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Ready to save lives: paramedics upgrade their skills in Syria

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Paramedic Borhan Jasem Kleeb, 33, participates in a practical session during training. Photo: WHO/Mrinalini SanthanamParamedic Borhan Jasem Kleeb, 33, participates in a practical session during training. Photo: WHO/Mrinalini Santhanam24 February 2025, Aleppo, Syrian Arab Republic – In a busy hospital in Azaz, northern Aleppo, Borhan Jasem Kleeb takes a short break between training sessions to share a story that shaped his life. In 2012, while rushing to the scene of an airstrike in Homs, his ambulance was hit. He hurt his shoulder badly, an injury that still troubles him.

“That day changed everything for me. It made me realize that I wanted to spend my life helping others in emergencies,” says Borhan.

Originally from Homs, Borhan lost his entire family during the 2011–2014 siege of the city. Moving to Azaz, northern Aleppo, gave him a fresh start. Now 33, he works with Syria Relief and Development (SRD).

“I’m married now and have 4 children. They help me see things differently and keep me going,” he says.

One moment during the 2023 earthquake stands out for him. He found a 2-year-old child trapped under rubble, still in his mother's arms. While the mother didn't survive, the child did. “The child turned out to be my friend’s son. While grieving the loss of a close friend's wife, saving the little one brought hope.”

Borhan’s job is challenging on many levels. Last year there were 84 attacks on health care across Syria, of which 77 occurred in November and December. The attacks damaged health facilities and disrupted supplies.

“The airstrikes didn’t spare our ambulances. We often made do with what we had, but health partners worked together to make the most of limited resources, ensuring critical services continued. Even with shortages, we kept ambulances running,” Borhan explains. 

Paramedics during a practical session in the training. Photo: WHO/Mrinalini SanthanamParamedics during a practical session in the training. Photo: WHO/Mrinalini SanthanamAfter 14 years of conflict, Syria's health system struggles with limited funding for ambulance services and gaps in coordination and referral systems, making it hard for patients to access timely care.

To address these gaps, WHO supports emergency services across the country. Of the more than 200 ambulances in northwest Syria, WHO currently supports 27, and backs the Referral Desk in northern Aleppo, helping streamline patient management and coordination, enabling faster treatment.

Recognizing the need for continuous support for paramedics, WHO has focused on enhancing critical skills such as lifesaving care, managing mass casualty situations and providing trauma care before patients reach hospital. WHO began by training 7 paramedics in northwest Syria who then passed on their knowledge to 80 more paramedics, expanding the impact.

Ahmed Jakmour, a paramedic in his thirties who works with SRD, says the training isn’t just about new techniques but building confidence.

“This training has helped us respond better during emergencies, especially when someone has a heart attack. We've learned how to use defibrillators more effectively and how simple things like the right head position can make a big difference in helping someone breathe,” he says. 

Trainers from Medivac Frontline have been central to this effort.

Trainers conducting a session on neonatal resuscitation. Photo: WHO/Mrinalini SanthanamTrainers conducting a session on neonatal resuscitation. Photo: WHO/Mrinalini Santhanam“Despite the challenges they’ve faced, the paramedics were eager to learn and adapt new knowledge to the Syrian context,” says Fergus Beeley, CEO of Medivac Frontline. “Watching these dedicated paramedics apply their new skills effectively is truly rewarding. Their commitment is to improving emergency care across Syria.”

In 2025, WHO will continue to support Syria’s health system, focusing on essential health services and working with the Ministry of Health. Building on lessons learned in Aleppo and Idlib, WHO also looks to expand emergency preparedness efforts in the northeast, including training paramedics to handle trauma and manage patient referrals during crises.

Borhan is hopeful about the future. “This training is helping us save more lives. We’re learning skills that really matter in emergencies and it means our communities will get better care when they need it most.”

The lifesaving impact of Japan’s support for Al-Razi Hospital Burns Unit

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The lifesaving impact of Japan’s support for Al-Razi Hospital Burns UnitNermin receiving medical treatment at the Burn Unit in Al Razi Hospital20 February 2025, Syrian Arab Republic – Nermeen, a lively 9-year-old girl from Aleppo, was playing in her home one morning when she touched a faulty electrical socket and received a powerful shock that went through her right hand and out her left. The shock caused severe damage to her arm and put her life at risk.

In panic, Nermeen’s parents rushed her to the emergency department of Al-Razi Hospital where the medical team began to treat her. The damage was serious and without immediate action her arm might have needed amputating.

Nermeen was admitted to the hospital’s Burns Unit for specialized care. Her parents held onto hope, trusting the doctors to save her. As they do with all cases admitted to the Burns Unit, Dr Alaa Al-Din Allou and his team worked tirelessly to treat Nermeen’s burn injury and restore her to health. The Burns Unit uses advanced equipment, the acquisition and installation of which was made possible by the generous support of the People of Japan. But it wasn’t just the technology that helped. Nermeen received the doctors' dedication and care, with her parents by her side.

Thanks to the skill, compassion and resources at Al-Razi Hospital, Nermeen’s arm was saved.

“I can’t think what would have happened to my daughter if this hospital was not in service. They gave my daughter a second chance at life. I will forever be grateful,” said Nermeen’s mother.

Nermeen’s story is a testament to the vital work done at Al-Razi Hospital, the only specialized treatment center for burns for nearly 4 million people living in Aleppo Governorate and surrounding areas. It covers a vast region that includes Aleppo, Idlib, and other conflict-affected regions.

Overwhelmed by years of conflict and the aftermath of the 2023 earthquake, the Burns Unit underwent extensive rehabilitation in 2022. In the past 2 years, the Unit has admitted 697 patients and provided emergency lifesaving care to over 5876 individuals.

Acting WHO Representative to Syria Christina Bethke emphasized the importance of Japan’s contributions to the hospital: “Without the support of the People of Japan we would not have been able to help Nermeen and so many others in need of specialized burns care. Their support has truly been a lifeline for the health of Syrians during the years of the crisis, enabling us to provide critical care when it is most needed.”

WHO is deeply grateful to the People of Japan who have been steadfast supporters of Syria’s health care system, ensuring that, even amidst conflict people can access the care they need.

Strengthening community health in the Syrian Arab Republic

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Maha Younes actively engages in raising awareness by distributing educational flyers on breast cancerMaha Younes actively engages in raising awareness by distributing educational flyers on breast cancer16 February 2025 –Amid Syria’s enduring crisis, waterborne diseases have remained a major concern, especially for the most vulnerable communities. In response, WHO, in partnership with the Ministry of Health, conducted risk communication and community engagement (RCCE) workshops in Deir-ez-Zor and Lattakia governorates in late 2024, with a focus on raising awareness and providing lifesaving support.

The Central Emergency Response Fund (CERF) allows the United Nations and its agencies to act quickly when humanitarian needs arise, enabling humanitarian responders to deliver lifesaving assistance whenever and wherever crises strike.

Thanks to funding from CERF, WHO trained 200 community health workers from NGOs and health directorates. These dedicated frontline workers gained essential skills to connect with at risk populations and deliver critical education on preventing waterborne diseases such as cholera.

Maha Younes, a 27-year-old health educator with Ayadina Association in Lattakia, was one of the trainees.

“The training was invaluable,” she said. “It gave me the tools and confidence to speak out about waterborne diseases in my community. Now I can clearly explain the importance of safe water and hygiene practices to the families who need it most.”

At Ayadina Association, Maha and her colleagues have turned waiting times at health facilities into valuable moments for education, focusing especially on women and children.

“Prevention is always our first line of defence,” she explained. “Thanks to WHO’s training, I now have the knowledge, confidence and capacity to share accurate health information, empowering people to protect themselves, their families and loved ones."

WHO supported interactive sessions provided community health workers with the ability to lead change in their communities, communicating crucial prevention strategies such as proper sanitation, safe water use and effective hygiene measures. These efforts not only strengthen community resilience but bolster the health care system’s capacity to respond to disease outbreaks.

Maha’s contribution to her community was made possible by resources that were part of a larger CERF-funded multisectoral emergency response project to support critical health interventions across Syria. The project focuses on reducing morbidity and mortality by restoring access to health care, strengthening emergency referral systems and addressing severe malnutrition.

Through these initiatives, WHO is creating long-term change by building local expertise to ensure vulnerable populations have access to lifesaving interventions. As Syria continues to manage multiple challenges these crucial efforts help safeguard public health and prevent future outbreaks.

Ebrahim’s journey back to joy: overcoming leishmaniasis in Aleppo

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Ebrahim and his brother Yousef can play again, and no one makes fun of their face.Ebrahim and his brother Yousef can play again, and no one makes fun of their face.2 February 2025 – Ebrahim, a lively 5-year-old boy from the Salah Aldeen neighbourhood in Aleppo governorate, Syria, had always been full of energy and smiles. But when a painful bump appeared on his nose due to a leishmaniasis infection, everything changed. His red, swollen nose began to draw unwanted attention and teasing from other children. Embarrassed and ashamed, Ebrahim avoided playing with his friends and often missed nursery school.

Ebrahim’s father, Mohammad, a photographer, initially didn’t realize the severity of the issue. “I work late nights and sleep during the day, so I didn’t understand how much this was affecting Ebrahim until my wife told me that he had stopped going out to play because he was ashamed of his nose,” Mohammad admitted.

Determined to help his son, Mohammad took Ebrahim to the Salah Aldeen health centre, which housed a leishmaniasis treatment clinic supported by the World Health Organization (WHO). There, Ebrahim began a 4-month free treatment programme in March 2024. As the bump on his nose faded, his confidence returned. Soon, he was smiling again, back in kindergarten and playing with his friends.

When Ebrahim’s younger brother, Yousef, also contracted leishmaniasis, Mohammad and his wife acted immediately. “This time, we knew what to do. We took Yousef to the same clinic right away, and within 2 months he had completed his treatment,” Mohammad shared. “We learned how important it is to act quickly and not ignore health issues.”

Each year, Syria typically records 68 000 cases of cutaneous leishmaniasis, the most common form of the disease. It is caused by a protozoan parasite transmitted through bites from infected sandflies. Without treatment, the disease can cause severe skin lesions that can scar and lead to social stigma.

Since 2015, WHO has partnered with national health authorities in Syria to provide free treatment, annually supplying 200 000 ampoules of the medicine meglumine antimoniate, and protecting families through targeted interventions to control the spread of leishmaniasis. These include indoor residual spraying of 73 000 households in Aleppo, Hama and Idlib governorates.

Today, Ebrahim is thriving. “I can play again, and no one makes fun of my face anymore,” he said proudly.

Reflecting on the experience, Mohammad shared, “This taught me how essential good health care is, especially for our children. I hope more families can access the support they need.”

World Neglected Tropical Diseases Day is celebrated every year on 30 January. This year, the theme of the Day is “Unite. Act. Eliminate." Leishmaniasis is one of many neglected tropical diseases that continue to affect vulnerable populations in Africa, the Middle East, Asia, Central and South America and southern Europe. Efforts like those at the Salah Aldeen leishmaniasis treatment centre are testament to the importance of uniting communities and acting decisively to eliminate the burden of these diseases.

Ebrahim’s story showcases the resilience of families and underscores the lifesaving impact of accessible health care, even in the most challenging circumstances.

Health care workers in Aleppo and Idlib strengthen tuberculosis referrals and care

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Dr Dato Chorgoliani, Tuberculosis Specialist, leads the training alongside Dr Mohammed Zeidan in Idlib. Photo: WHO/Mrinalini SanthanamDr Dato Chorgoliani, Tuberculosis Specialist, leads the training alongside Dr Mohammed Zeidan in Idlib. Photo: WHO/Mrinalini SanthanamSunday, 26 January 2025 – At Kafr Arouk Health Centre in northern Aleppo, a 6-year-old boy arrived severely malnourished and struggling to breathe – his condition worsened by months of delayed care. Paediatrician Dr Bayan Mohammed Hamidi remembers the case vividly.

Dr Hamidi is one of 150 health care professionals trained by WHO, with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, to strengthen tuberculosis detection, treatment and community awareness across Aleppo and Idlib in northwest Syria. Held just days before the 8 December 2024 political shift, the training’s significance has grown as these regions transition into a new phase of governance within Syria.

“The training has shown me how important it is to recognize tuberculosis symptoms early and act quickly,” Dr Hamidi says. “Now I can guide families and ensure patients get the care they need without delay.” 

In many parts of northwest Syria, stigma and misinformation often prevent people from seeking care. The training emphasized the importance of effective communication.

“We learned how to talk to families in a way that builds trust and encourages them to seek care early,” Dr Hamidi adds. “This is especially important where reliable health information is limited.”

Women doctors actively listen and participate in the tuberculosis training session in Idlib. Photo: WHO/Mrinalini SanthanamWomen doctors actively listen and participate in the tuberculosis training session in Idlib. Photo: WHO/Mrinalini SanthanamPrimary health care centres were a critical focus of the training, as they are often the first point of contact for families in underserved areas.

“Many families cannot afford the cost or time to travel long distances to specialized hospitals,” says Dr Jihad Al-Wahoub, a paediatric resident at Haritan Hospital for Women and Children in northern Idlib, who also participated in the training. “By raising awareness within primary health care centres, we can bridge the gap and identify tuberculosis cases earlier.”

The training covered topics, including diagnosing tuberculosis, managing extra-pulmonary cases and applying infection control measures such as administrative protocols and personal protection. Participants also learned how to strengthen connections between health care centres and tuberculosis centres to ensure timely referrals.

Since the start of WHO’s tuberculosis project in July 2019, over 2500 patients have been diagnosed in northwest Syria, including 47 with drug-resistant tuberculosis. In 2024, more than 460 patients were diagnosed.

Globally, without treatment, tuberculosis has a death rate close to 50%. However, WHO-recommended treatment regimens can cure 85% of cases.

Participants engage in case studies, role-playing and group discussions designed to encourage active participation and critical thinking. Photo: WHO/Mrinalini SanthanamParticipants engage in case studies, role-playing and group discussions designed to encourage active participation and critical thinking. Photo: WHO/Mrinalini Santhanam“These treatments are lifesaving for patients who often come to us in advanced stages of the disease,” says Dr Hassan Ibrahim, who coordinates the tuberculosis centres in Azaz and Al-Bab. “Our focus is on ensuring they receive care as soon as possible to prevent further spread.” 

Northwest Syria has long relied on just four tuberculosis centres supported by limited staff, with two coordinators – Dr Ibrahim overseeing those in Azaz and Al-Bab, and Dr Mohammed Zeidan managing the Afrin and Idlib centres. WHO continues to fund these centres, ensuring uninterrupted care for vulnerable communities.

“When we speak to health care workers after the training, it’s clear they are applying what they’ve learned – strengthening referral pathways, diagnosing cases earlier and educating families,” says Dr Zeidan. “Their commitment gives me hope for the future of Syria’s health care.”

WHO’s plans for 2025 include maintaining support for tuberculosis centres, sustaining diagnostic and treatment services and collaborating with the new Ministry of Health to strengthen Syria’s health care systems.

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