PHR Analysis of Newly Compiled Data Reveal that the Syrian Government Was More Likely to Detain and Disappear Health Care Workers Who Cared for Injured Protesters Than Health Care Workers Detained for Political Reasons During First Years of Syrian Conflict
 
Health care workers in Syria were significantly more likely to be detained, die in detention facilities, or be forcibly disappeared if they had provided medical care to injured protesters compared to health care workers arrested for political reasons, a report from Physicians for Human Rights (PHR) published today found. The findings underscore a government strategy to target health care workers from the earliest months of the conflict, when peaceful demonstrators calling for rights and democracy in Syria were met with brutal violence and cruelty.
 
Based on a new data set compiling information on 1,685 detentions of 1,644 health care workers from 2011 to 2012, the report analyzes patterns in the Syrian government’s detention, enforced disappearance, and abuse of health care workers during the early years of the Syrian uprising. The analysis also found that non-physician health care workers were less likely to be released from detention and more likely to die in detention or be forcibly disappeared compared to physicians who were detained.
 
“The Survivors, the Dead, and the Disappeared: Detention of Health Care Workers in Syria, 2011-2012” sheds new light on the Assad regime’s brutal and widespread crackdown on health care workers for treating perceived opponents of the government, even during the period of peaceful mass protests in the country. The report finds:
· Health care workers detained for providing medical care to injured demonstrators had 91 percent lower odds of release, 400 percent higher odds of dying in detention, and 550 percent higher odds of being forcibly disappeared compared to health care workers who were arrested for political activities.
 
· Physicians, who likely had more resources and connections to navigate detention, had 143 percent higher odds of release, 48 percent lower odds of dying in detention, and 52 percent lower odds of being forcibly disappeared compared to non-physician health care workers, such as nurses, pharmacists, and medical students.
The United Nations estimates that at least 100,000 Syrians have been forcibly disappeared and tens of thousands of civilians have died in detention facilities after being forcibly disappeared during the decade-long conflict in Syria. Forcible disappearance is defined as the secret abduction or imprisonment of a person, followed by a refusal to acknowledge the person’s fate and whereabouts, with the intent of placing the victim outside the protection of the law. In its recommendations, PHR strongly supports an emerging UN mechanism on the missing in Syria, urging that families of the missing and survivors of detention and torture play a leading role.
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PHR publishes this report as the Syrian government is actively seeking to normalize diplomatic relations with its neighboring states and the broader international community. In the light of the report’s revelations, PHR calls on governments to use this critical window of opportunity to compel all parties to the Syrian conflict to negotiate the release of detainees and to demand transparency from the Syrian government about the status of people who have died in detention. In any negotiations with the Syrian government, PHR calls on the international community to ensure that survivor-led plans for peace and accountability take precedence in decision-making.
 
“Syrian health care workers endured unthinkable brutality in detention facilities, with interrogators saying they were being tortured for providing medical care to injured protestors. This report confirms that those detained for treating wounded demonstrators often faced worse outcomes than detained health care workers who were political dissidents, which is profoundly disturbing evidence of the Syrian government’s war on health workers,” said Houssam Al-Nahhas, MD, MPH, report co-author, Syrian physician, and detention survivor, who served as PHR’s Middle East and North Africa researcher (November 2020 – August 2021). “Even during the time of peaceful mass protests prior to armed opposition, the Syrian government was detaining, torturing, killing, and forcibly disappearing hundreds of health care workers across the country. Our study makes it even more clear that any future discussions with the Syrian government must demand the release of all people unjustly detained as well as total transparency about the fates of the many missing to this day.”
 
The report is primarily based on a data set containing 1,685 community-generated records of the detention of health care workers in Syria between January 2011 and December 2012. The data set was developed by cleaning, recoding, and merging three independent data sets provided to PHR by the Open Society Justice Initiative, the Syrian Network for Human Rights, and the Violations Documentation Center. PHR researchers also conducted in-depth interviews with four members of a medical team that operated in Aleppo in 2012 and a desk review of open-source documentation to create a timeline and verify accounts presented in the case study.
 
Given the Syrian government’s decades-long failure to allow access to, publish information about, or even acknowledge the existence of its sprawling detention apparatus, the study is unable to generalize about the scope or scale of the government’s detention, enforced disappearance, and persecution of health care workers in Syria. The extreme security risks for and extensive stigma against survivors and their family members posed additional limitations to the research, which are noted in the study (see “Methodology” section). Additionally, only 18 percent of cases in the data set (299 of the total 1,685 detentions) included notes indicating the reason for detention. Despite these caveats, the report provides an unprecedented look at the Syrian government’s use of detention, torture, and disappearance both to punish health care workers and to reduce access to health services for peaceful protesters across the country.
 
“After more than a decade of atrocities, Syrians deserve justice and accountability for the mass enforced disappearance of opponents of the Syrian regime and the health care workers who provided care to the wounded according to their ethical and moral duties,” said Susannah Sirkin, director of policy at PHR. “Earlier this year, a coalition of Syrian organizations representing survivors, their families, and family members of the missing developed the ‘Truth and Justice Charter,’ which sets goals for transparency, redress, and accountability. PHR calls on the United Nations and international community to listen to survivors and fully embrace the Charter. There can be no sustainable peace or reconciliation without truth and justice, led by survivors and their families.”
 
The PHR report analyzes detention cases by profession, age, gender, governorate of origin, governorate of detention, reason for detention, duration of detention, and last known status. Of the health care workers known to have been detained for providing health care, only 14 percent were released; 10 percent are known to have died in detention; and 75 percent were forcibly disappeared, or taken by the government without recognition or a legal process.
Of the available cases where detention duration was noted, the median length of detention was 37 days, with a maximum of 2,778 days (7.6 years). The median length of time that elapsed between a health care worker’s detention and reported death was 137 days (about 4.5 months), with a maximum of 2,078 days (5.7 years).
 
The report also provides a timeline of events in Syria from 2011-2012 that highlights key events and the rapid escalation of the Syrian government’s violent crackdown on peaceful protests during the early phases of the Syrian uprising, as well as a case study about the Noor al-Hayat medical team in Aleppo.
 
The Noor al-Hayat group formed to provide medical care to injured protesters who were threatened with detention and death by security forces if they attempted to seek care at public hospitals. Within just one year of the group’s formation, six of the 13 members had been detained and four had died after reportedly being tortured in detention.
 
“This report paints a clear picture of how the Syrian regime has targeted health care workers since the first months of the popular movement in 2011 with persecution, arbitrary arrest, and enforced disappearance,” said Fadel Abdul Ghany, founder and director of the Syrian Network for Human Rights. “The international community must speak out on these cases, as we no longer hear any demands about their fate or release. States must condemn the continued violations committed against detainees and hold the Syrian regime accountable. Syrian health care workers’ heroic sacrifices have largely been forgotten. The fate of all the forcibly disappeared, including medical personnel, must be revealed to stop this never-ending cycle of suffering and mental anguish.”
PHR’s report findings, alongside extensive documentation of detention-related abuses in Syria compiled over the course of the Syrian conflict, warrant comprehensive accounting and redress for violations of domestic laws, human rights law, and international humanitarian law.
 
“This report confirms the Syrian government’s large-scale violence against the peaceful opposition and anyone who provides health assistance to it, in grave violation of international laws and treaties. The Syrian government uses these violations as a weapon of war, a pressure tool against its opponents, and a means of financial blackmail, regardless of humanitarian and legal considerations,” said Abdulrahman Dabbas, operations manager at the Violations Documentation Center (VDC) project at the Syrian Center for Media and Freedom of Expression (SCM), which has worked since 2011 on documenting violations of human rights law and international humanitarian law in the context of the Syrian conflict. “SCM emphasizes the importance of establishing a mixed UN mechanism to reveal the fate of the forcibly disappeared. We encourage the international community to establish a special fund to compensate victims and support them in finding the truth and reintegrating into economic life, as well as to put pressure on the Syrian government to sign the International Convention on Enforced Disappearances.”
 
“The Assad government continues to perpetrate atrocities against its own people with impunity. This robust data with the detention details of more than 1,600 health care workers should support criminal proceedings against those responsible for international crimes committed by the Syrian government, including Bashar al-Assad himself,” said Steve Kostas, senior legal officer at the Open Society Justice Initiative (OSJI). “OSJI represents several doctors in ongoing criminal proceedings, and we call on states to use all the tools at their disposal – whether it be pursuing universal jurisdiction prosecutions or pooling resources to form an international tribunal – to investigate and prosecute these and other atrocity crimes.”
 
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.
 

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Press release:
 
(Link below to download full report)
 
In its report released today, the Syrian Network for Human Rights (SNHR) condemns extremist groups’ displaying photos during Idlib and Raqqa protests of the terrorist who killed the French teacher Samuel Paty, noting that more work is needed to expose the extremists and their backers, and to strengthen society to enable an escape from the symbiotic evils of the Syrian regime and extremist groups.
 
The five-page report explains that on Friday, October 30, 2020, popular protests took place in several areas of northwest Syria outside the control of the Syrian regime, with protesters denouncing the insulting portraits of the Holy Prophet Muhammad, and also condemning what they viewed as offensive statements about Islam.
 
The report reveals that some of the protesters attending these demonstrations displayed photos of terrorist Abdullah Anzurov, the Chechen man who brutally slaughtered a French teacher named Samuel Paty on October 16, near the French capital Paris, for displaying cartoons insulting the Messenger Muhammad to his students in the school where he taught.
As the report reveals, the Chechen terrorist’s picture was displayed by some protesters at three of these protests, two of which were called for by institutions or bodies affiliated with the extremist group Hay’at Tahrir al Sham in Idlib city, which is under its control.
 
In regard to the popular uprising towards democracy in Syria, the report recalls the events that the uprising has endured, including simultaneous attacks by both the Syrian regime and extremist groups, noting that the al Qaeda affiliate al Nusra Front announced its presence in Syria nearly a year after the start of the popular uprising in March 2011, in which the people demanded freedom from the tyrannical ruling regime, and the fundamental right to live with dignity; this was followed by the establishment of the ISIS terrorist group in April 2013. The report points out that the Syrian regime’s response to these demands has been to perpetrate numerous types of violations against those demanding freedom and democracy, some of which amount to crimes against humanity, since the first months of the popular uprising.
 
The report stresses that violence in any society is the product of a complex variety of circumstances and contexts, noting that there are four main causes of violence in Syrian society, which are summarized in the following points:
 
1- The practices of authoritarian regimes, whose continuous looting and harnessing of the state’s resources in their favor have serious negative repercussions on the political, social and economic levels within society.
 
2- A nihilistic worldview in which injustice is the norm rather than the exception has spread among many in Syrian society as a direct result of the brutal violations by the Syrian regime on the one hand, and the non-intervention of the international community and failure to provide any protection for civilians on the other.
 
3- Any peaceful popular uprising by oppressed people demanding democracy and respect for human rights constitutes a fundamental threat to every totalitarian dictatorial regime, with the Syrian regime being the primary example of this, as well as posing the same threat to extremist groups, with both the Syrian regime and extremist groups needing a cowed and subservient populace. Given this shared interest, both the Syrian regime and extremist groups agree to weaken, threaten and terrorize society in order to subjugate and control it; the Syrian regime uses the capabilities of the Syrian state, including the security services and the army, to suppress society, while religious extremist groups label the vast majority of society as infidels unless they submit to the extremists’ warped perception of religion, with both the Syrian regime and extremist groups offering only two choices to those under their brutal rule: either accept their absolute power unquestioningly or be arrested, tortured, and/or killed.
 
4- The Syrian regime benefits from creating favorable conditions for the emergence of extremist groups in order to justify its own brutal violence and to validate its claim to be killing terrorists; likewise, the extremist groups benefit from the violence of the Syrian regime to recruit members, exploiting religious texts, taking advantage of the ignorance of many and mobilizing gullible young people from all over the world to join their ranks and adopt their extremist ideology.
 
The report notes that extremist groups have benefited from social media platforms in marketing and promoting their aspirations and ideologies, further noting that many non-religious youths have also joined these extremist groups, stressing that the regime’s machinery of repression and the lack of any economic and political horizons has pushed some Syrians and non-Syrians to join these extremist groups.
 
The report stresses that displaying the photo of the Chechen terrorist constitutes a violation of the rights of the Syrian people, and an attempt to impose extremist symbols and an extremist agenda on it; this is achieved via armed force, threats and terrorism. SNHR condemns the displaying of this or any other terrorist’s photo and all terrorist operations carried out by extremist groups, including the spread of extremist ideology.
The report emphasizes that extremist groups are actively spreading their ideology, and relentlessly trying to alienate society, isolating the people from the context of their culture and faith, which makes it easier for these groups to recruit as many people as possible into their ranks, mainly based on cynically exploiting the legitimate grievances resulting from the Syrian regime’s continuing crimes against humanity, and the lack of any political and economic hope on the horizon.
The report calls for a deeper understanding of the causes behind the spread of these violent phenomena and practices, in order to work to combat them and to sever their roots.
 
The report calls on the international community and the United Nations to work seriously to achieve a political transition towards democracy and human rights in Syria, stressing that the political transition is the only way to get rid of both the Syrian regime and the extremist groups, both of which consider democracy to be intolerable. The report recommends that a timetable must be set for the completion of this political transition, because leaving it open-ended means increased dissemination of the causes of extremist thought, and thus a greater proliferation of extremism, violence and terrorism.
The report also recommends that the international community and the United Nations should enhance the strength of Syrian society by providing more relief assistance, including in education and healthcare, and supporting local Syrian organizations working in the field of awareness, citizenship, and psychological rehabilitation.
Lastly, the report calls on the international community and the United Nations to target all terrorist groups whatever their sectarian or ethnic orientations.
 

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I. Introduction
 
1. More than 10 years have passed since the last review of the Syrian Arab Republic (Syria) before the United Nations (UN) Human Rights Committee (HRC). Many events have taken place in Syria. Notably, a non-international armed conflict ensued in early 2012, which have had devastating effects on Syrians. The conflict witnessed the commission of countless crimes, violations of civil and political human rights and the displacement of millions of Syrians.
 
2. Syrian women have long faced discrimination (both in law and practice) and violence. With the start of an armed conflict in 2012, Sexual and gender-based violence (SGBV) became a devastating feature of the Syrian conflict. While SGBV was committed against Syrians from all backgrounds, the Independent International Commission of Inquiry on the Syrian Arab Republic (COI) reports that “women and girls have been disproportionately affected, victimized on multiple grounds, irrespective of perpetrator or geographical area.”
 
3. This submission is made to the Human Rights Committee in advance of its adoption of list of issues prior to reporting on Syria at the 130th session. The submission will provide information to the members of the Human Rights Committee on acts of torture, enforced Disappearances and arbitrary detention perpetrated by the Government of Syria and its affiliated forces in Syria. The submission will also provide information on violence, discrimination, SGBV and other violations committed against Syrian women by the Government of Syria and its affiliated forces.
 

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Background:
 
The issue of the sanctions that are imposed on Syria, such as the American and the European sanctions, is considered one of the most controversial matters on the Syrian scene at the present time, especially amongst Syrian civil society organisations. This is due to the fact that, ever since these sanctions were imposed in 2011 and until now, there were only a few attempts to determine the extent of their effectiveness in achieving their intended objectives, and to measure their impact on the daily life of Syrians, which in turn made it difficult to differentiate between what is real and what is fabricated by the Syrian authorities in the context of the current economic and humanitarian crisis that Syrians are living through. Moreover, the topic of the sanctions is a complex one, and it has many dimensions; economic, political, social, humanitarian and legal, and all these aspects must be considered when adopting any position, with regards to the sanctions, by the Syrian civil society.
 
Furthermore, sectoral sanctions, and the sanctions that target specific individuals and entities are often confused. For, sectoral sanctions are sanctions targeting specific economic sectors, and they are mainly intended to deprive the Syrian authorities of their financial resources and of any technical support that may enable them to continue oppressing the Syrian people, and this includes, for example, restrictions on the import of Syrian oil and petroleum products, restrictions on the supply of equipment, technology or software that can be used to monitor or intercept internet and telephone communications, restrictions on equipment and technology for the oil and gas sector, and monetary and bank restrictions. As for individual sanctions, they target specific individuals and entities due to their association with the Syrian authorities and their crimes, and because they are considered responsible for oppressing the civilian population, and therefore, the individuals that are targeted under this type of sanctions, are subject to the freezing of assets, the prohibition of making funds available to them and to travel bans.
 
In light of this ambiguity and complexity surrounding the topic of sanctions, it was only natural to see an increase in the number of voices which consider sanctions a main cause of the economic and humanitarian crisis that the Syrian people are living in, with the argument that these sanctions prevent the import of many essential and basic items that Syrians need in their daily life, such as medicine, medical equipment and petroleum products, and that the sanctions hinder humanitarian funds from reaching Syria.
 

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Children who fled violence in Syria to find refuge in Jordan are increasingly forced to work long hours at low wages to help their families survive, according to a new report from the Euro-Mediterranean Human Rights Monitor and Syrian Network for Human Rights released on World Child Labour Day. It’s estimated that at least 60,000 children from Syria are working in conditions that are often dangerous, exploitative and without any real government oversight.
 
The report, titled “Weariness of the Young: Syrian Refugee Child Labor in Jordan” estimates that 51.4 percent (668,000) of the 1.3 million Syrians living in Jordan are children. An even more neglected group are the 16,000 Palestinians who fled to Jordan from Syria, of whom about 6,560 are children. Even adults from this group are prohibited from working in Jordan.
 
Based on information collected through interviews with child workers, their families and employers, and relevant government agencies and NGOs, the report outlines the dynamics that force children to work instead of attend school. The primary factor is the high cost of living; Amman, the capital city of Jordan, is considered the most expensive city in the Middle East. In addition, only about 10 percent of the refugees are eligible for cash assistance from the United Nations High Commissioner for Refugees (UNHCR). Yet many of the families lost breadwinners in the civil war; 30 percent of the Palestinian-Syrian families are headed by women.
 
Other factors fueling child labor are the demand among Jordanian employers for low-wage workers and the inability of the country’s schools to accommodate the influx of refugees. The report documents that 80 percent of child workers are not allowed any holidays and are paid wages of 90-150 dinar per month (US$127-211) –far less than the minimum wage in Jordan. In Al-Zaatari refugee camp (the largest camp in the Middle East and the second-largest worldwide) 24 percent of child workers said in a recent survey that they do not receive any payment at all; 15 percent were subjected to physical violence. Across Jordan, more than a third of child workers report suffering injuries on the job that require treatment. Meanwhile, an estimated 90,000 child refugees from Syria are not receiving any education at all.
 
“These children’s families fled oppression in one country, only to find it in another,” said Ihsan Adel, Euro-Med Monitor legal adviser. “It is true that Jordan has welcomed large numbers of refugees generously. However, these children have a right to protection, education and basic human dignities. This is the responsibility of both Jordan and the international community, which has not yet shouldered its share of the burden of the refugees created by the Syrian crisis.”
 

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Syrian regime forces, pro-government forces and foreign militias have widely adopted the practice of execution by burning and the burning of bodies of murdered persons since the start of the events in Syria in 2011. This practice has endured throughout 2012 and the following years.
 
Burning individuals to death at the hands of the Syrian regime has received little or no media coverage. Syrian government officials deny carrying out such practices; however such crimes are being embraced and published on several pro-government websites. These crimes have not been recorded by regime forces, but rather by the victims’ families and/or local human rights activists using modest recording tools and cameras. The content of these recordings have then been uploaded to several websites, and sent to the Syrian Network for Human Rights via email. Based on witness accounts, testimonies of family members and video evidence, the Syrian Network for Human Rights, in collaboration with the Euro-Mid Observer for Human Rights, has been able to monitor and document these crimes and produce accurate results.
 

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FOREWORD
“During my interrogation, with my father still present, the investigator threw coffee at me, and my father was unable to do anything to help me. As my interrogation proceeded and my father was no longer present, I was beaten on the hands and legs, spat at and whipped to the point of collapsing. Every time I collapsed, someone would pour a bottle of cold water on my head to revive me. The interrogations sometimes lasted for 12 continuous hours and more”.
Lamya, a student from Latakia was arrested with her father in June 2012 during a military intelligence raid on her house. Accused of equipping field hospitals with supplies, she was detained for 8 months during which she was exposed to severe acts of torture.
Unveiling instances of violence against women (VAW) is one of the most demanding tasks in the Syrian context.
Important challenges concerning sexual violence related to both the social cultural context in Syria and
methodology of documentation hamper the documentation process. Extensive and sustained efforts are necessary
to ensure that these violations will be addressed during the transitional justice period that should follow the end of the armed conflict and that adequate means are deployed in order to provide victims with support, accompaniment and rehabilitation.
This document is a documentation report prepared by Syrian human rights and women’s rights activist Sema
Nasar, a member in the Syrian Human Rights Network, with the support of the EMHRN and experts in
documentation.

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