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Hind Al Soulia - Riyadh - Monday was a day like any other in Damascus.
Shops were opened, the streets fully crowded with people, public transportation working and military checkpoints blocking roads everywhere. When asked if they should stay at home because of the coronavirus epidemic that has reached Syria, Jumana, a 38-year-old mother of three, waiting in the line with dozens of people in front of a bakery answered: “People lost everything and faced death for the last nine years, should we be scared of a virus?”
A massive lockdown appears difficult to set up in Syria after years of war. “We don't have any infrastructure, people queue to buy food and gas, and there is more medicine on the black market than at a pharmacy,” she said.
After weeks of denial, Syria has confirmed its first case of Covid-19: a young 20-year-old woman who had traveled to a foreign country, Health Minister Nizar Yazigi told the official Sana state news agency on Sunday. The health minister says cases have since risen to five.
The Damascus regime had previously claimed that Syria was spared by the virus, despite numerous warnings and the obvious risks of a rapid spread. But the figures are likely much higher, according to the account of at least one doctor in regime-held territory.
Dr Haya, a doctor at a Damascus hospital whose name has been changed, one of 22 hospitals working in the capital city, confirmed she had to deal with many more cases.
“Many people had Covid-19 disease symptoms. The hospitals are only able to deliver basic treatments, so I asked them to stay at home. We don't have medicines available, the only ones on the market come from Iran or India” the doctor says with a worried voice.
“We don't have a place for quarantined people, the government just started to build two dedicated buildings in Damascus. Many people die, most of them are registered as victims of pneumonias. In my hospital alone, we had around 50 deaths,” she says.
After nine years of war, half a million deaths and seven million internally displaced people, the population of Syria is particularly exposed. In the vicinity of Idlib, Syria’s last opposition stronghold, 900,000 inhabitants survive in very precarious conditions.
No border crossing remains open with Turkey. In the Syrian regime areas, the situation is not any better. Idlib and its countryside are completely isolated. But after a ceasefire was declared by Russia and Turkey last month, calm reigns and bombings from all sides stopped.
Streets are crowded, markets are full and living. “I want to breathe.” says Mahmoud Taha, 40, who lives in Idlib city with his family. “Life here is back to normal, unlike the whole world. We cannot be confined in our houses right after the bombing has stopped”.
On Sunday, the Health Directorate and a few aid organisations started to prepare for an increase of Covid-19 cases. A campaign of public awareness and sterilisation was launched in schools, universities and mosques. Plastic tents were set up for 200 quarantined people beside the hospitals in Idlib.
Some mosques even called people to pray at home to avoid gatherings. But extremist group and former Al Qaeda affiliate Hayat Tahrir Al Sham, which is dominant in Idlib, stopped it from working and arrested the Imam, according to witnesses.
According to Mustafa Al-Eid, assistant director of Health for the rebel administration in the Idlib region, a lack of equipment has made it increasingly difficult to administer tests to detect the virus.
Out of 18 hospitals working in the region, there is only one epidemiological device and it doesn't work at the moment, he says.
“Hundreds of civilians come with coronavirus symptoms, but we don't know whether they are negative or positive. We advise patients to go home and quarantine themselves, we don’t even have oxygen,” Dr Ahmed, 49, who works in one hospitals in Idlib city, says. A lab in Idlib started to perform tests on blood samples on wednesday.
The fight against the global pandemic requires flawless organisation, good information and the population's adherence to the instructions of the health authorities.
So many conditions to fight the coronavirus are impossible to meet in Syria. Half a dozen political authorities share control of the territory, each applying its own rules and setting its own health standards. They are the regime in Damascus and in the areas it has reconquered, the rebels and extremist groups in the Idlib region, the Syrian Democratic Forces in the north-east, Turkey and its auxiliaries in the north-west, the Iranian Shiite militias, Russia, the Lebanese Hezbollah militia and the remainder of the forces of the international coalition against ISIS.
Borders with Turkey or Iraq are closed but Damascus keeps its border with Lebanon open and flights continue to connect Damascus, Aleppo and Qamishli to foreign destinations.
Flights have been maintained with the holy Iranian city of Qom, the epicentre of the epidemic in Iran. The country is very badly affected with at least 1,700 deaths, but remains a strategic ally of the Damascus regime. Shiite pilgrims or Iranian militiamen who fight alongside loyalist forces may have brought the virus into Syria several weeks ago.
In the regions occupied by Turkey and its Syrian militias, Ankara has applied the same standards that it does on its own territory since March 20. People over the age of 65 have to stay at home. Information brochures on the coronavirus in Arabic have been distributed to 500,000 Syrian households. After days of hesitation, Turkey has closed its borders, deserted public places, and suspended collective prayers.
In the areas controlled by Kurdish forces and their allies, in northeastern Syria, a curfew was declared on Sunday.
Travel is no longer allowed between the different cities and non-essential shops, cafes, restaurants, were ordered to close on Monday.
Schools and public places had already been closed and all gatherings had been banned for several days.
“The virus is probably spreading very quickly throughout the area,” says a doctor from the town of Qamishli, shared between the Kurds and the loyalist forces.
There are two cases at the city hospital run by the Assad regime. But there are no means to test the population at large. Even less to treat the weakest patients. The Shebha hospital run by the Kurdish Red Crescent for the 200,000 displaced by the 2019 Turkish invasion of the Afrin region, has only three respirators.
The Hassakeh hospital has about 150 respirators and will be the main place of confinement for patients in case of a sudden influx.
It's likely a matter of days before that influx arrives, says the doctor, asking the World Health Organisation to act quickly to prevent yet another disaster in Syria.
Updated: March 26, 2020 10:05 PM
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