Afrin, Syria – When patients first arrive at the Amanos Hospital, the tents the facility is solely built of are a reminder of what this region of northwestern Syria has been through in recent months.
Constructed on the outskirts of Afrin, the hospital was pieced together in an unusual style because of the thousands of people who suddenly needed attention but had nowhere to go.
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Six months ago, devastating earthquakes hit this region, with the epicentres just across the border, in southeastern Turkey.
More than 4,000 people died in Syria, alongside the 50,000 or so who were killed in Turkey.
With aftershocks common in the wake of the quakes, a tent hospital seemed safer than already destabilised buildings.
“The hospital was established as an urgent response to the earthquake disaster and the region’s need for expanded medical services,” Dr Osama Darwish, a specialist in general surgery and the director of the Amanos Hospital, told Al Jazeera. “It is designed to operate for 15 years, according to the tents’ manufacturer.”
The structure may be made of tents, but it is expansive. A total of 112 beds, distributed across several sterilised tents, are available, along with two operating rooms, an emergency department, a radiology department, clinics, and a laboratory.
“The primary goal of constructing the hospital from tents was to provide a safer environment during natural disasters, and since our region is considered a war zone, it also allows for easier relocation to a safer place,” said Darwish, referring to the ongoing war in Syria, which is now more than a decade old and which has particularly affected opposition-controlled areas such as Afrin.
“We are working on expanding the hospital further, either by adding caravans or constructing a more permanent structure to provide additional services needed in the area, such as a central pharmacy,” Darwish, who is also a member of Syria’s Independent Doctors Association, said.
Half a year on from the earthquakes, the healthcare sector in northwestern Syria is still suffering the consequences, because of what healthcare professionals say is the scarcity of aid provided by international organisations.
“The healthcare sector is still suffering from many gaps and the need for modern medical equipment and quality medications,” said Dr Zuhair al-Qarrat, the head of the Idlib Health Directorate. Additionally, healthcare workers lack sufficient training in this field.”
Al-Qarrat told Al Jazeera that hospitals and medical centres in Idlib had received some medicine and medical equipment after the earthquakes, but that it only covered around 20 percent of the health sector’s needs, despite appeals to several international and Arab entities. The closure of the Bab al-Hawa border crossing with Turkey has further worsened the health situation in the region, especially for cancer patients.
“We urgently need specialised centres for cancer treatment, cardiac surgery, and neonatal care, in addition to a radiology centre equipped with all the necessary devices,” said al-Qarrat.
For cancer patients in particular, healthcare facilities in northwestern Syria are not capable of providing proper treatment.
Many have instead taken to travelling to Turkey for care, but the earthquakes brought on a new problem, as Turkish authorities temporarily halted the entry of Syrian cancer patients, saying that the process of rebuilding from the earthquakes had left Turkish hospitals in the south unable to receive Syrian patients.
Entry has since been restored for pre-existing patients to continue their treatment, but has not been allowed for cancer patients diagnosed after the earthquakes, according to officials on the Syrian side of the Bab al-Hawa crossing.
Medical sources in northern Syria estimate that the number of these new patients is more than 600, with some having already lost their lives while waiting for permission to enter and receive treatment in Turkey.
“The halt in entry for cancer patients seeking radiation therapy has put us under tremendous pressure, and we can no longer accommodate the large numbers of patients coming for chemotherapy,” said Dr Ayham Jamou, a specialist in haematology and oncology and the director of the Syrian American Medical Society (SAMS) Oncology Department at Idlib Central Hospital.
The services provided by the SAMS Cancer Treatment Center are now limited to diagnosing new cases and administering the available chemotherapy to patients for free, making it the only facility in northwest Syria offering such medical care.
“We are left powerless in the face of patients who require radiation therapy due to the unavailability of radiation devices in the area, as well as patients who need expensive immunotherapy,” said Jamou.
In response to the plight of cancer patients in opposition-controlled areas of Syria, staff from medical and humanitarian organisations in Idlib, as well as activists, have staged an ongoing protest near the Bab al-Hawa border crossing since July, demanding urgent action from the international community to facilitate the treatment of those affected.
The Turkish government responded to demands by allowing cancer patients with permission to cross to receive free treatment within its territory.
“I am six months late for the treatment prescribed by the doctor in Turkey, because of the closure of the border crossing,” said Hala al-Ahmad, a 17-year-old displaced girl from Aleppo residing in Sarmada city near the Syrian-Turkish border.
Al-Ahmad has been suffering from kidney cancer for two years and used to receive treatment in Turkish hospitals. She returned to Syria just before the earthquakes, waiting for her next treatment dose, but has not been able to re-enter Turkey after the border crossing closure, which has put her in a difficult situation as she waits for permission.
“The decision to reopen Bab al-Hawa crossing for cancer patients to receive treatment has given me hope for life again,” said al-Ahmad. “But today, I went to the crossing, and they scheduled my entry to Turkey for three months from now. I’m now worried about what will happen to me.”