Mowaffaq al-Khouja | Sedra al-Hariri | Cinderella al-Balaa| Marina Marhej
Syria’s medical sector continues to deteriorate after 14 years of war, marked by military violence, fragmented zones of control, and sanctions imposed over atrocities committed by the former Syrian regime.
Even after the regime’s fall, health services remain in decline, despite initiatives by the Ministry of Health and campaigns from local, international, and UN organizations that provided funding, equipment, and expertise, in addition to the lifting of long-standing sanctions.
This Enab Baladi file explores the main challenges facing Syria’s health sector, its impact on patients, and possible ways forward, through testimonies from patients, decision-makers, and aid organizations.
Patients Trapped
The health sector in Syria faces a severe crisis that endangers lives daily, with shortages of medical supplies, crumbling infrastructure, and soaring costs in the private sector.
Patients and families describe long waits for surgeries, a lack of hospital beds and essential equipment, and deteriorating conditions in public facilities.
This chronic crisis compounds the suffering of thousands of Syrians every day, highlighting the state’s limited capacity to provide safe and effective healthcare.
Aleppo University Hospital – March 28, 2025 (Enab Baladi / Mohammed Deeb Bazat)
Shortfalls in Hospitals
Manal Qasem, the daughter of a patient, told Enab Baladi that her father waited three months for a cardiac catheterization until his condition worsened. The family was forced to borrow money to operate a private hospital.
“We could have lost him had we delayed further,” she said.
Another woman, Abeer Miqdad, shared a similar experience: “The hospitals are in terrible condition. We brought my mother in extreme exhaustion, but they told us there were no beds or equipment. Even basic cleanliness was missing.”
With a shortage of staff and equipment, the search for a bed or a functioning device often becomes an ordeal equal to the illness itself.
Médecins Sans Frontières (Doctors Without Borders) estimates Syria urgently needs about $4 billion just to restore minimal healthcare services.
The health crisis is closely tied to the collapsed economy. The World Bank estimates Syria’s economy shrank by 84% between 2000 and 2023. Exports plunged from $18.5 billion to under $2 billion, and imports fell from $23 billion to about $6.5 billion, undermining the state’s ability to fund vital sectors, foremost among them health.
In Damascus and its countryside, hospitals such as al-Mujtahid and al-Muwasat, among others, are facing severe shortages in daily emergency and intensive-care supplies, forcing families to purchase syringes and IV lines themselves.
A report by Health Policy Watch warned of an escalating health crisis in Syria, marked by weak governance, staff emigration, crumbling infrastructure, and financial and security challenges.
According to government estimates, around 40% of Syria’s health infrastructure has been destroyed during the war. While the government is seeking funding for reconstruction, competing humanitarian crises and declining donor response remain major hurdles.
Health Minister Musab al-Ali noted that the most recent medical equipment in public hospitals dates back to 2011, underscoring a wide technological gap.
Currently, Syria lacks adequate dialysis and MRI machines, as well as basic resources such as ambulances.
Turning to Private Hospitals
Wael al-Amin, director of Qatana National Hospital in Damascus countryside, told Enab Baladi that the high cost of private healthcare, where an MRI scan costs around 500,000 Syrian pounds ($50), has driven patients to rely more heavily on public hospitals like al-Mujtahid and al-Muwasat.
Some tests are cheaper in public facilities, such as CT scans at about 20,000 pounds ($2), compared to 400,000 pounds ($40) in the private sector. But long waits and limited capacity make access difficult and exhausting.
Health insurance companies do not effectively cover treatment costs, leaving patients with rising financial burdens.
Heavy usage has also caused repeated equipment breakdowns, further delaying procedures.
Many government hospitals now require patients to purchase basic consumables such as cotton, gauze, and antiseptics out of pocket, costs that weigh heavily on already struggling families.
Doctors point to both poor funding and mismanagement of hospital inventories, meaning patients pay the price for systemic failures.
According to al-Amin, after the regime’s fall, the Health Ministry opened its warehouses to distribute pre-stored supplies, which covered needs briefly. But shortages soon resurfaced as no new materials were purchased. Hospitals increasingly turned to local communities and NGOs to fill the gap.
Infrastructure and Delayed Surgeries
Al-Amin added that in some hospitals, surgeries may be delayed for two months or more, whether due to shortages in anesthesia, poor administrative coordination, or even unethical practices by some doctors. Patients often resort to costly private clinics as a result.
In rural hospitals, surgeries are scheduled on only one or two days per week, creating additional pressure on limited staff.
Amid this ongoing decline, patients remain trapped between the incapacity of public hospitals and the unaffordable costs of private care.
Doctors who spoke to Enab Baladi stressed that addressing the crisis requires administrative reform, support and protection for medical staff, a guaranteed supply of essential equipment, and tackling renewed nepotism that undermines fair access to treatment.
Patients receiving treatment at al-Suqaylabiyah National Hospital in Hama – August 20, 2025 (Enab Baladi / Iyad Abdul Jawad)
Challenges to Reconstruction Efforts
The Syrian government is attempting to address the health sector’s shortcomings through contracts with international organizations, rehabilitation of medical centers, and the launch of support projects.
Over the past months, more than 40 health centers and 13 hospitals have been restored, 12 new centers opened, and 188 medical devices delivered, along with oxygen stations and solar energy sources.
During the launch of a joint project package with the al-Ameen organization, Zoheir Qarrat, director of planning and international cooperation at the Health Ministry, told Enab Baladi that the ministry alone (excluding facilities under the Ministries of Higher Education, Defense, and Interior) oversees 114 hospitals in northwestern Syria, of which 64 are fully operational, 19 partially, and around 106 are still under construction. Additionally, there are seven hospitals in northeastern Syria and 18 facilities entirely out of service.
Regarding emergency services, Qarrat explained that after the fall of the former regime, the ministry started with fewer than 200 ambulances. The fleet has now grown to 302, carrying out about 15,700 monthly transfers, a “notable but insufficient” improvement to meet rising needs.
Key Challenges
According to Qarrat, the ministry continues to face substantial burdens despite ongoing efforts:
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Infrastructure: Between 48% and 55% of health facilities need full or partial rehabilitation.
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Human resources: Shortages in specialized staff due to years of targeting, killing, and detaining medical personnel, as well as airstrikes on hospitals, which forced many doctors to flee.
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Medical supplies: A critical need for consumables and equipment, with procurement efforts ongoing through direct purchase and partnerships.
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Funding: Work is underway with experts on a comprehensive financing strategy for the coming years.
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Data systems: The lack of reliable data was a major obstacle; continuous surveys are now building a strategic database.
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Emergency response: A dedicated response center has been established within the ministry, with plans to strengthen disaster preparedness.
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Mental health and specialized surgeries: Gaps persist, compounded by outdated equipment—most devices are more than 20 years old.
Qarrat emphasized the importance of cooperation with international organizations and UN agencies, which has improved the health system not only through visiting doctors and surgeries but also through training, supply provision, and the launch of vital projects.
Syrian Health Minister Musab al-Ali during his tour of Razi Hospital in Aleppo – June 14, 2025 (Enab Baladi / Dyan Janbaz)
International Efforts
The fall of the Syrian regime on December 8, 2024, opened access for international organizations that had previously been barred from entering certain areas.
“Shifa”
One major initiative came from Germany, led by Syrian doctors abroad under the “Shifa” medical team. The group was formed immediately after the regime’s collapse to provide urgent medical and relief support.
Dr. Mahdi al-Ammar, head of visceral surgery at Hannover-Münden Hospital (University of Göttingen) and leader of the “Shifa” team, told Enab Baladi that studies revealed shortages in essential supplies, medicines, infrastructure, and personnel, as well as high surgical costs.
The first “Shifa 1” campaign, which took place in April, lasted three weeks. During this period, approximately 700 surgeries were performed, 4,000 patients were examined, and 34 workshops were conducted for local staff. The campaign covered nine provinces with 110 participating doctors across 17 hospitals.
“Shifa 2,” launched mid-July through late August, performed 1,000 surgeries, treated 6,000 patients, and delivered nearly 600 hours of training across 11 provinces, with 130 doctors participating in about 40 hospitals.
The campaign also provided technical and logistical support, including advanced equipment for hospitals in Daraa, Damascus, Aleppo, Homs, and Deir Ezzor, as well as maintenance services for broken machines. In southern Syria, given the emergency context, the team set up networks to handle war-related injuries and provided medical tents, ambulances, and supplies.
Costs for “Shifa 2” reached around €2 million, compared to €700,000 for the first campaign.
Syrian Health Minister Musab al-Ali alongside Christina Bethke, WHO Acting Representative in Syria – May 7, 2025 (Syrian Ministry of Health)
Partnerships with al-Ameen and Others
Health Minister Musab al-Ali told Enab Baladi that cooperation with al-Ameen organization, which began before the regime’s collapse in northwestern Syria, has expanded. The partnership includes equipping facilities, training staff, organizing medical campaigns, and conducting specialized operations.
He noted promised support from Qatar, Bahrain, and Kuwait, pending conversion into formal agreements.
On August 22, the ministry signed an agreement with the Italian NGO Emergency to rehabilitate Rastan Hospital in Homs, valued at $20 million, alongside a deal with Turkey to rehabilitate a cardiac hospital in Damascus’ Dummar district and a cancer hospital in Aleppo.
Emergency’s project in Rastan will prioritize the emergency ward, then extend to all departments, with rehabilitation expected to take 6–8 months. The NGO will operate the hospital for two years following its restoration. Services will include general, pediatric, obstetric, and cardiac surgery.
Doctors Without Borders Returns to Syria
Médecins Sans Frontières (MSF), sometimes known as Doctors Without Borders, regained access to previously restricted areas after the regime’s fall. In the first half of 2025 alone, MSF, in partnership with the Health Ministry, provided:
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396,200 outpatient consultations (including for non-communicable diseases),
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135,700 emergency consultations,
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125,900 pediatric consultations,
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85,400 sexual and reproductive health consultations,
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and 23,800 hospital admissions.
The organization currently works in six hospitals, 15 centers, and clinics across 11 provinces, and manages several mobile clinics.
At a Crossroads:
WHO Promises Support
Syria’s health system stands at a decisive crossroads, moving from years of conflict toward recovery, according to Christina Bethke, the World Health Organization’s (WHO) acting representative in Syria. She described the government’s “national health goals,” announced in July, as a clear roadmap for sector reform.
The plan includes expanding equitable primary healthcare, ensuring reliable drug availability, investing in the health workforce, and integrating mental health services into general care.
WHO officials met Health Minister Musab al-Ali on July 13 to discuss redistributing staff between rural and urban areas and improving service efficiency. The meeting also addressed modern planning methods, including the HELMA labor market analysis strategy, aimed at creating a reliable and updated health sector database.
On July 29, the WHO held an online meeting with the Health Ministry and Syrian officials to enhance technical support for pharmaceutical development, find solutions for sustainable health financing, improve infection control and patient safety, upgrade monitoring laboratories, and establish new hospital accreditation standards.
Medical teams evacuating wildfire casualties in rural Latakia – July 5, 2025 (Syrian Ministry of Health)
WHO’s Global Role
WHO describes its mission as ensuring the health and well-being of all people, guided by science, regardless of race, religion, gender, political belief, or socioeconomic status. Since its establishment in 1948, it has worked with 194 countries and operates in over 150 locations worldwide, leading emergency response, disease prevention, and expanding access to medicines and healthcare.
Conditions for Reform Success
Bethke stressed that reforms must be accompanied by practical enablers: sustainable financing, investment in infrastructure, and incentives to attract back health professionals who fled the country. She called for living wages, safe housing, schooling for children, family livelihood opportunities, and the integration of emergency preparedness into reforms to make the system resilient.
WHO, she added, is supporting efforts through hospital and health center rehabilitation, staff training, expanded epidemiological surveillance, and improved governance and financing mechanisms, to make healthcare a driver of stability and recovery.
Sanctions as a Longstanding Barrier
Years of U.S. and European sanctions, imposed on Syria for its military abuses, restricted the import of medical equipment and spare parts due to dual-use concerns.
Wael al-Amin, director of Qatana National Hospital (Damascus countryside), told Enab Baladi that sanctions also targeted major hospitals such as Tishreen Military, Children’s, and al-Muwasat, as well as the Health Ministry itself, complicating imports.
Although some restrictions were eased in recent years, many machines remain outdated, some dating back to the 1970s.
Bethke noted that sanctions long hampered Syria’s health sector, causing procurement delays, supplier reluctance, disrupted maintenance and warranties, and reduced local drug production. Hospitals still struggle with old equipment and acute shortages of essential medicines.
Since the regime’s collapse and Washington’s outreach to the new Syrian government, the U.S. has begun gradually lifting sanctions, recently allowing the export of civilian-use products to Syria without restrictions.
Despite this easing, Bethke cautioned that recovery will take time, requiring renewed supplier trust, steady inflow of spare parts and software, and stable funding for health facilities.
She also pointed to broader challenges: over half of Syria’s health facilities are damaged or non-functional, and up to 70% of medical personnel have left during the 14-year war. In northern Syria, about 250 health facilities risk closure due to funding shortfalls.
Other constraints include insecurity, liquidity shortages, inadequate basic services preventing staff from returning, legislative gaps, crumbling infrastructure, and an unstable investment climate.
Bethke concluded that easing sanctions is only a first step, but real progress depends on strategic investments in health equity, governance reforms, and sustained support so that ordinary Syrians can see tangible, fair improvements in healthcare access.
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