Syria: Médecins Sans Frontières Issue Dire Report

During a brief window in August, when the siege was broken, MSF sent in 128 tonnes of supplies, sufficient to last east Aleppo’s hospitals until October. “Six of the trucks had to turn back, because the bombing restarted, but 85 per cent of the supplies got through”, says Eduardo Yanez, MSF logistics manager. “Up to now the hospitals are still using those stocks – though they must be starting to run out.”

These supplies are likely to have been depleted quicker than usual, with the high numbers of wounded patients. And however carefully the hospitals are rationing drugs and other medical supplies, they cannot last indefinitely. There are currently no drugs to treat cancer, tuberculosis or hepatitis, and many other drugs will reportedly run out soon.

“We are on the verge of finishing the last of our supplies and, once this happens, we will be facing an acute medical shortage, especially with medicines for chronic diseases,” says Mahmoud Abu Hozaifa, manager of a pharmacy in east Aleppo. “Even finding painkillers is a challenge.”

Hospitals urgently need to be resupplied. As soon as it is possible and security conditions allow it, MSF is ready to send in more aid. “We have already positioned enough drugs in the area to supply 12 medical facilities in east Aleppo – eight hospitals and four health centres”, says Eduardo Yanez, whose team is on standby.

Fewer beds in underground hospitals

Hospitals have been forced to move underground to protect staff and patients from airstrikes. With the higher floors of hospital buildings abandoned, and emergency rooms, operating theatres and intensive care units moved down into basements, there has been a significant reduction in the number of beds available for patients.

Hospital staff have dealt with this by prioritising the most urgent cases, and setting up beds for post-operative care in nearby houses. Patients, meanwhile, are opting to spend as little time as possible in hospitals. “Women have a caesarean and are out within a few hours”, says Sara Ferrer Roura. Many people prefer to visit local health centres, which are closer to their homes and have been hit less often by airstrikes.

Fuel shortages

East Aleppo has been without electricity for months, and hospitals rely on generators to supply them with power for lighting and to run essential equipment such as life support machines and ventilators. But generators require fuel, which is increasingly hard to get hold of in the besieged area.

In response, hospital staff are carefully rationing the fuel they use, running generators for just a few hours each day, or only when power is urgently needed. “They only run generators when they really need them for an operation, so saving fuel”, says Patricia Garcia Peinado. “They are incredibly adaptable, and are learning how to work under besiegement.”

Prior to the siege, MSF had been providing drugs, medical supplies and equipment every three months to eight hospitals, six health centres, eight first-aid posts, a blood bank and an ambulance service in east Aleppo. Since August, no deliveries of aid have been possible.