Syria: Fighting Over Territory Blocks Access to Vital Medicine and Health Services

As Syrian government forces backed by Russian airstrikes pushed to cut off rebel-held territory north of Aleppo this year, they severed something beyond a supply route — the last practical way thousands of civilians had to reach a functioning hospital.

A Siege Measured in Blocked Roads, Not Just Bullets

Syrian government forces, supported by Russian air power, launched a ground offensive in late January in the northern Aleppo countryside aimed at breaking a rebel siege on the towns of Nubul and Zahraa — fighting that had the direct effect of cutting the supply route linking rebel-held areas and the Turkish border to Aleppo city itself. Civilians fleeing the fighting toward the Bab al-Salam border crossing described to Amnesty International a sharp escalation in airstrikes in the first week of February, forcing thousands from their homes with nowhere functioning left to seek medical care nearby — with no operational hospitals remaining in the immediate area, injured residents were left to make hours-long drives just to reach basic treatment.

That collapse in access wasn’t incidental to the fighting — it was, in significant part, a direct consequence of hospitals themselves being targeted. Baghdad Hospital in the town of Hreitan was struck directly on December 25 by what medical staff said was a Russian or Syrian warplane firing missiles at the facility, wounding ten medical workers and at least 20 patients and killing medical worker Ali Hamedo. The hospital never functioned again. A doctor there, identified only as “Abdullah” for his own safety, described the particular despair of the moment: “Not even underground hospitals are safe. We moved the hospital underground a year ago assuming that it will be protected from the airstrikes. But the missiles were able to penetrate the underground levels.”

A Pattern Documented Across the Country, Not Isolated to One Offensive

The Aleppo countryside siege reflects a broader pattern researchers and humanitarian organizations have tracked across nearly every major front of Syria’s civil war. Physicians for Human Rights has documented hundreds of attacks on medical facilities and the deaths of hundreds of medical workers since the conflict began — a scale of documented targeting that led human rights investigators to describe the pattern not as incidental battlefield damage, but as a deliberate strategy of war, one aimed at making entire opposition-held areas functionally uninhabitable by stripping away the medical infrastructure civilians depend on to survive.

Aid Organizations Struggling to Reach What They Can’t See

Médecins Sans Frontières has responded by building an unusually large remote-support program, backing more than 100 medical facilities across both government- and opposition-controlled areas where its own international staff cannot physically operate — providing supplies, training, and consultation to local doctors working in facilities MSF itself has never been able to visit directly. In besieged areas like northern Homs, where roughly 350,000 people have lived under siege for more than a year, MSF has supported field hospitals and medical points precisely because sieges make direct delivery of aid or personnel functionally impossible, leaving remote support as the only viable option for reaching residents entirely cut off from the outside world.

When Blocking Aid Becomes Its Own Weapon

For residents trapped inside besieged or newly cut-off territory, the distinction between “fighting” and “siege” can feel almost academic — both produce the same practical result: medicine that doesn’t arrive, patients who can’t reach a functioning hospital, and doctors forced to ration supplies for injuries that, in nearly any other context, would be entirely treatable. Humanitarian officials have increasingly described this blockade dynamic as its own deliberate military tactic rather than a side effect of active combat — a way of pressuring besieged populations into surrender not primarily through direct assault, but through the slower, quieter attrition of denying them the basic medical infrastructure a functioning society depends on.

This piece continues in our companion coverage of how fighting has pushed Syria’s health care system underground. For related coverage, see our piece on the UN report on Syria’s war crimes, or browse our full International archive.