In late 2024, families in Syria began returning to places they had not seen for years during the war. For many, the journey back to towns like Daraya in rural Damascus followed years of displacement, mov-ing between temporary shelters, overcrowded towns, and informal settlements in search of safety. Re-turning was rarely a simple decision, but driven by exhaustion, limited options, and the hope of rebuild-ing their lives.
In Daraya, returnees found a town that barely resembled the place they once knew. Entire neighbour-hoods were reduced to rubble, homes stood open to the sky, walls blackened by fire, belongings long gone. Streets that once bustled with life were now silent, and essential services no longer worked.
For families trying to start again, the lack of healthcare was especially alarming. Years of damage and neglect had left medical facilities unusable. After enduring prolonged displacement and interrupted treatment, returning to a town without functioning health services meant facing new risks at a time when resources were already stretched thin.
A return marked by urgent needs
As Daraya once again became reachable, Médecins Sans Frontières / Doctors Without Borders (MSF) assessed the needs of returning families. Access to healthcare emerged as a critical prior-ity. Many had gone years without reliable medical care, managing illness, pregnancy, and emergencies on their own or travelling long distances for help.
Over the next eight months, MSF worked closely with the Directorate of Health (DoH) to help restore essential health services in Daraya. The Daraya Primary Health Care Centre (PHCC) was rehabilitated, and a fully equipped emergency room was established. MSF addressed gaps in medical supplies, di-agnostic equipment, and staffing, enabling the delivery of comprehensive primary healthcare ser-vices.
Daraya’s residents now had something they hadn’t seen in a long time: a place close to home where parents could bring a sick child, where someone living with a chronic illness could receive regular care, or a pregnant woman could attend a consultation, and where an injured person could re-ceive emergency help. MSF’s goal was to ensure these services could be sustained by the DoH after MSF’s withdrawal.
Restoring healthcare in Daraya: Responding to people’s needs
MSF’s efforts in Daraya extended beyond treating illness. The team, worked closely with the DoH to re-store services and address health needs often neglected during conflict, particularly for women and girls.
Supporting women and girls
Sexual and reproductive healthcare services were strengthened to provide care during and after preg-nancy, family planning, and support for survivors of gender-based violence.
For women like Moneera, a 69-year-old patient, the restored services brought relief: “I can finally come here for my check-ups and know my children will be cared for too.” In a context shaped by loss and poverty, these services helped restore dignity, safety, and choice.
Mental health and psychosocial support
Mental health care was a key component of MSF’s response. Years of violence, displacement, and un-certainty had left many residents with psychological wounds. The PHCC offers counselling and psy-chosocial support, providing a safe space for individuals and families to share their experi-ences, find ways to cope with stress and loss, and begin healing.
Linking people to specialised care
For patients requiring advanced treatment, our team collaborated with the DoH to establish referral pathways to hospitals in Damascus. This ensured timely access to specialised care while strengthen-ing local healthcare systems and protocols.
Building safer, trustworthy care together
Restoring healthcare in Daraya primary healthcare centre was not just about reopening facilities but about rebuilding trust. MSF worked alongside the DoH to strengthen infection prevention and control measures, improve water and sanitation systems, and reinforce patient safety standards. Local health staff received hands-on training and ongoing support, helping to rebuild confidence in services that have been absent or unreliable for years.
Community outreach also played a key role. As services stabilised, more patients began visiting the PHCC, not only for emergencies but for routine check-ups, follow-ups, and preventive care. This re-newed trust reflected a shared effort between MSF’s and DoH’s shared commitment to providing re-spectful and reliable care. During the project period, the centre’s clinics provided care to more than 30,000 patients.
A collaborative model and a smooth transition
From the outset, MSF’s intervention in Daraya was designed in close coordination with the DoH, with a clear focus on strengthening local capacity and ensuring sustainability. By the end of the eight-month response, the PHCC and emergency room were fully operational, supported by trained staff, had es-tablished referral pathways, and improved safety protocols.
As other health actors resumed their activities in Daraya, MSF prepared a gradual transition of respon-sibilities including training, mentoring, and technical guidance – to ensure the continuity of services. The collaboration demonstrated how humanitarian organisations and local health authori-ties can work together to bridge recovery phases and lay the groundwork for locally led care.
