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Visualizing how Syria’s war undermines health

Two aid workers measure one year-old Syrian refugee Jawad al-Abbas at a medical clinic in the town of Kab Elias in Lebanon's Bekaa Valley. Syria's civil war has left many children suffering from malnutrition.

Ongoing conflict in Syria dominates the headlines as the Islamic State (ISIL) advances. The hysteria over this newest terror threat is obscuring the continued suffering of innocent civilians. The war destroys lives not only through the bombs that rip through neighborhoods, but also through its destabilizing effect on the country’s health system and other essential infrastructure.

Before the civil war started the spring of 2011, Syria was among the most impressive health success stories in the Arab world. Out of all the countries in this region, Syria ranked third for gains in female life expectancy and fourth for gains in male life expectancy between 1990 and 2010 (see graphs below).

Syria Graph 1

Notes: Healthy life expectancy is the number of years a person at a given age can expect to live in good health free from disability. Source: Article, “The state of health in the Arab world, 1990—2010: an analysis of the burden of diseases, injuries, and risk factors,” and infographic, Burden of Disease in the Arab World.

Between 1990 and 2010, Syria also succeeded in reducing early death and suffering from diseases primarily associated with poverty, such as lower respiratory infections (64% reduction), preterm birth complications (37% reduction), and diarrhea (54% reduction), which are shown in red in the screen grab below. All of these diseases tend to kill children.

Top 10 causes of early death and disability in Syria and percent change, 1990 and 2010

Syria Graphic2

Notes: Source: Global Burden of Disease Study 2010. To explore the data visualization online, go to http://ihmeuw.org/2cie

The Syrian civil war has weakened the country’s health system. In an article published in December 2012, IRIN News reported that the output of the country’s pharmaceutical factories, which formerly met 90% of the country’s needs for medicines, had been reduced by two-thirds. As of June 2014, the World Health Organization reported that nearly 55% of the country’s public hospitals were non-functional or partially functional due to the conflict.

Another indication of the civil war’s deleterious effect on the health system is the re-emergence of polio in the country. WHO estimates that Syria’s polio vaccination rate, estimated to be 91% before the war began, dropped to 68% in 2012. It estimates overall vaccination coverage in Syria fell from 90% prior to 2011 to 52% in March 2014. To make matters worse, aid agencies’ attempts to deliver polio vaccines have been dogged by accusations of mismanagement as reported by Humanosphere in August of 2014.  Also, a recent UN-run measles vaccination campaign in Syria came to a halt when a NGO mistakenly gave children muscle relaxant instead of the vaccine, killing at least 12 children.

The harmful impact of the Syrian civil war on Syrian children is evident in the following screen grab, which shows trends in child mortality between 1990 and 2013. Child mortality increased from 13 per 100,000 live births in 2010 to 17 per 100,000 live births in 2013. These data come from the Global Burden of Disease Study 2013.

Child mortality in Syria, 1990-2013

Syria Graphic3

Notes: Source: Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. To explore the data visualization online, go to http://ihmeuw.org/2cjk

After an estimated 191,369 killings and an untold number of indirect deaths caused by weakening of the health system and the collapse of other vital infrastructure, Syria’s civil war shows no sign of abating. An end to the conflict is urgently needed.

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About Author

Katie Leach-Kemon

Katherine (Katie) Leach-Kemon is a policy translation specialist at the Institute for Health Metrics and Evaluation (IHME). Katie specializes in two of IHME's research areas, the Global Burden of Disease and health financing. Katie has helped produce IHME's Financing Global Health report since it was first published in 2009. She received an MPH from the University of Washington and served as a Peace Corps volunteer in Niger. Her work has been published in The Lancet, Health Affairs, and the Journal of the American Medical Association. You can follow her on Twitter @kleachkemon.