BEIRUT -- With the coronavirus pandemic accelerating, Ithar al-Allam toured the sprawling refugee camps of Syria's embattled Idlib province last month to warn of the danger. But she realized awareness was not enough.
"People tell you, 'I can't buy face masks or hand sanitizer or do isolation, because whole families live in a tent.' A tent is not a place equipped to provide full isolation from the illness," said Allam, 34.
So her organization, which runs women's centers in the area, launched a project sewing homemade face masks to distribute in the midst of Idlib's humanitarian crisis, one of the worst in the world.
This pocket of rebel-held territory in northwestern Syria is home to more than 3 million people, half of whom have been displaced from elsewhere in the country, according to United Nations estimates. Many have been displaced repeatedly -- as many as five times. Children account for half the population, according to Save the Children.
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There have been no reported cases of coronavirus in the Idlib enclave, but the vulnerability of the people means the virus, if it breaks out, is likely to rage through the local population.
"A health system in ruins, weak disease surveillance, population density, low levels of sanitation services, poor response capacity and suboptimal levels of public health preparedness; are all factors that are likely to trigger a rapid transmission of the virus in the region," the United Nations Office for the Coordination of Humanitarian Affairs said of Idlib in a report released Thursday.
The World Health Organization has shipped more than 5,000 tests to a lab in Idlib city and is seeking to accelerate further shipments, anticipating possible restrictions or disruptions in the cross-border flow of aid in coming weeks, it said.
"We could be in a situation in a few months where we have an outbreak on our hands and we're all desperately scrambling to get in more protective equipment," said Misty Buswell, policy and advocacy director for the International Rescue Committee in the Middle East. "We're trying to prepare and preposition now as best we can to avoid that, but there are concerns about being able to access global supplies and the challenges of getting them into northwest Syria given covid-related restrictions."
In addition to the closed international borders and other public health restrictions, the grinding war in Idlib is also a significant obstacle to addressing a possible outbreak of disease.
Since early March, a cease-fire has largely held under the terms of a deal brokered by Turkey, which backs some rebel groups in the area, and Russia, which supports Syrian President Bashar Assad. But cease-fires in Idlib rarely last.
As a result of the conflict, countless children are withering from malnutrition, and families lack basic amenities, often living in thin tents hastily set up on rocky, hard terrain.
The mass movements of displaced Syrians makes it difficult to prevent, detect and respond to disease outbreaks, the U.N. report said. The ability to isolate, test, treat and trace the virus is extremely limited because of living conditions and shortages in staffing and medical equipment at health centers.
"There are people who are living under very difficult life conditions, and we couldn't tell them, 'We're here to make you aware about corona,' when they don't have any capabilities ... to fight this illness," Allam said.
A Section on 04/19/2020