Death and suffering in Eastern Ghouta, Syria: a call for action to protect civilians and health care

Jabbour, Samer; Fouad, Fouad M.; Lee, Jennifer; McKay, Donna; Nasser, Rabie; Rubenstein, Leonard S.; Sparrow, Annie; Spiegel, Paul; Tarakji, A.; Waldman, Ronald J.; Hallam, Rola; Mukwege, Denis; Tayara, Ghanem

doi:10.1016/s0140-6736(18)30527-0

Cited by 9 publications

(3 citation statements)

References 2 publications

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“…This has had devastating effects on the mental health of Syrians, creating an increased disease burden while compromising the country's capacity to provide health and mental health services. Targeted attacks on hospitals and medical professionals have severely impacted health provision (99)(100)(101); early in the conflict this included direct bombardment of psychiatric hospitals in Aleppo (102). Such attacks, widely reported in the popular press and the gray literature (103-105), have made their way into the research literature (106,107), including powerful first-hand accounts of the impact on both providers and patients (108).…”

Section: Syriamentioning

confidence: 99%

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

Cratsley

Brooks

Mackey

2021

Front. Public Health

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The most recent global refugee figures are staggering, with over 82.4 million people forcibly displaced and 26.4 million registered refugees. The ongoing conflict in Syria is a major contributor. After a decade of violence and destabilization, over 13.4 million Syrians have been displaced, including 6.7 million internally displaced persons and 6.7 million refugees registered in other countries. Beyond the immediate political and economic challenges, an essential component of any response to this humanitarian crisis must be health-related, including policies and interventions specific to mental health. This policy and practice review addresses refugee mental health in the context of the Syrian crisis, providing an update and overview of the current situation while exploring new initiatives in mental health research and global health policy that can help strengthen and expand services. Relevant global health policy frameworks are first briefly introduced, followed by a short summary of recent research on refugee mental health. We then provide an update on the current status of research, service provision, and health policy in the leading destinations for Syrians who have been forcibly displaced. This starts within Syria and then turns to Turkey, Lebanon, Jordan, and Germany. Finally, several general recommendations are discussed, including the pressing need for more data at each phase of migration, the expansion of integrated mental health services, and the explicit inclusion and prioritization of refugee mental health in national and global health policy.

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Section: Syriamentioning

confidence: 99%

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

Cratsley

Brooks

Mackey

2021

Front. Public Health

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“…In February 2018, the GoS and its allies commenced a military offensive to recapture eastern Ghouta. The military campaign started with heavy aerial bombardment, targeting all of the civilian infrastructure in the area (Jabbour et al, 2018). In the same time, airstrikes systematically targeted all health facilities in the area leading to the destruction of twenty-two hospitals in just one week in February (Rayes et al, 2018).…”

Section: The Eastern Ghouta Offensive Rural Damascus 2013-18mentioning

confidence: 99%

Targeting Healthcare in Syria

Ekzayez

Sabouni

2020

Journal of Humanitarian Affairs

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Nine years of continuous conflict in Syria have borne witness to various atrocities against civilians, some of which amount to war crimes. Most of the involved parties have committed such atrocities, but the Government of Syria (GoS) and its allies remain at the top of the list of perpetrators. Out of a population of 21 million in 2010, more than half a million Syrians were killed as of January 2019 with more than 13 million displaced either inside the country, in neighbouring countries or elsewhere. Moreover, civilian infrastructures, including but not limited to health, have been severely affected, resulting in interrupted services and suffering. Looking at patterns of these atrocities, timing of occurrence, and consequences, could allow us to draw conclusions about motivations. While the GoS maintains these attacks were against combating civilians, we argue that civilians and civilian infrastructure were military and strategic targets, rather than collateral damage to the attacks committed by the GoS and its allies. The motives behind attacking civilians may be related to military gains in imposing submission and surrender; whereas others may be linked to long-term goals such as forced displacement and demographic engineering. This paper argues, supported by several examples throughout the course of the Syrian conflict, that GoS has used a five-point military tactic with targeting healthcare being at the heart of it. This military tactic has been extremely effective in regaining most opposition strongholds at the expense of civilian suffering and health catastrophe.

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“…There is broad international support for improved record keeping concerning damage to healthcare infrastructure and harm to both international and local healthcare providers. Adherence to international conventions and norms concerning the exclusion of healthcare facilities from armed engagement is of notable concern, particularly after suspect actions in Syria on the part of Syrian and Russian forces (Allen-Ebrahimian 2017; Jabbour et al 2018). Calls for the reconsideration of the absolute "neutrality" of healthcare facilities and providers have highlighted the challenges experienced on the ground, where facilities and professionals are embedded in complex contexts of state control, state security provision and regional identities (Rubenstein 2014).…”

Section: Healthcare and Conflictmentioning

confidence: 99%

An assessment of attributing public healthcare infrastructure damage in the Donbas five years after Euromaidan: implications for Ukrainian state legitimacy

Buckley

Clem

Herron

2019

Eurasian Geography and Economics

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From the onset of the conflict in Eastern Ukraine in 2014, significant damage has been wrought to the public health infrastructure of the Donbas region. To date however, the full extent of that damage which is substantial, has not been documented: attribution of blame for that damage has not been attempted; and the implications for the region's residents in terms of access to clinics and hospitals has been difficult to assess. This paper presents a spatial database of damaged facilities and relates that to the fighting to assess whether the damage incurred was collateral or targeted. The concept of state capacity is used to frame a discussion of what the consequences are for those residents remaining and for the challenges this crisis presents to the legitimacy of the Ukrainian government. ARTICLE HISTORY

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Death and suffering in Eastern Ghouta, Syria: a call for action to protect civilians and health care

Cited by 9 publications

References 2 publications

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

Refugee Mental Health, Global Health Policy, and the Syrian Crisis

Targeting Healthcare in Syria

An assessment of attributing public healthcare infrastructure damage in the Donbas five years after Euromaidan: implications for Ukrainian state legitimacy

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