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Sunday 26 April 2020

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

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


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.