Dr Shamal has been the medical director of Syrian Arab Red Crescent clinic in Ghouta since October 2010, before the crisis. The clinic, supported by IFRC, provides a range of services including paediatrics, gynaecology and dental services. Due to high levels of demand, there are two internal disease clinics here.

“The two most crowded clinics are the internal disease clinics. Each specialist clinic here sees about 30 to 35 patients each day.

“Before the crisis, most patients at this clinic were Iraqi refugees. Now that has changed – the majority of our patients are Syrian, many are displaced. We still treat Iraqis, but far fewer, now the people who need this clinic the most are Syrian.

“We treat anyone who comes through our doors. We see people who have chronic diseases that they used to manage, but now they struggle to get medicines; they don’t have the money to pay anymore.

“We now run two internal diseases clinics and these are the busiest. They are always full. We could open a third clinic, and fill it with people. We need more capacity. Medicine is the main need, people come from miles around for their medicines.

“Here, we are surrounded by IDPs – people who left the Old City and areas of rural Homs. There was a time in the crisis when we were the only facility able to offer vaccinations in this area. We still offer vaccinations one day of every week. Many IDPs live in crowded conditions, this makes diseases more likely to spread. Skin diseases for example, like scabies or dermatitis, because people can’t wash properly or their water source is compromised. Hepatitis A is another problem. Earlier in the crisis, we had 40 cases of Hepatitis A. We discovered a water source had become polluted, due to damage to infrastructure. So we could talk to the water authorities to attend to this.

“One way the crisis has affected people is their finances – and this has an effect on so many other parts of people’s lives. It places pressure on them, on their health – and in turn, pressure on our clinic.”


The Ghouta clinic has existed since before the crisis. Then, most patients were Iraqi refugees. Now the majority are displaced Syrians from Old City and rural Homs. This SARC facility, supported by IFRC, has two internal disease clinics, paediatrics, gynaecology and a dental clinic. The busiest are the two internal disease clinics, which are always full. Earlier in the crisis, this facility was the only place offering vaccinations in this area.