EMBARGOED UNTIL MONDAY 16TH SEPTEMBER

Global doctors warn of impending medical catastrophe in Syria

Chemical weapons deal should make way for agreement on humanitarian access An unprecedented group of eminent doctors and medical professionals from across five continents have warned today that parts of Syria are completely cut off from any form of medical assistance as a result of deliberate and systematic attacks on medical facilities and personnel. The population are already suffering and are extremely vulnerable to any intensification of the conflict. In an open letter to be published in the health journal The Lancet this Friday ahead of this months United Nations General Assembly meeting, 55 signatories, including three Nobel Prize Winners and doctors whove worked on the ground in Syria, warn that countrys health infrastructure is at breaking point. They call on the Syrian government and armed opposition to lift unwarranted restrictions on full humanitarian access to the country. The letter is an extraordinary symbol of unity among medical professionals from 25 countries as diverse as the Russia, China, Brazil, US, and Egypt, at a time when politicians are struggling to find common ground on how to respond. The doctors are advocating immediate and unrestricted medical access to the beleaguered country. Dr Fatima Hamroush, former Minister of Health in the Libyan Transitional Government, and consultant Ophthalmologist said, Syria is almost certainly the most dangerous place in the world to be a doctor. It is in conflicts like this where the world's decision makers can unite to show true leadership and address the suffering of civilians. There is no acceptable reason why full unimpeded access for all doctors needed into Syria should not be granted immediately to prevent further medical catastrophe." Thirty-seven percent of Syrias hospitals have been destroyed and a further 25% severely damaged according to the letter. There is one doctor for every 69,444 people in Aleppoi and Syrias main hospital receives a new emergency patient every 32 secondsii. Dr Hany El Banna, Founder of the Humanitarian Forum and Islamic Relief, said, Syrias hospitals have been turned to rubble and over 15,000 doctors have fled the country already. Over half a million people have been injured and Syrians are undergoing c-sections and amputations without anaesthetic. Its hell on earth. If the international community can agree on getting chemical weapons out of Syria surely they can secure desperately needed aid into the country. The doctors describe patients with horrific injuries going untended and others battling chronic illnesses including cancer having nowhere to turn and concur with the WHO prediction that a breakout of disease is inevitable. They condemn attacks on doctors and hospitals as an unconscionable betrayal of the principle of medical neutrality and of international humanitarian law.

Over the last few months the Syrian government has increasingly restricted the delivery of medical supplies to opposition-controlled areas, refusing to approve medical deliveries; taking medical supplies out of aid convoys; and requiring case-by-case negotiations for the delivery of surgical kits. Dr. Gro Harlem Brundtland, former Director-General of the World Health Organization and Deputy Chair of The Elders said, I am very concerned by the deliberate and systematic attacks on medical facilities and personnel in Syria. The government is refusing visas for aid personnel entering the country. Armed opposition groups are blocking medical supply convoys. This is an unconscionable betrayal of the principle of medical neutrality. World leaders are discussing Syria intensively in the recent days and should find on a consensus to alleviate Syrians suffering and save lives. Specific actions that the doctors want governments to take include: The Syrian Government and all armed parties to refrain from attacking hospitals, ambulances, medical facilities and supplies, health professionals and patients; the Syrian Government to allow access to treatment for any patient; and hold perpetrators of such violations accountable according to internationally recognized legal standards; Governments that support the parties of this civil war should demand that armed actors halt attacks on medical personnel, facilities, patients, medical supplies and allow medical supplies and care to reach Syrians, whether crossing front lines or across Syrias borders; All armed parties to respect the proper functions of medical professionals and medical neutrality by allowing medical professionals to treat anyone in need of medical care and not interfering with the proper operation of health care facilities; The UN and international donors to increase support to Syrian medical networks, in both government and opposition areas, where, since the beginning of the conflict, health professionals have been risking their lives to provide essential services in an extremely hostile environment. ------------------------------------------- / Ends / ----------------------------------------------------The full list of signatories is below and the full text of the letter can be found on the Lancet website here For more information or to arrange interviews: Nirvana Shawky, M: +20 122 2424414, nirvana.shawky@crisisaction.org Crisis Action works behind the scenes to enable our partners to respond jointly to conflict and crises. Crisis Action should not be cited in media reports.

SIGNATORIES Australia 1. Dr Tilman A Ruff (Australia), Associate Professor at the Nossal Institute for Global Health, University of Melbourne, Co-President of International Physicians for the Prevention of Nuclear War 2. Dr Annie Sparrow (Australia), former director of UNICEF's malaria program in Somalia, intensive care pediatrician, and professor of global health, Icahn School of Medicine at Mount Sinai in New York. Bahrain 1. Dr Fatima Haji (Bahrain), rheumatologist and Internal Medicine Specialist at Salmaniya Medical Complex. Brazil 1. Dr Roberto Luiz d'vila (Brazil), President of the Federal Council of Medicine of Brazil 2. Dr Eloan dos Santos Pinheiro (Brazil), former Director of the Oswaldo Cruz Foundation. Canada 1. Dr Neil Arya (Canada), former President of Physicians for Global Survival, founding Director of the Global Health Office at Western University, and co-editor of Peace through Health. China 1. Yaolong Chen (China), Editor, Testing Treatments Interactive, one of the founders of the Chinese GRADE Centre. DRC 1. Dr Denis Mukwege (DRC), founder and medical director of Panzi Hospital in South Kivu Province, DRC. Egypt 1. Dr Hany El Banna (Egypt/UK), Pathologist, founder of the Humanitarian Forum and of Islamic Relief, and Chairman of the International HIV Fund. 2. HE Dr Laila Negm (Egypt), Director of the Health and Humanitarian Department, League of Arab States. France 1. Prof Dominique Belpomme (France), Director of the European Cancer and Environment Research Institute (ECERI) and President of the Association pour la Recherche Thrapeutique Anti-Cancreuse(ARTAC). 2. Dr Jules Hoffmann (France), winner of the 2011 Nobel Prize in Medicine. 3. Dr Michel Kazatchkine (France), Special Envoy of the UN Secretary General on HIV/AIDS in Eastern Europe and central Asia. Germany 1. Prof Dr Harald zur Hausen (Germany), winner of the 2008 Nobel Prize in Medicine. 2. Dr Monika Hauser (Germany), executive member of the board of medica mondiale, laureate of the Right Livelihood Award 2008. India 1. Dr Unni Karunakara (India), International President of Mdecins Sans Frontires/Doctors Without Borders. 2. Prof Prathap Tharyan (India), Professor of Psychiatry at the Christian Medical College (Vellore, India), Coordinator of the South Asian Cochrane Network, and member of the Scientific Advisory Group of the WHO-ICTRP. Kenya 1. Dr Rose Nyabanda (Kenya), Head of Radiology at Kenyatta National Hospital, Kenya.

Libya 1. Dr Fatima Hamroush (Libya), former Minister of Health in the Libyan Transitional Government, President of Irish Libyan Emergency Aid and consultant Ophthalmologist. 2. Dr Laila Taher Bugaighis (Libya), Deputy Director General of the Benghazi Medical Centre, Member of the RCOG of London, Senior Lecturer, founder of the National Protection Against Violence Committee, and Co-founder of the Al Tawafuk Al Watani Democratic Organization. Malaysia 1. Dr Jemilah Mahmood (Malaysia), founder and former President of the Malaysian Medical Relief Society, Board Member of DARA, recipient of the Isa Award for Service to Humanity. Norway 1. Dr Gro Harlem Brundtland (Norway), former Director-General of the World Health Organization, former Prime Minister of Norway, and member of The Elders. Qatar 1. Dr Mohammed G. A. Al Maadheed (Qatar), President of the Qatar Red Crescent and Vice President of the International Federation of Red Cross and Red Crescent (Asia). Russia 1. Dr Elizaveta Glinka (Russia), founder and President of the palliative health charity Spravedlivaya Pomosh (Fair Aid). 2. Dr Sergey Kolesnikov (Russia), Co-President of Russian IPPNW, Professor at Moscow State University, and Co-President of the All-Russia Social Movement For Safeguarding People. 3. Dr Vasiliy Vlassov (Russia), President of the Russian Society for Evidence Based Medicine. Saudi Arabia 1. Dr Salah Al Ansari (Saudi Arabia), Executive Director of the Islamic Medical Committee and the World Assembly of Muslim Youth. Senegal 1. Serigne Magueye Gueye (Senegal), fistula surgeon, Professor of Surgery/Urology at the University Cheikh Anta Diop and Head of Urology-Andrology, Grand Yoff General Hospital, and recipient of UN Medal for Peace in Rwanda. South Africa 1. Dr Salim S. Abdool Karim (South Africa), President of the South African Medical Research Council and Director of the Centre for the AIDS Programme of Research in South Africa, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal. 2. Dr Kgosi Letlape (South Africa), President of the African Medical Association and Executive Director of the Tshepang Trust. 3. Dr Imtiaz Sooliman (South Africa), founder and Chairman of Gift of the Givers, Africa's largest disaster response organisation. Sudan 1. Prof Hamid Rushwan (Sudan/UK), Chief Executive of Board at International Federation of Gynecology and Obstetrics. Syria 1. Dr Ahmad Hassan Batal (Syria/Bahrain), Professor of Ophthalmology, Chairman of the Batal Eye Center, and member of the Syrian Expatriates Medical Association. 2. Dr Rola Hallam (Syria/UK), Hand in Hand for Syria medical committee and Secretary of World Anaesthesia Society, Association of anaesthetist of Great Britain and Ireland. Turkey Dr Kerem Kinik (Turkey), President of Doctors Worldwide Turkey. 1. Prof Dr Sebnem Korur Fincanci (Turkey), President of the Human Rights Foundation of Turkey and one of the founders of the Turkish Association of Forensic Medicine.

UK 1. Sir Iain Chalmers (UK), British health services researcher, one of the founders of the Cochrane Collaboration, and coordinator of the James Lind Initiative. 2. Sir Terence English (UK/South Africa), former President of the Royal College of Surgeons of England, former President of the British Medical Association. Performed Britains first successful heart transplant. 3. Dr Richard Horton (UK), Editor of The Lancet. 4. Dr Paul McMaster (UK), surgeon working with Mdecins Sans Frontires in Syria. 5. Professor Sir Michael Rawlins (UK), President of the Royal Society of Medicine. 6. Dr Babulal Sethia (UK), President-Elect of the UK Royal Society of Medicine. US 1. Dr Peter Agre (US), Professor at Johns Hopkins Bloomberg School of Public Health, former Chairman of the Human Rights Committee at the National Academy of Sciences, and corecipient of the Nobel Prize in Chemistry, 2003. 2. Dr. Deborah D. Ascheim (US), Chair of the Board of Directors of Physicians for Human Rights (PHR) and Associate Professor in the Departments of Health Evidence & Policy and Medicine/Cardiology, Icahn School of Medicine at Mount Sinai in New York. 3. Dr Holly Atkinson (US), former President of Physicians for Human Rights and Director, Human Rights Program, Mount Sinai Global Health, at the Icahn School of Medicine at Mount Sinai in New York. 4. Dr Richard Carmona (US), 17th Surgeon General of the United States. 5. Dr Lincoln Chen (US), Chair of BRAC-USA. 6. Prof Atul Gawande (US), surgeon, writer, and professor at Harvard School of Public Health and Harvard Medical School. 7. Dr Ira Helfand (US), Co-President of IPPNW and Member of the Board, Physicians for Social Responsibility (USA). 8. Dr Robert Lawrence (US), Professor of Environmental Health Sciences, Health Policy and International Health at John Hopkins Bloomberg School of Public Health, Founder of the Centre for a Livable Future at John Hopkins Bloomberg School of Public Health and cofounder of Physicians for Human Rights. 9. Dr Abdulghani Sankari (USA), former Vice-President of Syrian American Medical Society, Physician and Researcher, Wayne State University-VA Health Services Research and Development Center, United States Department of Veterans Affairs. 10. Dr Michael VanRooyen (US), Professor of Medicine at Harvard Medical School, Director of the Division of International Health and Humanitarian Programs at the Department of Emergency Medicine, Brigham and Women's Hospital, and Director of the Harvard Humanitarian Initiative. 11. Prof Ron Waldman (US), President of Board of Directors of Doctors of the World, USA, and Editor-in-Chief of Global Health: Science and Practice. Zambia 1. Dr Robert Mtonga (Zambia), Co-President of International Physicians for the Prevention of Nuclear War.

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Joint Rapid Assessment of Northern Syria http://www.irinnews.org/pdf/aleppo_assessment_report.pdf WHO : http://www.emro.who.int/press-releases/2013/disease-epidemics-syria.html