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Sunday, 26 April 2020

Covid-19 threat to Rukban camp civilians: Letter to UK Government

The imminent threat of Covid-19 outbreak and urgent medical evacuation – Rukban camp
21.04.2020



To:
The Rt Hon James Cleverly, Minister of State for Middle East and Africa
David Ashley, Head of Syria Unit, Foreign and Commonwealth Office


We are writing to you to express thanks for your help with facilitating the safe delivery of the two pregnant women last month. The women and their babies are healthy and well, and one of the babies has been named after one of the activists who helped raise concerns about the dangerous situation these mothers were in. The camp, however, remains with no access to healthcare services and we have grave concern over the lack of preparation for a Covid-19 outbreak in the Rukban camp.

Since the closure of the Jordan Syria border in February, residents have had no access to healthcare services at all. I would like to highlight that currently there is an urgent case of a 4-month-old boy at high risk of renal failure due to a congenital anomaly of his renal system. He has urinary opening in the abdomen and suffers with dehydration due to lack of feeding, he has stopped nursing and formula milk is scarce. He is at risk of dying from dehydration and renal failure within days. This infant needs urgent medical evacuation as his condition is critical. His family are unable to return to regime areas due to risk of being detained. There are other cases in the camp of chronic health conditions – these people will be at high risk of suffering strokes and heart attacks as they do not receive regular monitoring or medications. They are unable to return to regime areas as that puts them at risk of detention and torture. It is well-documented that residents who have left in the past have been forcibly disappeared by the regime.

Multiple human rights and humanitarian aid organisations have condemned the situation in Rukban camp; a woman and three children have died in the past 18 months due to lack of access to medical care. It has been predicted that an outbreak of Covid- 19 in refugee camps – and these are usually much better equipped than the Rukban camp - will have devastating effects and much higher mortality rates than in other settings.

The UK government’s involvement in Tanf, its position in the Coalition, and its close relationship with both the Jordanian and United states governments, not only give the opportunity to act but make the duty to act inescapable.

We therefore ask as a matter of urgency to:
  • Ensure that Covid-19 outbreak preparations for the Rukban camp, including testing arrangements, are coordinated without requiring residents to leave the de-escalation zone putting them at risk of detention by the regime.
  • Arrange for an urgent medical evacuation for the infant mentioned above.
  • Arrange for primary healthcare services and medication supplies for residents with chronic health conditions.

Please act with the highest levels of urgency to prevent avoidable deaths in Rukban camp.

Dr Batool Abdulkareem, Syria Solidarity UK
Bronwen Griffiths, Syria Solidarity UK
Hamish de Bretton-Gordon, Doctors Under Fire




BACKGROUND ON RUKBAN CAMP

Rukban camp: A case study in reviewing the UK’s protection of civilians strategy
By Dr Kate Ferguson, Protection Approaches, June 2019.

The UK is complicit in a crime against humanity at Rukban camp
Syria Solidarity UK report, April 2019.




Covid-19 threat to Rukban camp civilians: Letter to WHO/UNICEF/UNHCR

The imminent threat of Covid-19 outbreak and urgent medical evacuation — Rukban camp
21.04.2020

To:
Mr. António Guterres, UN Secretary-General
Mr. Kevin Kennedy, UN Assistant Secretary-General, Regional Humanitarian Coordinator for the Syria Crisis
Mr. Filippo Grandi, UN High Commissioner for Refugees
Ms.Henrietta H. Fore, Executive Director, UNICEF
Mr. Manuel Fontaine, Director, Office of Emergency Programmes, UNICEF
Ms. Kelly Ann Naylor, Associate Director, Water, Sanitation and Hygiene (WASH) Section, Programme Division,UNICEF
Mr. Ted Chaiban, Regional Director for the Middle East and North Africa, UNICEF
Dr Tedros Adhanom Ghebreyesus, WHO Director General
Dr. Natalia Kanem, Executive Director, UNFPA
Dr Jorge Martinez, World Health Organization Health Cluster Coordinator
Dr Mahmoud Daher, World Health Organization, Emergency Health Coordinator


We, the undersigned Syrian and international organisations, are writing to you to express our grave concern over the lack of preparation for a Covid-19 outbreak in the Rukban camp and the WHO’s decision to set up testing for Rukban residents outside the de-escalation zone. Testing outside the de-escalation zone will force vulnerable and ill people to choose between getting tested or being forced back into regime areas, putting them at risk of forced disappearances, arrest, and detention. Forced disappearances of residents who have left in the past is well-documented.

The UN and the WHO have a responsibility of ensuring the measures they take to contain the pandemic do not put the same people they are trying to protect at an even graver danger of being detained or killed.

Rukban camp is inside a 55-kilometre radius zone around Tanf base controlled by Coalition forces. Until February the only healthcare service the residents had was the clinic run by UNHCR, UNICEF, and UFPA, which saw an average of 2800 patients a month. This clinic is now shut, and residents have no access to healthcare services. It would not be impossible for the WHO and the UNHCR to coordinate with the Coalition forces to ensure that the camp is well-prepared for an outbreak, including supplying testing kits and coordinating sample transport to the nearest testing lab.

I would also like to highlight that currently there is an urgent case of a 4-month-old boy at high risk of renal failure due to a congenital anomaly of his renal system. He has a urinary opening in the abdomen and suffers with dehydration due to lack of feeding. He has stopped nursing and formula milk is scarce. He is at risk of dying from dehydration and renal failure within days. This infant needs urgent medical evacuation as his condition is critical. His family are unable to return to regime areas due to risk of being detained. There are other cases in the camp of chronic health conditions – these people will be at high risk of suffering strokes and heart attacks as they do not receive regular monitoring or medications. They are unable to return to regime areas as that puts them at risk of detention and torture. It is well-documented that residents who have left in the past have been forcibly disappeared by the regime.

We therefore ask as a matter of urgency to:
  • Ensure that Covid-19 outbreak preparations for Rukban camp including testing arrangements are coordinated without requiring residents to leave the de-escalation zone putting them at risk of detention by the regime.
  • Arrange for an urgent medical evacuation for the infant mentioned above.
  • Arrange for primary healthcare services and medication supplies for residents with chronic health conditions.

Multiple human rights and humanitarian aid organisations have condemned the situation in the Rukban camp; a woman and three children have died in the past 18 months due to lack of access to medical care. It has been predicted that an outbreak of Covid- 19 in refugee camps, usually much better equipped than the Rukban camp, will have devastating effects and much higher mortality rates than in other settings.

Please act with the highest levels of urgency to prevent avoidable deaths in the Rukban camp.


Dr Batool Abdulkareem, Syria Solidarity UK
Bronwen Griffiths, Syria Solidarity UK
Hamish de Bretton-Gordon, Doctors Under Fire




BACKGROUND ON RUKBAN CAMP

Rukban camp: A case study in reviewing the UK’s protection of civilians strategy
By Dr Kate Ferguson, Protection Approaches, June 2019.

The UK is complicit in a crime against humanity at Rukban camp
Syria Solidarity UK report, April 2019.




Friday, 27 March 2020

Urgent call for medical evacuations from Rukban camp


Four women with high-risk pregnancies in Rukban camp need caesarean sections imminently. Rukban camp has no access to health services bar a small mud-hut clinic run by a few nurses.

US and UK Coalition forces control the area around Rukban camp and have a legal duty to civilians under Geneva Convention IV. Below is our letter to the UK Government.

PLEASE HELP by alerting your MP.

You can email your MP via www.writetothem.com.

UPDATE 30 March 2020: Response by Minister of State for Middle East and North Africa added below.

UPDATE 2 April 2020: Two women have now had caesarean sections in Tanf base, Richard Spencer reports in the Times:

The second woman, whose two previous children were born by caesarean section which meant giving birth naturally would have been dangerous, arrived at the camp yesterday, but again the US refused to help. Dr Abdulkareem said the US commander eventually agreed to repeat the operation so long as campaigners did not ask for help for anybody else. The second woman also gave birth to a daughter.

“They did it as a one-off and don’t want it to be repeated,” Dr Abdulkareem said. “The US and the UK, which is a senior partner as well there, are evading responsibility.”



Urgent evacuation of four women with high-risk pregnancies

27.03.2020

[PDF version]

To:
The Rt Hon James Cleverly, Minister of State for Middle East and Africa
David Ashley, Head of Syria Unit, Foreign and Commonwealth Office

We are writing to you to express our grave concern over the dire situation of four women with high-risk pregnancies, in Rukban camp, these women need caesarean sections imminently. Rukban camp has no access to health services bar a small mud-hut clinic run by a few nurses. They have been barred from access to the UNICEF clinic since Jordan closed its border. Two of these women have lost children due to lack of access to healthcare, one of them precisely due to the inability to have a caesarean section last pregnancy.

Yesterday, one of the women went into labour and after an extremely difficult and risky labour, her baby needed resuscitation due to respiratory distress and is still in a critical condition. Another mother is 12 days overdue today, this poses a very high risk to both the mother and baby. It is medically established that there’s a sharp increase in risk of fetal death at day 14 after the due date due to the inability of the placenta to sustain the fetus any longer, hence all obstetric guidelines dictate that women must be delivered at day 14 after their due date at the latest to avoid sudden fetal death. Day 14 for this woman is this Sunday after which there’s an exponential increase of risk of death to the unborn baby.

Rukban camp is inside a 55-kilometre radius zone around Tanf base controlled by Coalition forces, including the Royal Air Force.
This military occupation is part of a Coalition operation in Syria which claims legal justification under Article 51 of the UN Charter as collective self-defence of Iraq, as set out in a letter to the UN Secretary General on 23 September 2014 from then US Ambassador to the UN Samantha Power.

Under Article 55 of the Geneva Convention IV the UK is under legal obligation to ensure residents of Rukban have access to food and healthcare services.

Article 55 of the Geneva Convention IV states that: To the fullest extent of the means available to it, the Occupying Power has the duty of ensuring the food and medical supplies of the population; it should, in particular, bring in the necessary foodstuffs, medical stores and other articles if the resources of the occupied territory are inadequate.

We therefore ask as a matter of urgency to:

  • Evacuate these women within the next 48 hours from Tanf to hospitals in a safe location to be treated and to deliver their babies safely.

Multiple human rights and humanitarian aid organisations have condemned the situation in Rukban camps; 1 woman and 3 children have died in the past 18 months due to lack of access to medical care.

We call on you to evacuate these women within the next 48 hours, otherwise their lives and their unborn babies lives are at risk.

Dr Batool Abdulkareem, Syria Solidarity UK
Bronwen Griffiths, Syria Solidarity UK
Hamish de Bretton-Gordon, Doctors Under Fire



MINISTERIAL RESPONSE:

30 March 2020

Dr Batool Abdulkareem, Syria Solidarity UK Bronwen Griffiths, Syria Solidarity UK

Hamish de Bretton-Gordon, Doctors Under Fire


Dear Dr Batool Abdulkareem, Bronwen Griffiths and Hamish de Bretton-Gordon,

Thank you for your letter of 27 March about evacuating women from Rukban camp for Internally Displaced Persons in southern Syria.

I am sorry to hear about the women you describe with high risk pregnancies; of course I appreciate the severity of this situation. The UK is in regular communications with the UN and has continued to express concern, including in multilateral fora such as the UN Security Council and bilaterally with Russian counterparts, at the conditions in Rukban, where some 12,000 people still shelter and reports continue of a regime-imposed seige. We have pressed for the Assad regime to allow humanitarian aid access from Damascus which, although allowed only intermittently, remains the most appropriate route.

We do not accept that the UK has legal responsibility for Rukban. The UK is not an occupying power in Syria and Al-Tanf is a US military base. We have passed your urgent request to the US military to see if there is any way they can assist, but as you will be aware, the Covid-19 situation has complicated what was already a very difficult humanitarian situation in Rukban. The global strain on healthcare and newly introduced limits on travel will only add to the challenge.

On 25 March, I echoed UN Special Envoy for Syria, Geir Pedersen’s call for a nationwide ceasefire in Syria, in response to this new threat. Ultimately, a UN-led political solution is the only way to resolve the conflict. In the immediate term, however, I hope these women and their children, along with all those in Rukban, are able to access the support they need.

The Rt Hon. James Cleverly MP
Minister of State for the Middle East and North Africa



BACKGROUND ON RUKBAN CAMP

Rukban camp: A case study in reviewing the UK’s protection of civilians strategy
By Dr Kate Ferguson, Protection Approaches, June 2019.

The UK is complicit in a crime against humanity at Rukban camp
Syria Solidarity UK report, April 2019.




Thursday, 26 March 2020

To DFID on Coronavirus in Syria

[PDF version]

The imminent threat of Covid-19 outbreaks in IDP camps, Syria

To:
The Rt.Hon Anne-Marie Trevelyan, International Development Secretary


We, the undersigned Syrian and international organisations are writing to you to express our grave concern over the dire situation of the IDP camps in the north of Syria especially in the current Covid-19 pandemic. These camps are estimated to host more than one million displaced Syrians in overcrowded tents, with up to 35 people sharing a tent; lacking basic needs, such as sanitation, running water, safe food preparation facilities, and medical facilities.

Countries across the world are taking extreme measures to curb the spread of the virus. Basic measures recommended by the WHO to halt contagion such as frequent, thorough handwashing, using hand sanitisers, catching coughs and sneezes in a tissue, social-distancing, and self -isolation for symptomatic individuals are all impossible for Syrians living in IDP camps. Furthermore, there is no access to basic medical care, let alone, intensive care facilities for those who develop acute respiratory distress or need ventilatory support. Existing remote medical facilities lack the ability to test for Covid-19, lack trained medical staff, and protective equipment for healthcare workers.

To the UN and WHO on Coronavirus in Syria

[PDF version]

The imminent threat of Covid-19 outbreaks in IDP camps, Syria

To:
Mr. António Guterres, UN Secretary-General
Mr. Filippo Grandi, UN High Commissioner for Refugees
Dr Tedros Adhanom Ghebreyesus, WHO Director General
Mr. Kevin Kennedy, UN Assistant Secretary-General, Regional Humanitarian Coordinator for the Syria Crisis
Dr Jorge Martinez, World Health Organization Health Cluster Coordinator
Dr Mahmoud Daher, World Health Organization, Emergency Health Coordinator


Wednesday, 4 March 2020

Questions and answers on the war in Syria and the crisis in Idlib


An Assad regime helicopter in flames over Idlib after being shot by Turkish-backed forces, 11 February 2020. Photo by Ghaith Alsayed, AP.

The Syrian war has lasted nine years, and can be hard for many to understand.

We have written the following guide to help understand the war, and the current escalation in Idlib province. If you find it useful, please share on Twitter and on Facebook.

If you would like to write to your MP about any of these points, you can email them via writetothem.com.

• Why is there still a war in Syria?
Nine years after the first demonstrations of 2011, the Assad regime continues to pursue a forcible displacement strategy against a population that rejects its rule, deliberately bombing civilians to force them to flee.

• What caused the crisis in Idlib?
The Assad regime and its ally Russia broke a demilitarised zone agreement with Turkey, attacked population centres, and advanced into Idlib province, forcing a million people to flee to the Turkish border.

Two thirds of Idlib’s population are there because they were forcibly displaced from other parts of Syria.

• Why can’t people in Idlib escape into Turkey?
Refugees in Idlib are trapped across the border from Turkey by the border wall, built with EU financial investment to stop refugees from entering Turkey as part of the deal to keep refugees from Europe’s borders. They are unable to find safety from air attacks and are living in hazardous conditions. Some people trying to cross the border have been shot and even killed.

• What can be done about refugees in Greece and Turkey?
The UK is complicit in the crisis facing refugees in Greece and in Turkey due to past failure to protect civilians inside Syria and its role in developing hostile EU refugee policies. The UK should urgently resettle significant numbers of vulnerable refugees from both Turkey and Greece.

• What are Turkish forces doing in Idlib?
Turkish forces have been striking Assad regime military targets to force them to withdraw to a boundary previously agreed under the 2018 Sochi deal, a line delineated by Turkish observation posts.

UPDATE

On 5 March 2020, Turkey’s President Erdogan met Russia’s President Putin, and they agreed a ceasefire. The terms failed to achieve an Assad regime withdrawal to the 2018 Sochi line. As a result, over one million people recently displaced in Idlib will be unable to return home, as it is unsafe for them to return to towns now held by the Assad regime where they would risk abuse, forced conscription, detention, torture, and death.

See map below.



• Would an Assad victory allow refugees to return home?
No, in the case of an Assad victory, most of the six million refugees outside Syria would not feel safe to return, and millions more would try to flee Syria.

Nine out of every ten civilians who have been confirmed killed in the Syrian conflict were killed by the Assad regime and its Russian allies, according to human rights monitors. (See chart below.) As well as civilians killed by bombing and shooting, tens of thousands of civilians have been imprisoned, tortured, raped, and murdered by Assad regime security branches.

• What is the most urgent need for people in Syria?
The most urgent need is for civilian protection, firstly in Idlib, and also across the rest of Syria.

• Is humanitarian aid the best response?
Humanitarian aid is vital, but can’t stop attacks on civilians or stop forced displacement.

• Can the UK and allies stop Assad attacking civilians?
The UK could consider how best to support NATO ally Turkey in order to reduce the threat to civilians from Assad military forces, for example by directly supporting Turkish efforts to impose a no-fly zone against Assad regime bombers.

Turkish forces are currently the only UK ally on the ground in Idlib with the capacity to protect civilians from Assad regime military attacks.

The Assad regime sees the conquest of Idlib and displacement of its population as essential to its own future, and therefore diplomacy without the backing of force will fail. Assad has broken every previous agreement, and no enduring ceasefire can be established without enforcement.

• What about the Turkish government’s human rights abuses?
The Turkish government has one of the worst records on imprisoning journalists. Turkish action in the Afrin region of Syria led to the displacement of thousands of Kurdish residents. Turkish-backed forces in northern Syria have been filmed murdering unarmed prisoners.

However, the UK and its other allies are themselves implicated in human rights abuses that have caused the deaths of thousands of Syrian civilians, including refugees drowned in the Mediterranean due to hostile EU policies, civilians besieged and killed in the Coalition’s Raqqa offensive, and civilians starved in Rukban camp on the Syrian-Jordanian border.

The UK and its allies all need to work constructively to drastically improve the human rights performance of all parties, and to protect civilians inside Syria and protect refugees fleeing Syria.

• What about Russia?
The UK could introduce targeted sanctions against those Russian individuals who have been identified as having command responsibility for targeting hospitals and civilians.

While Assad regime officers and ministers have been sanctioned, and some Russian individuals have been sanctioned in connection with Russian aggression in Ukraine, no sanctions have been imposed on Russian individuals for their role in crimes in Syria.

• Can the UK and allies act when the Security Council is divided?
The Security Council has not authorised action to enforce a ceasefire or end the conflict. However Security Council Resolution 2139 (2014) demanded “that all parties immediately cease all attacks against civilians, as well as the indiscriminate employment of weapons in populated areas, including shelling and aerial bombardment…”

The UK has previously asserted that use of force in a humanitarian intervention is permitted on an exceptional basis even without Security Council endorsement.

• What else can MPs do?
There is a wide lack of understanding of what is happening in Idlib, and the reality of people’s lives there. Fact-finding missions to Idlib by MPs could help bridge the gap in understanding. There have been recent visits to Idlib both by senior UN staff and by senior US representatives.

• What else should the UK Government do?
To aid understanding, the UK Government should publish assessments of the probable consequences of failing to act to protect civilians in Idlib, both immediate humanitarian impacts and the wider political, economic, and military consequences for the region, Europe, and the UK.

• What about the future?
The UK has up to now followed a policy of containment on Syria, but containment has failed in every year of the conflict, in terms of refugee outflows, widening security threats, and widening political and economic impacts beyond Syria. The UK urgently needs a new comprehensive strategy to guide Syria policy.

Beyond the immediate need for civilian protection, lack of accountability is the central cause of the conflict. A peaceful secure future demands that individuals, armed groups, and governments can be held accountable, within Syria as well as internationally. The UK should give much greater support to accountability mechanisms, including inside Syria’s borders where possible.



Chart: Nine out of every ten civilians who have been confirmed killed in the Syrian conflict were killed by the Assad regime and its Russian allies, according to the Syrian Network for Human Rights.

Monday, 2 March 2020

Urgent request to invoke European Directive on Temporary Protection

[PDF version]

To M. Charles Michel
President European Council
Rue de la Loi 175
B-1048 Bruxelles
Twitter @eucopresident
Fax +32 22816934

Cc: Sir Tim Barrow, UK Ambassador to the EU
Twitter @UKMisBrussels

2 March 2020

Dear M. Michel,

URGENT REQUEST TO INVOKE EUROPEAN DIRECTIVE ON TEMPORARY PROTECTION
We are extremely concerned at the chaotic scenes on Europe’s frontiers, as desperate Syrian refugees attempt to enter Greece and Bulgaria, following Turkey’s recent decision to open its borders with the European Union.

The humanitarian catastrophe in Syria has had enormous consequences for its neighbours over the last 9 years, with Turkey Lebanon and Jordan bearing the largest burden of refugees; and among European countries Greece, and Italy.

With the latest massing of Syrians fleeing from Turkey, it is clear that the EU–Turkey Statement has broken down. Europe has reached the threshold of risk envisaged by the Directive’s creators—i.e. ‘a mass influx of displaced people’ with a risk of the standard asylum system in any one country being unable to cope with the demand. The basis of the Directive is the principle of solidarity among member states, and the sharing of responsibility for any emergency, across the Union.

All member states except Denmark have signed up to the Directive. We are copying in our Ambassador to the EU, Sir Tim Barrow, to remind our government of its responsibility.

You, M. Michel, as President of the European Council, have primary responsibility for making the crucial decision. We ask you to take all necessary steps (including consultation with the Council of Ministers) to trigger the Temporary Protection Directive immediately and as a matter of emergency.

This could open the borders to Syrian refugees and displaced people, put an end to the cruel and chaotic situation facing them, and establish an orderly and equitable process to shelter them while the risk to Syrian citizens from their own government remains. The scale of the crisis—the humanitarian tragedy of the 21st century—demands no less of us all.

Yours sincerely
Batool Abdulkareem
Syria Solidarity UK