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Funding cuts for medical referrals in northeast Syria will increase preventable deaths  

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  • The lives of people with illnesses in camps in northeast Syria, the majority of whom are children, are at high risk due to medical referral funding cuts.
  • There are now little to no options even for people with life-threatening conditions to be referred to a hospital outside camps.  

Médecins Sans Frontières (MSF) warns of a marked increase in the number of preventable deaths in northeast Syria, as the World Health Organization (WHO)-funded medical referral system from 11 camps, including Al-Hol camp, has ceased due to lack of funding. 

“Shortfalls in funding for the WHO mean that since the end of March, referrals for patients requiring specialist or complex care have no longer been funded,” says Allen Murphy, MSF Head of Mission in Northeast Syria.  

“This decision shows how the WHO has to make tough choices in an environment where humanitarian funding is being reduced across the board. This funding cut essentially eliminates the possibility for people in Al-Hol camp, where MSF works, and from other camps in northeast Syria, to access specialist healthcare,” says Murphy.

It leaves lives hanging in the balance, the majority of them children, some with treatable and preventable diseases. Allen Murphy, MSF Head of Mission in northeast Syria

“It leaves lives hanging in the balance, the majority of them children, some with treatable and preventable diseases, and others in need of urgent specialist care like surgery,” says Murphy.  
As of January 2024, 93 per cent of the people detained at Al-Hol camp were women and children, with 62 per cent under the age of 18 and 43 per cent under the age of 12.     
In 2023, MSF directed 1,446 patients for external referrals. However, at least 22 per cent of referrals were declined, either because the necessary services were unavailable, or due to security restrictions. Now, since the most recent round of service cuts, there are little to no options for even life-threatening cases to be referred to a hospital outside camps anymore.  
Even before the complete cessation of WHO support for medical referrals, there were an estimated 1,000 patients categorised as ‘cold cases’ (non-emergency cases, although they may deteriorate into life-threatening emergencies without treatment) in all 11 camps, including over 800 in Al-Hol alone.

These patients need specialised health services only available outside of the camp. These conditions include endocrinology, neurology, general surgery, ophthalmology surgeries, reconstructive surgeries, gastroenterology and skin diseases.  

Nabeela*, a resident of Al-Hol camp.

“My daughter has been battling kidney failure since 2023. Despite monthly referrals to Hassakeh hospitals, I was unable to accompany her due to security restrictions. Recently, I received the devastating news that she can no longer be referred to Hassakeh hospitals for treatment and in just five days she will run out of medication. Witnessing her suffering is more agonising than the horror we endure in Al-Hol camp. The feeling of helplessness when a loved one is in pain is truly overwhelming.”   

Maha*, a resident of Al-Hol camp.

“For over five years, I have called Al-Hol camp my home... Despite the immense challenges and hopelessness of life here, I persevere to ensure my children receive the love, care and attention they deserve.

“Two years ago, my son was diagnosed with a disease that shattered our world. His tiny body endured relentless nasal bleeding and unyielding bouts of vomiting – suffering that eclipsed even the horror we witnessed during the conflict and our time in the camp.

“It has been two years now since his diagnosis, yet I persistently ask for his urgent treatment... Recently, my son’s suffering intensified as he began experiencing vision disturbances. Although it took over six months for him to be referred to Hassakeh for medical consultation, still no treatment was provided, and my son lost his sight. For the past two years, my son has been denied treatment. His bleeding persists and every day he cries out in agony. Our faith in humanity has waned; within the confines of Al-Hol camp, compassion finds no sanctuary.”  

Jameela*, a resident of Al-Hol camp. 

“My daughter was diagnosed with a chronic gastro infection in 2023, a condition that necessitated a referral to hospital for essential treatment, as the required medication remains unavailable within the camp. Unfortunately, her last referral, a month ago in March 2024, yielded no relief.

“She has since exhausted her medications and her health has deteriorated significantly. Despite her excruciating pain, no organisation within the camp can alleviate her suffering. Now, my daughter teeters on the precipice of fatal consequences. Desperate, I pleaded for repatriation to my home country where healthcare was once accessible... Yet, my pleas remain unanswered; they tell me my country has abandoned us.”  

*Names changes to protect identity.


Witnessing her suffering is more agonising than the horror we endure in Al-Hol camp. The feeling of helplessness when a loved one is in pain is truly overwhelming. Nabeela*, a resident of Al-Hol camp.

Given the increasing humanitarian needs in northeast Syria, it is crucial for donors, especially Member countries of the Global Coalition to fight ISIS, led by the US, to increase funding for healthcare services instead of reducing it.

This is especially vital for external medical referrals. The capacities of local medical facilities serving as referral centres for Al-Hol camp, and other detention and displacement camps in northeast Syria, must be improved. Immediate funding is necessary to fill current gaps in this system.   
“More than 40,000 people, the majority of them women and children, remain detained at Al-Hol camp from countries including Syria, Iraq and over 50 others. Many of them have been held there since 2019 and some, who were born there, have never known life beyond the confines of the camp,” says Murphy.

*Names changes to protect identity. 

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