A health worker giving polio vaccine drops to a child, as part of a vaccination campaign organized by the opposition Assistance Coordination Unit, Aleppo, Syria, May 5, 2014

Article initially published in The New York Review on August 12, 2014 and written by Annie Sparrow.

In the weeks since mid-June, when the jihadist group known as the Islamic State of Iraq and Greater Syria (ISIS) obliterated the border between Syria and Iraq and then swept across much of northern Iraq, the extent to which the Syrian conflict has engulfed the region has become increasingly clear. But jihadism is not the war’s only wider threat. For medical workers in the Middle East, it has long been apparent that the catastrophic health effects of Syria’s crisis were spilling over into neighboring countries.

With several million Syrian refugees now living in Lebanon, Jordan, Turkey, and Iraq, and millions more displaced inside Syria living in dreadful conditions, the threat of epidemics spreading from Syria to surrounding countries has grown with frightening speed. Among the diseases that have spread most rapidly are measles, hepatitis, and leishmaniasis. Then there is polio, a terrifying disease of early childhood that had long been eradicated in the Middle East. In Syria, it was eliminated in 1995, yet since mid-2013 the country has faced an outbreak of polio that has spread widely across opposition-controlled areas of the north. And now polio, like the jihadists, has spilled across the border to Iraq, crippling a baby boy in February and a young girl in April, both in Baghdad.

Far from a natural tragedy, this public health crisis is largely a result of the Syrian government’s years of attacks on the medical system in opposition-held parts of the country, with its barrel-bomb and occasional chemical attacks, as well as its withholding of basic public-health measures such as vaccination and safe water. But as I have documented in The New York Review, the spread of polio has been aggravated by the inadequate response of the World Health Organization (WHO) and UNICEF—the two UN agencies responsible for dealing with the epidemic. And new revelations have made clear that independent polio vaccination efforts in northern Syria have been severely hampered by those agencies’ mismanagement.

Over the past year, ISIS has made this situation even worse with its kidnapping of international health workers, detention and intermittent execution of national medical personnel, and seizure of aid convoys. Dr. Wasim, a Shi’a doctor who had left southern Damascus in late March after three years of working in the conflict, told me that he had been one of only nine doctors serving a population of more than 150,000.

Pictures of expired vaccines

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