From self-sufficiency to survival: Syria’s orthopaedic sector before and after the war

Before the conflict, Syria’s healthcare system was largely self-reliant, supported by a strong private sector, skilled clinicians, and access to high-quality international medical supplies. More than a decade later, war, currency collapse, and prolonged instability have fundamentally reshaped how surgical care is delivered.

In this Q&A with Kamal Lutfi, Founder and Managing Partner of KL MedTech Innovation Advisory, Dr Khaled Bitar, Head of Orthopaedic Surgery at Oriana Hospital in Sharjah, UAE, reflects on practising in Syria between 2006 and 2012, the transformation of the orthopaedic market since the war, and why—despite severe challenges—the country still presents long-term opportunities for healthcare investment.

What the medical landscape like during your time practising in Syria?

Between 2006 and 2012, Syria’s healthcare system was largely integrated and self-sufficient. We were able to meet around 99% of the country’s medical and surgical needs domestically. Syrian doctors were highly skilled, and the overall quality of care—particularly in the private sector—was strong.

Patients often preferred private hospitals because they offered faster access and high standards of treatment. Public hospitals, by contrast, focused primarily on emergency care, trauma cases, and surgeries related to accidents and fractures.

What was your area of specialisation, and how accessible were medical supplies at the time?

I practised exclusively in orthopaedic surgery. During that period, Syria was effectively an open market for orthopaedic equipment. Private companies held official agencies for leading European and American manufacturers, supplying high-quality plates, joints, and surgical materials.

These products were available to both private and public hospitals, often through formal government tenders. The standard of care was sufficiently high that Syria attracted patients from neighbouring countries seeking medical treatment.

How did the situation change after 2012?

After 2012, the public healthcare sector deteriorated sharply. The war, combined with the collapse of the Syrian currency, severely reduced purchasing power. Hospitals could no longer afford expensive Western imports, which forced a shift towards lower-cost alternatives from Turkey, India, and China.

While these products have improved over time and now serve a large portion of the population, they generally lack the long-term clinical evidence base and validation associated with established global brands.

How were medical materials regulated during this period?

Most medical materials continued to enter the country through formal systems and were sold in regulated ways to ensure sterility and monitoring. However, this technical compliance does not reflect the full reality.

Inside the country, there has been significant internal suffering and chaos that is not always visible from the outside. The pressures on clinicians extended far beyond material shortages and directly affected personal safety and professional integrity.

Why did you ultimately decide to leave Syria?

My decision to leave was primarily about safety—amān. Orthopaedic surgeons were at particular risk because we treated war-related injuries. That exposure often led to political suspicion and, in some cases, false accusations.

I know of a colleague who was accused of leaking information simply because he used a camera to record surgical procedures. Practising medicine in that environment meant constant fear and uncertainty, making it impossible to work safely or ethically.

Looking ahead, how do you see the future of Syria’s healthcare sector?

Despite everything, I believe the Syrian healthcare market is ripe for large-scale investment—both in medical materials and hospital services. If the currency stabilises and international sanctions begin to ease, there will be an urgent need to replace the low-quality products that have dominated the market over the past 14 years.

Crucially, the medical expertise still exists inside Syria. Doctors remain trained, experienced, and capable. This creates a strong opportunity for companies willing to reintroduce high-quality medical products and services to a population that urgently needs better options.