Northern Syria: access to primary health care gives hope to malnourished child

Union of Medical Care and Relief Organizations (UOSSM)

Sham was 6 months old when her worried mother, Ghadir, brought her to a health facility in the town of Al-Zafaranah, about 30 kilometres from her village in the embattled countryside north of Homs, Syria.

For some time, Ghadir had been having trouble breastfeeding Sham. This was in part due to the extreme stress of living in a shelled home that barely stands, in an area long-consumed by violence. Her family struggles to get by as food prices soar and her husband’s job prospects and wages dwindle. But more so, Sham was increasingly unable to nurse because of a rapidly growing tumour on her lips. The little girl had become thin and weak.

“When Sham was referred to our primary health-care centre in Al-Zafaranah in early November, we immediately ran tests and found she was suffering from severe acute malnutrition,” recalls her physician, Dr Kamar Osta. “We quickly developed a treatment plan.”

Staff at the centre provided Ghadir with guidance on alternative feeding approaches and started a regimented nutrition programme that included the introduction of therapeutic foods, such as fortified, high-calorie pistachio paste, as well as weekly monitoring visits.

Two months later, in early January, Sham was at a healthy weight and was no longer suffering from malnutrition. Doctors also diagnosed the tumour on her lips as benign – a growth that would eventually need to be removed surgically.

“This little girl was one of the fortunate ones,” says Dr Abdullrazak Kintar, who coordinates primary health-care programmes for the Union of Medical Care and Relief Organizations (UOSSM), the WHO partner that runs the Al-Zafaranah facility. “Malnutrition rates are high in besieged areas, and far too many children cannot get screened or treated because they can’t safely access medical care or it’s no longer available.”

The Al-Zafaranah Primary Health Care Center was built in 2014 to provide free medical services for some 60 000 people living in the town and surrounding villages, including thousands displaced by the armed conflict.

The facility has been hit by air strikes 5 times since it opened, including an attack in 2016 that killed 4 patients. After each attack, UOSSM worked to repair, re-equip and reopen the damaged facility.

WHO has been funding the operating costs of the Al-Zafaranah Primary Health Care Center and its adjacent maternity ward, enabling 6500 medical consultations per month and the employment of a team of 24 nurses, doctors, midwives, nutritionists, counsellors and other health workers.

This support to the facility is part of a priority project, coordinated out of WHO’s cross-border hub in Gaziantep, Turkey, to restore and improve primary health-care services and referral networks across northern Syria that were decimated during the war.

The programme includes support, training and clinical supervision for Syrian health partner organizations and providers. It also supplies primary health-care centres and mobile medical teams with drugs, equipment, ambulances and other essentials. Health services supported by the programme have expanded to cover more than 1 million people in northern Syria.

WHO’s work to rebuild primary health-care systems in northern Syria is made possible with support from the Government of Japan and the United Kingdom’s Department for International Development (DFID).