Syria: effects of conflict and sanctions on public health

Abstract

The past 18 months have witnessed considerable turmoil in countries of the MENA region. The Syrian Arab Republic (SAR) is one such country, currently in the midst of a civil war. This report draws attention to some of the recent achievements of its health services, where, despite a dearth of published materials, the country achieved remarkable declines in maternal mortality and infant mortality rates. Its health sector now faces destruction from on-going violence compounded by economic sanctions that has affected access to health care, to medicines and to basic essentials as well as the destruction of infrastructure. This paper draws attention to the achievements of the country's health services and explores some of the consequences of conflict and of sanctions on population health. Readers need to be mindful that the situation on the ground in a civil war can alter on a daily basis. This is the case for Syria with much destruction of health facilities and increasing numbers of people killed and injured. We retain however our focus on the core theme of this paper which is on conflict and on sanctions.

Review of Health Systems of the Middle East and North Africa Region

“…Political conflicts across the region have had significant impacts on health outcomes achievements and health systems development for many countries (Sen et al, 2013). From 2010 up until 2014, political uprisings, protests, and armed conflicts have affected Tunisia, Egypt, Yemen, Bahrain, Syria, Algeria, Iraq, Jordan, Kuwait, Morocco, Sudan, and West Bank Gaza.…”

Infectious disease risk from the Syrian conflict

“…8,9 The conflict is expected to reverse the recent gains seen in the falling infant mortality rate and increased childhood immunization rate. 10 Under these circumstances a surge in infectious diseases in both Syria and neighboring countries can be expected.…”

Public health challenges in the political economy of conflict: the case of Syria

“…As in Iraq, the Syrian situation is compounded by economic sanctions imposed since 2011. Intended to ‘restrain’ the government in power, sanctions have had severe consequences for the general population well‐being, with a serious escalation in the cost of basic essentials (sixfold) for food, fuel and for medicines (Sen, Al‐Faisal, & Al‐Saleh ). Shortages have resulted in an inability to treat those injured in the conflict, whether wounded or those with long‐term chronic conditions (Al‐Faisal et al ; Nasser, Mehchy, & Abu Ismael ).…”

“…Whilst there were growing anomalies, free access to primary prevention and to public hospital services produced some of the best health indicators of the region in relation to per capita expenditure. Syria was, for example, on target to meet the Millennium Development Goals in Maternal Mortality Ratio (MMR) and Infant Mortality Rate (IMR) prior to the conflict, unlike most other countries (outside of Gulf Cooperation Council) of the region (Dostal 2008; International Monetary Fund ; Sen et al ; The World Bank ; United Nations Development Programme ).…”