WHO Warns of Pandemic’s ‘Catastrophic Impact’ on Syria

The World Health Organization (WHO) warned the U.N. Security Council this week that the coronavirus pandemic could have a “catastrophic impact” on Syria, citing shortages of medicines and supplies for up to 2.1 million people in the northeastern part of the country.

But the U.N. health agency apparently backed down from an appeal to the 15-nation council to reopen the critical crossing point along the Syria-Iraq border at Yaroubia in order to help stem the spread of the virus. The WHO appeal was included in a draft paper that WHO officials prepared for the Security Council’s Wednesday debate on Syria. At Russia’s insistence, it was scrubbed from the final paper—titled “Criticality of All-Modalities Response to COVID-19 Response in Northeast Syria”—that was presented to the council. Foreign Policy is posting the original draft as its Document of the Week.

The U.N. Security Council established four border crossing points, including Yaroubia, in July 2014 to facilitate the delivery of humanitarian assistance to millions of needy civilians living in opposition-controlled territory. The Syrian government has sharply criticized the so-called cross-border arrangement, saying it violates national sovereignty. But the council approved the arrangement on the grounds that the Syrian government, which had sought to starve hundreds of thousands of civilians in rebel-controlled cities and towns, was unwilling, or in some cases unable, to provide vital supplies to civilians in enemy territory.

Syria’s powerful ally Russia has argued Syrian President Bashar al-Assad’s case before the council, insisting that Damascus could be counted on to deliver any needed assistance to Syrian communities across enemy lines. On Jan. 10, Russia, which threatened to block the entire cross-border aid arrangement, forced the council to shutter Yaroubia and a second crossing point on the Jordanian border. It agreed to allow two remaining crossing points along the Turkish border to remain open.

The closure of Yaroubia—which was primarily used to deliver medical supplies—has rendered the medical supply chain “less effective and reliable,” according to the paper.

The Syrian government, meanwhile, has not been able to meet the medical needs of northeastern Syria since Yaroubia was shuttered. Over the past three months, only 31 percent of clinics and hospitals run by relief groups have received medical supplies from Damascus, including hospitals in Tabqa, Raqqa, and Hasakah, as well as camps for displaced Syrians. “UN partners do not believe that cross-line support [from Damascus] can be adequately expanded into all areas of need in the short- to medium-term,” according to the draft.

“Up to 2.1 million people in Northeast Syria (NES) rely significantly on cross-border support from northern Iraq for their medical services and supplies,” the draft paper noted.

“Re-establishing a reliable cross-border operation … is the most feasible means of ensuring a regular supply chain into areas of NES that cannot be reached from Damascus or through cross-line activities,” according to the draft. “United Nations partners therefore propose the re-opening of Yaroubia crossing as a matter of urgency. This would have significant impact on the COVID-19 response in NES.”

That recommendation was stripped from the final paper presented to the council. Instead, the final version noted that “UN and NGO partners agree that the cross-line option alone cannot be adequately expanded to meet the needs in NES and will not be sufficient to support an effective response to COVID-19. … New options are needed to fill the significant gaps and to continue the humanitarian assistance previously delivered through Yaroubia, through more cross-border and cross-line access.” Reuters previously reported on the revision.

The diplomatic standoff over humanitarian aid comes at a time when Syria has registered its first 43 cases of COVID-19, the disease caused by the new coronavirus. Three Syrians have died of the disease, but public health experts believe the low count is largely the result of scant testing.

The draft paper cited a single case in northeastern Syria, a 53-year-old man with no travel history and no known contact with an infected person. A close relative is hospitalized in Qamishli with symptoms consistent with the disease, providing a clear indication that the virus is spreading through community transmission.

“Recent explosive disease outbreaks in several countries with sophisticated health systems demonstrate the devastating effect that the COVID-19 pandemic can have on public health,” the draft paper noted. “In Syria—where the health system has been severely weakened by years of conflict—the impact could be truly catastrophic.”

Northeastern Syria has endured some of the worst violence during the country’s more than nine years of conflict, leaving its health system with severe shortages of hospital beds, health care workers, testing kits, and protective gear like masks and gowns. The hardships have been exacerbated by Syrian and Russian bombing campaigns that have reportedly targeted medical facilities. None of the districts in northeastern Syria meet the minimum standard of 18 hospital beds per 10,000 people. International relief agencies currently operate 58 primary health centers, 37 mobile clinics, and 13 hospitals in northeastern Syria and rely primarily on supplies delivered across land borders into Syria. Those supplies have been impeded since the closure of Yaroubia.

Kelly Craft, the U.S. ambassador to the United Nations, told the Security Council on Wednesday that the closure of the Yaroubia crossing point undercut the capacity of U.N. relief agencies and private charities “to serve those in dire need. It also set the stage for a disastrous COVID-19 outbreak that will ravage Syria—if we don’t immediately facilitate the delivery of additional aid.”

Russia fired back, accusing the United States of hampering the Syrian government’s ability to respond to the virus with the imposition of sanctions, and urged the U.N. and governments to step up cooperation with Syria to battle it. “The government of Syria is doing its utmost to fight the spread of COVID-19 despite cruel unilateral sanctions,” Russia’s U.N. ambassador, Vassily Nebenzia, told the council. “We strongly urge our colleagues not to waste their time on looking for a way to advocate, explicitly or implicitly, for getting Yaroubia back and saying that this be the ‘only solution.’”

“Don’t lose time, but rather focus on engaging humanitarian agencies in a constructive dialogue with Syrian authorities,” he added. “You don’t have to knock on the door. The door is open.”