Growing insecurity in the Aleppo region is weakening efforts to provide essential medical care. On 24 January a missile landed 800 meters from an MSF field hospital in the Aleppo area, although no casualties were reported. On 13 January, after an airstrike on a market in the nearby town of Azaz, 20 wounded were treated at MSF’s hospital.

“The growing number of attacks in this area is likely to undermine our capacity to carry out medical activities,” says Teresa Sancristóval, MSF’s emergency desk manager. “Since we started working in Syria, we have tried to find safe places in which to treat the population. Women and children are paying a very high price in this war.”

While MSF continues to treat people injured in the violence, they are just the tip of the iceberg in a humanitarian crisis that is affecting all sections of society. “Besides the war-wounded and the direct victims of violence, the conflict is affecting the most vulnerable, especially people with chronic diseases, women and children,” says Miriam Alía, MSF medical coordinator.

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Amongst pregnant women, miscarriages and pre-term births are on the rise because of the stress caused by the conflict. Women who would previously have given birth in hospital now find themselves with little access to free medical services. MSF’s field hospital in the Aleppo region is one of the few facilities providing much-need healthcare for pregnant women and newborn babies.

“Every day women are seeking medical care and delivering in our hospital,” says Sancristóval. “Deliveries in our facilities climbed from 56 in November to over 150 in the first three weeks of January.” So far this month, MSF has treated 15 pre-term babies who would normally require specialized medical equipment which is currently only available across the Turkish border.

Since the protests began in Syria almost two years ago, MSF has tried to gain access to the areas where humanitarian needs are most urgent. However, the scope of MSF activities inside Syria remains limited due to insecurity and official restrictions. For months MSF has been seeking official authorization to assist Syrians in government-controlled areas, so far without success.