BEIRUT: In a basement room at the American University of Beirut, some 50 doctors watch headcam footage of Dr. David Nott stitching together the abdomen of a man injured in fighting using a new technique he had perfected during the siege of Aleppo. Nott, a multispecialty surgeon based in London, aimed to share some of the knowledge gained during his 25 years working in conflicts to doctors from Lebanon and around the region. As well as imparting practical skills, he told The Daily Star of his concerns over the scale of the damage to the Syrian healthcare system, and the ripple effect that will likely have on Lebanon.
“The Syrian conflict is the world’s greatest humanitarian crisis ever,” Nott said between lectures for the three-day Hostile Environment Surgical Training course, taking place this week in collaboration with AUB’s Global Health Institute.
“It’s had a knock-on effect on so many countries around the world. The health care system is completely decimated: there are no doctors there anymore.”
Nott said that while the Syrian regime still has a number of surgeons, it has little by way of elective or tertiary care, with reduced access to, for example, treatment for cancer, heart disease or diabetes. The situation on the rebel side is even worse, where the health system is “totally and utterly, 100 percent destroyed.”
A recent report by Physicians for Human Rights said that 847 medical personnel were killed between March 2011 and the end of December 2017, while as early as December 2013 the Syrian Integrated Needs Assessment – a multisectorial humanitarian needs assessment – reported that 80,000 doctors had fled the country.
Many of the most vulnerable users of Lebanon’s health care are refugees. But the country’s politicians continue to call for Syrian refugees to return to their homeland, with caretaker Foreign Minister Gebran Bassil criticizing the “international community’s continued dependence on the policy of integration of displaced people into their host communities, rather than [facilitating] their return home,” during the international conference on Syria in Brussels in April.
Nott urged caution. He said that there would continue to be people living in refugee camps “for at least a decade” who would need to use the health services of host countries.
Even for those that return home, he noted, the health care system has been so badly damaged that many would continue to return to Lebanon to for their medical needs.
A spokesperson for INARA, an NGO funding treatment of Syrian minors in the country, said it was “likely that Lebanon will continue to be a center for the types of treatment that we provide to the refugee children that we work with.”
“It’s not just the acute problems, it’s chronic disease, vascular, cardiological, amputations and prosthetics,” Nott said. “It’s all those things that take a huge amount of health care and they’re not going to be provided in Syria for another 10 years, I would think.”