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Healthcare leadership in Syria during armed conflict and the pandemic
  1. Aula Abbara1,2,
  2. Abdulkarim Ekzayez2,3
  1. 1Department of Infection, Imperial College London, London, UK
  2. 2Syria Public Health Network, London, UK
  3. 3Conflict and Health, King's College London, London, UK
  1. Correspondence to Dr Aula Abbara; a.abbara15{at}

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  • Syria’s protracted conflict has driven an exodus of healthcare workers through the weaponisation of healthcare, leaving a diminished pool from which medical and healthcare leaders can arise.

  • Prior to the conflict, a lack of transparency, poor accountability and nepotism have influenced appointments to positions of power and influence in Syria, weakening such structures.

  • Despite this, there has been some evidence of strong leadership in key organisations that are responding to the COVID-19 pandemic in Syria, though decades of poor investment in leadership among healthcare workers have taken their toll.

  • Regional or international institutions with established medical and healthcare leadership programmes must build links to support the development of context-relevant programmes for Syria and other conflict-affected contexts.


The COVID-19 pandemic has challenged political and healthcare leadership internationally, including in settings that have seen sustained investment and emphasis in both. Although there has been increasing recognition for the critical role of healthcare leadership, particularly by women in areas of armed conflict,1 there has yet to be effective and sustained investment with sufficient support for the development of future leaders from within cohorts of healthcare professionals. This has been particularly so among the healthcare communities in countries that have been adversely affected by protracted conflict or humanitarian crises where violence, including attacks on healthcare, has driven the forced migration of healthcare workers, limiting the pool from which medical and healthcare leaders can emerge.2 These healthcare workers may have seen sparse opportunities before the conflict to develop relevant leadership or management skills, with little attention given to these during their undergraduate or postgraduate studies. Such skill sets among healthcare workers are crucial during times of peace and more so during crises. The COVID-19 pandemic has demonstrated just how essential these skills are with requirements for flexible and capable leadership at a national …

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