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In a May 2020 report, the Syrian Observatory of Human Rights estimated the number of deaths in the Syrian conflict at between 384,000 and 586,100 people. Since the outbreak of violence in 2011, the war has had a devastating impact on Syrian society and civilians in all regions of the country, including the autonomous regions which make up present-day North and East Syria (NES). The death of family members and bread-winners, the displacement of vast swathes of the population, the destruction of property, and an ongoing economic crisis linked to the war have all had a major effect on the daily lives of millions of people.

One often-overlooked aspect of this crisis is the impact of severe injuries, disabilities and mental and physical trauma occurred in conflict by both combatants and civilians. The Autonomous Administration of North and East Syria (AANES), the decentralized governing body in NES, places a great deal of rhetorical and practical focus on caring for those war-wounded individuals who have suffered permanent disability as a result of the conflict. The AANES faces many challenges in dealing with this aspect of the humanitarian crisis in its regions, particularly a lack of adequate medical expertise and supplies due to the embargo the region faces. On the other hand, the AANES’ attempts to establish self-managed community care put into practice their political principles of autonomy and self-determination.

An examination of the ways the AANES deals with its war-wounded will therefore help to illustrate both the severe political and humanitarian challenges the administration faces, and the unique policies and practices it is using to try and overcome these challenges.

This report constitutes a series of interviews giving insight into the realities faced by war-wounded individuals in NES. They track the different stages that individuals pass through from initial injury through to a new life living with a permanent or semipermanent disability. The testimonies give accounts of the barriers that professionals and war-wounded individuals encounter when accessing medicine, care and therapy in NES, but they also highlight solutions that have been developed in NES in order to establish more personal and community autonomy when it comes to covering the needs of the permanently and semi-permanently disabled.

Interviewees discuss the whole ecosystem of healthcare provision to wounded individuals in NES, across the following sections:

• Emergency care from the frontline to the hospital:

SDF combat medic Dilan Judi and KRC’s Sherwan Bery explain the first steps when fighters and civilians get injured during combat, while Nurse Adla Adib describes her work at Til Temir’s Shehid Legerin Hospital during the invasion of Sere Kaniye.

• The ‘Houses of Wounded Individuals’:

Shiyar Heseke, co-chair of the ‘Houses of the Wounded Individuals’ organization in the Jazira region and himself injured during the war, explains the work of this institution related to the SDF, which allows wounded individuals to recover after they have left the hospital.

• The ‘Federation of Wounded Individuals’:

The Federation of Wounded Individuals represents those whose bodies and health have been impacted by the war in the long-term – both civilians, and SDF fighters who have been wounded or handicapped. The federation supports their integration into community life and facilitates access to care, while advocating locally and internationally for better standards of care.

• The development of new, local solutions:

A factory was established in 2014 to allow the local production of prostheses for war-wounded individuals. This factory will soon be integrated into a new clinic which includes psychosocial support and physiotherapy, especially for children.

The testimonies collected here indicate a number of key barriers facing the provision of sufficient care to tens of thousands of war-wounded individuals in NES. The interviewees also indicate a number of steps which international governments and NGOs can take in order to support the AANES and its affiliated institutions in dealing with this crisis, such as:

• Reopen Yaroubiyah border crossing and open new border crossings to facilitate the import of medical goods to NES

• Send delegations of healthcare professionals to work in NES to treat the injured and, in particular, support the training of local healthcare professionals in NES

• Offer financial support for the development of healthcare infrastructure in NES

Read the report for more information.