Tune into any news channel and you will probably hear “Syria” within a minute. The talking heads are covering the security implications of the civil war and the alleged use of chemical weapons has prompted a moral and human rights debate. However, largely absent from public debate is a discussion about the basic health needs of Syrians and the international community’s role in ensuring those rights. WHO has declared the situation as a “Grade 3” emergency, the highest alert level. Grade 3 describes an event “with substantial public health consequences that requires international response”. 
As of this month, estimates predict that there are over 1.8 million registered refugees and over 2 million persons of concern. In addition, the UN estimates that at least 5 million Syrians have been internally displaced. [2, 3] While it is difficult to sum up the experiences of the displaced persons, a logical assumption is that their quality of life has changed, including their access to healthcare. Syria’s health care system receives little funding from the state and thus is largely decentralized and functions of the village, district, and provincial level. Even if displaced persons did not have institutional or comprehensive health care in their place of origin, their process of receiving care has been disrupted, and often, compromised.
This is by no means an exhaustive list, but factors influencing the change in health care access include:
- Health facilities have been targets and many providers have been killed and facilities destroyed.
- Transportation systems have been damaged, making it difficult to access care providers.
- If displaced persons previously had a provider they regularly saw, their patient-doctor relationship has been disrupted.
- Internationally subsidized programs such as clinics and refugee camps run by the UNHCR often provide basic services for free, however, some more advanced services are not. Many displaced persons do not have access to all of their resources, making affording some procedures and medicines impossible.
- Syrians who were receiving some form of schooling prior to the civil war might no longer be. While data is limited, some students are educated on how to lead healthy lives through their schooling.
In addition, inside of Syria the health care system is in decline due to the collapse of the Syrian pound and state instability. Pharmacies, including ones in Damascus, are facing shortages and substantial price increases in many medicines including children’s milk.  Lack of access to necessary medicines can harm children’s development.
There has been progress in several Millennium Development Goals areas in Syria. Between 1970 and 2009, infant mortality dropped from 132 per 1000 live births to 17.9 per 100, and maternal mortality fell from 482 per 100,000 live births to 52 per 100,000.  While it is still soon to tell, the inaccessibility to health systems might have a negative impact on these trends. Let us hope that the international community will consider these issues as much as security and diplomatic ones.