Antibiotic resistance – tackling a danger of a different kind in the Syrian Arab Republic

November 2017

Many pharmacists in the Syrian Arab Republic admit dispensing antibiotics without asking for prescriptions. Three pharmacy graduates decided to launch a campaign to inform fellow pharmacists of their role in preventing antibiotic resistance.

Two man showing showing a pamphlet at a pharmacy in Syria
Two pharmacists in the Syrian Arab Republic show the flyer developed to raise awareness around antibiotic resistance in the country

Hanaya Raad is a Syrian pharmacist who has dedicated herself to spreading awareness on antibiotic resistance in her home country. A topic not covered in her out-dated university curriculum, Ms Raad first heard about antibiotic resistance after she graduated when it was mentioned in a practical course for pharmacists. On hearing about this mounting threat, Ms Raad and two of her fellow graduates Sarah Safadi and Nour Allahham took it upon themselves to take action.

After digging further into the topic and educating themselves on the best course of action for pharmacists, Ms Raad and her colleagues approached the Syrian Pharmacists Association.

"Lots of patients in Syria don’t go to doctors to take advice if they get sick. They consider the pharmacists as the first people to go to, to ask for antibiotics."

Hanaya Raad, Pharmacist

“We met the head of the Syrian Pharmacists’ Association and the head of the Scientific Committee and explained the problem and the concerns in Syria,” she says. “In Syria, antibiotics are purchased in pharmacies and healthcare centres without the need to show a prescription, and lots of patients in Syria don’t go to doctors to take advice if they get sick. They consider the pharmacists as the first people to go to, to ask for antibiotics.”

The Syrian Pharmacists' Association threw their support behind the graduates and Ms Raad and her colleagues were able to launch an awareness campaign targeting antibiotic-prescribing habits among pharmacists and antibiotic misuse in the population, starting in the capital city of Damascus.

"The campaign aimed to target pharmacists around Damascus, with the plan to cover other Syrian cities in the future," says Ms Raad. "We were able to reach 413 pharmacies, which is roughly half of the pharmacies in Damascus."

The materials developed by these inspired graduates were delivered not only to pharmacies, but also to healthcare centres and hospitals. This was made possible by 19 volunteers who travelled around Damascus, providing advice and talking to pharmacists about the danger of dispensing antibiotics without a prescription from a doctor. They also created small cards for the pharmacists to give to their patients when they buy antibiotics, with instructions on how to use them.

In addition, they created a Facebook page to reach as many Syrians as possible, as the instability made it difficult to cover certain areas in the region. Several lectures and presentations were also held for pharmacists, students, and the general public.

The key messages in these materials and activities highlighted the magnitude of the antibiotic resistance problem and the role of pharmacists in decreasing antibiotic resistance among Syrians.

“It was important that they should know that they cannot give antibiotics without making sure that the patient has a bacterial infection, not a viral infection,” says Ms Raad.

The campaign had to navigate various hurdles along the way, including travel restrictions, lack of experience, and reluctance of pharmacists due to economic problems and insecurity in the country.

Yet, despite all the challenges, the campaign received very positive reactions, especially amongst the younger generations of pharmacists.

“It was a big achievement because there hasn’t been any initiative about this problem in Syria,” says Ms Raad.

The team have also used the campaign to conduct some preliminary research on the knowledge and attitudes around antibiotic resistance in the Syrian Arab Republic.

“We have a bit of an idea that the problem is big in Syria and it is not something that we can just ignore,” says Ms Raad. “Now I am trying to collaborate with the universities in London to do a real research project on this and to assess how big the problem is.”

Ms Raad did her Masters of Public Health at London Imperial College last year and is now based in London along with one of the other colleagues who started the campaign, working on improving the campaign strategy. They will continue the campaign this year with high hopes to expand into even more regions.