Last week, the conflict in Syria reached another shameful milestone—the Office of the UN High Commissioner for Refugees and UNICEF reported that 1 million Syrian children are now refugees across Lebanon, Jordan, Iraq, Turkey, and Egypt. In Syria itself, 3 128 000 children are currently living in poverty, situations of displacement, or are caught in the line of fire.
UNICEF's Executive Director, Anthony Lake, was unusually undiplomatic—“the global community has failed in its responsibility…We should stop and ask ourselves how, in all conscience, we can continue to fail the children of Syria.” Syria has presented the world with a geopolitical crisis. The global community must not ignore the health crisis that continues to deepen.
After 3 years of decimation to Syria's health system—and an estimated 100 000 deaths—the global community finally now seems to be waking up to the seriousness of this conflict for civilians. Ban Ki-moon, UN Secretary-General, was “shocked” by the new allegations of chemical weapons use and is now talking about its “serious consequences”.
Just how serious the international community will be in protecting the lives of Syrians remains to be seen. There is an urgent need to investigate the veracity of these latest events and the claims that sarin gas was deployed. WHO has a crucial part to play in verifying the cause of death of so many civilians.
But beyond the immediate urgency of these latest events, the chronicity of the humanitarian catastrophe in Syria and neighbouring countries must not be forgotten. The disruption to routine health services for children, women, and those who rely on stable supplies of medicines and health services—e.g., patients receiving insulin, undergoing regular dialysis, or receiving treatment for cancer—will inevitably cause substantial increases in preventable mortality. The cruelty of the destruction of the health system is one of the deepest tragedies for Syria today.
The medical humanitarian response to these desperate predicaments is being hampered by lack of coordination and insufficient funding, and above all a lack of access to all parts of the population, as reported recently by Adam Coutts and Fouad M Fouad in The Lancet.
Coutts and Fouad also warned that the Syrian refugee situation in Jordan and Lebanon would become so acute that the humanitarian response would be financially unsustainable if refugees' health needs and the immense pressures on domestic health systems were not addressed urgently.
In an imploring letter to The Lancet from Jordan's Ministry of Health on July 3, a plea was made for US$180 million to expand and upgrade existing facilities, together with around $135 million in 2013 (readjusted for 2014 and beyond) to meet the health care needs of Syrian refugees. Jordan reports that as many as 3500 refugees are entering the country each day. Health services for this population are “dangerously overstretched”.