Syria’s Idlib Province, Wrecked by War. Readies for Coronavirus Battle
Syria’s Idlib Province, Wrecked by War. Readies for Coronavirus Battle
An activist who has supported the democracy protests against Syria’s authoritarian president since they began nine years ago knows a thing or two about battling adversity. But Hosam al-Ali, 35, is more than a little worried about his new adversary: the coronavirus.
A pharmacist in Idlib, the last province still in the hands of Syrian opposition groups, Mr. al-Ali volunteered to be the main virus-response coordinator in his region.
An estimated 3.5 million people are crammed into the northern half of the province, at least half of them displaced, many in makeshift homes and tents. The lack of basic services, aid groups warn, makes Idlib particularly vulnerable to the virus.
As he set to work, Mr. al-Ali began keeping an audio diary, which he shared day by day with Carlotta Gall, the Istanbul bureau chief for The New York Times. His entries have been condensed, and edited for clarity.
April 1, 2020
The False Alarm
Today there was an announcement from the Minister of Health of the temporary government. We had concerns about 20 patients, and the results were negative. Thanks be to God.
A Day ‘Off’
It was a holiday, and a day off for me.
Like most Syrians who, on Friday, wake up and buy breakfast outside, I went to the center of Al-Atareb, which is very close to the front line and badly destroyed. There was only one breakfast shop open. It was very crowded and I had to wait.
I returned home to my wife and kids, and then I was fixing up solar panels and a battery. It was a very normal day.
Of course, I have coronavirus work, but I did this from home. There were a lot of communications, because I am on several WhatsApp chat groups.
The most important thing is training and social awareness, and how people should stay at home for safety. But society is disregarding that — that is the biggest problem we are facing.
Today they decided to cancel one of the new quarantine camps and make it a center for burning medical waste.
I have to prepare a lecture for midwife students at a university in Azaz on pharmacology. I have been teaching there for the last two years, but the whole university is going online because of the virus.
We went to the Directorate of Health today and were trained on how to take a sample from a person suspected of being infected.
Then they brought us a patient.
He had a high temperature, and was ill with flulike symptoms. Of course, this patient had been one week under quarantine at home, not in a health center, and he came in for the test. The trainer carried it out.
A Day of Pain
Today I conducted training for the White Helmets [a Syrian civil defense group].
There were two teams, each with 10 people. We did two sessions to avoid crowding.
The next morning, I woke at 5 a.m., and we modified slides for the lecture. The slides outline the criteria for sending people to health facilities. They also tell people how to handle dead bodies.
The trainees from the White Helmets are very interested. Their motto, I learned, is from the Quran: “Whoever saves the life of one, it is as if he saves the life of all mankind.”
The whole day my mood was very bad, because my tooth infection had moved from my mouth to my eye, and it was very painful. I started to look like a teddy bear.
So I finished my training early and went to Ad Dana, a village 15 kilometers away from my house where a dentist treated the infection. I cried from the pain.
The dentist gave me some medicine, I went back home, ate a little bit and then went to sleep.
See you soon, or maybe not.
The White Helmets
Yesterday we trained 20 people. The day before, also. We reached 62 trainees in three days, all White Helmets. Afterward, we posted the training material to the WhatsApp group.
The White Helmets will be responsible for burying the bodies. This requires special procedures, and then the car needs to be sterilized after the burial. That is what I spoke about.
I also gave a lecture to students of the Institute for Midwives and the Institute of Pediatric Nurses. It was a good lecture, but a little bit harder than an in-person one. I could not understand the body language of the students. I tried shouting and repeating again and again.
Then I took my family out for 10 minutes outside. We drank coffee and the children drank juice and then we returned home.
God willing, Monday we will do another training session.
The Search for a Ventilator
Today I had a planning meeting on Zoom. Everyone had good ideas. Everyone would like to work. But in the end, the main problems are weakness of coordination and lack of financial means. It is because of that we are moving forward very, very slowly.
Yesterday a friend called me. He was looking for an incubator for his new born baby.
I found an incubator, but actually he needed a ventilator.
After we understood that we started looking for a ventilator, but unfortunately we could not find one. All the hospital ventilators were busy — and still we don’t have a single coronavirus case.
If that is happening, it means the medical capacity is very poor.
Today I felt depressed: I heard the baby died.
Last week we trained a lot of teams on how to run a quarantine center. We found acceptance from a lot of organizations, and these organizations have some money which they could put toward this.
We divided the session into two parts: Before the virus appears in our area, and after.
In the first part it is about health awareness.
We will supply soap and clean water in the market and two tents for the center: one for isolation, and one for testing.
We will raise awareness of the people not to bring their children to the clinic, and only to come in an emergency.
And we will spray-paint health messages on the town walls.
All that is before the virus appears.
After it is here, there will be more serious coordination with the White Helmets, the local council and civil society organizations.
The plan is to put tents at the entrance of Al-Atareb. People will pass through the tents and be registered. If we have any doubts about someone who is trying to come into Al-Atareb, we will take them to the quarantine center.
There will also be a kind of home isolation for everybody, and there is a team of women who volunteered to teach people how to make homemade masks.
The White Helmets will start using their vehicles to disinfect the public areas.
The situation of the health authority is very, very bad. The Health Directorate laid off some employees and gave others unpaid leave because of the financial situation.
The rest of the employees will be paid $100 a month.
You know: $100 is nothing. I will pay $50 for my rent and $50 for fuel for my car. How will I deal for the rest of the month?
Soon, Ramadan is coming and the market will be crowded.
But I think the sickness will not spread too much in our area if we apply the plan. Each village should do social management. We need to spread awareness to the people to do self-isolation and social distancing, and then we will be in good shape.
Happy Ramadan — and I hope this year will be good for all the world.
Tents and Thermometers
It is really hard with Ramadan. We have a lot of work and it makes me tired.
The Kafr Karmin quarantine center has begun its work. This center is receiving people who are coming from Turkey. The border authorities are taking them to the center and isolating them for 14 days.
I also have a bad situation at home. My wife started crying.
Our fridge is not working and every day I say I will get a new one or fix it and I did not do it. And some of the windows are broken and I did not fix them. I am really busy, and when I am busy I forget.
Pressure on all Fronts
There is something very important going on these days. It is not about coronavirus.
It is about the people.
They are in a very difficult situation. Everything is super-expensive now. The dollar is rising and the Syrian pound is on the floor. The rate of one dollar is 1,500 Syrian pounds.
People are going crazy. God help the people with Ramadan, coronavirus and high prices. God help the people.
Update: As of this week, Idlib has had no reported cases of infection.
Saad al-Nassife contributed reporting from Gaziantep, Turkey.