Yesterday afternoon, Thursday 22 March, two airstrikes hit a densely populated neighborhood in the town of Harem (Idlib governorate), resulting in a mass casualty influx of 63 injured and 38 dead to the nearest field hospital supported by Médecins Sans Frontières (MSF).

The medics reported that a popular market was hit by a first airstrike in mid-afternoon, followed a few minutes later by a second strike. Casualties were immediately brought to the hospital. The medical records show around half the dead and wounded were children.  But the small facility could not handle such an influx of severely wounded patients on its own, and the medics were rapidly overwhelmed by the number of injured people.

Multiple hospitals in the vicinity helped in the response to this mass-casualty influx, mobilising ambulances to transfer patients and organising emergency surgeries. “The medics we support did their best to save as many patients as they could, but unfortunately, some of them died soon after reaching the facilities” explains Dr Khaled, who oversees MSF’s support to health facilities in the area.

“We had pre-positioned medical stocks in key hospitals there,” explains Dr Khaled. “But medical supplies never last long, especially when there are such a huge number of severely injured patients. So we are currently organising a resupply because emergency stocks are essential in such context. Without these, even more lives would have been lost.”

Since yesterday afternoon, medics in the area have been working round the clock to treat the injured. Until early this morning, people were still being found under the rubble and rushed to the hospital for emergency treatment. 

"Doctors in these facilities work in an incredibly difficult environment” comments Dr Khaled. “Medical care in Syria is highly needed, but in some areas the capacity struggles to cope with the day-to-day needs let alone massive casualty events like this bombing."

"It is painful to live in days when children are killed and wounded by the bombing of a busy public market. Our only relief is to keep supporting the Syrian medics to save as many lives, limbs and futures as possible."

MSF directly operates five health facilities and three mobile clinic teams in northern Syria, has partnerships with five facilities, and provides distance support to around 25 health facilities countrywide in areas where teams cannot be permanently present. MSF’s activities in Syria do not include areas controlled by the Islamic State group since no assurances about safety and impartiality have been obtained from their leadership, nor can MSF work in government-controlled areas since MSF’s requests for permission to date has not resulted in any access. To ensure independence from political pressures, MSF receives no government funding for its work in Syria.