Doctors working in rebel-held northern Syria will no longer share the locations of medical facilities with the United Nations after doing so failed to stop them being targeted by airstrikes.
The coordinates of nine of those facilities were shared with the UN, which passed them to Russia in an effort to protect them from being bombed and encourage some form of accountability for attacks. Instead, they also came under fire.
“Most of the partners will never again share their coordinates with the UN because it is not working,” said Dr Mohamed Zahid, from Physicians Across Continents, a medical organisation working in Syria.
“Last year six hospitals were attacked, and this month another eight hospitals were attacked after their coordinates were shared with the UN. So most NGOs in Syria decided to stop this process,” he told The Independent.
The move reflects a growing desperation on the part of doctors and medical staff working inside Idlib, as they struggle to treat patients while dealing with an unprecedented level of attacks on their facilities.
The Syrian government and its Russian ally launched an offensive to recapture parts of Idlib in late April. The province is mostly controlled by the formerly al-Qaeda-linked rebel group Hayat Tahrir al-Sham, and the Syrian government frequently cites the group’s presence as a justification for military action.
But intensive bombing of densely populated areas has killed more than 270 civilians since the offensive began. More than 300,000 people have been displaced during that time, pushing the province to the brink of a major humanitarian disaster. Idlib is home to some 3 million people, more than half of whom are displaced from other parts of the country.
An open letter signed by dozens of doctors from around the world and published over the weekend said the targeting of medical facilities by the Syrian government and Russia “has forced the hospitals that remain to operate under a state of emergency, only treating the most urgent cases and unable to take in patients for routine care”.
The targeting of healthcare facilities is not new in Syria’s civil war. The US-based Physicians for Human Rights documented more than 500 attacks on more than 350 medical facilities between 2011 and 2018 – 90 per cent of which were carried out by Syrian and Russian government forces.
The scale of the violence has forced doctors to adapt and hide, or face destruction. Dr Zaher Sahloul, president of MedGlobal, recently returned from a week-long visit to Idlib, where he saw first-hand the attempts of doctors to protect themselves from attack. One hospital he visited had been bombed twice before it was moved.
“They dug it in the heart of the mountain. It’s like a cave, but inside it’s like any other hospital,” he told The Independent. “It was still bombed and went out of service.
“They are using sophisticated missiles. They are becoming very successful in getting these places out of service. It is happening every day,” he said of the Russian and Syrian government attacks.
Other organisations have taken to setting up mobile clinics, which can be moved around to avoid being targeted.
“But even the mobile clinics are at risk of being attacked,” according to Dr Zahid. “And a lot of specific and specialised services cannot be provided through a mobile clinic.
“We don’t have a Plan B. This is a sector that should only have to have a Plan A. You shouldn’t attack hospitals. They shouldn’t be part of this war.”
Doctors had hoped that sharing coordinates with the UN would lead to some form of accountability for the frequent attacks, even if they didn’t stop them. But Mohamad Katoub, of the Syrian American Medical Society, which also operates medical facilities in the province, said some now feel that it has put them in greater danger.
“Local staff feel like the deconfliction didn’t push anyone to use the information to stop attacks. On the contrary, they think that information was used to attack the hospitals,” he said.
“I don’t think our local staff will be convinced that deconfliction of their facilities will protect them, or bring accountability or condemnation of the offenders,” he added.
That perceived lack of accountability has brought criticism of the UN from various NGOs working in Idlib.
“The UN is not only expected to be a news agency, reporting which hospital was destroyed. There are all kinds of human rights organisations reporting these details. The UN is supposed to provide protection and assign responsibility,” said Dr Sahloul, whose organisation provides medical and humanitarian relief in Idlib.
“It has failed in doing so. There is no effort in the UN to form an investigation team or to assign responsibility. People are asking: what is the purpose of the UN?”
That sentiment was echoed by Raed Salah, the head of the Syria Civil Defence, or White Helmets – a US and UK-backed organisation which acts as a first response in rebel-held areas.
He told reporters in Istanbul last week that a western diplomat had confided to him that UN officials had not yet any documentation to apply for increased resources for those in Idlib.
“We’re talking about 350,000 people living among the olive trees in the open air, and the UN does not have a clear assessment,” he said. “So far the UN is not playing a good role inside Syria.”
He added, “None of the people are talking about the people dying in Syria, as if the Syrians are just numbers.”
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