14 July 2019 – When Elizabeth Hoff was appointed as WHO Representative in Syria in 2012, she didn’t expect that she would spend the next several years leading the emergency health response in what has been described as the world’s largest and most complex humanitarian emergency. After seven years of working in the war-ravaged country, the next chapter of her career will take her to Libya, where she has been nominated WHO Representative.

“I leave Syria with a heavy heart,” she says. “This has been the richest and most rewarding position I’ve ever held.”

Hoff has been deeply touched by Syrians’ resilience and fortitude. “I’ve never stopped being impressed by the generosity and solidarity of people here. So many Syrians have helped their fellow citizens. Ordinary people have opened their doors and shared their homes, meals and possessions with others whose houses have been destroyed or who have been forced to leave their villages,” she says.

Being the WHO Representative in Syria has not been an easy task. “It has involved not only managing the emergency health response, but also navigating a complex political arena with different stakeholders, each with its own interests and agenda,” she explains. “And of course, to get things done in such a challenging environment, it’s important to maintain good relationships with the Government and Ministry of Health.”

Since 2012, Hoff has led the emergency health response in what has been described as the world’s largest and most complex humanitarian emergency

Strengthening the health system

Eight years of conflict have left the health system severely damaged. Under Hoff’s direction, WHO has led the health sector in Syria and worked closely with the national authorities to help avert the collapse of the health system. In spite of the devastating impact of the conflict, she remains hopeful. “The health system is slowly recovering. WHO has trained thousands of health care professionals to replace those who have left the country or have been killed over the past eight years,” she says. “We’ve built up a solid network of national NGOs that are providing health care services in some of the worst-affected areas, places where people would otherwise have no access to health care. Hospitals and other health care facilities are slowly being rehabilitated and new ones are being established. Emergency health services and ambulances are working hard to save lives.”

Under Hoff’s direction, WHO has led the health sector in Syria and worked closely with the national authorities to help avert the collapse of the health system

Passion for work in the field

Despite movement restrictions and security challenges, Hoff has travelled throughout Syria, including to some of the worst affected areas in the country. “My approach has always been that leaders have to earn the trust and respect of their teams. That means staying with my team in highly dangerous locations. We have to be committed humanitarians and that means going where the needs are greatest. In doing that, we’ve developed a very strong team spirit.”

“There were many moments that broke my heart,” she continues. “I will never forget my visit to Al-Moadamyeh. The town had been under siege for several years, and people there were literally starving to death. After the siege was lifted, assistance poured in. I met a little boy who had just received food from one of the aid agencies. He came to me to ask if he could have more food for his brother, who was too weak to come to the aid distribution point.”

Despite movement restrictions and security challenges, Hoff has travelled throughout Syria, including to some of the worst affected areas in the country

Advocating for health care protection

Hoff has been outspoken in her condemnation of the attacks on health care in Syria. “It appalls me to hear about new attacks on health care. I’ve seen the devastating impact of these attacks first hand. Ambulance drivers have raced to help the victims of bombing only to come under attack themselves. Pregnant women have been unable to reach health care centres. Patients have died on operating tables because hospitals have come under attack.”

Daily life in Syria

“I’ve never felt like a foreigner here,” she says. “Syrians are open-minded and eager to communicate with people from other cultures. They are peace-loving, highly-educated and hard-working. And they love their country.”

“I visited Syria long before I joined WHO. I loved it then and I love it now. It’s the cradle of civilization; the richness of its history and its architectural treasures are amazing.”

Hoff is full of respect and admiration for the tens of thousands of health care workers throughout Syria. “All the doctors, nurses, pharmacists and other health professionals I’ve worked with here are highly trained and extremely capable. Their dedication is just remarkable. Every day, they put their own lives at risk to help others. They earn very little, and so many of them work in highly dangerous areas. But they just keep going.”

Hoff finishes on a positive note. “I can see light at the end of the tunnel” she says. “It will take time, and it won’t be easy, but peace will come to Syria.”