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• Researching the Syrian tragedy: The need for evidence and moral reflexivity
  Adam Peter Coutts, PhD, Aula Abbara, Fouad Mohammad Fouad, MD, Donna McKay, Ahmad Tarakji, MD, Sophie Roborgh, Annie Sparrow, Sharif Ismail, Miriam Orcutt, Zaher Sahloul, MD and Wasim Maziak, MD, PhD
  Published on: 13 June 2018

• Published on: 13 June 2018

  Researching the Syrian tragedy: The need for evidence and moral reflexivity

  • Adam Peter Coutts, PhD, Lecturer in Public Policy Department of Sociology, University of Cambridge
  • Other Contributors:
    • Aula Abbara, Academic researcher
    • Fouad Mohammad Fouad, MD, Assistant Professor
    • Donna McKay, Executive Director
    • Ahmad Tarakji, MD, President
    • Sophie Roborgh, Postdoctoral researcher
    • Annie Sparrow, MBBS MRCP FRACP MPH MD
    • Sharif Ismail, MBBS MPhil MPH, Academic Clinical Fellow in Public Health
    • Miriam Orcutt, MBBS, MSc,Visiting Senior Research Fellow
    • Zaher Sahloul, MD, Global Response chairman
    • Wasim Maziak, MD, PhD, Professor, Chair

  ‘The nationalist not only does not disapprove of atrocities committed by his own side, but he has a remarkable capacity for not even hearing about them’ (George Orwell, Notes on Nationalism 1945).
  We read with concern Sen and colleagues’ discussion of potential breaches of ethical neutrality in the reporting of events in Syria by Non-Governmental Organisations (NGOs) and academic researchers. We fully concur that any research must be based on rigorous methodologies and robust ethical frameworks. However, when engaging in debates on ethics and critiques of existing research one should adopt a morally reflexive position and consider all the evidence that exists no matter who has produced it.

  Over the past five years a large body of evidence from credible humanitarian and international organisations has been accumulated which clearly documents the use of chemical weapons, heavy weaponry, ballistic missiles, cluster and barrel munitions deployed by Syrian Arab Army (SAA) forces and its allies. It is unfortunate that in the Syrian context, no side has spared civilians or prioritised the protection and well-being of civilians. Human rights abuses have been carried out by all sides. However, abundant evidence exists that the SAA have been largely responsible for the mass of civilian casualties. A major study in the British Medical Journal of the causes of mortality in Syria attests to this. Since September 2015 the SAA has been assisted by the Russ...

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  ‘The nationalist not only does not disapprove of atrocities committed by his own side, but he has a remarkable capacity for not even hearing about them’ (George Orwell, Notes on Nationalism 1945).
  We read with concern Sen and colleagues’ discussion of potential breaches of ethical neutrality in the reporting of events in Syria by Non-Governmental Organisations (NGOs) and academic researchers. We fully concur that any research must be based on rigorous methodologies and robust ethical frameworks. However, when engaging in debates on ethics and critiques of existing research one should adopt a morally reflexive position and consider all the evidence that exists no matter who has produced it.

  Over the past five years a large body of evidence from credible humanitarian and international organisations has been accumulated which clearly documents the use of chemical weapons, heavy weaponry, ballistic missiles, cluster and barrel munitions deployed by Syrian Arab Army (SAA) forces and its allies. It is unfortunate that in the Syrian context, no side has spared civilians or prioritised the protection and well-being of civilians. Human rights abuses have been carried out by all sides. However, abundant evidence exists that the SAA have been largely responsible for the mass of civilian casualties. A major study in the British Medical Journal of the causes of mortality in Syria attests to this. Since September 2015 the SAA has been assisted by the Russian army’s air force in addition to other allies leading to the accelerated destruction of physical infrastructure particularly healthcare facilities.

  Despite their insistence that research on Syria is politically one-sided and relies heavily on social media reports, Sen et al do not appear to have properly scrutinised the many reports that document the targeting and destruction of health facilities by all sides. This research particularly that of Physicians for Human Rights has painstakingly made efforts to utilise multiple sources regardless of their political affiliations – government and opposition eyewitnesses in order to corroborate events on the ground. It is clear from this research that SAA forces and their allies are responsible for the bulk of civilian mortality and injuries. This mainly stems from the fact that the official opposition and other rebel groups do not possess air force capabilities which have inflicted the largest amount of damage.

  In their previous work Sen et al have continually cited economic sanctions as being the primary cause of the detrimental health impacts on civilians in Syria and a driver of the refugee crisis. It is factually and statistically incorrect to claim that sanctions have had a greater health impact on the Syrian population than almost six years of direct military attacks on civilians, healthcare and systematic destruction of public infrastructure including water plants and sewage farms in opposition-held areas by three major armies (Syrian, Russian and Iranian).

  We acknowledge the difficulties of collecting verifiable data in conflict zones and welcome further research on the health and social situation of those living in Government Controlled Areas. This is an issue which has been lacking in the coverage of the Syrian crisis and has often been filled by journalistic sources. However, obtaining reliable data and information from the Syrian government such as the Ministries of Health and Social Affairs in Damascus has proved almost impossible for researchers, multi-lateral and donor agencies. Indeed, accurate mortality statistics for SAA soldiers are impossible to access and yet could provide a more balanced understanding of losses on all sides.

  Academics have a moral obligation to engage widely and with neutrality in information gathering, taking data provided by different sides of highly politicised debates into account. However, the facts-on-the-ground and weight of evidence in the Syrian crisis shows that parties on one side of the conflict – Syrian government forces and their allies in the air and on the ground – are committing the vast majority of violations. Failure to acknowledge this imbalance is academically, ethically and philosophically bad practice. The conclusion by Sen and colleagues that ‘the Syrian conflict urgently needs a reassessment of research ethics’ is out of touch with the urgent need for the Syrian government and its allies to cease targeting civilians, stop attacking healthcare facilities and lift the siege on over one million civilians.

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  Conflict of Interest:
  None declared.

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