 Good morning, and good evening. I know we have people tuning in from around the world. Thank you for joining us for a really important conversation. My name is Nancy Lindborg. I'm the president and CEO of the United States Institute of Peace, and it's my pleasure to welcome you to an important discussion on how the global COVID-19 pandemic is affecting Syria, one of the most complex conflict arenas in the world. We're doing this event in collaboration with our friends at the Syrian American Medical Society, or SAMS, who are instrumental in putting this event together. So in particular, I want to thank David Lilly, the executive director of SAMS, both for helping to organize this critical discussion, and more importantly, for the vital work of SAMS. I first encountered members of SAMS during the early days of the Syria conflict, when I was still working at U.S. Agency for International Development. And since then, I just remain in awe of the courage and their commitment over nine years of this terrible conflict. Sadly, after nine years of violent conflict, peace remains an elusive goal in Syria. At USIP, our teams have focused on deepening an understanding of the conflict's drivers and dynamics on building local capacity for conflict prevention and mitigation and engaging local leaders in dialogue. Every conflict occurs at multiple levels, and conflict usually engenders more conflict. So we've worked with partners in northeast Syria to convene religious, tribal, and civil society leaders for dialogues to resolve the local conflicts in their communities and facilitate the return of internally displaced people to their homes. But unfortunately, the 2019 incursion of Turkish forces across the border and now COVID-19 has interrupted our dialogue work in northeast Syria. But here in Washington, we continue to convene broad-based bipartisan discussions on Syria to maintain awareness of the conflict, broaden understanding, and identify policy options, including the recent congressionally mandated Syria Study Group, which published its final report last September. You can find it on our website. There are a few conflicts more complex than the war in Syria, and now we have the further complications of COVID-19. In the early weeks and months of the pandemic, Syria initially appeared to remain largely insulated from the virus with only a very limited number of reported cases. In recent weeks, however, we've seen an upsurge of reported cases and deaths in Syria, and what we can be certain of is that the data is very uncertain reporting a spotty, but we'll hear more from our very distinguished guests this morning. What we do know is how vulnerable large swaths of Syria is to the virus with large numbers of displaced persons and an absolutely devastated health system following a continued bombardment. And adding especially to the challenges in the north, humanitarian access was recently limited, following a reduction in the number of U.N. crossings from Turkey into southwest Syria. These U.N. mandated access points have been essential for the delivery of life-saving humanitarian assistance to 4 million civilians living, especially in Idlib. And they are now down to just one border crossing. So with COVID bearing down, the timing could not be worse. And on the northeast side, there are similar challenges with the growing threat of COVID, the shutdown of the U.N. border crossing between Syria and Iraq this year. And with the number of confirmed cases in northeast Syria still low, concerns remain over the inadequate healthcare infrastructure, limited humanitarian access, and the presence of large displacement camps, including the Al-Hol camp with nearly 70,000 residents, primarily women and children. I'm really honored that we're able to host this discussion today in partnership with these really courageous health workers. In the past months, we've talked a lot about the heroism of healthcare workers around the world as they risk their lives to confront the medical professionals who are here with us today. Our part of a truly extraordinary cadre of health workers, doctors, nurses, who for nine years have routinely risked their lives in a conflict that regularly targeted doctors and nurses through aerial bombardments, arrests, and deaths. It's almost unimaginable to add to this risk in the complexity of the coronavirus. So I really want to thank our distinguished panelists for their exceptional courage and for sharing today firsthand their experiences of confronting the challenges of COVID-19 in a Syria that is still at war, helping us to keep this conversation in the foreground. It will be a dynamic and important discussion. Thank you for joining us today. And let me encourage all of our viewers to participate in the live Q&A using the YouTube chat box function on the YouTube page. Please join the conversation on Twitter using the hashtag COVID Syria. And now I'm really delighted to turn it over to my colleague Mona Yakubian. She's a senior advisor here at USIP. She will introduce our panelists and moderate today's discussions. I had the pleasure of working with Mona when we were both at USAID. When she was the deputy assistant administrator in the Middle East Bureau, Mona brings deep experience and expertise and great passion to this issue. So there's not a better person to guide this conversation. And I turn it over to you, Mona. Thank you. Mona, you're on mute. Of course I am. It's the age of Zoom. Nancy, thanks so much for those kind words. I appreciate it. We've got a really jam packed event. So I want to dive right in, but first I'd like to offer our colleague Dave Lilly from Sam's the opportunity to make a few opening remarks. So Dave, over to you. Thank you, Mona. And thank you Nancy for those very nice words really appreciate being part of this important discussion and for USCIP hosting this. I'm really looking forward to a dynamic discussion and hearing from the experts are mentoring colleagues in the field. Sam's responded to this, the war, the onset of the war in Syria in 2011 by providing medical relief and doing much more. Sam's is a unique international NGO based in the United States because the backbone of our organization are our members and volunteers we have over 1500 medical professionals. Most of whom who speak Arabic, and who know the cultural context of the Middle East who constantly provide support and volunteer and their expertise in so many different ways. In Syria and in the surrounding area. Last year we provided over 2.5 million medical services in Turkey, Jordan, Lebanon, Iraq, Greece, even to the Rohingya refugees in Bangladesh where we're providing support. COVID support today. And we're also exploring support in Yemen, but really, Syria is where we have given so much so much and so many sacrifices. Here we are in a discussion for coded where, as Nancy had said, our medical workers last year and early this year were under constant environment and of aerial bombardment missiles, IEDs. Overall, we have lost over 50 Sam staff over the years have given the ultimate sacrifice to help others. They remain in Syria despite the fears that the threat of chemical attacks. The threat on their families just going to work is a threat. It's one of the biggest causes of death of workers in Syria. There have been over 500 medical attacks on medical facilities in Syria since since this war has started. And now we have this threat of COVID and our workers stay still stay there we support over 2000 medical workers. And I my hat is off to them they are the true hero heroes. Now we are facing another threat. This COVID. Again, it requires them it, we need them to stay at the medical facilities and provide support. And because we have built such strong community relations, and we are able to open up screening tents at the, at the entrances of our over 30 medical facilities and triage people before coming in and this is something really unusual, but because we have trust with the communities where we've been able to do that. There have, there has been a small outbreak in the Northwest there is an outbreak in Syria overall. And this is a fundamental, a new fundamental threat coupled with the ongoing fear of attacks with the actual attacks and violence in Syria today. And yet we can take we continue we carry on. There's essential services that are necessary. Last year we provided over 100,000 vaccinations to kids, we delivered 26 27,000 babies life has to go on. Despite the threats and COVID life must go on and and without the support of the US State Department, without the support of us ID the office foreign disaster systems we would not be able to do what we're doing today. We also get support from the Germans the French, the UK foundations and thousands of individual donors without without their support we could not do what we're doing today. And the voice, the voices that we're going to hear from today are so important our advocacy work or outreach work to share what is really going on in Syria and with refugees in the area is so important so again I want to thank you for this opportunity and I look forward to hearing from the experts, our humanitarian colleagues and thank them in advance and thank you Mona and Nancy for this opportunity. Thank you so much. So before I introduce the panel let me just quickly once again go over the rules of the road because we very much want you all to participate. Please feel free to tweet at the hashtag coven Syria about the event. You can also ask your questions and I see we're already starting to get some questions. You can also use the chat box below the video player on the US IP event page. So both Nancy and Dave, I think have laid out well, both the complexities and the challenges of a global pandemic, taking place in one of the most complex and dangerous conflict zones. I do though also just want to reiterate my deep appreciation for our four distinguished panelists, the incredible work they do is enormously challenging and dangerous. And we very much appreciate all four of you taking the time in the midst of the pandemic to speak to us and to help us learn and understand better what the challenges of coven are like inside Syria. What we'll do is we're going to have a conversation myself and the four panelists I'd like to introduce them in the order in which I'll be engaging them in conversation. So we will start with Dr Bashir Tajadine, who is the senior program manager for Sam's he's based in Gaziantep Turkey. Dr Bashir manages nearly 50 health projects inside Syria. He graduated from Aleppo University in 2005 with a medical degree. And then he received his master's in internal medicine from Tishreen University in Latakia in 2010. Dr Bashir has worked as an internist in Syria since 2010. Next we'll hear from Dr Hamza Sayed Hassan. Dr Hamza is the quality and development manager for Northwest Syria for Sam's. He is based inside Syria in the Northwest. He's literally on the front lines of the conflict. And now the outbreak of COVID-19. Before we started the event we were chatting and he was telling me about artillery and shelling that took place just yesterday in the city of Dignesh. So this is he is in the midst of both conflict and now pandemic. Dr Hamza worked as a trauma doctor for five years prior to coming to Northwest Syria in the besieged suburb of East Wuta just outside of Damascus where he managed 17 medical facilities. He graduated from Damascus University with a medical degree in 2006, and then earned his master's in 2011 from Damascus University. Next here from Dr Mohammed Haj Hamdo. He's the health coordinator for Northeast Syria for Syria relief, which is a Syria focused UK based charity. Dr Mohammed is joining us from Raqqa Syria. He has worked in humanitarian fields since 2013 based in Northeast Syria, working for a number of international NGOs. He's graduated from the College of Medicine at Latakia University in 2015. He was in the midst of pursuing his master's degree in endocrinology, when he had to leave his studies in order to return to Raqqa in 2017 to be with his family during the military campaign against ISIS. Finally, Dr Amjad Ras, his chairman of the Northern Syria Medical Relief Committee with Sam's. He was born and raised in Hamma, Syria. He graduated from the University of Damascus in 1989, and then emigrated to the US in 1991, where he completed his internal medicine reticent residency at the University of Connecticut. Dr Amjad joined Sam's in 2012 and he's held several positions with the organization. Most recently he served as chairman of the Sam's Foundation. He practices medicine in Ohio. So with that, let me start first with you Dr Bashir. And I'm wondering if you could first tell us a little bit about how Sam's has prepared for the COVID pandemic, which has arrived in Syria, but came a bit late. And so as the pandemic was ravaging other parts of the world, can you tell us a bit about how Sam's and others have prepared for the pandemic. So you were involved in establishing something called the early warning alert and response network or e-worn inside Syria. This was during the polio outbreak in 2013. So clearly you've had some experience with dealing with disease, epidemics, disease surveillance. I want to thank you and thank you everyone for attending this webinar. Regarding Sam's preparedness plan, actually the first lesson we learned from the other countries around the world that healthcare workers are the frontliners in fighting this epidemic. And we noticed that there is the cases between the healthcare workers I of high percentage. So our priority in our preparedness plan was how to keep the healthcare workers safe in North with Syria where we are operating for now, especially with the scarcity of the healthcare workers. Now there is a huge shortage of the healthcare workers, especially the specialized personnel in Northwest Syria. So they are the frontliners that are providing services not just for COVID, but also for the other essential services. Since March before the outbreak started in any part of Syria, including Northwest Syria, Sam's was an important part of the Northwest Syria COVID-19 task force under the umbrella of the health cluster with WHO and other humanitarian partners working in Northwest Syria. So we're part of the preparedness and response plan for Northwest Syria since this task force started in March. We're actively participating and feeding in the task force within the eight pillars of the preparedness and response plan that we agreed upon within the task force. So keep coordinating on almost daily basis with the WHO, the health cluster partners on the epidemiological situation in the region and following the guidelines, the protocols, the recommendation from different partners. And also we realized that the prevention of this disease is a cornerstone in the response. So we mobilized our community health programs along with other partners to target the communities and raising awareness. And also we used as much as we can from the staff working in Sam's facility to raise the awareness of the population and the community about COVID and trying to learn them the prevention or preventive measures. The surveillance also is a very important part in the, in the epidemics. So Sam's 40 projects inside Syria where I'm still actively participating in reporting to the surveillance system, the early warning. And response network which is the active surveillance system in Northwest Syria and it's my honor to participate in this program previously before I joined Sam's. So this surveillance we're participating either through our health facilities or through the community health workers. The lab confirmation, it's where also coordinating with other partners, mainly the EWARN program who's managing this pillar. But most important is the case management as Sam's is specialized health organization and Sam's is one of the biggest organization providing the health and medical service in Northwest Syria. So the case management pillar was one of our priorities and Sam's is co-leading this pillar beside the WHO. And in our plan we started preparing three COVID hospital based isolation units with a capacity of about 270 beds including 90 ICU beds and ventilators. And we started implementing this pillar in addition to the triage protocol in all of our facilities. For the IBC, the infection prevention and control, it's another important pillar where we need to prevent the healthcare worker from getting infection. And also in order to prevent that the health facility will be a source of infection to the community. So all our health facilities get the IBC standard training for the COVID and also we supported them with the protective or personal protective equipment that keep them safe as much as we can. And of course for the logistic pillar we are in on daily coordination with WHO and other partners regarding providing all the logistic support from the PPE, the personal protective equipment and IBC supplies infection prevention control supplies needed for running the COVID case management center. And also the medications and medical supplies that are needed for this. This is in general our preparedness plan in addition to one very important component it's updating or reviewing our duty of care policies that are getting the healthcare workers during the COVID and epidemics. So that they can feel they are safe and protective and keep not just in good health but in good social support as well and well being. So this is in brief our preparedness plan and actually we started implementing this preparedness plan after confirming the COVID-19 North West Syria on July 9. Thank you for that very helpful overview can can you just maybe very briefly give us a sense of the extent or the magnitude of COVID inside Syria and there's been some discrepancy between the WHO figures and maybe the reality on the ground. For example, we've heard recently about outbreaks in Damascus that are that are being under reported but we'll talk in more detail with our other colleagues about what's happening specifically in the northwest and the northeast but maybe if you could just give us a very brief overview of the extent of COVID inside Syria. Yes, for sure. I mean, actually, as you know, Syria is part of this world, and it's not isolated or protected against COVID, but it's the way how to how to deal with the epidemic. For some numbers, until yesterday in Syria, there are 847 confirmed cases with about 46 death cases. Unfortunately, we have to speak about Syria on different regions of Syria or different areas in Syria. For North West Syria, now we have till yesterday, we have 36 confirmed cases, 17 in Aleppo governorate and 19 in Aleppo governorate. In the government controlled areas, there are 800 and nine confirmed cases distributed between Damascus, Aleppo, Hama, Tartus, and the Homs and those numbers are including the numbers from northeast Syria. As we know, there are three cases confirmed in North Syria, two in the resort and one in the city. And during this week, but previously back in April, there were there was two confirmed cases in Kamishli and also the local authorities announced that they confirmed five cases. Not through PCR, but in the available lab capacity, which is the rapidest. The numbers are announced by WHO, of course, but for sure, according or comparing Syria with other countries where there is much better health system and better living situation for the population and better preventive measures. So the numbers looks very few comparing with, for example, Turkey, more than 200,000 cases in Lebanon, where there are thousands of cases in Jordan, about 100, 500 cases in Iraq, there is a thousands of cases. So it seems that the circulation of the virus is higher than the reported cases and that what we what we know also and hear from our colleagues, friends, relatives in inside Syria, but this is the announced cases. We can expect more. The numbers are higher, especially for example in northwest Syria, we are talking about an area that contains about 4.3 million population, more than one third of them are living in overcrowded situation in the camps according to the last CCM or the CAHMS cluster coordination management. There are about 1.4 million people are living in the camps with overcrowded situation and with the majority of population under the line of bufferty so no preventive measures are taking on serious scale in the community. And the same in other parts of Syria in the government control areas. So this is the situation in the announced number and the concerns about the higher number that we may have. Thank you so much, Dr. Bashir. I actually would like to turn to Dr. Hamza and pick up exactly where you left off. Dr. Hamza, you are there in northwest Syria. Can you tell us a bit about the situation on the ground, and in particular to two issues or challenges. One is there was a small outbreak reported at the Bab Al-Hawa hospital and this question about the medical providers being infected by COVID and the challenges that that entail. Can you speak about that? And also about the very precarious situation of the internally displaced people of the IDPs in northwest Syria and the vulnerabilities that they face with COVID. Thank you. Thank you, Mona. As Dr. Bashir said, we began or proved our emergency plan for COVID from March with coordination with the health cluster on WHO. And we are in, in the field began to implement the plan on the ground by distribution, distribute tents and PPE and on the health facilities and to apply the Teriyaj protocol which approved by the health clusters. We also began to train our health provider on IPC measures to prevent themselves from contracting COVID. And we trained all our staff and health workers and psychosocial workers on conducting awareness among population with their rounds in the fields. From the beginning, from the March to the beginning of July, there are no confirmed cases in northwest Syria. Why? Because in March, the border between Syria and Turkey was closed. So the movement between Turkey and Syria decreased. And the point of entry between the government area and northwest Syria also was where closed in from the March. So I can say that the northwest Syria was isolated from the world between March and the beginning of June. At the beginning of June, the border reopened and the movement between Syria between Turkey and Syria became to increase and smuggling people from the government area to northwest Syria also increased. So my expectation and my expectation and with my colleagues in SAMS, we expected that the first case in northwest Syria will be in July. And that actually what happened. Unfortunately, the first cases were in one of our biggest hospitals in northwest Syria, which is the Bab El Hawa Hospital. It is the biggest hospital in northwest Syria. And the last hospital in a referral system after this hospital, the complicated cases referred to Turkey. The first cases was a neurosurgeon. He contracted COVID from his wife, which she is a doctor. She came from Turkey. And our surgeon contracted the virus from here. Our doctor was have high suspicious with his cases and he said to the administrative and to his colleagues that he expected that he contracted COVID. His colleague, unfortunately, didn't believe him. And the administrative unfortunately also didn't believe him. Why? Because there is no cases in northwest Syria. And his symptoms was very mild. He repeated his request to make a swap and the administration called Iwan to take a swap from him. Unfortunately, Iwan, he won't take the swap and give us the result after 49 hours. So the delay was about 52 hours and the case confirmed at 9th of July. After we were informed in terms with the positivity of these cases, we meet in the Syria office and the Raziantap office and decided to close to stop the work in the hospital and close the hospital and isolate all the people inside the hospital. Doctors, nurses, patients, the companions of patients, and we began to coordinate our response with the health doctorate and the health cluster. And we asked Iwan to take swaps from all the people. I in Syria office activated the IPC committee, Infection Prevention Control Committee in the hospital and interviewed all the health staff and asked them for symptoms to know who have symptoms and who haven't symptoms. The staff who had symptoms, we asked them to isolate themselves until the swap appeared. And we communicated with all the staff out of the hospitals who went out of the hospital before the confirmed cases to isolate themselves in their houses. And if they had any symptoms, call us to take a swap from them. The tracing became to continue and we tracing all the people who contacted to the confirmed cases and this continued for about one week. After one week, we confirmed 13 cases among the staff, nine of them were doctors, two of them were nurses, two of them were related to doctors. And after that, from two weeks up till now, there is no confirmed cases in this cluster. After the, no one of patients confirmed, no one of, after the negativity of the test, we choose to open the, or to send the people to their houses to isolate themselves for 14 days. Some of the doctors didn't go from the hospital because and refused to go to the isolation, community isolation centers because these centers are not dignified for them and not on their levels. And this was a challenge for us. Fortunately, at the end, we decontaminated the hospitals, the hospital and reopened the hospital one week ago. So, this, this is an outbreak, a public health outbreak in North with Syria. I can assure that we term this bad story to success story in our response to COVID. Unfortunately, after that, we confirmed our cases from one of the patients who came from the government control area from Arabia. And this, this case, where in Samin, beside the city. Also, we isolated the cases and trace with coordination with the E1, the confirmed case, and from the 25 of July up till now, there is no new cases in this cluster that is a new success story. Unfortunately, there are two cluster in North Aleppo, one of them is in Al-Bab, and it's still up to now activated, still up to now active. And the last cluster is now in Al-Ra'id at the border between Syria and Turkey. This is our story with Bab Al-Hawa about the second question about the people in North with Syria and the situation of IDPs. As you know, from the beginning of 2020, more than one million people were displaced from their cities and towns and houses. And you saw the picture that the people satellite under the trees until they receive and shelter. From the beginning of this year, many people satellite in camps or before the camps to be established, they settled in tents with their relatives on the border of Syria and they settled in gathered pools in schools and mosques. So the schools and mosques and tents became and camps became overcrowded. As I walk in North with Syria, every day I see a new camps. The North with Syria is in sea of camps. This is unfortunately the situation. The tents are not wide, it's narrow, many people live in it, it's very crowded, no sanitation in these camps. The people in camps suffering from poverty, the poverty is a challenge for us in responding to COVID-19. When I sent a community health worker to raise awareness in some camps and the community health worker said that you must wear a mask. The people answer that they have no money to buy masks. They have no money to buy IBC material. This is a problem for us to prevent COVID. The other thing I want to mention is that the unemployment percentage or the range of unemployment in North with Syria, the most majority of North with Syria are unemployed. So if one of them contracted COVID, we cannot replicate him to stay in home or in isolation system without guarantee that the relief is for him and for his family. And this is another problem and this is big problem in responding to COVID. We must raise the relief rates to people in North with Syria. The other thing I want to say and I see in North with Syria is the range of psychological disorders are more than the normal. The range of depression and anxiety is very high. Those people are problem for us when we send our PSS worker, psychosocial worker to them to raise their awareness on preventing the COVID. They answered that they have a difficult life. They hope to die. They hope to die to get rid of this bad life. This is unfortunately not the Syria. I didn't mean to interrupt you. You've painted a very complex and very challenging picture in North with Syria. I want to make sure we have the chance to hear also from Dr. Muhammad so that he can provide us some insight on North East Syria, which where the pandemic has yet to really arrive in the same way that we've seen elsewhere in Syria as far as we know but perhaps you could Dr. Muhammad, give us your view from North East Syria. What are the particular challenges you're facing? We were talking before the event started about the need to perhaps re-institute curfews. They're not popular in the communities. How does COVID in Syria look like from Raqqa? Well, thank you. Honestly, the situation is very tense in North Eastern Syria. In regard to, let's say, the PCR machine or PCR device, there is only one in commercially and the samples are taken by different teams and there is no clear coordination between three actors, which the WHO, the self-administration and the EUR. And this makes the situation is more difficult. Let's go to the movement restriction, for example. This thing succeeded in Hassaki and Raqqa, where the local authority in somehow is empowered. And they resort. This is impossible because this area in somehow is subject to the clean and tribe's law. They rule this area. Knowing that there is still ISIS cells in the eastern countryside of the resort. In addition to the presence of a large number of illegal crossing between SDF controlled areas and government of Syria controlled areas and Iraq and Turkey. So, many people came through this point of interest without any peace, without any investigations and they came from areas of conflict really. Infrastructure. I would like to say some numbers. 68% of the health facility in Raqqa is partially destroyed and 10% are fully destroyed. So we have only 25% of the health centers are ready to use, but we need to equip it with the supplies and medicine. This is the next challenge. The supplies and medicine. After the Cesar Law, after the closure of Al-Yaroubiya border, after the high prices for the medicine and the government of Syria. All that lead to the lack of medicine and supplies delivered to the northeastern of Syria. As for the medical human resources, it's not only northeastern Syria problem. All Syria suffer from the deficiency of doctors. You may know that the Syrian doctor is ranking the first I think in the foreign doctors in Germany for an example. And there is the community awareness. The people here are not afraid of the disease. They may afraid of stigma more than the disease. They don't want to get infected and isolated at home. They will not accept that people will boycott them. Before I came to here, I took a taxi and the driver just told me he will refuse the curfew because he thought that the God will save him anyway. So all that, so all that myths are challenges also. Extremely helpful. And I actually want to pick up where you left off and bring the doctor into the conversation because you were noting the fewer number of doctors that we find in Syria. And I believe the proportions are quite low. It's maybe a little over one doctor per 10,000 people, whereas it typically it's about 25 doctors per 10,000. Dr. Amshad, you've been very involved in setting up training using video and other innovative methods. Can you tell us a bit about those efforts and how this sort of virtual training is helping to address some of the challenges at coven presents. Thank you, Mona. Thank you. Surely we these training started with Sam's involvement in the conflict. Our very first involvement was through a mission in mid 2011 early on in the conflict. A couple doctors went to a Hanley to assess the situation. They crossed the borders to the mountains outside the Latakia, and they did do some training intensive care. That did not stop. We later reacted to the needs. We had to deal with trauma so we did a lot of hands on trauma training in our hospitals in Aleppo and Idlib Latakia and Hama. Of course, the whole map had changed over the years, but but we continue to to to react to what's needed on the ground. We vividly remember the our capacity building in response to our to the chemical attacks that took place on April 2018 in the town of Khan Sheikhoon. That was not the first one. The bigger one was in August of 13. Dr. Hamza was one of the doctors who treated the victims. At the time we had to do the different approach. We did training, but we also with the help from the State Department, we did training of trainers. We brought them to Turkey and we did like conventional classroom training and then they went inside and trained the doctors on how to do early detection of chemical attack symptoms and also early intervention to rescue the victims. When it comes to COVID, we approach COVID in the same in the same mentality that this is another challenge to us. They're going to come ahead. So we start planning. Dr. Beshi mentioned we started planning in February and the training, the actual training started in May. The training for intensive care and other specialty took really big, big jump in SAMS in 2014 when Dr. Jabba Hassan organized a team to do to do ongoing training and either an in person in Turkey and inside Syria or through the internet and the same time technical support to online medical consultations. Now going forward to the person to COVID, one of the elements we decided to take on was the case management and part of that is capacity building in terms of technical skills and also make technology available to treat the patients. We did the assessment of what's needed inside and unfortunately, in terms of knowledge, first the disease was new. It's called novel virus. This is the first time I hear the novel doesn't necessarily mean positive things. And also we have we fall behind in terms of a lot of hospital management and ICU care. Luckily our members, SAMS members in the states were in the front lines, treating patients with COVID here in, I mean, in the Midwest, Ohio, Michigan, Chicago, or in the northeast in New York City, Boston. So I called, I called some of those doctors and I explored their interest in helping with the with lecturing, given online lectures and the response was overwhelming. I literally have more lectures than lectures and courses. So we started with the first course in mid May. And so far we've done 16, I say six courses, and we've done about 35 hours of lectures, all available online. And the access to those courses are targeted, depend on the course we do. We target certain healthcare professionals, and we, we are not limited to certain geographic area. We have these open to everybody in the Middle East. Certainly everybody inside Syria. And we've had attendees from Jordan, Lebanon, Yemen, Sudan in the last course and, and our highest in highest in course attendance was about 160 hours three weeks ago. So the, the, these training trainings are well received and we're going to continue with that we have for on the schedule three in August and, and one in September and more to go, of course, we look and forward to more collaboration with the State Department to do to do technologies focused training with newer technology and ICU medicine, and it will be, it will do the same concept of T or T that doctors will be skilled enough to teach their colleagues. Thank you. Thank you so much, Dr. I'm shot. So, we have just about 15 minutes remaining we do have a number of questions that have come in so what I'd like to do is perhaps pose one question to each panelist and I would ask you to be brief and you're in your answers just so we make sure everybody has a chance to speak. One question that's come in is about the impact of Caesar sanctions and the consequences for civilians. Dr. Muhammad I'm going to ask that question to you since you mentioned it briefly in your in your comments. After we hear briefly from Dr. Muhammad. Another question that's come in is is the situation in the Rukban camp. And maybe that's something Dr. Bashir that you can respond to. We're also looking at the question of the impact of conflict on your work and here Dr. Hamza I think it'd be very important to hear from you about how you're managing this covert response in the midst of live conflict as you noted yesterday even there were there were artillery attacks by the Syrian regime. And finally, Dr. Amshad I'd ask you to think about the question of the extent to which the pandemic has impacted Syrian refugees. Of course they're not inside Syria but given your work you may be able to offer some insights on that. So, Dr. Muhammad let me first go briefly to you on the question regarding the impact of the Caesar sanctions. Well, you know that northeastern Syria has three borders with Iraq and Turkey and the government of Syria. Border with Iraq's are closed with Turkey is closed also. So, the only border was with the government of Syria. After the civil law, the prices of medicines and supplies increase it, increase it maybe 500% or 600% in addition to the cost of the shipment and illegal crossing to this area. I think this is, I think that's what Caesar law did in this area, despite that self administration with us tried to isolate this area from the slow. Thank you so much Dr. Muhammad and then briefly, Dr. Bashir, can you respond to the question about the situation in the Rukban camp down in the southwestern part of Syria. Actually, regarding Rukban, no specific information about COVID is going out. It's, as you know, the same miserable humanitarian situation in Rukban camp where there's a lack of almost everything. It's like a besieged area as I remember us with the Eastern Ruta two or three years ago, where it's not accessible except from by some conveys from the UN after the permission from the Syrian government, but I don't have specific information about the camp mainly regarding COVID. Okay, thank you so much for that. Dr. Hamza, I'd like to turn to you now. And maybe you could speak a little bit about how you are managing your planning with the fear of escalation of conflict also just over the horizon. Yes, as you know, this is the 10th year of the conflicts and we are we in terms always we have contingency plans for any escalations. The core thing in our responding to COVID is, is isolation hospitals. So our plan was, as you know, we have, we are establishing now three isolation hospital for COVID. One of them in Idlib city. And this city in now in risk for in high risk for escalation. And we take in our consideration that the two other hospital must be at the border. And now we are establishing two isolation hospital on the border between Syria and Turkey, and this is maybe safer than the inside area such as it. On the other facility, we have always contingency plan with dealing with escalation escalation and pamperment and sharing. Thank you so much. Please continue. Please continue. And we apply this contingency plans as usual in we applied this last year and before and before. Dr. Amshad, do you have some information about the impact of COVID on Syrian refugees as we know there are large numbers of refugees currently based in Turkey and Lebanon, Jordan. Do we have information on how how the how the pandemic is impacting those populations. Dr. Amshad. Okay, yes. Actually, may continue with the other question that Dr. Hamza is answering. Actually, we just put in numbers what we are doing we are trying to double the number of ICU beds and double double the number of ventilators in Northwest Syria. We have something like 85 86 ventilators so that will be doubled by the time we finish our plans. And the same I think the number of ICU beds will, I think 110 will be a bit over 200. This is from with the help from our. That's what the help from our supporters our funders. Just to mention that the off that and also the European government like the French and Germany. Diving into the the question you mentioned the impact of COVID on on refugees out of Syria. The economic cascade the bad economic cascade is the major impact on on the already vulnerable populations living in, in very poor conditions. When you look at the condition off of refugees, we always caught five star the ones living in Europe, and maybe four stars and Turkey. I don't I don't know if I can put a star there. The having visited the these mean the size some of the sites in Lebanon and of course in Jordan, Lebanon is really bad situation. It's a very poor country. And, and when you add the, the a million refugees, whatever the number is, it's, it's, it's add a lot of economic bad economic impact. So, we talked about medical medical here. The same thing was happening to the Lebanese and Lebanon happening to the to the Syrian refugees in Lebanon from health wise, but but the economic impact is as much bigger and not as proportion was much bigger when it comes to that. And we did help a little bit with with economics we distributed some humanitarian aids a couple of months ago and we targeted. I don't know if you can hear me now. Hello. You're good. Yes. Yeah, we targeted the Syrian refugees. Yeah, we're talking to see if you. We lost you momentarily. I'm back I hope. Okay, you're back anyway. We talk to see an refugees and host communities in Jordan. We luckily we have not had any case and in refugee camps. And I think the Jordanian government has done a tremendous job in containing the, the infection. It's not even epidemic level there. What we've done we had assisted the government over there with monetary aids actually. I think we, I don't remember the exact number is 25,000 or 50,000 it's very very little amount but it's more I guess sure that we are in this fight together. But we, we are doing mental health programs targeting the, the kind like mental health consequences of of COVID in terms of staying like staying in isolation or in quarantine or in terms of fear from from the infection we have these, these sessions on going every other week. Thank you. Thank you, Dr. So we have about five minutes left and there's one other question that's come up and this one is also for Dr. Muhammad it has to do with the whole displacement camp that that Nancy mentioned in her introduction this camp which has, you know, nearly 70,000 residents mostly women and children. There was fear, maybe last week, or the week before of a potentially positive COVID test it turned out to be negative. But can you talk a bit about the planning for what what to be done. If the virus makes its way into into a camp such as that. Fortunately, the fears became true. Two days ago, there were three confirmed cases in a low camp. All the three are NGO health workers. They're previously and precaution and this OB for any for an activity in the camp, wash, health, distributing kids, anything. And, but after the, the three cases. Two days ago, all NGOs should ensure that their employees will sign a commitment document that they should wear. And all health NGOs in the camp must prevent their health workers to work in in more than one health facility in order to prevent the virus of the breeding. We hope that that these majors could help. But it's very, it's very difficult thing. I know that there has been quite a bit of concern about the implications of that. As we come toward the conclusion of today's event. I really do want to thank all of our participants for your work, most importantly, under such difficult circumstances. And to have you with us today. And you've really been able to bring, I think a great deal of insight into the enormous challenges that Syria faces as COVID begins to bear down on the country so I want to thank all of you very much for your time for your work. And I want to thank in particular, as well, Dave Lily and Sam's for helping us to put this together. And of course, thanks to Nancy Linboard, our president and fearless leader for for all of her guidance throughout all throughout this. On behalf of us IP. Thank you all very much. And everyone please stay safe. Thanks for being with us. Thank you USIP.