Infection Prevention and Control (IPC) in conflict-affected areas in Northeast Syria: A cross-sectional study

In regions affected by conflict, the effects on the healthcare system can be far-reaching and devastating. This is particularly evident in northeastern Syria (NES), a home to an estimated 2.4 to 4 million people. The region has been profoundly affected by the Syrian conflict, the rise and eventual decline of ISIS, and continuing internal strife. Since 2011, NES has faced recurrent violence, internal displacement, and extensive damage to health facilities, which has exacerbated the public health crisis. The conflict has damaged healthcare infrastructure through attacks on health facilities and the repurposing of old buildings, limited access to medical services, a workforce exodus, weak governance, overcrowded refugee camps, inadequate sewage management, reliance on untreated water sources, and poor infection control practices. These factors have heightened the risk of infectious disease transmission [1,2]. Compared to the other areas in Syria, the humanitarian response in the NES didn’t expand until the decline of ISIS in 2018. Even before the conflict, healthcare resource allocation in NES was marked by significant regional disparities, exemplified by the 2009 statistics indicating only less than one hospital bed per 1000 inhabitants in Raqqa, substantially fewer than the 2.6 beds per 1000 observed in Tartus and Lattakia [3].