“After my husband's death eight years ago, I began feeling discomfort and constant fatigue”.

The widow Umm Abdullah, 55, is one of between two and three million people that are displaced due to the fighting in northwest Syria; refugees within their own borders. Her husband’s death, one year into a conflict that’s been named the most complex humanitarian crisis of our times, left Umm Abdullah as the sole provider for her son, who at the time was only eight years old.

“We’ve had to flee several times, we’ve been on the move between western Aleppo and northern Idleb for years. And after the recent escalation in fighting, we ended up here, in Kafr Safra”. The most recent hostilities, that displaced nearly 1 million people, started in December 2019 and came to a halt when Turkey and Russia agreed upon a ceasefire in March 2020.

Before the conflict started in 2011, the village of Kafr Safra, part of the Afrin district in Aleppo governorate, had a population of only a couple of thousand. Since then, its population has steadily grown and it is now home to dozens and dozens of Syrians whose fate is the same as Umm Abdullah and her son.

“We’ve gone through hardship”, she says.

Being internally displaced – without a roof over your head and with your few remaining belongings on your back, if you’re that lucky – is not easy. And suffering from a chronic health condition is an added challenge, and can in many cases be life-threatening, when access to medical assistance and drugs can’t be relied on or is simply unavailable.

“What’s been most challenging on the run is finding health centres that cater to those with chronic diseases. Finding the right drugs has been difficult, let alone being able to afford them. That’s been a heavy burden”.

While most internally displaced persons (IDPs) use most of their waking hours trying to stay away from danger, reading the environment, avoiding circumstances where things could possibly escalate, trying to stay warm, safe, fed – staying alive simply – the challenges for the internally displaced that have underlying diseases and suffer from a chronic condition, take on a different dimension. That means that every new displacement has required of Umm Abdullah to locate and seek health services, simply to be safe.

“The moment we reached Kafr Safra, I started asking around about the nearest health centre, I wasn’t well. You can therefore imagine how happy I was learning there is one in town. It’s the only one in this area, serving 10 villages.”

The fact that more than half of Syrian health workers have left the country or lost their lives during the conflict, means that those that remain have taken on a double workload, if not more, with limited resources. One of them is Dr Ali and it was he who examined Umm Abdullah on her first day in Kafr Safra.

“Hypertension and diabetes, the two conditions that plague Umm Abduallah, actually require routine, constant monitoring and regular medication“, explained Dr Ali, as he prescribed the drugs and booked the next appointment at centre.

“I’m better now, I see the doctor regularly and the drugs are free of charge. I still dream of returning home though; of raising my son there and being able to visit relatives“.