An ambulance operated by the Syrian American Medical Society arrives at Latakia Health Directorate during the wildfire response. Photo credit: WHO14 September 2025, Idlib, Syrian Arab Republic – This summer, when wildfires swept through the forests of Latakia, ambulance teams from Idlib were called in to support the emergency response. Paramedics rushed into smoke-filled hillsides where fire crews struggled to breathe. Among them was Mohammed Al Shahad, a father of three from Idlib, who recalls carrying a civil defense worker with severe burns and respiratory distress into his ambulance.
“We gave him fluids, oxygen, and urgent care before rushing him to Latakia National Hospital. That intervention saved his life, allowing him to return to his children and family. I will never forget that moment, knowing we had given him and his loved ones hope again,” Mohammed says.
Life on the frontline
For Mohammed and his colleague Bashar Al Ali, every day begins and ends in uncertainty. Bashar, from rural Idlib, joined the Syrian American Medical Society (SAMS) ambulance system in 2020 out of a sense of duty. “One moment I may be sitting quietly with my colleagues, and the next we receive an urgent call. Within seconds, we must be in the vehicle, preparing our equipment and rushing towards the patient. Even a single minute can mean the difference between life and death.”
SAMS ambulances navigate smoke and rough terrain in Latakia to reach people affected by the wildfires. Photo credit: WHOBoth paramedics describe relentless challenges: navigating damaged or blocked roads, stabilizing patients with life-threatening trauma, and, until December last year, working under the constant threat of airstrikes. For Bashar, what keeps him going is the gratitude he sees in families’ eyes when their loved one makes it safely to hospital. “Ambulances here are not a luxury – they are the difference between life and death.”
On an average day, Mohammed may transfer up to 10 patients, ranging from newborns needing oxygen to trauma cases requiring urgent surgery. With only one paramedic often on board, the task is daunting. Yet, as he says, “Being a paramedic is not only about transporting patients – it is about carrying out a profound humanitarian mission: to save lives in the most dangerous places, where few others can reach.”
Strengthening the referral lifeline
The work of Bashar and Mohammed is part of a wider system that WHO and partners are supporting to ensure patients reach specialized care on time. Of the more than 200 ambulances operating in Idlib and Aleppo, WHO has supported over 30. This includes ambulances managed by SAMS, as well as the referral desk in northern Aleppo, which coordinates patient transfers and enables faster treatment.
Ambulances supported by WHO and managed by SAMS prepare to transfer patients with war-related injuries in Sweida. Photo credit: WHOIn 2025, SAMS teams operated seven fully equipped ambulances in Idlib and facilitated nearly 3000 referrals, benefiting more than 2700 people, including over 160 people with disabilities. More than 1000 of these cases were for trauma and rehabilitation care.
Through this initiative, SAMS was also called on to respond to national priorities at the request of the Ministry of Health. In Latakia, its ambulances supported the response to the wildfires. In the south, four ambulances were deployed to Sweida and Daraa to transfer patients with severe war-related injuries to hospitals in Daraa and Damascus. These efforts reflect how referral services are adapting to national needs and integrating into the broader health system.
The bigger picture
This work is made possible through funding from the European Union (EU), through its Civil Protection and Humanitarian Aid Operations (ECHO). To date, the EU has provided around €15 million to WHO across Syria, supporting ambulances, referral systems, essential medicines, primary health care, trauma and rehabilitation services.
In addition, the EU recently committed another €22 million to sustain life-saving and life-sustaining health services across the country, keeping hospitals, clinics, medical supply chains and referral pathways running for more than 6.5 million people into next year.
Why it matters
After 14 years of crisis, emergency referrals remain one of the most urgent gaps in Syria’s health system. For patients with trauma, maternal complications, or chronic disease, timely transfer can be the difference between life and death.
Reliable ambulance services reduce preventable deaths and help connect people to specialized treatment. They are also strengthening resilience – training health workers, improving coordination, and aligning with the Ministry of Health’s goals to expand access and preparedness. Each ambulance on the road represents more than a service: it is a critical step toward a stronger, nationally supported health system.
For Bashar, the calling is clear: “I have seen dozens of cases on the verge of death, but with quick intervention and the right tools, lives were saved. That support gave people confidence that someone was standing by them – that hope still exists, even in the darkest moments.”
And for Mohammed, the motivation is deeply personal: “When we arrive, people know help has come. That’s what keeps us going.”