Update: 29 January 2016
Starvation continues in Madaya
MSF denounces continued blockage of essential aid and medical evacuations
Residents of the besieged Syrian town of Madaya continue to die of starvation, despite the provision of aid in convoys, as the Syrian government-led coalition blocks life-saving medical supplies from the town.
“It is totally unacceptable that people continue to die from starvation, and that critical medical cases remain in the town when they should have been evacuated weeks ago,” said Brice de le Vingne, MSF’s director of operations.
After the heavy shelling of Madaya last summer and the tightening of the siege during the winter, massive restrictions placed on humanitarian assistance mean that essential medical supplies – including enough therapeutic food to treat the most severe cases of malnutrition – are not available.
Medical evacuations prevented by sieges
MSF estimates that between 1.5 and two million people are trapped in sieges imposed by the Syrian government-led coalition, as well as by opposition groups. In many of these places, medical evacuations are prevented and medical material, drugs and therapeutic food is repeatedly blocked at checkpoints. As a result, medical teams in these areas simply cannot cope with the demands they face. The situation in Madaya is even worse as there are no doctors present in the town.
According to health workers supported by MSF inside Madaya, 16 people have died since the delivery of aid in three convoys earlier this month.
Update: 15 January 2016
MSF urgently calls for medical evacuations for eighteen patients whose lives are in the balance
Medics supported by MSF in the besieged town of Madaya confirmed five deaths from starvation since the first UN/ICRC/SARC* humanitarian convoy arrived on the afternoon of 11 January. MSF calls in the strongest terms for an immediate medical evacuation to safe places of treatment for the most critically malnourished and sick, to avoid further loss of life.
23 patients died of starvation in Madaya in December, five more on Sunday 10 January, and two more on Monday 11 January, as the first convoy was en-route. The latest five deaths amount to a total of 35 deaths from starvation confirmed by the MSF-supported medics in Madaya.
Immediate medical evacuations and medical resupply essential to save lives
The MSF-supported medics in Madaya have identified 250 people with severe acute malnutrition, including 10 patients who are in immediate need of life-saving hospitalisation care. The number of people in need of medical care is growing. If a safe medical evacuation procedure can be agreed, MSF is prepared to facilitate the identification of patients in need of evacuation at that time.
8 January 2016
Since July 2015, a siege has been imposed by the Syrian government forces around the town of Madaya, near the border with Lebanon in Syria’s Rural Damascus Governorate. Since the single one-off food distribution on 18 October, this has been tightened to a total stranglehold siege.
Around 20,000 residents of the town are facing life-threatening deprivation of the basics for survival, and 23 patients in the health centre supported by Doctors Without Borders (MSF) have died of starvation since 01 December.
MSF welcomes reports that the Syrian government will allow food supplies into the area, but urges that an immediate life-saving delivery of medicine across the siege line should also be a priority, and calls for sick patients to be allowed urgent medical evacuation to safe places of treatment.
Of the 23 people who have died, 6 were under one year old, 5 were over 60 years old, and the other 12 were between five and sixty. 18 were men and 5 were women. This indicates that the situation is affecting all age-groups and both sexes, and makes MSF extremely alarmed for the patients currently under treatment, and for the 20,000 residents who have had little to eat for months.
Severely malnourished children
“This is a clear example of the consequences using siege as a military strategy,” says Brice de le Vingne, MSF Director of operations.
“Now that the siege has tightened, the doctors we support have empty pharmacy shelves and increasing lines of starving and sick patients to treat. Medics are even resorting to feeding severely malnourished children with medical syrups as they are the only source of sugar and energy, thereby accelerating the consumption of the few remaining medical supplies. As well as supplying food, an immediate medical evacuation of sick patients, and an urgent resupply of medicines is the only way to stave off a situation that is now catastrophic.”
Siege in Syria
The situation in Madaya is an extreme example of sieges that are in place in many parts of Syria, enforced by both the Syrian government and by Armed Opposition Groups. MSF is very worried about the potential for similar situations to arise in other besieged zones.
“Madaya is now effectively an open air prison for an estimated 20,000 people, including infants, children and elderly. There is no way in or out, leaving the people to die,” says de le Vingne. “The medics we support report injuries and death by bullet and landmine wounds from people that tried to leave Madaya. The desperation is getting so acute that yesterday there were scenes of rioting as people tried to seize the last remaining food available at the MSF-supported food-distribution point, intended to provide for the most vulnerable.”
MSF has been supporting a medical facilities and a food distribution point in Madaya since August 2015, when the siege started tightening around the town. Although difficult, at first it was still possible to arrange supply of food and medicines, but it has more recently become totally impossible to get anything through the siege lines.
MSF has specific concerns also for the medical staff it is supporting. They are working under unbearable conditions, with already big medical needs now exacerbated by food insecurity and nutrition concerns, and there is an urgent need to resupply them with basic medical essentials.
Increased suffering due to low temperatures
Furthermore, the current sub-zero temperatures in this mountainous area causing increased suffering, particularly for sick patients who are less able to recover in the freezing cold. Fuel for heating must be included in the humanitarian aid, as people trying to collect firewood in the surroundings risk being shot or blown up by landmines.
MSF calls for immediate medical evacuation of sick patients to a safe place for treatment. And MSF equally calls for immediate and unhindered access for life-saving medical supplies, as well as food, for the civilian population in Madaya. This access must be sustained, given that a one-shot distribution now will not alleviate the problems in the months to come.