• 81% of surveyed health workers said they had a coworker or patient who had been injured or killed due to an attack 

  • 77% had witnessed an average of four attacks on health care - some had witnessed as many as 20 over the course of the war

  • 68% were inside a health facility when it was attacked

  • 59% of civilians surveyed had been directly impacted by an attack on a health facility during the course of the conflict 

  • 49% fear accessing health care as a result of attacks

  • 8 in 10 indicate having fled home at least 6 times during the conflict - some as many as 25 times

As the world marks 10 years of conflict in Syria, a new report from the International Rescue Committee (IRC) and its Syrian partner organizations Independent Doctors Association (IDA), the Syrian American Medical Society (SAMS), the Syrian Expatriates Medical Association (SEMA), Sustainable International Medical Relief Organization (SIMRO), Syria Relief and Development (SRD) and the Union of Medical Care and Relief Organization (UOSSM) reveals the widespread and devastating impact that a decade of systematic attacks on health facilities has had on Syrian civilians, and the crippling effect the decimation of the country’s health care system has had on its ability to respond to the COVID-19 pandemic.

A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives. 

“I had a friend who wanted to go to the hospital for treatment, and took her children with her, and then the hospital was bombed and my friend was killed, along with one of her children. She was pregnant. It also led to the complete destruction of the neonatal intensive care unit. The incubators were destroyed, even the children inside the incubators.” - Muna*, Psychosocial Support Worker

Almost 60% of the 237 people surveyed by the IRC and its partner organisations had been directly impacted by an attack on health care over the past 10 years. Additionally: 

“My house was bombed while I was pregnant. I suffered from severe bleeding and lost my first child. I was unable to go to the clinic because I was afraid of the bombing.” – Layla* from Atareb, Aleppo.

Surveys conducted with health care workers also illustrate the extreme risks taken to maintain the provision of life saving care, with 68% having been inside a health facility when it was attacked and 81% saying that a coworker or patient was injured or killed as a result of an attack.

“I was in the operating room during one of these attacks. A bomb hit the ground a few metres from the building. All the staff, including the people who were with me in the operating room, ran for safety, but I stayed because I was operating on a patient. So I completed this surgery under very high pressure. I was scared, but I couldn’t leave my patient.” – Dr Yamen

This deliberate targeting of health care has left many health workers fearing for their lives and the lives of their families. An estimated 70% of the workforce has left the country, leaving just one Syrian doctor for every 10,000 civilians. On top of this, more than one in six health workers report working at least 80 hours a week to try and make up this shortfall. 

The data also demonstrates the sheer scale of psychological suffering inflicted on health care workers and civilians by the regular attacks. 67% of the 237 people surveyed report that their wellbeing had been negatively impacted, while among the 74 health workers surveyed, this figure was 74%. 

Despite health facilities and health workers being protected under international humanitarian law, Physicians for Human Rights have documented 595 attacks on health care in Syria since 2011, and the IRC has documented at least 24 attacks on its programming in northwest Syria in just the past 2 years alone. As a result, more than half of Syria’s hospitals are not fully functioning and these attacks have left the country woefully unprepared to support the 12 million Syrians now in need of health assistance - let alone to deal with the effects of a pandemic that has crippled even the world’s strongest health systems. 

Reductions in cross-border humanitarian access - resulting from the failure of the UN Security Council to renew the only humanitarian resolution passed during the 10 years of the Syrian conflict - have further hampered the response, leaving health workers also facing the desperate challenge of operating with reduced supplies and equipment. 

David Miliband, President and CEO of the IRC, said:

“As we mark 10 years of conflict, Syria has become the poster child for the ‘Age of Impunity’, where the rules of war are ignored, and attacks on health care in violation of international law continue without consequence. COVID cases climbed to an alarming 41,406 across Syria in January this year – a more than five-fold increase in the last three months alone - and attacks on health care have severely compromised the ability of the health care system to respond to the pandemic. Despite growing evidence and international recognition of the widespread - and sometimes deliberate - nature of these attacks, action by the international community to hold those responsible to account has been absent.

“The international community has a choice. It can drive collective efforts to ensure Syrians have continued access to the aid they require by reauthorizing UN cross border aid into Syria, and it can establish meaningful steps to hold those responsible for attacks on health care to account. Or it can stand by and watch as the Syria playbook becomes the blueprint for future wars in which the lawlessness and brutality of the last decade becomes the norm, and no longer the exception.”


Read the full report here.

IRC spokespeople are available, and it may also be possible for us to arrange interviews with doctors working in Syria

Notes to editors

*indicates that we changed the person’s name to protect their identity 

About the IRC in northwest Syria

The IRC has been delivering aid in Syria since 2012, and last year the IRC and partners delivered health, protection, and livelihoods to over 900,000 people in the country. In northwest Syria, the IRC and its partners the IRC and its partners reached over 318,000 patients in 2020 through 17 health facilities: 2 hospitals - including 1 COVID isolation hospital, 2 mobile clinics, 12 primary health care centres and 1 mental health centre. Additionally, we have one fleet of 10 ambulances, 5 of which are dedicated to the COVID-19 response, transporting suspected cases to testing facilities and then transferring them for treatment. In addition to our ambulances, our response to the pandemic includes implementing infection, prevention and control measures across all IRC supported health facilities; training staff in how to protect themselves and their patients from the virus; and continuing to raise awareness of the pandemic in the communities where we and our partners operate. The IRC also provides specialist care to vulnerable women and girls, pregnant women and the elderly; provides psychosocial support to help children and their families overcome emotional distress; and helps thousands of Syrians gain an income through emergency cash distributions, business grants and training.