NFI distributions and water provision in various camps of Northwest Syria. © MSF



outpatient consultations


routine vaccinations


births assisted, including 3,670 Cesarean sections

In Syria, civilian areas and infrastructure, including medical facilities, came under direct fire again in 2019. Thousands of people were killed or wounded, and many more driven from their homes.

MSF teams negotiated access where possible, following independent evaluations of medical needs. Where direct presence was impossible, we donated medicines, medical equipment and relief items; remotely trained medical staff; and offered technical medical advice and financial assistance to facilities’ running costs.

In April, hundreds of thousands were displaced after the offensive launched by Syrian government forces and allies, notably Russia, in Idlib, the last opposition stronghold. Schools, hospitals, markets and camps for displaced people were also hit and damaged. Some MSF-supported hospitals had to reduce or suspend services, for fear of being hit.

We supported healthcare in hospitals and clinics in Idlib and Aleppo governorates. We also continued partnerships with three reference hospitals.

In Atmeh, we ran a specialized burns unit, offering surgery, skin grafts, dressings, physiotherapy and psychological support. An average of 150 procedures were performed a month in 2019, with severe or complex cases referred to Turkey by ambulance.

In January, we launched an emergency response in Al-Hol camp in Hassakeh governorate. The camp swelled after 60,000 people arrived. Ninety-four per cent of people living there are women and children. In a highly politicized and militarized setting, we provided relief items and emergency care at the reception, then opened a comprehensive healthcare facility and an inpatient nutrition centre.

The situation changed significantly in northeast Syria in October, when U.S. led coalition forces suddenly relocated further east. The Turkish military, alongside allied Syrian armed opposition groups, launched operation ‘Peace Spring’, aimed at clearing the Kurdish People’s Protection Units from the Turkish border. As a result, we had to suspend some projects and temporarily evacuate international staff to Iraq and relocate some locally hired teams.

Comprehensive activities, including treatment for over 280 patients for the blood disease thalassemia, were suspended in Tal Abyad hospital after Turkish-backed groups took control of the area. Our hospital program closed towards the end of 2019, as we were unable to negotiate resumption of activities with new authorities.

In Raqqa city, we continued to run a healthcare centre offering emergency care, outpatient consultations, mental health support and vaccinations. At Raqqa National Hospital, MSF completed a large facility rehabilitation, then set up and supported emergency, inpatient and post-operative care, general and orthopedic surgery and radiology, as well as the blood bank and laboratory.

We maintained support for the maternity hospital in Kobanê/Ain Al Arab, in Aleppo governorate, with provision of medical supplies and financial support to health workers. We supported routine vaccination programs in 12 locations.

Following the temporary evacuation of our international colleagues, we were forced to suspend our activities in Tel Kocher in Hassakeh governorate, where we ran a general healthcare centre. We gradually resumed some medical activities.

In Tel Kocher, we provided hygiene kits and blankets to victims of floods and donated 1,000 blankets and a triage tent to Hassakeh National Hospital during a mass casualty response.