Can COVID-19 be contained in war-torn Syria?

David Miliband: Well COVID-19 is obviously a threat in advanced, industrialized societies where there is extensive public health and health infrastructure. Just imagine what it’s going to be like in a country that is ravaged by war. In the northwest of Syria, 85 hospitals have been bombed in the course of the last year during that war. And so we’re talking about a highly densely populated population — even higher density than the 25,000 people per square mile that is the case in New York — highly densely populated population with very little public health infrastructure. We know that a million people have been displaced from their homes by the fighting over the last three months alone. And so people are living in tents, under trees, even in the cold — conditions that still currently operate inside Syria. And we know that if they do get sick, the public health infrastructure is very weak indeed. So we’re doing everything we can to use our expertise in infection prevention and control to prevent this becoming a rampage across the country.

So we’re working in the northwest and in the northeast — that is the northwest Idlib province, about 3.5 million people there, in the northeast, two provinces there, about 4 million people. We don’t yet have a recorded case — I emphasize recorded. The case that the United Nations reported earlier this week was in eastern Damascus. That’s a government-controlled area. And obviously, there’s a grave concern that there is movement across the Iraq-Syria border. I know that Turkey is very concerned about movement across the northern border. And we know that Iran has suffered grievously from the spread of the disease. But we really think that if there is the gift of time, we’ve got to use it to try and get the preventative measures in place.

You’re absolutely right that the relationship of the United Nations is with the government of Syria, which controls the other parts of the country. The supplies that go across the line from government-held to rebel-held areas is virtually nonexistent. We know that from the United Nations report. We also know that cross-border supplies are now being interfered with because the number of cross-border checkpoints has been reduced from four to two. There remains UN crossings in the northwest of the country from Turkey into Syria. And it’s essential that they are properly used. So we are deeply concerned.

We’re desperately trying to get supplies in, not just to protect our staff, but to protect the people that we serve. That’s why we’ve launched our own appeal, because we cannot rely on the money that’s going into the official channels. We’ve got to make sure that the people on the ground, the nongovernmental organizations like us, that they’ve got the supplies that they need to do their jobs. And 400 Syrian staff that we’ve got are recruited locally in the warzones and refugee-hosting countries where we work. So people are defending their own communities, their own families, as well as their clients.

Well, the top priority is to sustain the ceasefire. The UN Secretary-General Antonio Gutierrez has called for ceasefires in all war zones. Obviously, war is now the main driver of poverty and displacement. A second thing that is absolutely key is to get medical supplies through. At the moment, there are real constraints on that. Third thing, we need to do preventative work to ensure that the population understands from people they trust the measures that they need to take. And then we’re into the same syndrome that exists in this country.

We need to test, test, test. We need to isolate, isolate, isolate. And then we need to treat, treat, treat. That’s five, 10 times harder in a warzone. But it’s not beyond human ingenuity, and we’ve got to get on with it.