468 Health workforce response to the 2023 earthquake in non-state Northwest Syria: cross-border challenges and lessons for future emergency preparedness

Abstract OP 6: Health Policy 2, B308 (FCSH), September 3, 2025, 15:45 - 16:45 Aims The 2023 earthquake in northwest Syria worsened the vulnerabilities of a health system already weakened by conflict, displacement, and resource shortages. The crisis affected local populations and Syrian refugees in Türkiye, as health workers and humanitarian organizations faced legal restrictions, border closures, and fragmented aid distribution. This study examines the health workforce response in Syria, focusing on cross-border service provision, coordination mechanisms, and workforce adaptations to inform future emergency preparedness. Methods Fourteen key informant interviews were conducted with academics, local NGOs, and international organizations in southeast Türkiye involved in the earthquake response in Syria. A thematic analysis explored workforce availability, coordination structures, emergency deployment, cross-border patient referrals, and logistical barriers. Results The earthquake response in northwest Syria was hindered by a lack of preparedness, political constraints, and restricted cross-border access. Widespread damage to health facilities and shortages of physicians further strained the system. While health workers were relocated from less-affected areas, resource limitations and bureaucratic delays slowed reinforcements. In Türkiye, legal barriers prevented Syrian health workers from traveling or returning to Syria, while border closures delayed critical patient referrals. Bureaucratic hurdles obstructed the rapid deployment of international medical teams, increasing strain on the local workforce. Despite these challenges, cross-border coordination gradually improved with health clusters and humanitarian organizations redirecting resources, deploying mobile clinics in IDP camps, and integrating emergency services into refugee health programs. Lessons from past crises, including COVID-19, supported task shifting, emergency recruitment, and expanded mental health support for health workers. Conclusions The earthquake response exposed critical policy gaps in workforce preparedness and cross-border collaboration. Future efforts must pre-position medical supplies, fast-track licensing for displaced health workers, and improve cross-border coordination and referrals. Strengthening local workforce resilience through training, financial support, and policy reforms will be essential to mitigating future health crises for IDPs and Syrian refugees.