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Medical services stretched beyond limit after shelling in East Ghouta

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MSF calls for respect for healthcare and an urgent resupply of medical essentials.

Brussels – In the besieged East Ghouta enclave near Damascus, Syria, intense bombing and shelling is resulting in huge numbers of wounded and is creating a disaster for patients in need of medical treatment, says Médecins Sans Frontières (MSF).

From 14 to 26 November, five MSF-supported field hospitals in East Ghouta, to the east of the Syrian capital Damascus, have responded to 24 mass casualty influxes. Including those mass casualties and other individual admissions, the reported numbers in those medical facilities so far amount to 576 wounded and 69 dead.  This does not represent the total casualty numbers as there are further wounded and dead being reported from facilities that MSF does not regularly support in the area.

Among the casualties counted so far, 149, or just over a quarter, of the wounded, and a quarter of the dead have been women and children under 15 years old.

“During this period of intense conflict, medical care - for men, women and children – is at its most needed. But the services in East Ghouta are stretched beyond their limits”, says Bertrand Perrochet, Director of Operations for MSF. “ Even those who risk trying to reach a hospital or clinic may find it has reduced services due to the fear of bombing, and many facilities are consuming exceptional amounts of medical supplies that will be difficult to replenish.”

The availability of medical care has reduced due to bombing, shelling and fear of attacks. A major field hospital in Kafr Batna in East Ghouta that MSF has been supporting from abroad since 2013 was hit on 20 November by two rockets, destroying a water tank and solar panels, causing some damage to the in-patient department, and putting one ambulance out of service – but fortunately with no serious injuries of staff or patients. The medics there suspended their services for two days to enable essential repairs. Another two field hospitals supported by MSF and a supported clinic temporarily suspended their non-emergency services between 15 and 18 November out of fear of exposing medics and patients to being wounded or killed.

Aside from assisting 21 regularly-supported facilities in the area with medical supplies, MSF had built up reserve stocks in the area for distribution at times of critical need. These MSF reserve stocks are now being used up at a fast rate, with some items completely run out and others almost fully depleted, such as blood bags, dextrose IV-fluid pouches, large size examination gloves, iodine and oral paediatric antibiotics. Most of the facilities MSF is in contact with report being in need of further supplies, not only for treating wounded but also for treating sick patients who constitute the majority of the urgent needs. If these facilities cannot obtain essential medical supplies, treatment options will further reduce putting more critical patients at risk of further deterioration or death.

The pervasive fear of being hit in the near-constant bombing and shelling means people needing medical care and medical personnel are staying at home. Therefore many patients are not getting the care they need and medical personnel are even more reduced than usual in facilities that MSF supports.

“The medics we support and their patients need to be safe in hospitals and clinics,” says Perrochet. “But even if people can get to healthcare and can be safe there, without a huge exercise to resupply the area with medical essentials, the medics’ capacity to save lives will be increasingly limited.”

MSF calls for due precautions to be taken by all belligerents, in accordance with International Humanitarian Law, to avoid hitting civilians and civilian infrastructure including hospitals and residential areas. MSF also urges the Government of Syria to authorise without delay the supply of medicines and medical material into East Ghouta for all agencies or organisations ready to provide aid.

MSF is aware of reports of shelling by armed opposition groups over this period on central Damascus, but because the organisation has not yet been granted authorisation to work in government-controlled areas, MSF does not have access to on-the-ground information that would enable commentary on the situation or the needs there.

MSF directly operates five health facilities and three mobile clinic teams in northern Syria, has partnerships with five facilities, and provides distance-support to around 70 health facilities countrywide in areas where MSF cannot be directly present. No MSF staff are present in supported facilities. MSF’s activities in Syria do not include areas controlled by the Islamic State group since no assurances about safety and impartiality have been obtained from their leadership, nor can MSF work in government-controlled areas since MSF’s requests for permission to date has not resulted in any access. To assure independence from political pressures, MSF receives no government funding for its work in Syria.