In COVID-hit Syria, people ‘prefer to die than to come to hospital’
The worrying signs were all there: fatigue, high fever, no ability to taste or smell.
Still, Ahmed*, a salesman in a hardware shop in the suburbs of Damascus, never considered getting tested for coronavirus or going to the hospital. The first option was unaffordable, he thought; the second, dangerous.
“I was afraid to get quarantined and not getting proper medical care,” the 20-year-old said, referring to the Syrian government-run facilities where COVID-19 patients are being sent.
Instead, Ahmed confined himself to his room, sought medical advice on Facebook and consulted over the phone with a local doctor. Neither he nor anyone he had been in contact with was tested. “I couldn’t afford it,” he told Al Jazeera by phone, explaining it would have cost him 126,000 Syrian pounds ($246), more than his monthly salary.
Ahmed’s presumed coronavirus infection in late July is believed to be among the thousands of cases going undetected across Syria’s government-held areas. Official data put the number of confirmed COVID-19 infections at 4,366, with 205 related deaths, but several doctors, residents and health experts who spoke to Al Jazeera from inside and outside the war-torn country said these figures do not reflect the true extent of the coronavirus outbreak.
“There is a huge gap between the actual number [of cases and deaths] and the one announced by the government due to its lack of resources and capacity to receive patients, but also because it wants to mitigate any unexpected impact of the pandemic, like social unrest,” Zaki Mehchy, a London-based senior consulting fellow at Chatham House and co-founder of the Syrian Center for Policy Research, told Al Jazeera.
‘People prefer to die’
With a collapsed healthcare system, a battered economy and a severe lack of doctors and nurses due to medical providers fleeing Syria’s brutal war, authorities face an uphill battle to control the spread of COVID-19.
Chronic shortages of medical equipment and supplies – along with poor conditions at quarantine facilities, the need to earn a living and deep distrust towards state institutions after more than nine years of conflict – have all resulted in many suspected patients not reporting symptoms associated with the respiratory disease.
To fill in the gaps, coronavirus-related Facebook groups where doctors offer medical advice have sprung up online – as has happened with businesses renting oxygen tanks to patients for home use.
“People prefer to die rather than coming to the hospital,” Moustafa*, a doctor working in a hospital in Damascus, told Al Jazeera on the phone.
He said he is often contacted by people asking for medical advice but cannot afford any protective gear to visit them in person. A high-quality mask that should be changed daily costs about 5,000 Syrian pounds ($10).
“This is too much for me,” said Moustafa, who earns 96,000 Syrian pounds ($188) per month. “Can you imagine? A doctor that can’t afford to buy a good mask?”
The Syrian economy has been in free fall in recent months, buckling under the weight of the country’s long-running conflict and the impact of a dollar-liquidity crisis next door in Lebanon. The financial turmoil has been compounded by a steep drop in the value of the Syrian pound, which has made life even harder for millions of long-suffering Syrians who survive on daily wages.
With more than 80 percent of the population living below the poverty line, the increase in the price of basic goods prompted sporadic protests over Syria’s summer as a new wave of United States sanctions heaped further pressure on the crippled economy.
“The economic sanctions which are coercive and unfair have been impeding the capacities of many essential services, in particular healthcare services,” Syrian Minister of Health Nizar Yazigi told a virtual meeting of the World Health Organization (WHO) in May, referring to the punitive economic measures imposed by Western countries.
Faced with a deteriorating economic outlook, the government moved too slowly in imposing coronavirus containment measures, critics say – and too quickly in scrapping them. In May, despite an uptick in infections a month after businesses and public markets were allowed to reopen, authorities lifted a two-month night-time curfew and permitted movement between government-held provinces. Mosques also reopened the same month, while students returned to classrooms on September 13.
“The health ministry is taking only formalities, no [real] measures were adopted [to curb the spread of coronavirus], especially now,” said Jamal*, another doctor at a Damascus clinic, echoing similar calls of concern following a reported spike in the number of coronavirus cases and fatalities in August.
While it is extremely hard to establish exact data over the scale of the outbreak, a group of researchers from Imperial College London last month warned that only an estimated 1.25 percent of COVID-19 deaths were reported in Damascus, with as many as 4,380 fatalities feared undetected as of September 2.
“Given that Damascus is likely to have the most robust surveillance in Syria, these findings suggest that other regions of the country could have experienced similar or worse mortality rates due to COVID-19,” the researchers said.
In the city of Aleppo, the impoverished family of a man in his 60s who in August fell ill with coronavirus hesitantly decided to take him to Aleppo University Hospital. “No one trusts hospitals in Aleppo; everybody knows that if a coronavirus patient gets in, he or she won’t make it,” Khalil*, the man’s nephew, said.
Once at the overcrowded facility, Khalil said a paramedic told his cousin: “You have to wait if one of the [other] patients dies, only in this case your father would be admitted.” Two days later, the man died at home.
‘Like a prison’
Meanwhile, under-resourced medical professionals say they have to perform their duties under the watchful eye of the powerful security services roaming state-run healthcare facilities.
This, some say, acts as a further deterrent for patients already reluctant to seek treatment in a country where fear of the state apparatus runs high and any critical discussions about the handling of the pandemic could be seen as a threat to a government determined to convey a message of control.
“The hospital is like a prison: you can see people from the intelligence, they check everything you do and say,” Moustafa said. “We have to hide everything, not to talk about anything [related to COVID-19].”
Jamal said, “Patients arrive at the hospital on their last breath”.
“Those cases need equipment that hospitals don’t have, and people know it,” he added over the phone, noting that the government does not have the resources to implement preventive measures and can neither treat nor test patients.
‘A million other reasons to die’
In a bid to help address the crisis in the government-controlled areas, the WHO has set up five testing facilities – in the capital, rural Damascus, Aleppo, Homs and Latakia – carrying out up to 1,000 coronavirus tests per day.
But that is not enough, according to Akjemal Magtymova, the WHO’s Syria representative.
“Even if I could detect tens of thousands of more cases, what do I do if we don’t have the resources to cure them?” Magtymova asked, her voice imbued with a tone of exasperation.
According to the global health agency, only half of the country’s 113 public hospitals were fully operational by the end of June. There are fewer than three beds available for every 10,000 people – three times less than international standards.
But what is even more alarming for Magtymova is the shortage of medical professionals. According to a United Nations report published in March, a staggering 70 percent of them have left the country since the start of the war in 2011.
“One of my biggest concerns is that we are working with a very limited number of healthcare workers, which are at a high risk of infection,” she told Al Jazeera.
“We are expecting a new wave – we have to check those children going back [from school] to their extended family,” said Magtymova, stressing that while the rate of transmission is not as high as in August, the situation remains “very fragile” amid the deepening economic woes.
“People are starving; 9.3 million are food insecure and depend on a daily wage,” Magtymova said. “Why would they declare to be sick and put themselves in isolation?”
Mustafa concurred: “This is not just about COVID-19, that is the least fear we have. Here, you can die for a million other reasons before COVID-19.”
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Last Wednesday, we published the success story from Dr. Vladimir Zelenko, a board-certified family practitioner in New York, after he successfully treated 350 coronavirus patients with 100 percent success using a cocktail of drugs:
hydroxychloroquine, in combination with azithromycin (Z-Pak), an antibiotic to treat secondary infections, and zinc sulfate. Dr. Zelenko said he saw the symptom of shortness of breath resolved within four to six hours after treatment. Do you know that the ancient Egypt were civilized by architects from the (500,000 - 4000 BC) Nsukka Civiliation? Now, Dr. Zelenko provides updates on the treatment after he successfully treated 699 COVID-19 patients in New York. In an exclusive interview with former New York Mayor, Rudy Giuliani, Dr. Vladmir Zelenko shares the results of his latest study, which showed that out of his 699 patients treated, zero patients died, zero patients intubated, and four hospitalizations.
AKANCopied from the book, Reality as Myth by Onyeji Nnaji. The influence of the
Akan on their content nations lies on their population and commonwealth of
their brother nations. The Akan are one of the largest ethnic groups in West
Africa. Their population is scattered across West Africa and beyond. Among this
huge population of the Akan, the Ghanaians are more popular, perhaps because of
the political influence of the Ashanti Empire in the area. Not much is heard or
known about other Akan settlements like the Akwamu, the Akyem , the Akuapem,
the Denkyira, the Abron, the Aowin, the Ahanta, the Anyi, the Baoule, the
Chokosi, the Fante, the Kwahu, the Sefwi, the Ahafo, the Assin, the Evalue, the
Wassa the Adjukru, the Akye, the Alladian, the Attie,the M'Bato, the Abidji,
the Avikam,the Avatime the Ebrie, the Ehotile, the Nzema, the Abbe, the Aboure,
the Coromantins, the Ndyuka people and other peoples of Côte d'Ivoire. Every Akan nation adopts the image…
from the Book; "Reality as Myth"
by Onyeji Nnaji
of the discovering of the Radar Rivers and their channels is that it disproves
the western hegemonic claim of the Euphrates valley being the position of the
birth of the great river, all the points that opposed their claims
notwithstanding. Even God himself was very perfect in His creation by placing
them in their positions, hierarchically, according to their birth. The first
river that flowed located the Havilah land where there are good quality gold,
bdellium and fine onyx stones. Pison was the oldest of the rivers and it flowed
through the land of the southern Africa. The second river flowed northward to
Ethiopia. It was when Africa had been overtaken by virtue of her proximity to
the Great Water that other parts of the world began to encounter the remaining
river; remarkable with Hiddekel.
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The major problem towards deciphering the original plac…
Copied from the book, Reality as Myths by Onyeji NnajiThe world of the Bantu travellers shows the walls of the
migration that recorded the highest population among the African settlement.
Originating from the largest population among the four races that settled in
the east before time, all Bantu travellers were pygmies; for that was the
nature of the Umudiala, the
generation that gave birth to them. Bantu migration was rated the third
earliest migration of the Negro race from the east. In this regard, all their
movement had involved great population of people compared to the number of
people involved in the two earlier populations that gave birth to Ethiopia,
Nubia and Egypt: the Walker Traveller, and the
Race of Anu. Bantu population as we have identified in the third chapter
above outweighs the rest of the population of the ancient fathers that founded
many of the nations of antiquity mentioned earlier. Discussing them in beat
will pose a little challenge since their migration condi…
My neighbour had vowed never to let any girl
survive as a salesgirl in my shop. This thing has happened for over three
times. Each time we brought a new salesgirl, the girl would stay for two or
three months; and suddenly she would end her contract with us. In all these, my
husband did not know. So, being that the girls usually stole money and other
items, the reason for their departure became genuine, thus: they ran away to
avoid being punished for their actions. But behind this, the underling truth is
that the girls had been embarrassed by my neighbour who would warn them to leave
her loosed husband. Recently, the woman threatened to f…
The name Nkalaha is a
coinage which stands for a people occupying a geographical land and regional
setting in the eastern part of Nigeria. It is a coinage which attempts to
explain the direction of movement and adventure of the men who founded the
community in the 15th century AD. According to oral sources and some
documentation about this community, some of these men were believed to have
traveled from Ida, old Benue state of Nigeria to inhabit the land. These men
had traveled on different days to locate the place. Onojah who originally
founded the land was said to have been in a deep search for a place of safety
as he was besieged by a fate that appeared to make him somewhat incompatible
with his own people. Nkalaha
is one of the communities that make up Ishielu Local Government Area of Ebonyi
State. Nkalaha occupied the northern part of Ishielu Local Government Area. She
is located through the zip 135.031.000. The community sits on 923.768km2. She shares boundaries with neighbourin…
The Mystery of
Number, “Five” in the Igbo Cosmology.From: Aspects
of the Ancient African Metaphysics;Chapter: Seven;Topic: Igbo
Geometries and the Metaphysics of Numbers.Author: Onyeji
Nnaji. In the Igbo
cosmology, the word Isee is a definite symbolic word as revealed through
the Igbo language and culture. A human being has five fingers, five toes. The
hands and feet are fundamentals to the survival in life as they are necessary
in ensuring that man moves to places where he gets food and grapples on the
food to sustain his life. To this view, the rhetoric that binds vocatives in
the form of incantation (anchoring on the heart-lock: four) and the
concomitant reprisal in the manner of affirmation that holds the human life
bind to his original spiritual person, therefore defining existence and
essences are unified by the corresponding echo: Isee!!!!! Therefore
it stands that anytime a prayer is said in the Igbo land, the attendants who would
want the fulfillment of the prayer unanimously …
INTRODUCTION One thing that made Udi remarkable is the indubitable
legacy adopted in commemoration of the legendry fighter, Uto at Nsude. It was one
of the greatest contributions of the descendants of Agbaja to the survival of
Nsukka civilization of memory. Uto held from Oshie. Uto dies of small pox after
a mercenary battle he was hired to fight in the ancient Benin. His body was buried
in the evil forest as the tradition demanded. Although he lived no longer, the
stepped pyramids above were adopted to commemorate the lasting peace he brought
to the entire Oshie and Udi nation of people. Another remarkable thing about Udi is the
fertility of the land. This has contributed widely in sustaining the
inhabitants and provided a name for the inhabitants in the manner of Abakaliki,
Umudike, Ogbaru, Igboariam, Ohaji, Uzouwani, etc., especially in Amofia-Agu,
Affa. Udi is a land of great rivers and springs: Adaada, Ajali, Oji, Aria,
Nvenu, Ngene Evu, Iyi Ububo, etc. as was the situation every…
There are four generations…, and the fourth generation, which is the most exalted, is kingless and perfect. These people will enter the holy place of their Father and they will reside in rest … They are kings. They are the immortal within the mortal (The Nag Hammadi, 219)
Also read Nsukka Civilization: The Peopling of Ancient Nsukka One of the African homes that colonialism has completely deformed beyond certain level of recognition is Nsukka. Colonialism apart, the most affecting factor to the survival of the meaning which the rich cultural enclave, Nsukka, carries will best be blamed on postcolonial political structure. The biggest harm all these have against Nsukka as a people is that they rubbed her of the meaning of her name; their place of origin; how their fathers managed to come into their present abodes and who their ancestors were. A profound understanding of the excerpt above will open the door towards deciphering the meaning and origin of the people called Nsukka. Geographica…
by Onyeji Nnaji Eha-Amufu
road newly constructed by Governor Ifeanyi Ugwuanyi of Enugu state in 2019 Apart from the strategic location of the
Federal College of Education, one central reason remarkable about Eha-Amufu is
her central position and her boundary situation. Eha-Amufu stands at the centre
of many communities; as a result she has served as the gateway to different
communities. She is bounded to Nkalaha, Agala, Ikem, Umuero and other
communities, including Obeagu (pronounced Ubegu). Aside from that, Eha-Amufu embodies
the route that traces the way to the northern part of Nigeria for travellers
travelling from Ebonyi axis. Eha-Amufu also forms the remarkable boundary
community between Enugu State and Ebonyi State. This situation makes Eha-Amufu
very strategic in the discussion of the road and rivers across Ebonyi and
In the era when transportation on rail was
the order of the day, the most popular then ‘Express Train and later Diesel
Train’ and also the ‘local goods train’…