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Health Response to the Situation in Ar-Raqqa

Health Response to the Situation in Ar-Raqqa: Establishing trauma referral pathways to provide urgent life-saving assistance for displaced populations and civilians remaining in Ar-Raqqa

Report of a WHO assessment mission to Al-Hasakeh and Ar-Raqqa governorates

EXECUTIVE SUMMARY

Tens of thousands of civilians have fled Ar-Raqqa city in Ar-Raqqa governorate since the Syrian Defence Forces (SDF) began their offensive to retake control of the city from the Islamic State of Iraq and the Levant (ISIL). Around 190 000 people have been displaced; another 30 000 to 50 000 people are thought to remain inside Ar-Raqqa city. In July 2017, a WHO team comprising an external trauma care specialist and two WHO staff members visited the governorates of Ar-Raqqa and neighbouring Al-Hasakeh to assess the situation.

The purpose of their mission was two-fold:

  1. to assess the health situation in Ar-Raqqa (available health services, geographical scope required) and propose optimal response modalities;
  2. to develop an operational plan to set up trauma referral pathways for WHO’s health emergency response in north-east Syria.

The team visited eight hospitals and health care facilities in Ar-Raqqa and Al-Hasakeh governorates to assess their capacities and infrastructures. It also met with representatives of eight NGOs to discuss collaboration and coordination for potential evacuation pathways for severely injured patients. The team’s main findings and recommendations are summarized below:

Findings

  1. Health care services in Ar-Raqqa governorate have been severely disrupted because of the ongoing military campaign, massive population displacements and damaged health care facilities.
  2. Currently, health care services are being provided by private and government hospitals as well as hospitals under Kurdish control and by NGOs such as KRC and Medecins Sans Frontieres.
  3. The number of casualties as a result of the Ar-Raqqa offensive is rising, and hence increasing the workload of all hospitals in the region.
  4. Thus far, only one trauma stabilization point (TSP) north of Ar-Raqqa is working. Two more are expected to be up and running in the next few days. Kurdish organizations and European NGOs plan to open three more TSPs in the vicinity of Ar-Raqqa city. (TSPs serve to triage and resuscitate patients. Once stabilized, seriously wounded patients from Ar-Raqqa are transported by ambulance from TSPs to Tal Abyad public hospital.)
  5. Tal Abyad hospital has temporarily suspended elective surgery due to the number of patients requiring emergency surgery. (NB WHO has since been informed by one of its NGO partners that elective surgery in this hospital restarted the week of 17 July.) According to the hospital staff interviewed by the assessment team, some patients treated in this hospital are currently being transported to Qamishli for secondary surgery.
  6. Al Tabqa hospital, within an acceptable distance from Ar-Raqqa city, is currently not working.
  7. Mine and sniper injuries are occurring east of Ar-Raqqa and north and west of Deir-ez-Zor. Patients on the eastern frontline are evacuated by private car, since there are no TSPs for civilians in this area. These patients are treated mainly in private hospitals in Al-Hasakeh before being evacuated to the government hospital in Qamishli.
  8. Hospitals in Al-Hasakeh are admitting injured patients on a daily basis and handling moderate mass casualty events every one or two weeks.
  9. The battle zone is expected to move eastwards. Work is ongoing to transform a public clinic into an emergency hospital to handle the caseload.
  10. The government hospital in Al-Hasakeh is being re-equipped to make it functional.
  11. Hospitals in Ain Arab (Kobane) and Ras el Ain are working and receiving casualties. However, they are too far away from the conflict zone to be able to perform damage control surgery.

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Webspace(s): 
Organization(s): 
World Health Organization
Cluster(s)/Sector(s): 
Original Publication Date: 
31 Jul 2017
Document type: 
Assessment Report
Location(s): 
Ar-Raqqa
Theme(s): 
Needs Assessment
Disaster(s)/Emergency: 
Syria: Crisis 2011-2019