A surge in hepatitis A cases has emerged in Syria’s eastern Deir Ezzor countryside, highlighting the region’s deteriorating healthcare infrastructure under the Autonomous Administration of North and East Syria (AANES). The outbreak, primarily attributed to contaminated drinking water, has forced many residents to seek treatment in distant cities due to local hospitals’ severe limitations.
Medical surveillance data reveals the scope of the crisis, with over 900 cases recorded in just 40 days across September and October. The early warning system operated by the Future Organization documented 732 cases in September alone, followed by an additional 232 cases in the first week of October. However, healthcare workers suggest these numbers likely underrepresent the true extent of the outbreak, as not all cases are officially reported.
Hepatitis A is a viral infection caused by the hepatitis A virus (HAV) and results in severe liver disease and sickness. Inflammation not only damages the liver but also prevents other organs from working properly.
Unlike other diseases and illnesses, hepatitis A cannot be passed by casual, person to person transmission. Meaning, touching, sitting next to, or being coughed on by an infected person will not lead to an infection. Hepatitis A is instead spread as the result of contact with an infected person’s stool, which can happen in a number of ways:
- Consuming food prepared by an infected person that didn’t wash their hands after using the bathroom
- Drinking untreated water
- Placing something that has been in contact with an infected person’s stool in one’s mouth
Vaccination is the most effective way to avoid hepatitis A, even after exposure, and is recommended for everyone ages one and older, and those traveling outside of the United States.
The situation in Syria has been particularly challenging for local residents like Abdul Qader al-Zanad, a 28-year-old who experienced firsthand the consequences of the region’s inadequate healthcare system. After receiving incorrect medication from a local doctor that worsened his condition, al-Zanad was forced to travel to al-Hasakah for proper treatment. The journey proved financially burdensome, with treatment costs ranging from 1.5 to 2.5 million Syrian pounds (approximately US$150) for medical consultations, imaging, and tests. The round-trip transportation costs alone added another 800,000 Syrian pounds in costs.
The outbreak’s root cause appears to be the region’s compromised water safety. According to Dr. Jalal al-Khalid, a general practitioner in eastern Deir Ezzor, the spread of hepatitis A is directly linked to contaminated and untreated water supplies. The World Health Organization (WHO) confirms that hepatitis A transmission occurs through contaminated food and water consumption or direct contact with infected individuals, with poor sanitation and hygiene practices increasing infection risks.
The healthcare crisis extends beyond the current hepatitis outbreak. The region’s medical infrastructure suffers from severe shortages across multiple fronts. Public hospitals lack essential medical supplies, medications, and specialized personnel. Critical medical specialties such as digestive medicine, pulmonology, ophthalmology, and neurology are largely absent from local facilities. This shortage forces patients to seek treatment in other provinces, primarily al-Hasakah and Raqqa, creating additional financial and logistical burdens for already struggling families.
Current statistics paint a sobering picture of the healthcare workforce in the region. According to Dr. Bakr al-Sayed Ahbash, only about 250 doctors across all specialties are registered with AANES in the Deir Ezzor countryside. This shortage is exacerbated by ongoing security concerns, as medical professionals face continuous threats that drive many to abandon their posts in search of safer working environments.
The situation at al-Basira General Hospital exemplifies the broader crisis. A doctor there, speaking anonymously due to media restrictions, revealed that the facility struggles with basic medical supplies and frequently cannot provide treatment due to medication shortages. The doctor attributes these deficiencies to insufficient funding from the region’s Health Committee.
While hepatitis A typically allows for full recovery and lifelong immunity in most cases, the WHO notes that a small percentage of infections can progress to fulminant hepatitis, potentially proving fatal. Treatment recommendations focus on following medical prescriptions, consuming sterilized water, and avoiding certain foods that might aggravate liver inflammation, such as dairy products.
The crisis has created a two-tiered healthcare system where those who can afford private treatment travel to better-equipped facilities in other provinces, while others must rely on the limited resources available locally. This disparity particularly affects vulnerable populations who cannot afford the significant costs associated with seeking treatment elsewhere.
The recurring outbreaks of bacterial diseases in the region underscore the urgent need for comprehensive healthcare reform and infrastructure investment. The absence of crucial medical specialties, particularly in neurology and cardiac surgery, combined with the ongoing exodus of medical professionals, suggests that without significant intervention, the healthcare crisis in eastern Syria’s Deir Ezzor region may continue to worsen.
Food Poisoning News has covered several cases of Hepatitis A infection this year in both the United States and Canada, including:
- Potential Hepatitis A infection at Vancouver Island Dairy Queen
- Confirmed Heptatis A infection at Honolul brewery
- Hepatitis A outbreak confirmed at Tim Horton’s Nova Scotia location
- Hepatitis A incident reported at Beverly Hills Whole Foods
Commenting on this article, one national Hepatitis A lawyer said, “The recurring outbreaks of Hepatitis A in the region really stress the urgent need for healthcare reform and investment in infrastructure. However, the lack of certain medical specialties, coupled with the ongoing exit of medical professionals, suggests that this crisis is unfortunately far from over.”
