SCOTT SIMON, HOST:
The U.S. enjoys one of the most developed health care systems in the world. But the rollout of the COVID-19 vaccine has been challenging. Now imagine rolling out vaccines in war zones. NPR's Ruth Sherlock asked about just that to the people who deliver aid in Yemen, Libya and Syria.
RUTH SHERLOCK, BYLINE: When I asked Tamuna Sabadze, the country director for the International Rescue Committee in Yemen, to tell me her worries about distributing the COVID-19 vaccine, she gives me a long list.
TAMUNA SABADZE: First of all, I mentioned the logistical obstacles.
SHERLOCK: Chief among problems in Yemen is how to reach large parts of the population in a country with a weak infrastructure that's been further destroyed by airstrikes and shellfire. The IRC has 18 mobile clinics, four-by-four vehicles with medicines and equipment strapped to the roof to reach Yemen's rural communities. Sabadze says the conditions are often extreme.
SABADZE: Like, the roads that they travel on a daily basis is just extraordinary. We have driven in just riverbed, dry riverbed.
SHERLOCK: This situation complicates which COVID-19 vaccine they can even use. Sabadze says Yemen can't deal with vaccines that have to be kept at extremely cold temperatures. Electricity there can be spotty even for regular refrigeration.
SABADZE: There is absolutely no way that that can be managed in Yemen.
SHERLOCK: And it's unclear if the Houthi rebels, who ousted the government from the capital, will even encourage people to get the shots. They were slow to acknowledge the virus in the first place.
There is a global organization that helps poor countries get vaccines. But aid workers say these countries are only expected to get a small percent of what they need in the next few months. One issue in Libya is that the government has said it doesn't plan to use any of these first doses on the some half million migrants who've come into the country as the war has made the borders more porous.
Safa Msehli, a spokesperson at the U.N.'s migration agency, the IOM, says it's wrong to exclude migrants.
SAFA MSEHLI: Especially that many of them in Libya are in vulnerable situations, including those in government detention centers.
SHERLOCK: Governments and militias excluding people from vaccination campaigns is a concern in Syria, too, where there's been a civil war for a decade. Sara Kayyali from Human Rights Watch worries that the government may favor giving vaccines to its supporters. She says they've already done this with medical supplies.
SARA KAYYALI: We've also seen discriminatory distribution of medical supplies even within areas that are held by the government, where some areas were able to receive ventilators, masks and PPE. And other areas that are affiliated or used to be affiliated with anti-government sentiments never received them.
SHERLOCK: Kayyali is especially concerned for people in the north of Syria, where millions live under opposition rebels or a Kurdish-led administration. Akjemal Magtymova, the head of the World Health Organization in Syria, says there have been delays to so-called crossline deliveries, aid across front lines, in the past. But she says they've got better and that the government has agreed to collaborate on COVID-19 vaccines.
AKJEMAL MAGTYMOVA: Whomever I discuss in government departments, all of them have this solidarity and understanding that it should be for all Syrians.
SHERLOCK: Aid workers and doctors NPR spoke with are skeptical of this somewhat rosy expectation of the Syrian regime. But for now, all they can do is wait and see. Ruth Sherlock, NPR News, Beirut.
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