After years of neglect, east Ghouta, a region located only 6 miles from Damascus, Syria, shows little signs of normalcy, the streets lined with the ruins of buildings emptied of signs of life.
The people here are struggling under the strain of overwhelming economic hardship. Years of health facility closures have left huge needs for medical care, and the available services are incredibly limited. East Ghouta’s suffering is far from over and urgent support is needed now.
“Going to east Ghouta and seeing it with my own eyes was heartbreaking,” said Patrick Wieland, head of mission for Doctors Without Borders/Médecins Sans Frontières (MSF) in Syria. “The scale of destruction is huge—people are trapped in extreme poverty, barely holding on, and in urgent need of medical care.”
Following the fall of Bashar al-Assad’s 24-year rule, MSF has gained access to Damascus for the first time in over a decade. We began operating mobile clinics on January 21, offering basic health care like consultations for gastrointestinal infections. In this short time, we have seen 576 patients, including 77 children under the age of 5.
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Families are living in shells of buildings
East Ghouta was once a lush and green 70 square miles, filled with fruit trees and farms. After years of relentless airstrikes by the former Syrian government forces it now lies in ruins. All that’s left behind of this major food-producing region is destroyed land dotted with grey buildings that have been stripped of rooftops, windows, and life. Still, families are here and struggling to make do.
People are living in difficult conditions. They lack clean water, proper food, sanitation infrastructure, and heating for their homes, exposing them to many health hazards.
“Entire families are living in the rubble of destroyed buildings that look as if they have come from the Middle Ages,” said Bilal Alsarakibi, MSF medical referent in Syria. “The level of negligence is unimaginable; the medical needs are huge. Finding health care is a desperate race against time.”
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The siege of east Ghouta
When the opposition forces gained control of east Ghouta in 2012, the Syrian armed forces then imposed a severe siege on the area. Relentless ground and aerial bombardments targeted homes, markets, and hospitals, while food, water, and medicines were deliberately denied as a method of warfare.
A UN report shows the devastating toll on people. Between February 18 and March 11, 2018, attacks by the former government’s forces killed 1,100 people and injured 4,000. During the same period, shelling on Damascus city by different armed groups killed and injured hundreds more people.
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A new chapter of hope for Syria
Since January 2025, MSF has sent several teams to cities in east Ghouta, including Douma, Harasta, Zamlka, Hamoria, Ain Tarma, and Kafr Batna. Our teams are providing basic health care including medical consultations and mental health support, through mobile clinics.
We attempted to reach east Ghouta many times during the rule of Bashar al-Assad. Our teams were repeatedly denied entry, which blocked people from adequate access to health care they desperately needed.
“When people get sick or injured, getting health care is really hard—there are no ambulances and medicine is too expensive,” said Mohammed Riad, who visited a mobile clinic. “Mobile clinics are a great idea. If they were covering all the areas, it can save people a lot of trouble.”
MSF teams are helping people suffering from different conditions, the most common being respiratory infections, asthma, and gastroenteritis due to food contamination. We are also seeing people for non-communicable diseases such as diabetes, hypertension, and other cardiovascular diseases.
Our teams are assessing the overall medical and humanitarian situation in these cities. The work is currently underway to understand the depth of people’s needs after years of our absence.
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Saving lives is everyone’s struggle
“Due to the siege in 2013, a lot of people were injured and lost their limbs in daily airstrikes,” said Othman Al-Rifai, a resident of east Ghouta. “The doctors traveled abroad because salaries were low and until today you can see the impact.”
Between 2013 to 2018, MSF provided remote support to Syrian medics in east Ghouta. Our teams sent medical supplies, offered financial support, and provided technical guidance. Since MSF could not work in east Ghouta directly, this was the only way to help medical teams there.
We supported 20 clinics and hospitals in 2013. Over the years of escalating violence, the number went down to just one clinic by 2018. The other 19 facilities were either closed or abandoned after former government forces took over the area. At a certain point, there was nothing left that we could support.
“Today, the mobile clinics give a small sense of relief to the people who endured a lot in east Ghouta over the past years,” added Bilal Alsarakibi. “Despite what they have seen, people are still able to smile. They have been through a lot of suffering, and they urgently need support to regain their lives.”