Overview
The healthcare system in Syria has been hugely affected by the Syrian crisis. Many qualified physicians and healthcare professionals have left the country. Access to healthcare services is limited especially in rural areas where there is a lack of functioning healthcare facilities. In addition, the deteriorating economic situation has resulted in expensive transportation which makes it harder for people in rural areas to access healthcare facilities in the city. According to a study published in 2020 by the London School of Economics and Political Science “data from WHO and Syria’s Ministry of Health (MoH) shows that out of the total 111 public hospitals in Syria, only 58 are fully functioning, with the remainder either partially functioning (27) or fully destroyed (26). On March 6, 2020, a UN report stated that up to 70% of the health workers had left the country as migrants or refugees”. Especially since the breakout of the COVID-19 pandemic, accessing and receiving quality healthcare has been one of the most prominent challenges.
What happens if you want to see a doctor?
First, you would have to search for a specialized physician in your area of residence. Unfortunately, most specialized and skilled physicians are located in the city. Secondly, if you have insurance, you need to make sure the doctor you are intending to visit accepts payment by insurance companies; because a limited number of physicians in Syria accept non-cash payments. Finally, if you intend to make an appointment with a well-known physician, it will probably be scheduled a month from the time of your request.
Who decides what medicines a doctor can prescribe?
The availability of the medications in the pharmaceutical market is one of the prime determinants of the doctor’s prescription. Another determinant (to some doctors, not all) is the pharmaceutical company that provides the best offers to the physician. Finally, it also includes the patient’s preference based on their economic situation and their personal experience with each medication.
Practically, what is it like to live with type 1 diabetes in Syria?
Due to the economic deterioration, healthy food is more expensive than ever before. Fruits and vegetables cannot be afforded by many Syrians. As for insulin, mixed insulin is provided for free by the Syrian Ministry of Public Health (MOPH). However, to take the basal-bolus regimen, a patient would have to purchase their insulin from pharmacies. Insured t1d patients’ insulin cost is covered partially depending on the type of insurance. However, insulin remains extremely expensive to most Syrians which makes many purchase insulin that has been illegally shipped from Turkey; which is lower in price but is also lower in efficacy due to inappropriate storage conditions during shipment. Also, newer types of insulin such as insulin degludec (Tresiba) are not available in the Syrian pharmaceutical market. Many patients have to re-use the insulin pen needles, syringes, and lancets multiple times due to their high cost. In addition, monitoring blood glucose remains a huge challenge because glucose monitors’ test strips are unaffordable to many Syrians and Continuous Glucose Monitors are not available in the Syrian market and are too expensive to be bought from nearby countries. Recently, two pharmaceutical companies imported insulin pumps. Unfortunately, the cost of an insulin pump is 4,500$ with an additional 200$ monthly cost whereas the average Syrian income is around 50$. Therefore it remains very challenging to be a person with diabetes living in Syria, especially during the current circumstances.
What about getting admitted to the hospital?
During the current COVID-19 pandemic along with years of the Syrian crisis and the major economic deterioration, being admitted to a hospital is very challenging. Most hospitals are fully occupied with covid-19 patients, and many other hospitals are partially functioning or fully destroyed. When admitted to a hospital there are three main concerns: accessing a hospital; the quality of care provided in Syrian hospitals; the cost of hospital care.
How does diabetes care vary throughout Syria?
Diabetes care varies hugely throughout Syria. Most qualified and skilled endocrinologists are located in the capital of Syria; Damascus. Even in Damascus, the care varies between the rural and urban areas. There is a lack of functioning healthcare facilities in rural Damascus which creates a major struggle for Syrian patients.
Big thanks to Laila Alfares for contributing the information to this entry. We are grateful for your support.
Last updated 2023
