This increase in the number of displaced individuals has increased pressure on the healthcare infrastructure in the areas around Idlib, as well as in the countryside around Aleppo and Hama. Russian warplanes have continued to target IDPs, forcing Syrian medical organizations to provide more support to facilities in urgent need of aid.

Commenting on these events, Dr Omar al-Masri stated: “One gathering of displaced individuals in Idlib’s eastern countryside was targeted by an air attack, and injured people arrived at the hospital including a woman and her four-year-old daughter. The woman had an injury to her spinal cord which left her paralyzed from the waist down, while her daughter had facial injuries. We transferred the lady to a hospital on the border because of the seriousness of her injury which could not be treated here.”

Dr. Al-Masri confirmed that continued aerial bombardment and the increased rate of displacement has also forced a number of doctors to leave their homes. The town of Maarrat al-Nu’man has been targeted on more than one occasion, according to Dr. Al-Masri. He also mentioned that the targeting of Al-Salam Hospital, which has been rendered as non-operational, was a major cause of psychological stress to the doctors working there.

In spite of all this, Dr. Al-Masri and his colleagues continue to work in Maarrat al-Nu’man and other hospitals regardless of the fact that they remain targets of the regime and their Russian ally.

Hasan Arfeh is a media officer for the Syrian American Medical Society (SAMS) and based in Turkey.

Image: Photo: A man lies on a bed inside a clinic, a former school renamed Martyr Khaled Fajr hospital in Aleppo's Sheikh Maqsoud neighbourhood, Syria July 15, 2017. Picture taken July 15, 2017. REUTERS/Omar Sanadiki