Note: The Syrian Voice published a report last month on the medical situation in Madaya, where one field hospital provides services to the entire town.

As of Sunday, one can count the number of nurses at the Madaya Field Hospital on one hand.

Two medical staff members are the latest to be infected with meningitis, bringing the total to 18 cases. The only hospital, which serves 40,000 Madaya residents, now has only four nurses.

Just a day after the infections were disclosed, a delegation from the regime-affiliated Syrian Arab Red Crescent (SARC) entered the besieged town to assess the meningitis patients.

In a statement to Umayya Press on Sunday, an unnamed SARC doctor addressed the besieged town’s critical status.

“The situation in Madaya needs a radical solution,” he urged. “Evacuating those infected with meningitis won’t be enough considering the worsening humanitarian situation there.”

Prior to contracting the disease, the two nurses were caring for the family of Yeman Izz a-Din. A nine year-old boy, Izz a-Din was evacuated to Damascus two weeks ago for meningitis treatment, but not before his entire family contracted the disease.

‘Madaya is infested’

Prior to the latest cases, the hospital staff in Madaya included six nurses and three doctors, one trained as veterinarian who also serves as the hospital’s director. Two former dental students also assisted as medical personnel.

The Medical Corps of Madaya and Baqin announced the infection of two staff nurses in a video recording on Sunday.

The regional medical group sounded the alarm, declaring that “Madaya is infested with meningitis. It is contagious and spreading rapidly.”

The announcement has incited panic among civilians, Abdul Wahab Ahmed, a local resident, told the Syrian Voice.

He explained that people are afraid to interact with one other, even with residents who are completely unaffected by the diseases.

The stages of Madaya’s siege

The meningitis epidemic is just the latest link in a chain of humanitarian crises to hit Madaya.

After the siege began in July 2015, the lack of food, drink, and medicine resulted in a wave of civilian casualties, documented by Physicians for Human Rights and the Syrian American Medical Society in a July 2016 report.

Though humanitarian assistance arrived in Madaya in January, the situation has not improved significantly.

“Food assistance lacks any animal protein, leading to new cases of kwashiorkor [or severe malnutrition],” a Madaya relief worker, requesting anonymity, informed the Syrian Voice.

After months of relying on meager food supplies, residents have entered the latest stage of the humanitarian crisis, the meningitis epidemic.

The first obstacle is diagnosis for which the field hospital in Madaya is unequipped.

“There aren’t any medical laboratories for diagnosing the disease,” Dr. Darwish, a member of the medical corps, explained to a Syrian Voice correspondent.

In order to confirm the meningitis infections, patients must display the full range of symptoms for doctors to make an accurate assessment. However, early diagnosis is a critical step in stemming the spread of the infection.

In addition to being understaffed, the facility is severely lacking in supplies.

“The disease is spreading because of the lack of preventative medicine in town,” Dr. Darwish told the Syrian Voice.

“The United Nations and the Red Crescent haven’t brought in any quality medical supplies since the beginning of the siege, only emergency materials,” a Madaya relief worker, requesting anonymity, explained to the Syrian Voice.

Madaya’s 40,000 civilians are in need of a direct response from the United Nations or the Red Crescent. However, medical evacuations and assistance have become tangled up in ceasefire politics, as Syria Direct reported on Tuesday.

The most recent convoy of UN humanitarian aid arrived in the besieged town four months ago.

Besieged in a town with rampant malnutrition and lacking proper medical services, Madaya’s civilians await this ‘radical solution.’

Translated by Tariq Adely