Talking about Syria can trigger a range of emotions and thoughts that are all rather negative and there is usually not a happy story to tell due to the fact that the country has faced a brutal civil war for the last decade. Then why, when looking at the World Health Organization’s report of statistics for the sustainable development goals, is this story not conveyed? Several health statistics are presented and I was prepared to be able to quite easily analyze these statistics based on what I know about the civil war and corruption in Syria. This was not the case, as most of the statistics presented in this report, compared with the rest of the world, do not seem as terrible as one might expect. With 80% of people living under the poverty line, one would think Syria would face more blatant health problems (‘World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals’). For this reason, I will focus on uncovering the truth about Syrian health, including risk factors, how the poor access healthcare, and how much is spent on healthcare, and see how this relates to the data presented by the WHO.
First, what does the data that seems to not accurately explain the problems in Syria actually say? WHO classifies Syria in the Eastern Mediterranean Region, along with Iran, Iraq, Sudan, Yemen, and many other Middle Eastern countries. I will compare Syria’s data to this geographical area and the United States for reference. As of 2015, the maternal mortality rate was at 68 for every 100,000 live births in Syria (the US was at 14), the under 5 mortality rate was at 17 for every 1,000 births in 2017 (US was at 7), and the neonatal mortality rate was at 9 for every 1,000 births as of 2017 (the US was at 4). While yes, all of these mortality rates were higher in Syria than in the US, only maternal mortality was significantly higher (‘World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals’). Compared to the rest of the region, Syria is roughly average, as most of the other countries’ mortality rates are similarly as low as Syria’s, with the exception of a few countries where the rates are drastically higher (Somalia, Afghanistan, and Yemen in particular). The average life expectancy at birth in 2016 was 63.8 (59.4 for males and 68.9 for females), while the healthy years of life was at 55.8 on average. These numbers seem particularly low for the 21st century, and begin to show part of the negative health story that is expected. In 2017, nearly two million people required help to fight neglected tropical diseases (‘World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals’). To further the story, the amount spent on health in Syria must also be understood. The current health expenditure as a percent of the GDP was around 4% between 2000 and 2012, and then dropped to 0% the year after the civil war began (‘Health Expenditure Profile Syria’, 2016). I think that for most of the expenditure data, there has not been much if anything to collect due to the war. After seeing the data, I am still not convinced that the true health story of Syria has been produced by the WHO.
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The World Health Organization released a report this year outlining the ways that they help support health in Syria, and this helps put some context to the aforementioned mortality data. The first thing this report says is that “Dangerously low vaccination rates in some areas, combined with a breakdown of water and sanitation systems and pockets of malnutrition, are making disease outbreaks in Syria more frequent and deadly” (WHO, 2019). This is likely in coordination with the NTDs that affect roughly two million people, which vaccinations would help prevent or cure. They also provide medical and health supplies (1,900 tons in 2018), and transportation to medical centers for those living in remote and rural areas. This is often a barrier for the rural poor to receiving healthcare is the lack of infrastructure and accessibility. According to this report, half of the health centers in Syria were not operational, and WHO is helping to reopen hospitals and clinics to provide more people with access to the care they need. One final goal of the World Health Organization is to provide mental healthcare to those needing it (WHO, 2019). Mental health is something that is often looked over and forgotten about all over the world it seems like, and the problems do not stop in Syria. The cost of the civil war takes a mental toll on people's lives. It is often easy to overlook mental health because when looking at someplace like Syria, diseases and other physical ailments are much more noticeable. This report gives a much better picture for the health situation in Syria insofar that the WHO is at least trying to improve the situation, and the data shows that there is at least some positive effect to their contributions.
Lastly, I would like to touch on those who provide healthcare in Syria to explain the ways in which those in poverty might lose access or further their distance from reliable healthcare. First, going back to some of the WHO’s data, they list the number of medical professionals per 10,000 people. Using this criterion, there are 12.2 medical doctors, 14.6 nurses or midwives, 6.8 dentists, and 10.1 pharmacists. The number of dentists and pharmacists are fairly decent, if not above average, while the number of medical doctors and nurses is quite low (‘World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals’). One report from the Syrian American Medical Society (SAMS) might explain this. Their report cites that the WHO found that, “70% of total worldwide attacks on healthcare facilities, ambulances, services and personnel have occurred within Syria” (Rae, 2018). It is further explained that healthcare centers are purposefully attacked in Syria, but the reason is not explained. In fact, the same health centers are attacked multiple times. This leads me to believe that these are acts of terror and are meant to hold people in poverty down, showing just how corrupt the country really is. Other harsh statistics are given in this report, including the fact that between 2011 and 2017 (the first six years of the civil war), nearly 500 attacks on medical centers took place and over 800 medical providers were killed. Over 100 more were killed in the early months of 2018 alone. With this, 38% of medical workers in Syria are not officially trained (Rae, 2018). Due to the danger surrounding hospitals and other medical centers, people avoid going unless they are on the verge of death, because they believe they are more likely to die or be injured by going to receive treatment than from the ailments for which they need to be treated. This report helps explain that the health problems in Syria might not be what one would think. The problem might lie more with the fact that healthcare is being targeted and destroyed in the civil war, rather than there not being enough money or a good enough economy to take care of the people.
Overall, I was surprised with these findings about health in Syria. The story to be told here is that the war and corruption in Syria have led to some negative effects in the health sector, but as of recently, the data seems to show that things are improving, or are at least better than what the public might believe. I expected the data from the WHO reports to show much worse numbers than they did. I also did not expect purposeful attacks on healthcare centers to be such a large part of the problem. If work continues to go into helping the poor in Syria, I think that they can start to reunite as a country and build themselves up once again.
References
- Health Expenditure Profile Syria (2016). Retrieved from: http://apps.who.int/nha/database/Country_Profile/Index/en
- Rae, Madison (19 October 2018). Impacts of Attacks on Healthcare in Syria. Retrieved from: https://www.sams-usa.net/2018/10/19/the-impacts-of-attacks-on-healthcare-in-syria/
- World Health Organization (2019). 8 Ways WHO Supports Health in Syria. Retrieved from: https://www.who.int/news-room/feature-stories/detail/how-does-who-work-amidst-conflict
- World Health Statistics 2019: Monitoring Health for the SDGs, Sustainable Development Goals. Geneva: World Health Organization. (2019). Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/324835/9789241565707-eng.pdf?ua=1
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