• 81% of surveyed health workers said they had a coworker or patient who had been injured or killed due to an attack 
  • 77% had witnessed an average of four attacks on health care - some had witnessed as many as 20 over the course of the war
  • 68% were inside a health facility when it was attacked
  • 59% of civilians surveyed had been directly impacted by an attack on a health facility during the course of the conflict 
  • 49% fear accessing healthcare as a result of attacks
  • 8 in 10 indicate having fled home at least 6 times during the conflict - some as many as 25 times

As the world marks 10 years of conflict in Syria, a new report from the International Rescue Committee (IRC) and six Syrian partner organisations* reveals the widespread and devastating impact that a decade of systematic attacks on health facilities has had on Syrian civilians. 

“A Decade of Destruction: Attacks on Healthcare in Syria” highlights with chilling detail how this 10-year war strategy has turned hospitals into no-go zones where Syrian civilians now fear for their lives. It urges the EU and broader international community to use the upcoming Brussels V Conference as a watershed moment to set a new course of action on the crisis in Syria that puts humanitarian considerations and civilian protection firmly front and centre.

“I had a friend who wanted to go to the hospital for treatment, and took her children with her, and then the hospital was bombed and my friend was killed, along with one of her children. She was pregnant. It also led to the complete destruction of the neonatal intensive care unit. The incubators were destroyed, even the children inside the incubators.” – Muna**, Psychosocial Support Worker

Almost 60% of the 237 people surveyed by the IRC and its partner organisations had been directly impacted by an attack on healthcare over the past 10 years. Additionally: 

“My house was bombed while I was pregnant. I suffered from severe bleeding and lost my first child. I was unable to go to the clinic because I was afraid of the bombing.” – Layla** from Atareb, Aleppo.

Surveys conducted with health care workers also illustrate the extreme risks taken to maintain the provision of life saving care, with 68% having been inside a health facility when it was attacked and 81% saying that a coworker or patient was injured or killed as a result of an attack.

“I was in the operating room during one of these attacks. A bomb hit the ground a few metres from the building. All the staff, including the people who were with me in the operating room, ran for safety, but I stayed because I was operating on a patient. So I completed this surgery under very high pressure. I was scared, but I couldn’t leave my patient.” – Dr Yamen** 

 This deliberate targeting of healthcare has left many health workers fearing for their lives and the lives of their families. An estimated 70% of the workforce has left the country, leaving just one Syrian doctor for every 10,000 civilians. On top of this, more than one in six health workers report working at least 80 hours a week to try and make up this shortfall. 

Despite health facilities and health workers being protected under international humanitarian law, Physicians for Human Rights have documented 595 attacks on healthcare in Syria since 2011, and the IRC has documented at least 24 attacks on its programming in northwest Syria in just the past 2 years alone. As a result, more than half of Syria’s hospitals are not fully functioning and these attacks have left the country woefully unprepared to support the 12 million Syrians now in need of health assistance - let alone to deal with the effects of a pandemic that has crippled even the world’s strongest health systems. 

Reductions in cross-border humanitarian access - resulting from the failure of the UN Security Council to renew the only humanitarian resolution passed during the 10 years of the Syrian conflict - have further hampered the response, leaving health workers also facing the desperate challenge of operating with reduced supplies and equipment. 

Imogen Sudbery, the IRC’s Director of Policy and Advocacy, Europe, said:

“The European Union must throw its full weight behind ending the decade-long nightmare endured by the people of Syria. It’s time to lead by example, and set the international community on a fresh course that puts humanitarian considerations and civilian protection front and centre.

The upcoming fifth Brussels Conference is a watershed moment. It’s a chance for the EU to press international donors to fill the funding gap for 2020 while making new pledges for 2021-22 and beyond. Specifically, they must commit to providing funding to rebuild, restore and strengthen the dozens of health facilities in Syria that have been ravaged by 10 years of war. 

This report - and the testimonies of the courageous, determined healthcare professionals featured within it - should serve as a wake up call to the EU and its member states. They must show the same resolve to finally end the crisis in Syria by providing generous funding, sending an unequivocal message that life-saving aid must be able to enter and reach every corner of the country, and pushing to hold perpetrators to account for these horrifying attacks on civilians that are in clear breach of international humanitarian law."

David Miliband, President and CEO of the IRC, said:

“As we mark 10 years of conflict, Syria has become the poster child for the ‘Age of Impunity’, where the rules of war are ignored, and attacks on healthcare in violation of international law continue without consequence. COVID cases climbed to an alarming 41,406 across Syria in January this year – a more than five-fold increase in the last three months alone - and attacks on healthcare have severely compromised the ability of the healthcare system to respond to the pandemic. Despite growing evidence and international recognition of the widespread - and sometimes deliberate - nature of these attacks, action by the international community to hold those responsible to account has been absent.

“The international community has a choice. It can drive collective efforts to ensure Syrians have continued access to the aid they require by reauthorizing UN cross border aid into Syria, and it can establish meaningful steps to hold those responsible for attacks on health care to account. Or it can stand by and watch as the Syria playbook becomes the blueprint for future wars in which the lawlessness and brutality of the last decade becomes the norm, and no longer the exception.”


*Syrian partner organizations: Independent Doctors Association (IDA), the Syrian American Medical Society (SAMS), the Syrian Expatriates Medical Association (SEMA), Sustainable International Medical Relief Organization (SIMRO), Syria Relief and Development (SRD) and the Union of Medical Care and Relief Organization (UOSSM) 

**indicates that we changed the person’s name to protect their identity