Tarek Al-Sheikh helps load a patient into the ambulance for urgent referral to hospital in northern Aleppo. Photo credit: WHO15 September 2025, Aleppo, Syrian Arab Republic – “I leave home early every morning to start my shift in the ambulance. Some days I wait for hours until a call arrives. Other days I respond immediately to emergencies – a child struggling to breathe, a mother in labour, or a patient who needs to be transferred urgently to another hospital,” says Tarek Al-Sheikh, a paramedic with the Syrian Relief and Development (SRD) team at Afrin National Hospital in Aleppo, northern Syria.
Tarek has been serving his community for more than 4 years. For him, this work is more than a job – it is a lifeline for families who otherwise would not be able to reach the care they need.
“The importance of this work is that it is purely humanitarian. Our people in the north need these services, which reach many people who otherwise would not be able to access care,” Tarek says.
Referral systems as lifelines
The referral system Tarek is part of is designed to save lives by moving patients quickly and safely across Idlib and Aleppo. Operating in areas where over 4 million people remain in need of health assistance – including 2 million living in camps – and with more returning to Syria, the need is immense. Since 2024, more than 1.2 million Syrians have returned to the country, while internal returns continue, with 1.7 million internally displaced returnees recorded since December 2024.
Against this backdrop, referral pathways help ensure that emergencies do not become tragedies. Tarek recalls one case that captures both the challenges and the impact of this work.
“We were at Bab Al Hawa Hospital, transferring a newborn from the incubator unit to Rajou Hospital in Afrin. When we arrived, we found two newborn twins, only 2 hours old, who urgently needed intubation and transfer to another hospital. The ambulance on site was not ready, and we were not fully prepared either. Despite this, with the help of the medical staff, the babies were intubated and we managed to transfer them safely to Azaz National Hospital.”
For families, the referral system also reduces the financial burden of health care. “In the past, people often had to pay extremely high costs for private transport or private hospitals. Now we can transfer patients for free to facilities where they can receive care,” says Tarek.
Building for today and tomorrow
Paramedic Tarek provides emergency care to a patient inside an ambulance in Aleppo. Photo credit: WHOThe referral system is not only saving lives today – it is shaping the future of Syria’s health system. It supports the Ministry of Health’s goals to expand access, improve quality and strengthen preparedness. It reinforces WHO’s broader efforts to train health workers, improve coordination between facilities, and ensure patients reach specialized care without delay. Crucially, it keeps hospitals, clinics, referral pathways and medical supply chains functioning despite years of conflict and crisis.
In the last year, these services have improved significantly thanks to sustained support. Ambulances are better equipped, medical staff receive more training, and coordination has grown stronger. “We now have better training, more advanced equipment and stronger coordination. This has helped me save many more lives. It also brings stability to my own family, while serving the wider community,” says Tarek.
EU support keeping systems running
Paramedic Tarek provides emergency care to a patient inside an ambulance in Aleppo. Photo credit: WHOThis 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 healthcare, trauma care and rehabilitation services.
A recent commitment of an additional €22 million will sustain life-saving and life-sustaining health services for more than 6.5 million people into next year – keeping hospitals, clinics, referral pathways and medical supply chains running as the country begins its transition to recovery and rebuilding, while still maintaining critical humanitarian services.
Looking ahead
Despite the risks and difficulties of his work, Tarek remains motivated.
“This is humanitarian work. It helps the people who need it most, reduces risks and delivers healthcare quickly. The world outside Syria should know the role of paramedics and how essential these services are to saving lives here.”
