International Journal of Public Health

, Volume 60, Supplement 1, pp 63–72 | Cite as

Syria: health in a country undergoing tragic transition

  • Ziyad Ben Taleb
  • Raed Bahelah
  • Fouad M. Fouad
  • Adam Coutts
  • Meredith Wilcox
  • Wasim MaziakEmail author



To document the ongoing destruction as a result of the tragic events in Syria, to understand the changing health care needs and priorities of Syrians.


A directed examination of the scientific literature and reports about Syria before and during the Syrian conflict, in addition to analyzing literature devoted to the relief and rebuilding efforts in crisis situations.


The ongoing war has had high direct war casualty, but even higher suffering due to the destruction of health system, displacement, and the breakdown of livelihood and social fabric. Millions of Syrians either became refugees or internally displaced, and about half of the population is in urgent need for help. Access to local and international aid organizations for war-affected populations is an urgent and top priority.


Syrians continue to endure one of the biggest human tragedies in modern times. The extent of the crisis has affected all aspects of Syrians’ life. Understanding the multi-faceted transition of the Syrian population and how it reflects on their health profile can guide relief and rebuilding efforts’ scope and priorities.


Syria Conflict Health care Refugees 


Conflict of interest

All authors declare no conflict of interests.


  1. Abdo G (2013) Why Sunni-Shia conflict is worsening.
  2. Ahmad C (2013) Is malnutrition Syria’s next epidemic? November 26, 2013. Accessed 5 Feb 2014
  3. Al Ali R, Mzayek F, Rastam S, Fouad FM, Martin O, Capewell S, Maziak W (2013) Forecasting future prevalence of type 2 diabetes mellitus in Syria. BMC Public Health 13(1):507PubMedCentralPubMedCrossRefGoogle Scholar
  4. Amnesty International (2011a) Climate of fear in Syria’s hospitals as patients and medics targeted. Accessed 18 Feb 2014
  5. Amnesty International (2011b) Health crisis: Syrian government targets the wounded and health workers. Accessed 18 Feb 2014
  6. Asfar T, Ahmad B, Rastam S, Mulloli TP, Ward KD, Maziak W (2007) Self-rated health and its determinants among adults in Syria: a model from the Middle East. BMC Public Health 7:177PubMedCentralPubMedCrossRefGoogle Scholar
  7. Attar S (2014) Field hospitals in Syria. Lancet 383(9914):303CrossRefGoogle Scholar
  8. Aylward RB (2013) An ancient scourge triggers a modern emergency. East Mediterr Health J 19(11):903–904PubMedGoogle Scholar
  9. Bashour HN, Kharouf MH, AbdulSalam AA, El Asmar K, Tabbaa MA, Cheikha SA (2008) Effect of postnatal home visits on maternal/infant outcomes in Syria: a randomized controlled trial. Public Health Nurs 25(2):115–125PubMedCrossRefGoogle Scholar
  10. Cherif M (2013) Health care in Syria is “beyond catastrophic”. Accessed 10 March 2014
  11. Coutts A, Fouad FM (2014) Syria’s raging health crisis. Accessed 1 March 2014
  12. Coutts A, McKee M, Stuckler D (2013) The emerging Syrian health crisis. Lancet 381(9865):e6–e7PubMedCrossRefGoogle Scholar
  13. CSIS (2013) Center for strategic and international studies. Appendix A: estimates of casualties and refugees. Accessed 26 Feb 2014
  14. De Vries AK, Klazinga NS (2006) Mental health reform in post-conflict areas: a policy analysis based on experiences in Bosnia Herzegovina and Kosovo. Eur J Public Health 16(3):246–251CrossRefGoogle Scholar
  15. Deeb R, Eid S (2012) The environmental causes of cancer distribution in Syria. Accessed 8 March 2014
  16. Dewachi O, Skelton M, Nguyen VK, Fouad FM, Sitta GA, Maasri Z, Giacaman R (2014) Changing therapeutic geographies of the Iraqi and Syrian wars. Lancet 383(9915):449–457PubMedCrossRefGoogle Scholar
  17. Döner P, Özkara A, Kahveci R (2013) Syrian refugees in turkey: numbers and emotions. Lancet 382(9894):764PubMedCrossRefGoogle Scholar
  18. Estrin N, Shapiro J (2014) The proxy war problem in Syria. Accessed 21 April 2014
  19. FAO/WFP (2013) Crop and food security assessment mission to the Syrian Arab Republic. Accessed 5 Feb 2014
  20. Global Polio Eradication Initiative (2014) Polio this week. Accessed 14 April 2014
  21. Hand in Hand for Syria (2014) Accessed 28 Feb 2013
  22. HelpAge International and Handicap International (2014) Hidden victims of the Syrian crisis: disabled, injured and older refugees. Accessed 21 April 2014
  23. Human Security Centre (2005) Human security report 2005: war and peace in the 21st century. Oxford University Press, OxfordGoogle Scholar
  24. Hurley R (2013) Who cares for the nine million displaced people of Syria? BMJ 347:f7374PubMedCrossRefGoogle Scholar
  25. IFAD (2011) Syrian Arab Republic. Country fact sheet on youth unemployment. Accessed 5 March 2014
  26. IOM (2010) Providing primary health care services for conflict affected communities. Accessed 20 April 2014
  27. IRIN (2008) IRAQ: drive to get doctors to return. Accessed 21 April 2014
  28. IRIN (2010) SYRIA: drought pushing millions into poverty. Accessed 8 March 2014
  29. Johnson G (2013) No country for Syria’s IDPs. Accessed 9 March 2014
  30. JRAN (2013) Assessment Working Group for Northern Syria. Aleppo city assessment report. Accessed 10 Sep 2013
  31. Kherallah M, Alahfez T, Sahloul Z, Eddin KD, Jamil G (2012) Health care in Syria before and during the crisis. Avicenna J Med 2(3):51PubMedCentralPubMedCrossRefGoogle Scholar
  32. Kruk ME, Freedman LP, Anglin GA, Waldman RJ (2010) Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: a theoretical framework and research agenda. Soc Sci Med 70(1):89–97PubMedCrossRefGoogle Scholar
  33. Lacopino V (2014) Attacks on medical care in Syria. Lancet. Accessed 9 March 2014
  34. Masterson AR, Usta J, Gupta J, Ettinger AS (2014) Assessment of reproductive health and violence against women among displaced Syrians in Lebanon. BMC Women’s Health 14(1):25CrossRefGoogle Scholar
  35. Maziak W, Asfar T, Mzayek F, Fouad FM, Kilzieh N (2002) Socio-demographic correlates of psychiatric morbidity among low-income women in Aleppo, Syria. Soc Sci Med 54:1419–1427PubMedCrossRefGoogle Scholar
  36. Maziak W, Rastam S, Mzayek F, Ward KD, Eissenberg T, Kell U (2007) Cardiovascular health among adults in Syria: a model from developing countries. Ann Epidemiol 17(9):713–720PubMedCentralPubMedCrossRefGoogle Scholar
  37. Mershed M, Busse R, van Ginneken E (2012) Healthcare financing in Syria: satisfaction with the current system and the role of national health insurance-a qualitative study of householders’s views. Int J Health Plann Manag 27(2):167–179CrossRefGoogle Scholar
  38. Morikawa MJ, Schneider S, Becker S, Lipovac S (2011) Primary care in post-conflict rural northern Afghanistan. Public Health 125(1):55–59PubMedCrossRefGoogle Scholar
  39. Muhjazi G, Bashour H, Abourshaid N, Lahham H (2013) An early warning and response system for Syria. Lancet 382(9910):2066PubMedCrossRefGoogle Scholar
  40. Murshidi MM, Hijjawi MQB, Jeriesat S, Eltom A (2013) Syrian refugees and Jordan’s health sector. Lancet 382(9888):206–207PubMedCrossRefGoogle Scholar
  41. Murthy RS, Lakshminarayana R (2006) Mental health consequences of war: a brief review of research findings. World Psychiatry 5(1):25PubMedCentralPubMedGoogle Scholar
  42. Mzayek F, Asfar T, Rastam S, Maziak W (2002) Neoplastic diseases in Aleppo, Syria. Eur J Cancer Prev 11(5):503–507PubMedCrossRefGoogle Scholar
  43. Nebehay S (2013) U.N. feeds record 3.3 million Syrians but malnutrition rising. November 1, 2013. Accessed 5 Feb 2014
  44. Physicians for Human Rights (2011) PHR releases accounts of violence in Syria. Accessed 18 Feb 2014
  45. Physicians for Human Rights (2014) Syria’s medical community under assault. Accessed 9 March 2014
  46. Pitts-Tucker T (2012) Healthcare in Syria is close to collapse as drug shortages bite. BMJ 345(e5410):345Google Scholar
  47. PRB (2008) Contraceptive use among married women ages 15–49, by method mix.
  48. Rashad H, Zaky H (2013) A comparative analysis of fertility plateau in Egypt, Syria and Jordan: policy implications. Accessed 11 April 2014
  49. Rastam S, Al Ali R, Maziak W, Mzayek F, Fouad FM, O’Flaherty M, Capewell S (2012) Explaining the increase in coronary heart disease mortality in Syria between 1996 and 2006. BMC Public Health 12:754PubMedCentralPubMedCrossRefGoogle Scholar
  50. Relief Web (2013) WHO warns of increased risk of disease epidemics in Syria and in neighbouring countries as summer approaches. Accessed 19 Feb 2014
  51. Reuters (2014) Save the children describes healthcare disaster in Syria. Accessed 10 March 2014
  52. Rosen A (2013) Counting the dead in Syria. Accessed 26 Feb 2014
  53. Sahloul Z, Coutts A, Fouad FM, Jabri S, Hallam R, Azrak F, Maziak W (2014) Health response system for Syria: beyond official narrative. Lancet 383(9915):407PubMedCrossRefGoogle Scholar
  54. Salama H, Dardagan H (2013) Stolen futures: the hidden toll of child casualties in Syria. Accessed 27 Feb 2014
  55. SAMS (2014) Syrian American Medical Society. Accessed 28 Feb 2013
  56. Save the Children (2014a) A devastating toll. The impact of three years of war on the health of Syria’s children. Accessed 10 March 2014
  57. Save the Children (2014b) Syria’s children at risk of malnutrition. Accessed 15 April 2014
  58. SCPR (2013) Socioeconomic impacts of the Syrian crisis. Accessed 4 March 2014
  59. Solomon E (2013) Syria death toll hits nearly 126,000: monitoring group. Accessed 26 Feb 2014
  60. The Nation (2013) Egypt’s Syrian scapegoats: Syrians fleeing the fighting at home have found themselves targeted amid Egypt’s political upheaval. Accessed 28 Feb 2014Google Scholar
  61. Uenuma F (2013) Food shortages put Syria’s children at risk of malnutrition, save the children warns. 23 Sep 2013. Accessed 5 Feb 2014
  62. UN (2014) Syrian Arab Republic. Accessed 8 March 2014
  63. UNDP (2011) United Nations human development report. UNPD, United Nations Population Division, New YorkGoogle Scholar
  64. UNDP (2012) United Nations world population prospects population database (UNPOP). UNPD, United Nations Population Division, New YorkGoogle Scholar
  65. UNHCR (2014) Syria regional refugee response, information portal. Accessed 20 Feb 2014
  66. Vaux T, Visman E (2005) Service delivery in countries emerging from conflict. DFID, LondonGoogle Scholar
  67. WFP (2014) Syria emergency. Accessed 3 Feb 2014
  68. WHO (2011) Syrian Arab Republic: NCD country profile. Accessed 8 March 2014
  69. WHO (2013a) Global health observatory data repository. Accessed 8 March 2014
  70. WHO (2013b) Health: Syrian Arab Republic 2013. Accessed 10 March 2014
  71. WHO (2013c) Donor update Syrian Arab Republic-Quarter 3 report. Accessed 18 Feb
  72. WHO (2013d) Global alert and response (GAR)—polio in the Syrian Arab Republic—update. Accessed 2 Feb 2014
  73. WHO (2013e) News release WHO warns of increased risk of disease epidemics in Syria and in neighbouring countries as summer approaches, 3 June 2013. Accessed 18 Feb 2014
  74. WHO (2014) WHO vaccine-preventable diseases: monitoring system. 2013 global summary. Accessed 16 April 2014
  75. World Bank (2009) Contraceptive prevalence (% of women ages 15–49). Accessed 11 April 2014
  76. World Bank (2012) World Development Indicators 2012. Accessed 15 Jan 2014

Copyright information

© Swiss School of Public Health 2014

Authors and Affiliations

  • Ziyad Ben Taleb
    • 1
  • Raed Bahelah
    • 1
    • 5
  • Fouad M. Fouad
    • 2
    • 3
  • Adam Coutts
    • 4
  • Meredith Wilcox
    • 1
  • Wasim Maziak
    • 1
    • 2
    Email author
  1. 1.Department of Epidemiology, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiUSA
  2. 2.Syrian Center for Tobacco StudiesAleppoSyria
  3. 3.Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  4. 4.London School of Hygiene and Tropical MedicineLondonUK
  5. 5.Faculty of Medicine and Health SciencesUniversity of AdenAdenYemen

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