AMMAN: Medical personnel in East Ghouta say they are are facing “severe shortages” of supplies needed to store and transport blood used in transfusions for residents injured by intense pro-government bombings on the besieged enclave.

“With the heavy bombing, things are getting worse in a way that we cannot handle,” Muhammad, the director of East Ghouta’s Central Blood Bank tells Syria Direct. He asked not to be identified by his full name. The Central Blood Bank is one of two main blood storage facilities in the opposition-held enclave.

Pro-government shelling and airstrikes have killed nearly 500 people and injured 3,000 others in East Ghouta since a major military escalation against the besieged pocket began on December 29.

At local hospitals, an influx of residents injured by airstrikes and shelling has increased the need for blood. At the Outer Damascus Speciality Hospital in Douma city, blood transfusions have increased “tenfold” during the latest escalation, estimates hospital director Basim Salem.

“About 35 percent of all patients who come to our hospital need blood,” says Salem.

Half a dozen medical personnel at blood banks and hospitals in East Ghouta described shortages of rare blood types, sterile blood bags, needles and mobile storage units in conversations with Syria Direct this week. A handful of them said they were concerned about the long-term ability of doctors to continue providing blood transfusions if the current pace of bombings persists.

At the Central Blood Bank in East Ghouta, blood stores will be depleted after “a very short period of time” due to “severe shortages” of the equipment needed to transport and store it, says director Muhammad.

Muhammad requested that Syria Direct not publish any details about the Central Blood Bank, from its location to how much longer it will be able to continue operating, citing “security concerns.”

Staff at both East Ghouta’s blood banks said they could not comment about the locations of the facilities or how much blood they currently store.

When bombing is particularly intense—as it has been for much of the past two months—the Central Blood Bank cannot arrange for general blood drives, an employee who requested anonymity tells Syria Direct.

“With the heavy bombardment, donors can’t make it to the bank to give blood,” the anonymous employee, who draws blood from donors during the drives, tells Syria Direct.

“If there is a dire, immediate need, we take blood from the doctors in the blood bank,” says Muhammad. At East Ghouta hospitals, doctors ask relatives to donate blood when necessary.



Smoke billows after an airstrike in Jisreen on February 8. Photo by Abdulmonam Eassa/AFP.

Even before the latest escalation, gathering and storing sufficient supplies of blood was a chronic difficulty, says Majid Burhan, a doctor at the Central Blood Bank.

“We can’t ask people to donate blood on a large scale,” Burhan tells Syria Direct, because the blood bank’s refrigeration units, which are powered by gasoline generators, have limited space.

When possible, blood drives are announced by mosque loudspeakers and private groups on the encrypted messaging app Telegram. Donors give blood in “mosques, in basements, in places that are somewhat safe,” says Burhan.

At the Specialty Hospital in Douma, blood is needed not only to treat bombing victims, but also patients suffering from chronic illnesses such as sickle cell anemia and thalassemia, as well as childbirth complications.

Moving blood from the bank to hospitals and medical facilities is a community effort involving both doctors and civilians “day and night,” Muhammad says.

Vehicles equipped with refrigeration units ferry blood from banks to East Ghouta hospitals “according to demand,” says the director, using secret routes to avoid bombings. When necessary, blood bank staff use portable coolers and motorcycles to quickly traverse the ruined roads of East Ghouta.

‘Powerless’

East Ghouta, home to 400,000 people, has been encircled by government forces since 2013. Last February, the Syrian government further tightened the siege of East Ghouta by capturing a network of smuggling tunnels used to bring food and other supplies into the enclave from three neighborhoods in northeastern Damascus.

Smugglers moving through the tunnels once helped replenish East Ghouta’s store of medical supplies, including needles and single-use sterile bags for storing and transporting units of blood.

Without the tunnels, East Ghouta doctors and blood banks are unable to replenish their stock of sterile bags, hospital director Salem and Central Blood Bank staff member Burhan says.

Previously, the blood bank bought bags on the black market from tunnel smugglers for “reasonable” prices, says Burhan.

Today, the Specialty Hospital is tapping into its reserves of blood to continue providing transfusions to patients, director Salem tells Syria Direct.

Doctors triage incoming patients for blood transfusions “according to need,” Salem says, to ensure that their supplies last as long as possible.

Without blood reserves, doctors in East Ghouta would “become completely powerless,” he says.

With additional reporting by Ammar Hamou.