Al Hol. “The crisis will be over when everybody can go home”

Summer is over in the Al Hol camp on the Syrian-Iraqi border in north east Syria, which shelters more than 90,000 people fleeing war. The soaring temperatures and scorching heat have passed, and with them the inevitable spread of disease and epidemics.

What has not passed is the urgent need to ensure access to healthcare and assistance for the people fleeing war or whatever is left of the last Daesh strongholds.

We have been working here with the Kurdish Red Crescent for many months, and in that time we have seen the arrival of thousands of people fleeing the fighting in Baghouz.

We have seen the camp expand and an increase in medical emergencies, child deaths and treatable disease. We have also seen the dedication of non-governmental organisations, our men and women health workers going from tent to tent to talk to all the camp inhabitants about their needs, and trying to find ways to help them.

“The crisis is certainly not over. It will be over when everybody can go back to their homes”, says Luca Magno, part of our Syria Team who has followed every phase of our work in the camp over recent months.

“Providing humanitarian assistance is our duty but it is a short-term solution: we must make efforts to pave the way for a dignified return for all those who were forced to flee. We have coped with the crisis but now we have to focus on the future”, he explains.

The crisis peaked in the spring, with the unexpected arrival of 64,000 people, including 60,000 women and children, which aggravated conditions in the camp. There was not adequate sanitation, and medicine and medical and psychological support services were not available.

“The two clinics we had set up in the camp were overcrowded, epidemics were rife, children were dying of dehydration and malnutrition. Thanks to the many donations we received, we worked with the Kurdish Red Crescent to contain the crisis”, says Luca. One of our first initiatives was the establishment of two “Ors corners” (for the distribution of oral rehydration mineral salts).

“Thanks to the work of many organisations, 3 camp hospitals were set up, which reduced the pressure on local over-stretched hospitals. We introduced the ‘Operational Desk’ system: a ‘triage’ office which became the first point of contact for people in need of urgent medical advice or a check-up. A basic radio system was set up to coordinate transport of patients by ambulance to the nearest healthcare facility, which helped cut waiting times”, explains Luca.

 Thanks to this system, we organised medical  assistance for 2,200 people in July and August, redirecting more than 100 patients to hospitals outside Al Hol.

“WHO organised obligatory vaccination campaigns in the camp to prevent further epidemics amongst the children,” he adds. “One of the biggest challenges we faced and still face is malnutrition: in February and March, 300 children died, it was vital to take action. We are working on campaigns to encourage mothers to breastfeed their babies, to reduce the use of powdered milk which is far less healthy and very hard to find in times of war. But it is a delicate situation: by the time women get to Al Hol, they have already been through great trauma so there are many cases of depression and post-traumatic stress disorder”, he explains.

Which is another reason the Community Health Workers play such an important role. These are normal women, who before the war were employed in other sectors, but who chose to start working to help their communities.

We trained them, in collaboration with the Kurdish Red Crescent, and now they can provide basic medical advice to people in need. “They have been working very hard for months, going from tent to tent. They know the women living in Al Hol, and do their best to help them and understand their needs. Now we are organising more advanced training courses, so these Community Health Workers can offer psychosocial support too”, Luca says.

But our main focus is ensuring the respect of human rights.

We are building Info Points, where people can get information about their rights. “We tell them how the camp works, how they can register to return home to Iraq or Syria. We tell them about the available healthcare services, because access to healthcare is one of their rights, even if they don’t know. This is also a way to mitigate the ever-present tension in the camp”.

We plan to keep working in Al Hol: “We managed to cope with the humanitarian crisis at its height. There were not enough tents, toilets, medicine, everything. Gradually the situation improved. Now we have to tackle child malnutrition, human rights and the prevention of gender-based violence. We will keep strengthening our ambulance system, improve the clinics we opened, set up training courses for our health workers and strive to improve our services every day”, Luca states.

“And we will keep pushing for a dignified return home for all the men and women in the camp. When that happens, we can consider the Al Hol crisis over”.

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L’intervento nel campo di Al Hol è implementato nell’ambito del progetto “Fourniture de soins de santé primaires et de services d’urgence aux réfugiés iraquiens et aux personnes déplacées à l’intérieur du camp d’Al Hol (2019-009)”.