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.

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,” says Hessel. 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.

General 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 newly presenting patients were also provided with initial 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,” says an MSF staff member.

Nevertheless, many patients could not be reached. Prior to the Syrian government takeover, we estimated that 347 people were enrolled in our noncommunicable disease cohort alone, many of whom were lost to follow-up during the chaotic transition.

During our years of presence in Al Hol, MSF 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,” says Stephen MacKay, Operations Manager responsible for MSF programmes 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 organisations to ensure uninterrupted access to essential healthcare for all people relocated from Al Hol camp, including continuity of care for noncommunicable 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, many of whom had been treated by MSF medical teams. We call 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.