A new ambulance system in Syria: hope runs to the sound of sirens

If there is one sector more affected than others by the decade-long Syrian conflict, it is undoubtedly the healthcare sector. A new ambulance system acts as a bridge between the few healthcare facilities in the north of the country, giving some hope to a population tormented by an endless war and now dealing with the aftermath of the earthquake.

Shortages of medicines and medical personnel, high prices for private healthcare services, and the closure of many healthcare centers (often caused by the destruction of infrastructure) are the sad norm in Syria. The war, among other things, has severely attacked the ability of families to spend their money on health: paid healthcare facilities are now out of reach for almost the entire population. For these reasons, since 2015, our commitment in northeastern Syria has focused on the rehabilitation and strengthening of public healthcare facilities to ensure free and equal access to healthcare services for everyone. The right to health is a fundamental means for people to pursue their self-determination.

Thanks to joint work with our local partner “Kurdish Red Crescent (KRC)” we have set up a new ambulance management and coordination system, with a central office and three operational centers located in the main urban areas, that can not only reach people in the northeast of the country but also go as far as Raqqa and Aleppo. The network created with the support of the European Civil Protection and Humanitarian Aid Operations (ECHO) and the LEARN Consortium connects healthcare facilities in the Qamishlo, Hassakeh, and Malikiyyeh areas with those further west (Raqqa and Manbij). The connection of the various healthcare centers allows for a coordinated response to emergencies throughout much of the north of the country. This ensures better and equal access to the right to healthcare for all people in the area.

Through a dedicated telephone line used by healthcare facilities, the ambulance coordination center has centralized the system of patient transfers to specialized healthcare facilities or to areas where necessary services are available. This service allows transfers to be made more quickly and efficiently, trying to avoid wasting time, an essential factor in saving human lives. The ambulances serve the entire area of the north of the country and are not dedicated to a specific healthcare facility, ensuring a flexible and timely response to emergency transfers. The coordination centers and ambulances operate 24 hours a day, 7 days a week. The system manages over 50 ambulances, located in various operational centers.

“Our work involves transferring patients between all the cities in northern Syria, even between hospitals in the same city, depending on the needs,” says Omar Salem, KRC ambulance center coordinator. “When we receive an emergency call, an ambulance with a medical team is sent immediately to assess the patient’s condition and choose the appropriate hospital destination,” he adds. After this step, coordination is made with the hospital that will receive the patient. All ambulances are monitored 24 hours a day by the coordination center, until the vehicle reaches the specified destination. The vehicles have been equipped with all necessary devices, such as defibrillators, nebulizers, oxygen cylinders, and medicines. Thanks to this service, an average of 1,350 seriously ill patients are transferred every month to the most appropriate healthcare facilities. Needs are many, and suitable facilities are often hundreds of kilometers away. Indeed, “Many people need surgical interventions that are not available in their city and must travel to other areas, but cannot afford to rent an ambulance or organize their own transfer because it would be very dangerous for their health,” Salem continues. In the past, people were forced to take out loans to rent an ambulance or ended up using a normal car, without the necessary equipment. Most of the time they gave up because the expenses became unsustainable. With the creation of this coordination system, we are instead able to safely transport patients by ambulance, with a medical team on board and in coordination with all hospitals in the area. Even during the emergency following the earthquake, this service proved to be essential for responding to the affected population in the west of the country. The service is completely free for the population. Even Mohamed Salah, a paramedic at the ambulance center, tells how the new ambulances are making a difference: “Today people in need of emergency care know that they can be transferred free of charge to any health facility in northern Syria, they no longer have to think about expenses or use normal cars with all the risks that come with it.” Of course, the situation remains complicated, in fact, “often hospitals do not have all the necessary equipment, especially for kidney, liver and oncological diseases,” he adds. Many people are forced to go to Damascus to obtain doses of anti-tumor drugs, which is why “it would be important to make these drugs available also in the Northeast regions of Syria where we operate” – concludes Salah. The work is hard, especially when going to remote areas and in addition to paying attention to everything related to the patient’s health, it happens to face risks related to safety and road conditions. The ambulance driver Ibrahim Mohammed tells about it – “We are happy when we manage to save a person thanks to timely intervention. During one of my rides, the ambulance broke down. So I contacted the main operational group, and another ambulance was sent from the nearest center to complete the journey. In the end, the patient arrived in time and we saved his life.”

Rebuilding hospitals, maternity wards, clinics. Purchasing ambulances and training doctors, paramedics, nurses, and midwives. Supporting networks of associations that organize campaigns for social cohesion and municipalities that put into practice the experiment of democratic confederalism, an example of coexistence and female participation for the entire region. Encouraging exchanges and support, because only from below will solutions to conflicts be found. It is possible to build bridges with Syria every day. We are trying to.