Lilia Sebouai Global Health Security Reporter

Syria’s health system is buckling under the pressure of a mass influx of returnees following the fall of the Assad government, new research suggests.

Nearly 1.4 million Syrians have returned from neighbouring countries or from internal displacement since late 2024, far outpacing the restoration of hospitals, clinics and essential services, according to a report by Relief International.

Only half of hospitals and one third of primary healthcare facilities are fully operational, while more than 15,000 doctors – roughly half of Syria’s pre-war medical workforce – left the country during the 14-year conflict.

Many Syrians have returned to areas that are relatively safe, but are unable to support basic healthcare needs, researchers found, adding that women, people with disabilities and those with chronic illnesses have been left especially vulnerable.

The findings come as President Ahmed al-Sharaa last month unveiled an ambitious $1tn (£734bn) plan to rebuild the war-ravaged country – a project experts have described as one of the most complex reconstruction efforts in modern history.

Rachel Sider, the report’s author and a humanitarian policy expert, warned that Syria’s recovery could not succeed without rebuilding the country’s shattered health system.

“Recovery in Syria is inseparable from the health of those returning,” she told The Telegraph.

“If this issue is not taken seriously … then I think we’re going to have a real challenge on our hands – an intergenerational challenge”.

The research, conducted between November 2025 and January 2026, found that many Syrians have returned to what the report describes as “relative physical safety” but not conditions fit to rebuild their lives.

In rural Deir-ez-Zor, a city in eastern Syria, 78 per cent of returnees reported that healthcare is simply unavailable. In Al-Tibni, a town in the same governorate, 93 per cent of households reported needing care in the last six months but being unable to afford it.

Global aid cuts have also come at a time when Syria’s healthcare system is under severe strain, the report warned.

“Cost is a huge barrier to people being able to receive the treatment they require,” Ms Sider said.

“People can hardly afford transportation. Equipment is out of date and needs to be either repaired or replaced,” she added.

There is also a growing gender divide, according to the report, with female returnees found to be experiencing the highest rates of psychological distress.

In Rural Damascus, 81 per cent of women reported feeling “overwhelmed” by daily life, compared with 15 per cent of men. Researchers linked this to conflict trauma, widowhood, unpaid care burdens and the near absence of maternal and mental healthcare services.

But it is not all bleak. Syria has so far avoided being drawn directly into the widening conflict between Israel, Iran and the US, despite pressure.

The new administration has also secured significant political and financial backing from regional powers. Saudi Arabia, Qatar and Turkey have emerged as key supporters of Syria’s reconstruction drive, with Gulf states pledging billions of dollars in investment and aid aimed at reviving the country’s shattered economy.

Alongside the easing of US and European sanctions, Saudi Arabia and Qatar also paid off Syria’s $15.5m debt to the World Bank earlier this year, reopening access to international financing and reconstruction support after more than 14 years of war.

Yet the report warns that these improvements have not yet translated into sustainable conditions for all returnees.

While many Syrians said they returned because active conflict had ended, the report also pointed to deteriorating economic conditions in Lebanon, tighter refugee restrictions in Turkey, and worsening camp conditions as key pressures shaping return decisions.

It also raised concerns over the government’s push to shut displacement camps in Idlib – home to hundreds of thousands of internally displaced people in northern Syria – by the end of the year.

“The pace at which camp closures are being pursued risks accelerating movements absent the conditions that make return sustainable,” the report warned.

The move “risk[s] manufacturing the appearance of voluntary return while delivering distress and additional displacement”, it added.

Ms Sider said Syria’s wider recovery would depend not only on rebuilding hospitals, but also restoring essential services.

An estimated 15 million people remain at risk from landmines and unexploded bombs, which have killed nearly 1,800 people since the fall of the Assad government, according to the Halo Trust.

The report’s release coincides with the first EU-Syria High-Level Political Dialogue, which is expected to open the door to wider cooperation and investment in Syria’s health system and broader reconstruction efforts.

“Healing Syria starts with healing individuals, and that is done through the provision of quality, affordable healthcare,” Ms Sider said.

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