Polio spreads as targeting of health workers continues

A girl receives a dose of oral polio vaccine at a health centre in Damascus, Syria. Photo: UNICEF/Halabi
A girl receives a dose of oral polio vaccine at a health centre in Damascus, Syria. Photo: UNICEF/Halabi

In the latest example of Syria’s dire health crisis, ten cases of polio were confirmed by the World Health Organization (WHO) this week. But this shouldn’t come as a surprise given the circumstances. While the conflict puts many Syrians at risk, two particular kinds of tactics—the targeting of health workers and the denial of access to humanitarian and medical workers—constitute violations that are exacerbating a critical situation.

Back in June, a WHO official claimed that in Syria “outbreaks are inevitable.” The prediction is being born out today in unfortunate clarity. Last week’s World Polio Day, which celebrated global progress toward eradicating the disease, came in stark contrast to Syria’s recent confirmed cases. The outbreaks mark the first reports of polio in Syria in over a decade, according to WHO. The 22 suspected cases all involve children in the Deir el-Zoor province and over 100,000 children in the province are thought to be at risk. There is no cure for Polio, but it can be protected against with just three doses of a vaccine. WHO reported that “[h]ealth authorities in Syria and neighbouring countries had already began the planning and implementation of the comprehensive outbreak response.”

The recent polio outbreaks –along with other diseases including meningitis, measles, and leishmaniasis according to WHO—reflect a much broader failure health services and safety in Syria.  As WHO pointed out earlier this year, with destruction to the country’s medical infrastructure, local medicine production has dropped by 90% and vaccination coverage has dropped dramatically. But other threats also obstruct the provision of needed medical care.

One big problem is that health workers are being targeted. Doctors in Syria may not even get the chance to save a life because they are being targeted, “without respect for their professional neutrality,” as Dr. Saleyha Ahsan recently wrote in the New York Times. Earlier this month six ICRC staff members and one Syrian Arab Red Crescent volunteer were abducted in Idlib. August witnessed the death of two Syrian Arab Red Crescent workers killed by “a mortar shell that landed in front of the Syrian Arab Red Crescent’s branch in Homs.” The severity of these crimes was made clear last month in a “Conference Room Paper” from the UN’s Independent Commission of Inquiry on Syria [available here], which stated, that “[i]ntentionally directing attacks against hospitals and places containing the sick and the wounded and against medical units using the Red Cross or Red Crescent emblem is a war crime in non-international armed conflict.”

And it’s not just the targeting of doctors that contributes to health problems—those who need care are being prevented from receiving. “Humanitarian efforts are failing in Syria,” explained Dr. Sameer Attar in a recent Washington Post Op-Ed, “because [healthcare providers’] access to those who most need help is threatened, restricted or denied.” Attar lamented that the Syrian government and fighters are obstructing medical and humanitarian access to areas in need. In the town of Moadimiyah, a nearly year-long siege by the Syrian army aiming to cut off supply and relief routes, has led to a humanitarian crisis. In response to the severity of the situation in Moadimiyah, UN Under-Secretary-General for Humanitarian Affairs, Valerie Amos, issued a statement calling on all parties to “respect their obligations under international human rights and humanitarian laws” by allowing humanitarian access to those who need it.

So what’s behind Syria’s disease outbreaks and spiraling health situation? It isn’t just due to a shortage of supplies or the destruction of health infrastructure, which the SJAC has previously discussed. Syria’s health situation is made worse by the serious violations of targeting health workers and denying humanitarian access to those who need them. The risk factors for disease and infection are exacerbated at both ends when doctors cannot operate freely, and when vulnerable populations are restricted from receiving care. These practices are violations of international humanitarian law and have no place in a conflict.

While holding an area under siege to prevent humanitarian access may not be as graphic as a video of a summary execution, it is still very much a violation—and it can have even greater repercussions. Similarly, the killing of a doctor also robs the chance of life from all those she could have saved. These actions negatively affect countless would-be patients in need of aid. They demand accountability.

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