Corpses in Hospital Hallways: The Unreported Outburst of COVID-19 in Syria

“A mural which reads ‘Syria isn’t safe’ in Idlib by Aziz Asmar. (Mohamad Jamalo)”

“There were corpses in the hospital hallways and around the entrance,” my father reiterated the words of his friends back in Syria, “there is no more space for them,” he added. 

A Syrian businessman witnessed this as he accompanied his coronavirus-positive colleague to an Aleppine hospital. He assumes the corpses in the hallways were victims of the same disease. Upon refusal for admission, his colleague passed away. “There is no more space for them” my father’s words reverberated with the dark news. 

The reality of COVID-19 cases in Syria is difficult to capture—there is not one set of official numbers that everyone agrees on, rather horror stories, like this one, being shared back and forth. 

According to the World Health Organization (WHO), the numbers stand with 3,041 cases and only 127 deaths—many have claimed these numbers to be suspiciously low.  

Based on implications by the deputy health director of Damascus, Al-Monitor reports 112,000 cases in Damascus and its rural areas alone. The same article shares a policy memo released by the London School of Economics and Political Science (LSE)  which estimates around two million cases in Syria by the end of August. Zaki Mehchy, a researcher at LSE and an author of the memo, confirmed to Watchdogs Gazette that their estimation is now a likely reality. “We didn’t update our numbers,” Mehchy said, “but based on evidence from the ground, we believe that the number of total cases is around two million.” 

Many blame the lack of testing for such a sharp contrast between high numbers, like LSE’s,  and the low official numbers. According to the Middle East Institute (MEI), “Testing kits in Damascus are scarce and usually only made available to those with connections and enough money.” As Dr. Zaher Sahloul, president of Medglobal, confirmed to MEI, “So far not enough testing is being done.” Medics report numbers as low as 300 in the number of tests done per-day, though albeit not in the entirety of Syria, but in government-run areas.

In their policy memo, Mehchy and his co-writer, Rim Turkmani, estimated 119,000 deaths if the cases got to the current two-million. However, as Mehchy confirmed to Watchdogs Gazette, the two million cases did not evoke the anticipated number of deaths. Rather, numbers presented in other parts of their study–somewhere between 17,400 and 24,100.  Regardless, both numbers are around two-hundred times higher than the official number, a shy 127. 

“We have hundreds of unconfirmed coronavirus-related deaths every day,” reports a Syrian medic in their anonymous piece to the Guardian, “Aleppo hospitals are running out of body bags,” they added echoing the terror my father had heard through telephone lines. 

For one, the rapid infiltration of death in the country can be attributed to the already devastated economic scene and medical field. As Dr. Khaled, Syrian writer and doctor, tells Watchdogs Gazette, “There was already a large destruction of both health and economic infrastructure [due to the nine-year conflict], which was causing a decline in healthcare services; now as the pandemic strikes, the system is collapsing further.”

“Some of the remaining public hospitals, Al Razi and the Cardiology and Cardiac Surgery Hospital got privatized to handle only coronavirus cases,” explains Dr. Khaled, “There were no beds or ventilators remaining in the other hospitals.”

Yet, this does not seem to be enough. “As of now, even after all the efforts, all of the hospitals in Aleppo together have 159 beds and 47 ventilators for coronavirus patients,” Dr. Khaled claimed. Although these numbers are already devastatingly low, they seem generous in comparison to Al Monitor’s survey of another LSE policy memo which estimates around 325 ICU beds with ventilators in the entire country. 

Not to mention, a lot of the medical staff fled during the war, and the ones that are remaining are at the forefront, falling victim to the virus. As the anonymous medic reports, “every day, the list of healthcare providers who have died from the virus gets longer.” 

This, what MEI calls “the battered Syrian health system,” is now forced to turn away patients and are confined to dirty rooms without proper medication. “As doctors, this is our worst nightmare,” adds the medic. 

The dire economic situation of the country is also inseparable from the COVID-19 outburst. The recent US CAESAR Act sanctions pushed the already depreciating Syrian pound to a devastating 3,200 SYP to $1 USD — as of July, the cost of a survival basket had increased by 68%. With such an increase in prices, “medical equipment is often the last priority for people, with food and shelter taking precedence,” reports the MEI as they survey the prices of PPE. In the case of Damascus, where the average salary is around 50,000 Syrian Pounds, “Basic face masks can cost between 1,500 and 2,000 Syrian pounds, hand sanitizer can cost up to 3,000, while oxygen cylinders can go for as much as 150,000 Syrian pounds.”

The current economic situation is not only making the instruments needed to deal with the pandemic inaccessible, but also enabling protective measures to become strenuous. After the confirmation of the first case back in March, safety restrictions were imposed in the country; however, they were quickly removed due to the strain they were causing on the economy. Numbers as large as 4 trillion Syrian pounds were being estimated as the amount of economic loss in the months of March and April–the short period of time with harsh safety restrictions. While the MEI has suggested albeit that such numbers might be an exaggeration; “they reflect the essence of the problem facing Damascus, as a lockdown means inching ever closer to total economic collapse.”

The removal of this restriction also instilled an atmosphere of carelessness, as people believed the lack of restriction implied freedom from the pandemic, what the medic calls, “the wrong message.”  I saw the reflections of this attitude via my own Syrian grandmother, who insisted that the dangerous rhetoric surrounding COVID-19 was an exaggeration and that life is normal in Aleppo. MEI shared the same sentiment, “In Aleppo, the crisis has also been exacerbated by large gatherings,” where the people seem unaware or careless about the virus. As analyst Ruwan al-Rejoleh told MEI, “There seems to be a state of denial in Syria regarding COVID-19,” and that “people have little proper education about the virus or its symptoms.”

In addition to this internal collapse, there is a lot of tension concerning external aid; the reliance on NGOs or even international aid is not as simple. In the case of the latter, as Mehchy described to Al-Monitor, many countries are hesitant when it comes to sending aid after the recent US CAESAR Act sanctions were implemented. Although there has been reported aid sent by regime supporting countries like Russia and China, others send “little or no outside assistance.” While in the case of the former, there seems to be a fear on the side of potential donors, to “legitimize the government through fundraisers,” a Syrian expatriate tells Watchdogs Gazette. 

A small social media brawl, between two Syrian Instagram Pages, acted as a microcosm of the aforementioned tension. By mid-August, a Canadian-based Syrian NGO collaborated with a cultural platform to raise funds for the COVID-19 crisis. A couple of days after going public with the collaboration, another cultural platform took on Instagram stories to expose the fundraiser as untrustworthy. 

On Instagram stories which have since expired, the cultural platform pointed out all possible, and tangible, connections of both associations to the regime, and then urged its followers to not “throw your hard-earned money away to anyone when it comes to Syria.” Adding that in spite of good intentions, “every dollar you put in the wrong hands contributes to more time for the Syrian government” who, they claim, will only help the Syrians by stepping down. 

The accused cultural platform then responded, claiming the page and initiative are in no way political, rather “real, pure, and effective.” They also promised to keep the donors updated “with the progress and aid.”  

These back and forths prove that even expatriates are not rushing in with their money. There is rather an atmosphere of utmost caution, and rightfully so. Thus, the hesitation with providing aids seems to be all encompassing, both from expats and other countries. This caution, even when it’s justified and rightful, is one of Syria’s particularities which proves the country is not ready for a pandemic on any of its fronts, either in its social and political spheres. 

The anonymous medic who used their report to The Guardian as a plea, attributes the possibility of change to the hands of the powerful. They call for the WHO office in Syria to achieve transparency, for urgent measures of support towards the healthcare system by the UN and the international community, and the distribution of medical supplies by both local authorities and the UN. This plea is not done in an attempt to glorify any of the systems or associations mentioned, but coming from a place of pure necessity. “We have no choice but to appeal once again to the world’s conscience.” 

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