In a Vulnerable State: Being COVID positive in Syria
Razan Naffakh
Damascus, Syria. Photo by Abd Sarakbi.
“Assalamalaykum habibty,” my khaleh (aunt in Arbaci) greets me over the phone in between a few coughs. I was relieved to hear her voice. Only two weeks prior, my mom informed me that my aunt was sick, leaving me stunned and upset. I had not read anything in the news about COVID in Syria and I had previously thought of the pandemic as somehow distanced from the region. Syria – and the people who remained there - already had too much to worry about, and the addition of a fatal virus would increase suffering in a way I could not bear to imagine. However, word of my aunt’s infection, as well as that of many of her friends and coworkers, whom I was very fond of as a child, quickly cleared the illusion that had settled in this quarantine. After months of being preoccupied with myself and my own worries, I was abruptly reminded of the world of people who experienced barely a fraction of my privileges.
Syria has been embroiled in a civil war for close to a decade, a conflict that has both created and exacerbated the country’s numerous crises. Mass displacement, poverty, food insecurity, economic collapse, lack of health care, bombings, failure of essential infrastructures (i.e. energy, water, and sanitation), and pervasive violence have subjected the people of Syria to constant risk, danger, and fear for their lives and wellbeing. These circumstances are the backdrop of the current COVID outbreak in the country. But unlike it is commonly termed, this situation and vulnerability to infectious disease is not unprecedented. An article published six years ago, regarding epidemics in war-torn Syria, highlights the above mentioned conditions (i.e. malnutrition, displacement, and poverty) as risk factors for cutaneous leishmaniasis, an infectious skin disease similar to leprosy. Unfortunately, the implications of this new epidemic in Syria could be more fatal.
A specific and apparent burden Syrians face is their sparse health care system, which is severely lacking in equipped hospitals and facilities as well as doctors and trained healthcare workers. Throughout the war, clinics and hospitals have been weaponized and destroyed, with only 57 fully operational locations as reported at the beginning of the outbreak. As of March, the entire country only contained 325 intensive care units with ventilators, with most resources concentrated in the capital city. Additionally, with an extremely strained economic state resulting from the war, sanctions, and a regional economic crisis, these deficiencies will likely remain unremedied. Even before the pandemic, the financial situation was dire, with more than 80 per cent of the population living in poverty, 11 million people “receiving humanitarian assistance”, and about 8 million depending on food aid. Notably, some of the most vulnerable groups of people comprise of the about 6 million internally displaced persons and the hundreds of thousands of prisoners and detainees in the country, all of whom live in extremely crowded and unsanitary conditions, which, paired with the spread of infection, would likely lead to numerous fatalities. Pre-pandemic, Syrians were already grappling with extremely challenging circumstances. Now, in full-swing COVID-19 times, the pandemic is yet another challenge for the country.
“Walaykumassalm khaleh! I’m sorry to bother you with this call, I know it’s late for you.” It was about 9 p.m. in Damascus and my aunt was having dinner when I called her. “Not at all, it only bothers me if you don’t call me,” she responds. I chuckle, “Ok then I’ll make sure to call you more often!” Already, I was smiling widely after hearing my aunt speak, however, the questions I wanted to ask her were not quite as cheerful. “Khaleh, can you describe to me your experience with coronavirus?”
A week after I learned of her infection, and after being told she was feeling better, my aunt’s health took a turn for the worst. This is what I had feared, telling my mom only a couple days earlier that it usually gets better before it gets worse. For a few days, all we could do was hope and pray for the best. Fortunately, my aunt has been slowly recovering for the past week and I was able to talk to her to gain more insight on the present situation in Syria. In chronicling her personal experience with the virus, khaleh confided that she truly felt as though she would die. Her answers deeply resonated with me as she told me that she came to term with death, “having lived a fulfilling 60 years in the service of God.” In fact, she welcomed death and was ready to leave in peace: “Everyone is scared of death because they see it as an evil/bad thing,” she responded in Arabic, “but death is not an evil thing, it is our shared fate.”
In the capital city, where she resides, my aunt tells me every household contains someone who is sick. In a grave voice she reveals, “Very many people have died.” I mutter a prayer for the deceased. This was what I expected; my family members here in America have been speaking of the spread of the virus in Syria. One member remarked that her friends in Syria stopped opening Facebook because too many people were dying. Other family members have lost relatives to the virus. As of August 14, the Syrian government reports 1,432 cases and 55 deaths. These numbers, however, are a gross underestimate, with there being little to no access to testing in the country and a desire to underplay the situation by officials. “Everyone is doing their best to help each other,” my aunt tells me, “people are scared, rightfully so.”
“Did you feel you would be taken care of when you got sick?” I ask. She tells me how her friends with medical backgrounds tried to help her, but as her health suddenly deteriorated and she found it hard to speak without gasping for air, she reached out to my uncle who is a dentist in California. He and his doctor friend assessed her condition and researched the best treatment for her symptoms. My aunt acquired medicine based on their recommendations and, thankfully, she began to regain her health. Her situation, though, is not representative of most Syrians as she was luckily able to reach out to a doctor overseas who had more access to pertinent knowledge and information. “I would never go to the hospital, it is like a death sentence,” she tells me. And if she is meant to die, she adds, she would not want to die there. The sentiment she expresses seems to be shared by the public; Syrians do not have much faith in the available medical care. Even before the pandemic, the healthcare system was not reliable. Khaleh explained to me how she had previously gotten an MRI and was misdiagnosed (she later received proper diagnosis and treatment in America).
I try to delicately phrase my next question using my limited Arabic vocabulary, careful not to put my aunt in an uncomfortable situation. I ask her how the government has been handling the situation. “There is not much they can do or are doing. You must wait in big lines and are at constant risk of exposure. They recently said they want to open schools and that is a bad decision. Students don’t have their own desks and can’t social distance like they do in America.” My aunt is a schoolteacher, which is reflected in the concerns she brings up. Despite the rest of her family living in America, khaleh could never find it in herself to leave Damascus because the children and the people needed her. And such is the character of my aunt, and of many of those left behind - in the face of hardship, they selflessly strive to help their communities. With a heavy heart, I thanked my aunt and bid her farewell, as the weight of her answer set in.
Syria’s story is unfortunately not unique. Many countries and regions have similarly been exposed to strenuous circumstances, such as extreme famine and war, for prolonged periods of time. Countries like Yemen, South Sudan, and Venezuela as well as refugee camps around the world have little to no line of defense when they are afflicted with infection. Just recently Syria’s neighboring country, Lebanon, was devasted by a massive explosion in the midst of a steep economic downturn, adding it to the list of the defenseless. These vulnerable areas account for hundreds of millions of human lives that cannot be ignored. Meanwhile, some world powers, such as America, cannot claim that they have done all that was in their power to combat this pandemic and subsequently shield these nations. Namely, the U.S. was too slow at establishing widespread testing and was not aggressive in its isolation or contact tracing efforts. The cost of trying to maintain the illusion of prosperity by downplaying the pandemic and impending doom is the rapid spread to areas around the world whose main concern is not ‘quarantine fatigue’ or ‘annoyance’ of wearing a mask.
This is a butterfly effect on an enormous scale; slow reaction time and insufficient action by big players like the U.S. led to more rapid spread, the lost hope of containment, and consequences that we are not yet able to comprehend. In Syria alone, the accelerated collapse of what remains of the country will likely inflate the political tensions of those invested in exploiting the land and could have drastic consequences aside from the already inevitable deaths of thousands of Syrian people from disease and starvation. Even now as the U.S. president, Donald Trump, continues to downplay and misinform on the pandemic, oppressive leaders and regimes around the world, who have already proven they have no care for the lives of their civilians, are empowered to imitate the approach and abandon their people, as we see is happening in Syria.
What is important now though, is that we, as a country, look ahead at what we can do for the people of Syria and all those suffering around the world. We must not forget them, even amidst our own pandemic struggles and worries. We must advocate for the aid of those countries in need and spread awareness of the humanitarian crises occurring around us. Otherwise, millions of people may die due to our inaction.
Razan Naffakh is a rising sophomore studying chemical engineering at Northwestern University. As a Syrian American with family members in Syria who have been infected with coronavirus, she has been inspired to bring awareness to the experiences of people facing the pandemic in more vulnerable parts of the world. She is also interested in analyzing how the actions of the U.S., and other world powers, have far-reaching and fatal consequences.
