Syria: After years of detention former Al Hol residents face uncertain future
The sudden closure of Al Hol detention camp by the Syrian government on 22 February, and the chaos that preceded it, has exposed thousands of people — including children and individuals with chronic medical conditions — to increased risks and reduced access to healthcare.
Médecins Sans Frontières / Doctors Without Borders (MSF) teams have been providing healthcare to people who have been detained in the camp for seven years.
At its peak in 2019, more than 76,000 people were detained at Al Hol, the majority of whom were women and children. The camp was divided, with Syrian and Iraqi nationals held in one area and nationals of other countries detained in a segregated section.
By January 2026, the population had reportedly fallen to around 23,000 following multiple repatriation trips, particularly to Iraq. When control of the camp shifted from the Syrian Democratic Forces to the Government of Syria, the camp population sharply declined during a period of insecurity, including reports of people escaping and being smuggled out.
In the week leading up to the closure, remaining residents were relocated to Aq Burhan camp in Akhtarin, northern Aleppo, while some families returned directly to their areas of origin.
“We spoke to families and individuals, some of whom had been waiting for more than fourteen hours to leave, while others were still trying to arrange for their belongings to be collected,” said Barbara Hessel, Head of MSF programmes in northeast Syria.
“The lack of clarity around the process created anxiety, while at the same time everyone I spoke to was looking towards a more hopeful future.”
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Gaps in healthcare, protection and assistance have been reported in Aq Burhan camp. MSF is particularly concerned that women and children face heightened risks of violence, exploitation, and further displacement following this haphazard relocation process.
“A dead place”
As people left Al Hol, emotions were mixed.
“Some were relieved, some were confused, and some were angry they were going to another camp instead of home — but almost everyone was carrying years of exhaustion,” Hessel said.
One resident told MSF that he hoped the new camp would at least have trees and some green space, as Al Hol had felt like “a dead place”.
“After seven years in Al Hol, many people did not ask where they were going next — they were simply grateful to be leaving,” Hessel added.
Throughout the transition period, access to healthcare for people in the camp was severely compromised. Many humanitarian organisations were forced to suspend activities due to insecurity and shifting control of the area.
Despite these challenges, MSF remained one of the few organisations providing healthcare and access to clean water in the camp until the final day of closure. MSF teams continued operating a water treatment plant supplying drinking water to both the main camp and the annex.
Primary healthcare services were maintained as long as possible, and continuity of care was prioritised for people with non-communicable diseases. Patients already enrolled in MSF treatment programmes received extended supplies of medication, while new patients were also provided with supplies to help prevent treatment interruption.
“When we gave patients with chronic diseases a three month supply of medication, you could see immediate relief — especially among those who were not previously enrolled in our programmes,” said one MSF staff member.
Nevertheless, many patients could not be reached. Prior to the Syrian government takeover, MSF estimated that 347 people were enrolled in its non-communicable disease cohort alone, many of whom were lost to follow-up during the chaotic transition.
Prolonged detention
During years of presence in Al Hol, MSF teams directly witnessed and documented neglect and violence imposed on the camp’s residents. People, including children, were consistently treated as a security threat rather than as individuals with rights and needs. For some, their time in the camp involved a history of coercion, exploitation, and abuse, reflecting a far more complex reality than is often acknowledged.
“For seven years, the international community has participated in and maintained a system of indefinite confinement in the desert of northeast Syria, justified in the name of security,” said Stephen MacKay, operations manager in Syria.
“The sudden closure of the camp, without a clear, rights-based plan for residents’ future, underlines the arbitrary nature of both their prolonged detention and their release. It also underscores the sustained failure over the past seven years to meet their basic humanitarian needs or to resolve their legal limbo.”
MSF calls on Syrian authorities and international actors to ensure uninterrupted access to essential healthcare for all people relocated from Al Hol camp, including continuity of care for non-communicable diseases. MSF also urges the authorities to uphold their commitment to provide legal documentation for Syrian nationals, enabling people to rebuild their lives.
MSF is concerned about the fate of the foreign nationals who previously resided in Al Hol and many of whom had been treated by MSF medical teams. The organisation calls on all concerned governments to strengthen protection measures, particularly for women and children, to safeguard them from violence, exploitation, and abuse, and to facilitate their voluntary repatriation.
MSF in Syria
Since it began in 2012, the civil war in Syria has killed hundreds of thousands of people, displaced millions more, and caused widespread destruction and suffering.
The impact of the war continues to hit hardest in northern Syria, where many people struggle to access clean water and essential healthcare.