The intractable armed conflict has fragmented the geography of Syria between several local, regional, and international actors. This fragmentation resulted in the creation of conflict-centered institutions; as the conflict became the source of power, resources, and incentives. These institutions negatively affected the overall health system; including hampering access to services and medications; perpetuating pervasive discrimination; weakening healthcare capacity; and causing the destruction of health infrastructure, including the targeting of hospitals and Healthcare Workers (HCWs).
The Syrian Center for Policy Research in cooperation with the Arab NGO Network for Development prepared the paper “Devastating of the Right to Health during the Syrian Conflict” as part of the Arab Watch Report on Economic and Social Rights 2023 on the Right to Health. It aims to assess the right to health during the conflict in Syria. The paper uses the political economy approach to deepen the understanding of power relations in conflicts through analyzing the context of war, mapping the key actors, analyzing the policies and interventions, and assesses the impact of different factors on populations’ capabilities and opportunities.
This paper reads public health as a basic human right and as an aspect of human capability within the political, social, and economic context in the time of armed conflict in Syria. The paper analyzed the impact of conflict dynamics on the right to health through the assessment of health outcomes, impact on the health system, and health related policies in the time of conflict.
The paper highlights how warring parties targeted public health, distorted the health system, and reallocated tangible and intangible resources away from healthcare to fuel the war. The conflict-centered institutions destroyed several determinants of health, such as governance, social capital, welfare, living conditions, food security, and environmental sustainability. Political authority is fragmented between several state and non-state actors and has become the “enemy of public health.” as they violate international and local laws and legislations that affirm the right to life and the right to health and well-being for all. The paper highlights indicators of health deterioration in the areas of mortality, communicable and noncommunicable diseases, disability and food security. It also identifies the most prominent policies that have been adopted to distort the health system, such as killing, torture, displacement, siege, and discrimination in access to health services among others. The paper concludes with the importance of dismantling oppressive institutions, restoring security by investing in rebuilding social institutions that enhance social cohesion and establishing and implementing the rule of law that protects all people, in addition to integrating health with other sectors and giving priority to the people most affected during the period of conflict.
The report relies on several surveys that have been conducted by the Syrian Center for Policy Research (SCPR) in the whole of Syria, the population status survey in 2014, socioeconomic surveys in 2020 and 2021, and citizenship surveys in 2022. These surveys used participatory approaches with the local community and comprised in-depth interviews with key informants. Also, this paper uses the monthly SCPR Consumer Prices surveys 2020-2022; the SCPR contribution to the Lancet-AUB Commission on Syria; and a background paper on Syrian Conflict and Health Capabilities.
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In English:
SCPR – Devastating of the Right to Health during the Syrian Conflict EN
In Arabic:
SCPR – Devastating of the Right to Health during the Syrian Conflict AR