Syria’s healthcare system under strain—and reinvention

As Syria’s healthcare system struggles to move beyond crisis management, public hospitals face acute equipment shortages, stalled procurement, and a breakdown in traditional funding models. Yet amid these challenges, new informal pathways—from charity-funded imaging to direct donations—are beginning to reshape how care is delivered.

In this Q&A, Khaled Bkeirati, Service Manager at Al-Faisaliah Medical Systems (AFMS), shares an on-the-ground perspective on why public hospitals are failing, how clinicians are coping, and what international healthtech companies must understand before engaging with one of the region’s most complex—and underserved—markets.

How would you describe the current state of Syria’s public healthcare system?

Public hospitals are in a state of severe crisis. Much of the equipment in use today is more than 15 years old—some dating back to 1999 or 2001—and many systems are either partially functional or completely broken. This isn’t a temporary issue; it’s the result of decades of neglect rather than recent shocks alone.

What are the consequences of relying on such old equipment?

The problem isn’t just age, it’s intensity of use. In many hospitals, a single machine may be serving more than 200 patients a day. That level of utilisation rapidly accelerates wear and tear, especially when maintenance support and spare parts are no longer available. Once equipment fails, there is often no replacement plan, so clinical capacity simply disappears.

Are sanctions the main reason procurement has broken down?

Sanctions complicate the picture, but they are not the root cause. The core problem is a dysfunctional procurement system that has been underfunded and poorly managed for years. Even when sanctions are navigable, tenders frequently fail because there is no funding certainty and no incentive for suppliers to participate.

How does this affect hospitals on a day-to-day basis?

It affects everything. Hospitals are not only short of advanced equipment; they often lack basic consumables. In some cases, doctors are forced to buy their own surgical gloves or supplies just to perform routine procedures. That places an enormous personal and professional burden on clinicians and directly compromises patient safety.

Are these challenges evenly distributed across the country?

No. Some major regions—including Homs, Hama, and even parts of Aleppo—lack any functioning public or private X-ray infrastructure. Patients are either referred long distances or go without diagnostics altogether, which delays treatment and worsens outcomes.

International organisations have donated equipment in the past. Why hasn’t this solved the problem?

In several cases, equipment was delivered without a sustainable plan for maintenance, training, or local support. For example, WHO-funded CT scanners were installed, but once technical issues emerged, there was no long-term servicing structure in place. As a result, many of these machines are now idle.

What funding or procurement model is working today?

The system has shifted towards direct donations. With government procurement effectively stalled, local charities have stepped in to fill the gap. Organisations such as Absher Al-Quran are directly funding and purchasing major equipment—MRIs, CT scanners, patient monitors—and placing them where the need is most urgent.

Why has this charity-led approach been more effective?

Because it bypasses a broken system. Decisions are faster, needs are assessed locally, and equipment is delivered with a clear purpose. It’s not a perfect solution, but right now it’s the most functional pathway for bringing modern technology into public hospitals.

How would you describe Syria as a market for international healthtech companies?

It’s a high-risk, high-reward market. The unmet need is enormous, but this is not a place for short-term sales strategies. Success requires patience, a long-term commitment, and a genuine focus on value rather than volume.

What do serious market entrants need to get it right?

Local presence is essential. Companies need in-country teams who understand how hospitals actually function, how decisions are made, and what constraints clinicians face. Without that, even good technology is likely to fail.

Despite the challenges, does Syria still have strong human capital?

Very much so. Syrian doctors and biomedical engineers are highly skilled and exceptionally resourceful. They are used to working under extreme constraints and are eager to adopt modern technologies—provided those technologies are reliable and properly supported.

Where do you see the biggest opportunities for impact?

Digitalisation is a major one. Much of the system is still paper-based, which creates significant inefficiencies and data gaps. There is also strong demand for technologies that improve surgical precision and efficiency, such as surgical navigation systems, as well as telehealth solutions that can extend specialist expertise to underserved regions.

What should international partners understand before engaging with Syria?

This is not a conventional emerging market. Anyone looking to engage must be prepared to invest in relationships, capacity building, and long-term support. Those who approach Syria with realism, respect, and a value-driven mindset can make a meaningful difference—but only if they are willing to stay the course.

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