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QAMESHLI, SYRIA —Barely conscious, 70-year-old Abbas yanks on the tube piping oxygen into his lungs.
His son, Mohammad Haitham, leans down and gently tightens the dirty cotton strips that bind his father's arms to the bed.
The strips prevent Abbas from hitting himself or staff members when he convulses, Haitham says, or from pulling out the tube through which he is breathing. Abbas has been sick with COVID-19 for nearly three weeks, and his condition has worsened every day, says Haitham, who asked that his father's last name not be disclosed.
"At first he wasn't very ill but then he got a strong fever," the son explains over the rhythmic beeping of machines helping dozens of patients breathe. "We brought a doctor and medicine to our home, but he didn't get better. It was hard for him to breathe."
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Northeastern Syria is a semi-autonomous region of about 5 million people, tucked between Turkey, Iraq and government-controlled Syria. The region has been reeling from civil war, terrorist attacks and border conflicts with Turkey for years.
It now is suffering its worst wave of COVID-19 yet, with infection and death rates soaring. Medicines, oxygen and tests are in short supply, and vaccines are almost nowhere to be found.
Vaccine shortage
Haitham and his father spend long days in a specialized hospital in Qameshli, a beleaguered border city. Other family members are not permitted to visit. Mohammad wears a thin blue mask and douses his hands with sanitizer from time to time. He is unvaccinated and says there is little else he can do to protect himself.
Around the world, many hospitals do not let families visit COVID-19 patients, but here, some members are permitted to do so.
"There are still a lot of people here alone," says Haitham.
More people inside the hospitals, however, could be disastrous, as most of the population in northeastern Syria is not vaccinated, according to doctors.
"The vaccination rate is very, very small," says Dr. Rawan Hassan, downstairs from the intensive care unit. He has been treating people at the Jiyan Center for COVID-19 for about a month, and he has had only one dose of a two-shot vaccine. "No one who has come here for treatment has been vaccinated."
Northeast Syria has enough vaccines for about 2% of its population, and the death rate has risen by 50% over the past two months, according to Dr. Juan Mustafa, who co-chairs the regional health department.
"During new waves of the disease, like now, there is a shortage of oxygen, and the whole process of providing oxygen doesn't work," he tells VOA in his Qameshli office. "If the wave is heavy, some hospitals have to turn patients away."
Concerns for the future
In the markets, however, many people are either unconcerned about this new wave, or unaware that it is happening.
Some sellers say they will not get vaccinated because they cannot afford to take time off from work. Others fear the shots could make them sick. For Essam Hassan, a 28-year-old vegetable salesman, missing even a few hours of work also could mean missing meals.
"I work from early morning to late at night," he says. "And I just have enough to feed my family."
Unvaccinated and unmasked, Hassan says he isn't worried about getting COVID-19, but he, like many others in the market, is deeply concerned about the economic crisis the pandemic has caused.
Health officials say the best tool they have to combat the disease caused by the coronavirus is periodic lockdowns, or curfews that force businesses to open for only limited hours and people to stay home. These lockdowns, says Abdullah Omar, 25, who owns a small children's clothing store, are in some ways more frightening than the infection. The region is already desperately poor, isolated and physically difficult to leave in a crisis.
"Last time we had a lockdown, I couldn't pay rent, utilities or salaries," he said. "Hunger is more frightening than coronavirus."