Dr. Munzer Alkhalil
Research Associate, R4HSSS
Steering Committee Member, Syria Public Health Network
The ongoing conflict in Syria, specifically in the northwestern region, has highlighted the vital role of both individuals and institutions in addressing the needs of affected communities. As the region continues to be plagued by violence and population displacement, the question arises: should we prioritize the value of individuals or institutions in conflict-affected areas?
On the one hand, individuals have played a crucial role in providing aid and support to affected communities, particularly in the early stages of the conflict when state institutions collapsed. For example, health leaders, doctors, nurses, and community members have been instrumental in establishing field hospitals and ambulance systems in areas that were heavily impacted by the bombing and siege of the Syrian regime and its allies. Additionally, the role of individuals in local governance institutions and emerging humanitarian local organizations remains vital, as their contributions often shape the vision and direction of these institutions.
On the other hand, institutions are crucial for providing long-term support and sustainability. For example, local humanitarian organizations and health governance bodies that arose during the conflict phase have worked to establish search and rescue centres, primary healthcare centres, mobile clinics, hospitals, and central projects. These institutions provide a vital lifeline for the local population and advocate for the rights and needs of affected communities on the global stage.
Attempts to erase the personality of individuals in favour of institutions, particularly when forming steering committees, developing training programs, conducting stakeholders’ analysis, and planning for strategic conferences, under the pretext that institutions are the foundation of interventions and the pillars of stability, poses significant risks that threaten the progress made in the health sector over the past decade. This also undermines the entrepreneurial spirit of local leaders and innovative individuals and threatens interventions’ sustainability and long-term success.
In a conflict-ridden region such as Syria, where institutions’ absence, weakness, and collapse are not uncommon, adaptive and resilient individual initiatives remain paramount in addressing the needs of affected communities. In addition, in a region where there is no security and dangers abound, starting with the bombing of civilians with chemical weapons and not ending with the agenda conflict between donors and local communities, the communities’ trust in the local personalities they know sometimes exceeds their trust in any institution, including UN institutions. As the Director of the Idlib Health Directorate, I experienced this first hand in 2014, when a complication occurred during the second measles vaccination campaign led by the WHO; leading to the death of 15 children in Sinjar area. In the absence of the state and the chaos of weapons proliferation, this incident caused a significant challenge for the health sector. Vaccine refusal prevailed in northwestern Syria. The lives of the medical team responsible for the area were threatened and detained by an armed group. Most official opposition government institutions at the time were quick to disavow the incident and throw the accusation of negligence on other parties; the WHO stood helpless, unable to save the vaccine program in this region where vaccinations had been suspended for years due to the conflict. I resorted to the local community and engaged well-known families. This starting point was the most crucial breakthrough in resolving this complex issue. The son of one family, a dentist and an engineer, played a pivotal role in solving the problem and the community’s acceptance of the resumption of vaccination campaigns.
On February 6th, a massive earthquake measuring 7.8 on the Richter scale struck Turkey and Syria, triggering numerous aftershocks and causing one of the most catastrophic events of the century. According to the Assistance Coordination Unit (ACU), the death toll in northwestern Syria had surpassed 4,500 as of February 22, 2023.
In the immediate aftermath of the earthquake, the primary coordination umbrella for humanitarian responses in the area, the health cluster in Gaziantep, was almost absent for the first four days due to its members being among those affected by the disaster in Gaziantep. However, local organizations, including the White Helmets, health directorates, health facilities, and individuals stepped up to lead the initial response efforts.
Individuals played a critical role in the first days following the disaster, mobilizing donations, volunteering with rescue and research operations, organizing advocacy campaigns, and forming volunteer groups to support the responding organizations and quasi-governmental institutions.
On the other hand, on February 12th, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Mr Martin Griffiths, acknowledged the UN’s failure to adequately assist civilians in the region during a visit to the Bab Al-Hawa border crossing. He pledged to take steps to prevent such negligence in the future.
These are prominent examples of how we need, at times, to include individuals in our response and, later on, institutions’ support with their comprehensive response approaches.
Ultimately, individuals and institutions are vital in addressing the needs of affected communities in northwest Syria. Individuals such as health leaders, medical professionals, and community members provide immediate aid, support, trust, resilience, and an understanding of local communities, while institutions offer systems building and long-term support. Ignoring either component poses significant risks to the success and sustainability of interventions in the region.