title: War is the Enemy of Health. Pulmonary, Critical Care, and Sleep Medicine in War-Torn Syria.
abstract: The Syrian crisis, now in its fifth year, has created an unprecedented strain on health services and systems due to the protracted nature of the warfare, the targeting of medics and health care infrastructure, the exodus of physicians and nurses, the shortage of medical supplies and medications, and the disruption of medical education and training. Within a few short years, the life expectancy of resident Syrians has declined by 20 years. Over the first 4 years of the conflict, more than 75,000 civilians died from injuries incurred in the violence. More than twice as many civilians, including many women and children, have died prematurely of infectious and noninfectious chronic diseases for want of adequate health care. Doctors, local administrators, and nongovernmental organizations are struggling to manage the consequences of the conflict under substandard conditions, often using unorthodox methods of health care delivery in field hospitals and remotely by telehealth communication. Much-needed medical supplies are channeled through dangerous routes across the borders from Lebanon, Jordan, and Turkey. Physicians in the United States and other western nations have helped Syrian physicians make the most of the situation by providing training on introducing innovations in technology and treatment. Portable ultrasound machines have been introduced and are being used extensively in the management of trauma and shock. This report, prepared by members of the Syrian American Medical Society, documents current needs for health care relief within Syria, focusing on pulmonary, critical care, and sleep medicine, and some of the efforts currently underway to meet those needs.
authors.affiliation: 1 Pulmonary and Critical Care, Christ Advocate Medical Center, Oak Lawn, Illinois.|2 Department of Internal Medicine, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Mohammed Z
authors.initials: MZ
authors.lastname: Sahloul
authors.affiliation: 3 Department of Pulmonary and Critical Care, Blount Memorial Hospital, Maryville, Tennessee.
authors.forename: Jaber
authors.initials: J
authors.lastname: Monla-Hassan
authors.affiliation: 4 Department of Internal Medicine, Wayne State University-School of Medicine, Detroit, Michigan.
authors.forename: Abdulghani
authors.initials: A
authors.lastname: Sankari
authors.affiliation: 5 Department of Internal Medicine, University of North Dakota, Grand Forks, North Dakota.
authors.forename: Mazen
authors.initials: M
authors.lastname: Kherallah
authors.affiliation: 6 Department of Internal Medicine, Hematology, and Clinical Oncology, Chicago Medical School, North Chicago, Illinois.
authors.forename: Bassel
authors.initials: B
authors.lastname: Atassi
authors.affiliation: 4 Department of Internal Medicine, Wayne State University-School of Medicine, Detroit, Michigan.
authors.forename: Safwan
authors.initials: S
authors.lastname: Badr
authors.affiliation: 7 Department of Internal Medicine, Imperial College, London, United Kingdom; and.
authors.forename: Aula
authors.initials: A
authors.lastname: Abbara
authors.affiliation: 8 Department of Global Health, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Annie
authors.initials: A
authors.lastname: Sparrow
mesh_terms: D002618:Chemical Warfare; D003422:Critical Care; D003695:Delivery of Health Care; D004190:Disasters; D011211:Electric Power Supplies / Q000600:supply & distribution; D004864:Equipment and Supplies / Q000600:supply & distribution*; D006268:Health Facilities / Q000600:supply & distribution; D006301:Health Services Needs and Demand; D006280:Health Workforce; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy; D008952:Mobile Health Units; D009359:Neonatology; D010372:Pediatrics; D004364:Pharmaceutical Preparations / Q000600:supply & distribution; D011634:Public Health; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D015272:Pulmonary Medicine; D012066:Relief Work; D012140:Respiratory Tract Diseases / Q000628:therapy; D012141:Respiratory Tract Infections / Q000628:therapy; D056508:Sleep Medicine Specialty; D012907:Smoking; D013593:Syria; D014397:Tuberculosis, Pulmonary / Q000628:therapy; D000067453:War Exposure / Q000009:adverse effects*
chemical_list: D004364:Pharmaceutical Preparations
keywords: Syrian crisis; attacks on healthcare; chemical weapons; crisis; disasters