24 December 2024, Damascus, Syria/Gaziantep, Türkiye – As Syria stands at a crossroads following the recent transfer of authority, the World Health Organization (WHO) has launched a US$ 56.4 million flash appeal to address the urgent health needs of Syrians affected by years of conflict.

A nurse cares for a 5-day-old baby at Shams Children's Hospital in Idlib amid hostilities since November 27. WHO is supporting the hospital to keep its services running. Photo credit: WHO

The WHO appeal seeks to address the humanitarian crisis while laying the groundwork for recovery. Over the next six months, WHO together with its partners will continue to focus on trauma care, continuity of essential services, disease outbreak prevention, patient referrals and strengthening health system coordination.

Since November 2024, intensified hostilities have displaced over 882,000 people, further disrupted access to healthcare and placed immense pressure on Syria's already fragile health system. Attacks on health facilities have surged, with 37 WHO-confirmed incidents reported in the last month alone. These attacks have severely damaged infrastructure, rendered ambulances non-operational and hindered access to life-saving care.

“The health infrastructure in Syria is severely strained, more than ever, with over half the country’s hospitals non-functional. Even before the recent events, 141 health facilities in northern Aleppo and Idlib were at risk of closure due to funding shortages. Without urgent support, these facilities could shut down in the coming weeks, with devastating consequences,” said Christina Bethke, WHO Representative a.i. for Syria. “Our teams are currently providing care through mobile clinics, restoring immunization services and integrating mental health support into health facilities, especially for those affected by trauma. This appeal is about safeguarding health and dignity while offering Syrians hope for a safer future.”

Up to now, WHO’s response has included expanding trauma response in functional hospitals, ensuring healthcare access in high-displacement zones, restoring operations in priority facilities, and working with health authorities to strengthen the health system in several ways.

WHO’s proposed strategy for the next six months includes:

Strengthening life-saving trauma care: Providing emergency supplies, deploying additional ambulances and ensuring hospitals remain operational.

Ensuring continuity of essential health services: Addressing maternal and child health needs, restoring immunization services and deploying mobile clinics to people who would otherwise be unable to access the health system.

Bolstering disease surveillance and outbreak control: Enhancing early warning systems and deploying rapid response teams to contain outbreaks.

Coordinating emergency patient referrals: Facilitating timely and efficient referrals of patients to appropriate healthcare facilities, ensuring access to critical treatment and specialized care.

Enhancing health system coordination: Strengthening partnership across the health sector to ensure a unified and effective health response across Syria.

“WHO will continue to leverage its presence in Gaziantep, Türkiye, to deliver life-saving medical supplies and services,” Rosa Crestani, WHO Emergency Lead for the WHO Gaziantep field office. “This hub coordinates assistance delivered from Türkiye to an estimated 5 million Syrian people, ensuring that essential trauma care, immunization, and maternal health services reach even the hardest-to-reach areas.”

Access the WHO flash appeal for Syria here.

Media contacts:

In Damascus, Syria: Halah Kabash, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

In Gaziantep, Türkiye: Mrinalini Santhanam, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Good morning,

20 December 2024 - I’m speaking to you from Damascus at a moment of profound significance in Syria’s history. The resilience of the Syrian people is on full display, as is their hope for the future. Over the past 12 days or so, I’ve witnessed both the joy of reunions and returns, as well as the concerns about the uncertainty of what lies ahead.

In the midst of these challenges, WHO remains steadfast—not just in delivering life-saving aid and ensuring healthcare reaches those who need it most, but also in helping Syrians rebuild their lives and recover from years of crisis.

Just yesterday, WHO teams were in Idlib, visiting hospitals that have become lifelines during the recent escalation of conflict. They met with dedicated surgeons who have worked tirelessly, often under attack, to save lives. One surgeon shared with us the words of a patient who walked through their doors: “We finally sleep at night, no longer worrying about being bombarded.”

Our team also met Ahmed, a 64-year-old man who relies on kidney dialysis. Over the past decade, he has been displaced multiple times and has faced enormous uncertainty to access his treatment. Thanks to Bab Al-Hawa Hospital in Idlib, which is supported by WHO, Ahmed has been able to maintain his care. Yet, the funding for this essential service will run out in three months. Ahmed is deeply hopeful, not just for himself but for all Syrians, dreaming of a future where no one has to endure the uncertainty he has lived through.

It is this fragile hope that keeps them going, even as they endure tremendous hardships—sleeping in tents through the bitter cold of winter and the scorching heat of summer. In these conditions, displaced populations, especially those living in camps or informal settlements, are extremely vulnerable. Overcrowded living conditions, food insecurity, and inadequate sanitation are perfect breeding grounds for nutritional deficiencies, respiratory infections and other communicable diseases such as diarrheal disease, as well as lice and scabies, which can lead to long-term health complications.

Many people the team met in Idlib have returned to visit their homes since December 8th, only to find them reduced to rubble. These individuals, displaced multiple times or having returned from Lebanon and Turkey, need support to rebuild their lives. Rebuilding homes is just one part of the solution; they also need access to healthcare and essential services to feel secure and to lay the foundations for recovery.

And in a nation reeling from over a decade of conflict and displacement, mental health and psychosocial services are not just critical—they are lifesaving for families. Our team met Fatima whose two daughters, aged 6 and 10 years, have suffered from sleepless nights, recurring nightmares, and anxiety. Over the past three weeks, they have benefited from psychosocial support services, giving them a sense of stability and hope. But this support must continue.

The reality is, even in this historic moment, the humanitarian need remain immense and immediate.

Syria is grappling with one of the largest displacement crises in the world, with 7.4 million people internally displaced before this recent escalation. Over 880,000 have been displaced since then. Among them, 6% are individuals with disabilities who face severe barriers to accessing care.

The health infrastructure is severely strained. In just three weeks, 36 attacks on healthcare have been reported and over half of the country’s hospitals are non-functional.

WHO has launched an appeal to raise $56.4 million to meet these urgent needs over the next six months. This funding will sustain critical health services during this transitional period – including 141 health facilities in northwest Syria at risk of closure in the coming weeks – and support Syria’s long road to recovery.

WHO is doing everything possible to bridge this gap. Our teams are:

Facilitating access to healthcare for displaced populations and returnees through referrals to functional facilities and mobile clinics providing basic care, vaccinations, and maternal health services.

Integrating mental health support into healthcare facilities, particularly for those affected by trauma.

Coordinating referrals between non-functional and operational health facilities and ensuring the safe transportation of patients to specialized hospitals for critical care.

But we cannot do this alone.

The resilience of the Syrian people is inspiring, but without immediate international support, their hopes for a peaceful and healthy future are at risk.

Everyone my team and I speak to here is hopeful—hopeful for their children, for their homes, and a Syria rebuilt on peace and solidarity. We must help them realize this dream.

We call on the international community to act now—your swift action can save lives, restore hope, and help rebuild a nation yearning for stability and peace.

Thank you.

Dr Mahmoud Hariri, one of the lead trainers, guides participants through a practical session during the Hostile Environment Surgical Training. Photo: WHO28 November 2024 – For surgeons in the operating rooms of northwest Syria, where the hum of generators replaces the sterile quiet of modern hospitals, every decision is a race against time, every procedure a battle to save lives amidst conflict.

For doctors like Dr Abdullah Al-Saleh, a general surgeon at Al-Andalus Hospital in Idlib, the stakes could not be higher. “The hardest cases are the ones where every second counts,” he says. “We deal with severe abdominal and chest injuries, where even a small delay can mean losing a life. The reality is harsh. We do what we can with what we have.”

A surge in need amid escalating hostilities

After years of conflict, the health care system in northwest Syria is hanging by a thread. Hostilities, and the associated displacement and deteriorating living conditions, have led to a sharp rise in trauma cases, overwhelming already strained hospitals. The lack of resources and specialists often forces surgeons to step into roles outside their specialty. They must master multiple skills to meet the pressing demands.

Amid this mounting pressure, the Hostile Environment Surgical Training (HEST) programme is proving to be a lifeline. Developed to empower surgeons to manage complex emergencies, it combines technical expertise with real-world application.

“If you know how to hold a knife, you can do miracles”

Participants at the HEST collaborate on a practical exercise, using anatomical models to refine critical surgical techniques for conflict and emergency settings. Photo: WHOFor Dr Mahmoud Hariri, one of the lead trainers, the training is not just about technical skills – it’s a culmination of lessons learned working in conflicts.

“There’s no room for strict specialization,” he says. “One day you’re a general surgeon, the next you’re managing vascular injuries or performing thoracic surgery. If you know how to hold a knife, you can do miracles.”

The training curriculum combines advanced techniques with innovative teaching tools tailored to conflicts. Participants work on lifelike simulators, practicing procedures like suturing a heart, stabilizing severe vascular injuries and performing tracheostomies under battlefield-like conditions. This hands-on approach ensures that surgeons are prepared to act decisively, even in the chaos of mass casualty events.

“These aren’t just theoretical skills,” says Dr Hariri. “When I performed 11 emergency heart sutures in Aleppo 13 years ago, 7 patients survived – a testament to the power of preparation.”

“Empowered to act in the moments that matter most”

Participants practice wound management techniques on a medical mannequin during the Hostile Environment Surgical Training, focusing on real-life scenarios in conflict zones. Photo: WHOFor participants, the training is more than an opportunity to learn – it’s often the difference between life and death for their patients.

Take Dr Shahira Al-Hameed, an obstetrician and gynecologist at Jisr Hospital. Recently, she faced a complex case of uterine rupture and internal bleeding. “The patient’s abdomen was filled with blood, and it was nearly impossible to identify the anatomy,” she says. “The techniques I learned here helped me stabilize her. She left the hospital alive and healthy.”

Dr Shahira joined the HEST programme to prepare for emergencies that go beyond her specialty. “As a gynaecologist, I often encounter cases where I need to manage injuries to the intestines or bladder,” she says. “This training has given me the confidence to handle such situations until a specialist arrives.”

For Dr Alaa Barhoon, a general surgeon with over a decade of experience, the training introduced faster, more effective methods that fit the realities of northwest Syria. He highlights how techniques like vascular shunting – a method to restore blood flow when vessels are severely damaged – have become essential when traditional resources are unavailable.

“Time is everything,” he says. "The new methods we’re learning can save lives in ways that older approaches cannot."

Preparing for the unpredictable

HEST also emphasizes triage systems, a critical need in hospitals faced with mass casualties. “Triage planning can make or break a hospital’s response during emergencies,” says Dr Hariri. “In many hospitals here, the lack of proper triage leads to chaos. Through this training, we’re showing how even simple systems can save lives.”

Participants gain confidence through scenario-based learning. Simulations of battlefield trauma and mass casualty events help them practice the most complex procedures under harsh conditions.

The toll of working in such conditions is heavy. Dr Al-Saleh, a father of 3, says treating injured children is particularly harrowing. “It’s impossible not to imagine my own children in their place,” he says.

Dr Shahira echoes these sentiments. “The emotional strain is immense, but seeing a mother and child survive after a complicated delivery reminds me why I chose this path.”

Ready to save lives

A trainer demonstrates advanced surgical procedures to participants during a hands-on session of the training. Photo: WHOAs the training concludes, its impact is already evident in the preparedness of its participants. “This isn’t just about surgery,” says Dr Hariri. “It’s about empowering doctors to face the worst and still deliver care.”

Beyond immediate skills, HEST focuses on long-term impact. Many participants, like Dr Ahmed Ghandour, have gone on to become trainers themselves. “I learned these techniques in 2019 and have since trained my entire surgical team in them,” says Dr Ghandour. “The ripple effect is profound – every surgeon we train can save hundreds of lives.”

The HEST training, delivered by expert trainers from the David Nott Foundation, was made possible through the support of USAID’s Bureau for Humanitarian Assistance (BHA) and implemented by the World Health Organization (WHO).

25 November 2024 – When Abbas* arrived in Lebanon in 2014 he was in his mid-20s, seeking safety and work away from the conflict in Syria.

At the Aoun al-Dadat crossing, health partners provide psychosocial support to help families – especially women and children – feel safe. Photo credit: Shafak Organization“I went alone, hoping to find a better life,” he says.

For nearly a decade Abbas managed to build a life, finding occasional work, marrying and having 4 children. By September 2024, however, the escalating violence in Lebanon left his family with no choice but to return to northwest Syria.

“We were renting a small apartment, and the financial situation was becoming unbearable,” Abbas says. “I was the only one working, and expenses kept piling up with four children. Then the shelling started. Every night, we had to evacuate to safer areas, only to return in the morning.”

After a week of constant fear, Abbas and his wife decided they had no choice but to leave. “We tried moving to a different neighborhood, but even there, the shelling continued. My children couldn’t sleep; they were terrified. That’s when we realized it was time to return to Syria.”

For many families like Abbas’s, the decision to return is not made lightly. It is often a last resort, driven by the worsening conditions in Lebanon. Northwest Syria remains unstable, offering limited resources and safety, but families are left with no other choice as they try to rebuild their lives.

A difficult journey

The journey was grueling. Families crossing into northwest Syria often have to wait for days at overcrowded border crossings, facing harsh conditions and delays. Abbas’s experience was no different. “We were stopped at checkpoints and forced to wait for hours without knowing when we could move. Traveling with 4 small children, including my 10-month-old, made everything even harder,” he shares.

Tragically, during the journey Abbas’s wife suffered a miscarriage. The emotional and physical toll has left her weakened and she is still struggling to recover.

“My wife is strong,” says Abbas, “but this loss has been very hard on her.”

After 8 exhausting days, Abbas and his family finally arrived in northwest Syria, physically and emotionally drained.

Health partners extend support to Abbas’s family

When they crossed into northwest Syria, Shafak, a humanitarian organization stationed near the Aoun al-Dadat crossing, was among the first to welcome them. “The team greeted us with kindness,” Abbas recalls. “They played with the children and helped them feel safe —something we hadn’t felt in a long time.”

Supported by UNHCR, Shafak is also coordinating the response of local organizations to support people returning. The team provided Abbas’s family with much-needed supplies, including food and nutritional support for the children, as well as psychosocial help. “They offered psychological first aid for my wife and spent time with my children to help them feel less anxious,” says Abbas.

“For many families like Abbas’s, the trauma of displacement does not end when they cross the border. Our team provides immediate care, including psychosocial support, to ensure that families—especially women and children—feel safe and supported in these difficult moments,” says a Shafak representative.

In northwest Syria, local health partners, with technical support from WHO, have scaled up services to address the needs of displaced families like Abbas’s. These include emergency care, vaccination campaigns, and mental health support at border crossings and in host communities.

Abbas now looks to rebuild

Abbas’s family now lives in a small, unfinished house in Jarablus, provided by his brother. “It’s better than living on the streets,” he says, “but it is not easy. We have no heating, and the roof leaks when it rains. The children still get scared by loud noises—they remember everything that happened in Lebanon and during the journey.”

The influx of over 8,100 Syrians fleeing Lebanon since late September has stretched the region’s already fragile health system. At border crossings like Aoun al-Dadat, medical teams provide immediate screenings and care, while ambulances are on standby for urgent referrals. Vaccination teams work to ensure children are immunized against diseases like polio and measles, particularly as many returnee children lack updated vaccinations.

Despite these efforts, the needs are vast.

“I want my kids to go to school, but I cannot afford it. My family is still distraught and in need of continued psychosocial support,” Abbas says.

Mental health support has also been critical. Families exposed to conflict and displacement often carry deep psychological scars. Health partners, like Shafak, continue to deliver psychosocial support to new arrivals, referring severe cases to healthcare centres for ongoing care.

For Abbas, the journey is far from over, but he is still hopeful. “I am grateful for the help we have received, but we will pick back up and try to rebuild our lives again. I owe it to my children and their future to keep going,” he says.

*Name changed to protect identity