The Syrian uprisings are an excellent example of how the political can become personal. What started as a series of protests about displeasure with the government quickly devolved into civil war, with families forced to give up their jobs and homes in order to find safety. The situation in Syria is also an important reminder about the impact of political instability on health care.
Since March 2011, around 1.4 million citizens have fled Syria. Most of these refugees have escaped to nearby countries in the Middle East, including Turkey, Lebanon, and especially Jordan. Located on the southern border of Syria, Jordan is a nation accessible from Syria by foot. The World Health Organization (WHO) estimates that around half a million Syrian refugees have already made the journey to Jordan.
Although Jordan has welcomed its neighbors from the north, this influx of refugees has put a major strain on the nation's health care system. A huge number of Syrians have entered Jordan in a very short period of time; many with existing health problems. Since the beginnings of the civil war, health services in Syria have gradually decreased. Many doctors and other medical personnel have left the nation due to safety concerns, and those health facilities that do still exist in Syria may be inaccessible thanks to snipers, bombings and road destruction. It has also become difficult for Syrian citizens to access drugs. WHO reports a shortage of anesthetics, antibiotics, and drugs used to treat chronic conditions such as hypertension and diabetes. Mental health medication has also become more difficult to find.
Because of these medical service failings, Syrian refugees often focus on health care immediately upon reaching Jordan; whether looking to treat a recent injury due to the war, or seeking aid for a chronic health condition that has gone untreated for quite some time. To help these refugees, health care workers and resources from around Jordan are being diverted to refugee camps near the Syrian border.
Maternity care is one major health issue for Syrian refugees in Jordan. Family planning and birth control are not common in many parts of Syria, and the United Nations Population Fund (UNFPA) reports especially high fertility rates amongst Syrians coming from rural areas. Pregnant women, concerned about the country's dwindling supply of doctors, may feel particularly compelled to leave Syria - these women want easy access to competent health facilities in which they can deliver a baby.
In Jordan's biggest camp for Syrian refugees, known as camp Zaatari, around 10 babies are born every day. Pregnancy and delivery services have therefore become a major focus of health care workers at Zaatari and other camps. To further cope with the refugees' need for reproductive services, UNFPA has recently created a clinic at camp Zaatari that is dedicated to offering reproductive services and family planning advice. Opened in April 2013, the clinic also strives to aid women who are experiencing or have been victims of sexual or domestic abuse.
Older refugee children are also a concern amongst local and international health care workers in Jordan. Children are more susceptible than adults to diarrhea and respiratory infections; two illnesses that are common amongst populations living in close quarters, such as those at a refugee camp. WHO and other organizations have expressed fears that these health issues may worsen during the coming summer, when water supplies are low.
At camp Zaatari, the medical aid group Doctors Without Borders/Médecins Sans Frontières (MSF) has recently founded a children's hospital; the only one of its kind in the area. Focusing on children aged one month to 10 years, the hospital has already proved of great benefit to area Syrian refugees - 270 patients have made use of hospitalization services, and doctors have seen over 2,000 consultations with children and their families.
Stories from MSF of Syrian children at this hospital highlight the importance of pediatric care for refugee families, but also the difficulties that refugees face in accessing such services. One Syrian mother came to the hospital with her five-month-old baby, seeking treatment for the child's gastric problems; however, staying with her infant meant leaving her other children alone in the refugee camp, where they might be vulnerable to injury or illness. Another mother at the pediatric hospital sought care for an asthmatic infant constantly made ill by the dusty living conditions of the camp.
However, refugees not in established camps may find it even more difficult to get health care. Syrians who have managed to make it into larger cities may not know the process of seeking care, or be unable to afford the cost. Jordanian hospitals, likewise unfamiliar with the protocol of treating unregistered refugees, may also run into problems when scheduling medical procedures and recouping health care costs.
Luckily, UNFPA is supporting other agencies in Jordan, including the Jordanian Health Aid Society and the Aman Jordanian Association, as they work to set up clinics around the country designed to help Syrian refugees who need health care but are not living in a refugee camp.
But to keep the health care infrastructure in Jordan running smoothly, WHO and other UN agencies agree that more international funding and support is desperately needed. The international community has been slow to respond to calls for further aid to Jordan. Although the health care system in Jordan is quite strong for the region - with 8 percent of GDP spent on health services and an average life expectancy of around 80 years - the increasing number of Syrian refugees may prove more than Jordan's services can handle.
At the moment, WHO is collecting data about the effect of refugees upon communities and government health facilities in Jordan. The results of that study may prompt more nations to offer financial aid. If the Syrian conflict does not end soon, that aid could mean the difference between a functioning or a floundering health care system for Jordan, its citizens, and the refugees it has agreed to shelter.