‘New terror’ in scarred Syria region
Amid long civil war, Idlib now overrun with virus cases
IDLIB, Syria — Nurses hover over a patient to insert a breathing tube as his condition suddenly deteriorates. ICU beds fill up almost overnight. As one patient dies of the coronavirus and is wheeled out, another is whisked in to take his place.
The pace is dizzying at the largest isolation hospital in Syria’s northwestern city of Idlib. There are no bombs falling outside and the wounded don’t crowd bloodstained corridors amid a shaky cease-fire in the country’s decade-old civil war. Still, the intensive care unit staff is overwhelmed with beds full of elderly patients gasping for air.
COVID-19 infections in the last opposition-controlled territory in Syria have been increasing rapidly. Spared until July, the region is now recording between 300 and 500 infections a day, and the number is rising fast.
The area, battered by repeated military offensives from the government of President Bashar Assad, is home to nearly 4 million people, most of them displaced and living in tent camps or unfinished buildings.
Infection rates jumped nearly twentyfold between September and October, the U.N. said. Since then, it has climbed 300%, with nearly 11,900 cases recorded by Nov. 16, up from 8,100 a week earlier, and the number of infections is probably much higher.
“There are many patients, most in very bad condition. We have no time to give them all they need,” said Aref Shabib, one of over 95 nurses and techni
cians in the 70-bed isolation hospital, one of two in the city of Idlib, now a virus hot spot.
The pandemic, which has severely tested even developed countries, is the biggest challenge yet for Syria’s health sector, already depleted by years of conflict. Authorities are pacing themselves, deploying equipment and supplies where needed in war-scarred areas.
Ambulance driver Rami Khalaf ferried a patient and a nurse for three hours from the city of Idlib to a southern town for a breathing machine. By the time they arrived, they found there
was no oxygen available, so they headed to a third location, another three-hour drive.
With the nurse tending to the unconscious patient with one hand and operating a walkietalkie in a search for life-saving equipment with the other, they drove more than 125 miles.
Khalaf sat sweating behind the wheel for seven hours in his hazmat suit and mask, driving on unpaved and bombed-out roads. At least he didn’t have to dodge bombs. Medical teams and hospitals often were targeted by government forces that accuse them of treating “terror
ists” — its label for opposition fighters.
But carrying virus patients is a new challenge. Khalaf transported nearly 50 patients in 10 days, up from practically none in October. He keeps away from his children for two to three days to avoid infecting them.
“It is a new terror that is going around among us,” he said.
Announcements of virus deaths on social media or mosque loudspeakers compete with posters honoring those killed in battle, with 95 fatalities linked to COVID-19.
As winter rains began, bring
ing with it renewed rumblings of war, fear is growing that exhausted medical teams may not be able to cope.
Nearly 17% of infections were among health workers, who were first to get the virus. At least three doctors and an administrator died. Medical workers who survived the battlefield find themselves fighting an invisible enemy.
Unlike the war wounded, an entire 24-hour shift can be devoted to just one COVID-19 patient, said Shabib, the ICU specialist.
“We could work for six or eight hours nonstop without even sitting down. It is very hard work,” he said.
At the Ziraah or Agriculture Hospital, most of the 42 patients were elderly. At least 16 were getting some form of breathing assistance, said Dr. Salah Eddin al-Saleh, in charge of the ICU at the hospital operated by the Syrian American Medical Society.
Al-Saleh said he had to turn some patients away.
“We are working at full capacity and all our (ICU) beds are taken. The minute one bed is empty, a patient is admitted,” he said.
In northwestern Syria, which has been outside government control for most of the last decade, dispersing aid is as complicated as the politics of the conflict.
According to the U.N. task force coordinating efforts, there are at least 142 ICU beds and 155 breathing machines in use in the area. The plan is to eventually have 219 ICU beds and 162 machines. Nearly 500 doctors and nurses are working in COVID-19 centers.
Seven of eight hospitals in northwestern Syria that are equipped to treat the virus are already overwhelmed.
“The increase in COVID infections, cases of hospitalization and nearing full occupancy of ICUs, brings us closer to a state of emergency,” said Salem Abdan, head of Idlib’s health directorate.
Virus misinformation also is spreading, such as eating garlic and onions as a preventative. Some see masks as a sign of infection, adding to the stigma of covering up.
Children play a game in which one picks up a mask found on the street and chases others screaming: “COVID! COVID!”