April 14, 2020
In Idlib, Syria, where I was born, officials warn as many as 100,000 people could die as a result of covid-19. We are pitifully prepared, and it fills me with abject fear. 
Here In Syria, We Have Already Lost So Much. Now We Face Coronavirus Unprepared
Countries like Italy and the UK with very developed health systems are struggling to deal with this crisis, but ours have been decimated by nine years of war. Only a month ago, there were catastrophic bombing attacks in Idlib. More than 84 hospitals and medical facilities have been destroyed, damaged or forced to close since the beginning of December last year, many of them deliberately targeted.
This has been a long, ugly and dirty war. Thousands of trained health workers have been killed or have fled for their lives. I, myself was displaced in July last year, after eight bombing attacks in my village in Maarat-al Numan claiming the lives of 43 civilians, including three girls and one boy. I fled at one o’clock in the morning with my wife, mother and two daughters. My youngest daughter, Sana, was two years old and she had a panic attack. These continued for three months afterwards, every time she heard a loud noise.
And now we have the scourge of coronavirus. Thankfully, there hasn’t been any official cases in Idlib, because we don’t have the capacity to deal with a few, never mind an influx. A week ago, I was feeling optimistic about the plans for testing kits and isolation centres but we are not seeing anything yet. Apparently, there are 300 testing kits so far – for a population of 3.5million people. And more are on their way. But I have no idea how we can access those kits.
There are three major hospitals in Idlib, Afrin and Al Rai, who have any capacity to deal with covid-19. These hospitals have a total of 260 hospitals beds (32 of which are intensive care unit beds) and only 24 ventilators to cover a population of six million people. And that’s not to mention most of these beds are already occupied by people suffering traumatic injuries as a result of the war.
I cannot even begin to explain my frustration. I was born in Idlib, this is my city, and these are my people.In Idlib, there are 300 testing kits so far – for a population of 3.5million people.People are struggling to make ends meet and live a hand to mouth existence, earning a bit of money here and there. They have to go out and earn some money to put food on the table, so it’s very difficult to ask them to stay indoors. They tell me we’ll die if we stay indoors as we won’t be able to eat. So many families have lost their main breadwinners, so young and old are forced to do what they can to eke out a living.
Life is hard in the camps too, with many people forced to live out in the open or in flimsy tents, already vulnerable to acute respiratory infections. People with low or compromised immunity suffering from these non-communicable diseases are far more likely to contract covid-19. 
It’s such a worrying situation, especially for older people who are particularly at risk. Many of them, especially those with cancer and kidney diseases, need to go for medical treatment, but this is now very difficult when they are being asked to stay in their homes. In my hospital alone, we have 50 patients who come for dialysis two or three times a week.We have survived so much, and I can’t bear the thought of this virus taking yet more lives. The world has stood by while we have been slaughtered. I hope the international community will provide more support immediately, so we can stop yet more needless deaths.
People around the world are, rightly. so scared about coronavirus. But over half a million people have died in Syria in this bloody war, so we have a different attitude towards death.  Some people feel that if they have survived nine years of war and almost constant bombings, how could they succumb to covid-19? Their lives, they believe, are in God’s hands and he has spared them so far, so it’s unlikely they will lose their lives to a mere virus.However hard we work, however much we worry, this pandemic is beyond our control. We urgently need the means to effectively prevent, test and treat this disease.I feel an overwhelming sense of responsibility to protect my people, and like many other health workers, I am working more than 15 hours a day every day. In addition to my Job as a general surgeon, I lead the projects educating people about avoiding contracting coronavirus, training hospital staff in infection control, providing tents for triage, and procuring personal protective equipment for health workers.
But however hard we work, however much we worry, this pandemic is beyond our control. We urgently need the means to effectively prevent, test and treat this disease. 
I’m not sure I can take the stress any more, if this doesn’t materialise.
Dr Wasel Aljork, general surgeon at Idlib City Hospital and project manager for Syrian Expatriate Medical Association (SEMA), supported by HelpAge International and Age International
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