“Even in a global pandemic, people are not treated equally”

Chiara moved to Syria in August, when the infection rate was already starting to rise, to train healthcare workers in the Covid-19 centres we opened in the region. In this interview, she talks about our efforts to contain the pandemic.

By Cecilia Dalla Negra, Un Ponte Per Communication General Coordinator*

Chiara is talking to us from Kobane; the connection is not as strong and stable as her smile. Chiara is a Medical Advisor from the northern Italian region of Lombardy, so she had already experienced the full force of Italy’s first wave of Covid-19 infections and learned how to handle patients.

She has been working with Un Ponte Per since May and travelled to Syria in August, when infection rates were starting to fall here but were increasing to dangerous levels in Syria. “They were hit very hard”, she tells us.

“In the first few days I visited all the UPP Covid centres in the hospitals of Derek, Tabqa and Mambij, and another which was built from scratch by converting an old un-used school” she continues.
The various wards are far apart and it took hours of travelling to visit them all.

“We needed to know what they needed most: equipment, extra staff, guidance on how to begin working. Infection rates were rising every day so there was no time to lose.”

Once the centres were set up, it was time to hire healthcare professionals: this was quite a challenge as there are not many doctors in the country, and very few in the northeast. Since specialist healthcare workers are so hard to find, “they are extremely important: We cannot risk them falling ill. Doctors cannot be replaced,” Chiara explains. “We do everything possible to protect them: But there are just not enough doctors to cover our healthcare centres”. As soon as the right people for the centres were identified, training began.

“We began with personal protective equipment, which is vital to protect the staff. Firstly we covered the basics – the correct way to put on PPE and how to remove it before leaving the ward, to minimize the risk of infection,” she explains.

“Then we looked at general prevention measures: in a Covid ward, patients and staff cannot move around like in other wards. There is a ‘clean’ zone where people get changed, and a ‘contaminated’ zone, where the patients receive their treatment. Everybody must take great care when moving between the zones. After that, we worked on actually treating the Covid patients: healthcare protocols, caring for the patient and the use of oxygen. In our centres we treat patients with moderate to serious symptoms, not the patients who require ventilation.”

Chiara had first-hand experience of working with Covid patients in Italy, which is why she is so concerned by the situation in Syria, where the healthcare system has been left in ruins by 10 years of war.

“The pandemic is global, undoubtedly. But it doesn’t affect everybody in the same way. If you fall ill in Italy or Europe, you know you will have good doctors and treatment. Falling ill here almost always means death. Even in a pandemic, people are not treated equally.”

Over here, even the basics, like getting hold of face masks, cannot be taken for granted. “There are families who just cannot afford them. There are masks for sale on the roadside for 5000 Syrian pounds, when a basic food shop would cost around 500 Syrian pounds. Do you see what I mean?” says Chiara.

“A few days ago I was in Raqqa with colleagues from the Kurdish Red Crescent. People who were on the front line during the fight to liberate the city from Daesh. They said ‘look around you, all of the houses are in ruins. Do you really think that people who lived through all this, are frightened of a virus?’ And I think they are right. People here know about risks. If you have already experienced war, devastation and displacement, maybe the risk of infection doesn’t seem so terrible. We have a different perception of life, death and the amount of suffering we can withstand. But nonetheless we must strive to ensure healthcare for all the men and women here.”

Every week, Chiara checks in with the healthcare team to discuss how their work is going. The team has become a group of close friends. Amongst them, a young anesthesiologist who loved his job so much that had been working in the Covid wards for 2 months before he mentioned that his wife was immunocompromised because of her leucemia. “He continued working despite the risks: he knew he was very good at his job and wanted to make his contribution. When he saw that his colleagues could handle the work, he took a step back.”

“That’s how it works here: there are so many people who put the needs of their community before their own”.

And it is because of this level of dedication that, despite all the challenges, there are some encouraging signs of improvement. “The mortality rate in the hospitals is now 10% which means that people have started to trust us enough to come to us before it is too late to help them. The staff are doing a really good job: none of them have been infected which is a wonderful result for us.”

Chiara must be exhausted. A few days ago when she was taking a quick break outside Tabqa hospital, “There was a very old man standing nearby. An old lady and a nurse were leaning out of a window. The lady had been very seriously ill for days and had only just managed to get out of bed. Her husband had come to see her from the window. I was so touched by their massive smiles. If you put aside the exhaustion, the worries, the frustration, that’s what is left: people’s humanity and the beauty of the small things.” Chiara is clearly moved as she relates the moment.

“When you see something like that, you think OK we are doing something worthwhile. It helps you to keep working. If we could make those people smile, we are doing our duty.”

*This article was originally published in the December 2020 issue of Un Ponte Per’s Newsletter.