Evacuation Of Critically Sick Patients From Syrian Rebel-Held Enclave In Eastern Ghouta

In December 2017, the United Nations pushed for the immediate evacuation of critically sick children and patients from the besieged Syrian rebel-held enclave of Eastern Ghouta. Over the past few weeks the process of evacuation has begun; however, the lives of hundreds of people requiring immediate medical attention remains uncertain.

The International Committee of the Red Cross (ICRC) in Syria, working alongside the Syrian Arab Red Cresent, confirmed that they had “begun the evacuation of critical medical cases from Eastern Ghouta to central Damascus” on Wednesday. The official Syrian government news agency confirmed this, following local negotiations and numerous humanitarian appeals from high-profile figures. This included Russia’s Foreign Minister Sergei Lavrov, Turkey’s President Recep Tayyip Erdogan and King Abdullah of Jordan. Mohammad Katoub, the Advocacy Manager of the Syrian American Medical Society (SAMS), tweeted that five people had been approved for the first group of evacuations. However, it remains unclear as to why only four of the five have left the zone. SAMS subsequently confirmed that a further 29 critical cases had been approved for evacuation and that the remainder would be removed from the area in the days to come. This currently includes four women and 18 children with a blood disease, kidney failure, heart disease, and cancer.

The evacuations resulted from long negotiations and are part of a complex exchange of detainees between Assad’s government and rebel group Jaish Al-Islam. The group stated that they “have agreed to the release of a number of prisoners… in exchange for the evacuation of the most urgent humanitarian cases.” This was confirmed by a spokeswoman of the ICRC who was unwilling to comment further, citing that the operation was sensitive and that there remained potential for the deal to fall through. Despite the efforts of many, including an offer made by Erdogan to facilitate patients in Turkish hospitals, the process remains uncertain and lengthy. The United Nations has been waiting for several months for Syrian authorities to provide ‘facilitation letters’ that would enable aid operations to commence in the region. Without this, a spokeswoman for the Rural Damascus Health Directorate expressed that the number of patients waiting for evacuation because of inadequate medical attention has risen to 600. UNICEF workers have further described the scene as one of the worst health situations since the conflict began in 2011.

The Eastern Ghouta is home to 400,000 residents and has been under siege since 2013. The region is the only rebel-held area near the Syrian capital of Damascus. It is part of a ‘de-escalation zone’ that was negotiated by Russia earlier this year. Cease-fires brokered by Russia have been successful elsewhere in Syria, however little progress has been made toward a political solution in the conflict claiming 400 000 lives since 2011. Despite the difficulties in facilitating the evacuations, this is a long-awaited and much-needed response by medical groups, humanitarian organisations and national governments, since violence in the region was intensified on the 14th of November. The Syrian Observatory of Human Rights stated that at least 202 people, including 47 children, have died since the deterioration of humanitarian conditions.

Hamish De Bretton-Gordon, director of Doctors under Fire, a charity working alongside local hospitals, stated that the evacuations were a ray of light in the six-year-long conflict. He hopes that the deal might eventuate into a ceasefire and has urged Russia, a key ally of Assad, to show mercy in their medieval siege techniques resulting in no aid for four years. While many remain hopeful, there seems to be a long way to go before many innocence civilians can access the medical attention they so desperately need. Although the evacuations are a first and needed step to rectify the problem, a stronger humanitarian response is needed. all players need to come together and broker a deal by which humanitarian aid can flow more easily into the region itself so that both critical and non-critical cases can be treated.