Abdulsalam Al-Ali, a WHO- trained local community health volunteer communicates health messages to individuals and households.10 March 2025 – Overcrowding, unsafe sanitation, restricted movement and limited access to secondary health care all contribute to the significant public health challenges faced by more than 42 000 refugees and internally displaced individuals living at Al-Hol Camp in northeast Syria.

Conditions have led to repeated outbreaks of infectious diseases, placing immense strain on medical services and public health surveillance. The resurgence of cholera in 2024 underscored the urgent need to enhance surveillance and early detection systems.

In response to the outbreak, the World Health Organization (WHO), in collaboration with local health partners, launched a community-based initiative aimed at strengthening disease surveillance within the camp. Starting on 15 November 2024, WHO began integrating community-based surveillance (CBS) into the existing Early Warning, Alert and Response System (EWARS), enabling the rapid detection and reporting of diseases like acute watery diarrhea (AWD) through community channels.

The initiative focused on training and empowering local community health volunteers (CHVs) to identify priority diseases, refer cases to health facilities, contact trace and report disease surveillance information to the camp health authorities. CHVs played a pivotal role during the outbreak by collecting data on AWD and other illnesses and ensuring the timely reporting of health information to local health facilities for quick action. CHVs also conducted community engagement sessions with individuals and households to raise awareness about the risks of waterborne diseases and the importance of seeking health care early, and the role of oral rehydration solution (ORS) in home treatment of mild cases of diarrhoea.

CHV Huda Mahmoud Hamdan said the main goal of her participation was to help the people she lives with. Her task was made easier by the trust people in the camp have in her. She is well known and lives beside them in the same area of the camp. Being well-regarded by neighbours means people are more accepting of her health messages.

As he underlined how his team was offering essential services to people in desperate need, CHV Abdulsalam Al-Ali said the training provided by WHO had greatly improved the ability of volunteers to effectively communicate health messages to individuals and households.

The CBS initiative has proven effective in early disease detection. Since the initiative began, 294 health alerts have been generated, including 123 suspected AWD cases, 96 tuberculosis cases and 62 suspected cases of hepatitis A.

The alerts triggered swift responses from health partners, enabling timely interventions. CHVs played a crucial role in facilitating these faster response times by ensuring the prompt collection of samples for laboratory delivery, providing ORS and referring patients to health facilities for treatment.

The work done in Al-Hol Camp highlights the effectiveness of community-driven surveillance in strengthening public health systems during crises. By empowering local volunteers to improve disease monitoring, the initiative has been pivotal in protecting the health of camp residents. The spread of cholera in Al Hol Camp was more rapidly controlled due to the timely detection of cases at community level and improved hygiene practices – both of which were made possible by the committed efforts of CHVs. Expanding CBS to other high-risk areas will help ensure more effective health interventions and bolster the overall public health response across the Syrian Arab Republic.

Nurse Fawziya carefully changes a child’s dressing, ensuring proper wound care and recovery. Photo: WHO27 February 2025, Aleppo Syrian Arab Republic – For Fawziya Ismail Al-Hasan, nursing is more than a profession; it is a commitment to serving those who need care the most. Displaced from rural Homs, she has lived with her husband and three children in Qara Kobri camp in Aleppo for over six years. For the past five years, she has worked at the Qara Kobri primary health care center, a facility managed by Al-Ameen, where she joined as a nurse in 2021.

“I provide nursing care for both displaced people and residents in the village and nearby communities,” she explains.

“Since there are no other health centres around, we offer vital services like dressing wounds, disinfecting and stitching injuries, administering IV and intramuscular injections and other essential nursing support.”

A health system under strain

Fawziya’s work is a lifeline for many in the camp and surrounding areas, where health care remains difficult to access. In 2025, 15.8 million people – more than 65% of the total population – will need humanitarian health assistance. Among them are 7.4 million internally displaced persons (IDPs), 22% of whom live in Aleppo. Many, like Fawziya’s neighbours, live in tents with little protection from extreme weather, limited access to clean water and poor sanitation.

With no nearby hospitals, the Qara Kobri primary health care centre is often the only option for people in need. Located in Al-Bab in northern Syria, the centre provides free health care services, from prevention and awareness to treatment. Thousands of patients visit each month for consultations, medications from its pharmacy, and referrals for critical cases in partnership with other health providers.

“We know how important this centre is for people living under tough conditions, far from larger hospitals,” Fawziya says. “Sometimes, we are the only hope for people who cannot afford to travel long distances for basic medical care.” 

Saving lives against the odds

With a rise in influenza cases during winter months, Nurse Fawziya provides oxygen support to a young patient struggling to breathe. Photo: WHOSyria’s health system is in crisis. Across the country, only 57% of hospitals and 37% of primary health care centres are fully functional, with widespread shortages of medicines and equipment. More than 100 health facilities in the northwest lack funding to ensure continuity of services. Those that remain operational struggle with insufficient medical supplies, trained personnel and resources.

Despite the challenges, Fawziya is determined. She recalls a young boy suffering from severe dehydration. Without the centre’s quick intervention his condition could have been fatal.

“We face tough situations but standing by our patients, offering not just medical care but emotional support, is what matters most,” she says.

Keeping health care running

WHO, supported by KSrelief, is providing vital assistance across Syria to keep critical health services operational. Over the past 4 months funding from KSrelief has helped sustain more than 50 health facilities in northwest Syria, including hospitals, primary health care centres, dialysis units and tuberculosis treatment centres. Since November 2024, over 154 000 people have benefitted from medical consultations, treatments and surgery.

As well as keeping facilities open, KSrelief support strengthens the referral system and provides essential medicines and medical equipment to ensure patients receive the care they need.

Care and resilience

Despite the hardships, Fawziya finds strength in the team she works with.

“My colleagues are like a second family. We work together with love and dedication, driven by the need to ease people’s suffering.”

She is grateful for the support that keeps the facility running. “Thanks to KSrelief funding our health facility can cover staff salaries, which is vital. Without this support many of us would have to work as volunteers because resources are so limited. KSrelief’s help ensures we can continue to serve our community consistently and with the care they deserve.”

Through partnerships like WHO and KSrelief, facilities such as Qara Kobri primary health care centre remain open, offering a vital lifeline to people in need, today and in the years to come.

Wafaa Al-Doush performs a routine ultrasound, checking on the health of an expecting mother and her baby. Photo: WHO26 February 2025, Aleppo, Syrian Arab Republic – Wafaa Al-oush has no doubts about what her role as a midwife entails – it is a mission to ensure every mother and baby receive the care they need. Living in Al-Bab, in northern Aleppo, with her husband and young child, she has worked at Al-Ameen Medical Centre for the past 4 years, providing essential maternal health services.

“Every day women come to us full of worries, not just about their pregnancy but about how they will afford food, shelter and medical care for their babies,” says Wafaa. “Sometimes they just need someone to listen, to reassure them that they are not alone.”

A lifeline for maternal health

In northwest Syria, where accessing maternal health care can be a major challenge, Wafaa’s role is critical. In 2025, 15.8 million people will need humanitarian health assistance across the country, many of them women and children. Syria, where years of conflict and natural disasters have made accessing health care even more difficult, is also home to 7.4 million internally displaced people.

“Many women here face challenges getting prenatal care because of the distance to health centres and the costs involved,” explains Wafaa. “Our clinic is often the only option for these women to receive safe and timely care.”

The Al-Ameen Medical Centre serves as a vital health care hub, offering free services to thousands of women in need. Expectant mothers receive prenatal checkups, family planning support and essential maternal health guidance to help ensure safer pregnancies and deliveries.

One of Wafaa’s patients, Rana, a mother of 2, was hesitant to seek care for her third pregnancy.

“I kept delaying my visits because I was afraid of the cost,” she says. “I didn’t realize how much I needed help until I started feeling weak and dizzy all the time. The midwives here didn’t just treat me, they made me feel safe.”

Saving lives against the odds

Wafaa Al-Doush reassures her patient with care and compassion. Photo: WHODespite the rewarding nature of her work, Wafaa faces daily challenges. Too often women arrive late in their pregnancies, unaware of complications that could have been managed with earlier care.

“I remember one case where a mother arrived in critical condition due to untreated preeclampsia,” she recalls. “She had been feeling unwell for weeks but didn’t come in because she didn’t have the money for transportation. Immediate intervention saved both her and her baby’s life.”

In northwest Syria, over 30 health facilities – including major hospitals – were damaged or destroyed in front-line areas of Idlib and western Aleppo, leaving communities without essential care. The destruction of these facilities has put enormous pressure on the few that remain functional.

“There are entire areas where hospitals no longer exist,” say Wafaa. “Women in labour have to travel for hours to find a place to deliver safely. Some don’t make it in time.”

In northwest Syria, over 100 health facilities are at risk of closure. Across the country, just 57% of hospitals and 37% of primary health care centres remain fully functional. The need for support has never been greater. 

Keeping health care services running

KSrelief is supporting more than 50 health facilities across northwest Syria, ensuring that critical medical care remains available. This assistance helps hospitals, clinics and maternity centres stay open and deliver lifesaving services to communities affected by conflict, displacement and the 2023 earthquake.

By funding staff salaries, providing essential medicines, medical equipment and strengthening referral systems, KSrelief’s support ensures that mothers and newborns receive the care they need, at no cost. Since November 2024, over 154 000 people in northwest Syria have benefitted from consultations, treatments and surgeries.

A future in which every mother receives care

For Wafaa, the impact of her work keeps her motivated.

“I dream of a future where no mother has to fear giving birth,” she says. “Where hospitals are restored, where clinics have enough supplies, where women can walk into a health centre and know they will be cared for, no matter what.”

Dr Aziza Al-Naasan attends to a patient. Photo: WHO25 February 2025, Aleppo, Syrian Arab Rebublic – As an internal medicine doctor at Al-Ameen Medical Centre in Al-Bab, northern Aleppo, Dr Aziza Al-Naasan knows that every day is a battle to heal. She treats a steady stream of patients, many suffering from chronic conditions such as asthma, diabetes, heart disease and high blood pressure.

Originally from Idlib, Dr Aziza now lives in Aleppo with her husband and 2 daughters. Like millions across Syria, she witnessed firsthand the devastating toll of conflict on families, communities and the health care system.

“We help patients by providing the right treatment and guiding them on how to take their medication properly,” she says. “We also offer lab tests and diagnose conditions, which greatly improves their health.”

Many of her patients are displaced people who fled their homes due to violence. Syria is home to an estimated 7.4 million internally displaced people, nearly a third of whom live in Idlib and over a fifth in Aleppo. For them, accessible health care is not just about survival today, it is a vital step towards rebuilding their lives.

“We make sure they get the care they need without having to travel far,” says Dr Aziza. “It brings me joy to know that my work helps ease their suffering.”

A health system struggling to cope

Nearly 14 years of conflict severely weakened Syria’s health system. Only 57% of hospitals and 37% of primary health care centres are fully functional and there are widespread shortages of medicines, equipment and trained personnel.

Despite the challenges, hope is emerging. Dr Aziza speaks of a newfound sense of optimism across Syria – a possibility, however fragile, that years of conflict may be nearing an end.

“People have endured unimaginable hardships and what matters now is ensuring they continue to receive health care,” she says. “Even if peace is within reach, rebuilding lives takes time. Without reliable medical care, the suffering will not end.”

She hopes to see her patients – many of whom have lived through profound trauma – return to their homes, rebuild their communities and access health care in stable environments. But without sustained support, facilities like hers struggle to stay open. 

Keeping health care running

Dr Aziza writes a prescription for her patient, ensuring they receive the care they need. Photo: WHOTo keep critical health services operational, WHO, supported by KSrelief, is providing vital assistance across Syria. Over the past 4 months funding from KSrelief has helped sustain more than 50 health facilities in northwest Syria, including hospitals, primary health care centres, dialysis units and tuberculosis treatment centres.

KSrelief support has ensured Syrians continue to receive medical care. It has covered staff salaries, preventing health workers from having to serve on a voluntary basis, or worse, see their facilities shut down. It has enabled facilities like Al-Bab National Hospital, Hope Hospital for Pediatrics and Maternity, Al-Bab TB Centre, Mare Dialysis Centre and Jarablus primary health care centre provide lifesaving care. Over 154 000 people have benefitted from medical consultations, treatments and surgeries.

“KSrelief’s support has kept our facility running,” says Dr Aziza. “Without it, many health workers would have no choice but to work unpaid. Consistent funding ensures we can provide quality care – not just in emergencies, but to meet long-term health needs.”

A future built on health and stability

Knowing the road to recovery will be long, Dr Aziza is committed to serving those who need her most.

“We want families to return home knowing they will have the health care they need. Health is not just about treating illness, it is about restoring dignity, stability and hope for the future.”

Thanks to partnerships like that of WHO and KSrelief, Syria’s most vulnerable communities will continue to receive the care they need, today and in the years to come.