Religious freedom advocates and medical practitioners have expressed concerns about the COVID-19 response in northeast Syria.

"There is a quadruple threat to religious freedom and the fight against ISIS that is going on there. Turkey has been relentlessly bombing and shutting off the water supply to the city (of Hassakeh). The U.N. and Human Rights Watch have spoken out about it, yet Turkey continues," said Lauren Homer, an Anglican lawyer on international religious freedom issues, speaking to the International Religious Freedom Roundtable April 21.

Homer chairs the roundtable's Middle East Working Group. She spoke during the group's online meeting, which normally is held on Capitol Hill in Washington. Her remarks were made available to Catholic News Service and underscore concerns for the health and welfare of the region's Kurdish, Syriac Christian and Yazidi residents facing the coronavirus crisis.

"There's an impending COVID-19 crisis. The area is cut off by Syria's Assad regime and Turkey from getting assistance. The KRG (Kurdistan Regional Government in Iraq) has tried to help, but you've got 5 million people with three test labs and a smattering of test kits, and that's it. The U.S. government and our military have helped with suppling personal protection equipment. Samaritan's Purse is there now providing assistance," said Homer, who heads Law and Liberty Trust, which promotes religious liberty worldwide.

She urged the United States and President Donald Trump "to put pressure on Turkey to stop cutting off humanitarian aid and the water supply that is needed."

On Feb. 26, Turkey imperiled the water supply to Hassakeh and its surrounding region of some half a million people, including Syrians internally displaced from other parts of the country because of the conflict.

Homer said northeast Syria and its Kurdish and Syriac Christian fighters remain crucial allies in combatting the Islamic State group. These fighters, allied with U.S. troops, were largely responsible for eradicating much of the Islamic State presence in Syria, until Trump pulled out 2,000 American troops from the area, saying the extremists were "defeated." After much criticism of the move, a remnant of the U.S. military presence remains to protect oil fields.

More than 300,000 people were displaced and more than 70 civilians in Syria and 20 civilians in Turkey were killed during the Turkish military offensive. Amnesty International has evidence of war crimes and other violations committed by Turkey and the Syrian forces it used, including Islamist militants. Until the Turkish invasion in October 2019, Kurds, Christians and other religious minorities said they felt protected by the presence of U.S. ground troops.

Greek-Melkite Archbishop Jean-Clement Jeanbart of Aleppo, Syria, said in October that the Turkish military offensive created a "demographic earthquake, displacing Kurds from their homes and lands and creating the conditions for serious internal tensions."

Homer said: "The key thing about northeast Syria is that fight against ISIS is continuing, and ISIS is stepping it up.

"There has also been a rebellion in the prison where there are 10,000 ISIS fighters, and there have been rebellions in the camp where there are about 80,000 ISIS wives and children. So the is situation is critical. Some of the rebellions in the prisons have been directly linked to the lack of water and fears about COVID-19."

Homer added that the U.S. government needs to "think strategically about U.S. national security and the security of our troops over there."

"The best way we can advance both is to try to keep up the pressure on ISIS and try to keep people there healthy. Because if COVID-19 sweeps through the area, we are not going to have any allies there to be our boots on the ground the way they have been."

Bassam Ishak, who heads the Syriac National Council, agreed. He told CNS by phone that there is little reporting on coronavirus cases out of northeast Syria because of a "lack of testing ability."

"Living conditions in general are difficult and the situation is not getting better. We need help from our allies to improve living and health conditions for the people of the region who supported the international coalition to defeat ISIS," said Ishak, a member of the political bureau of the Syrian Democratic Council in northeast Syria and a graduate of The Catholic University of America in Washington, D.C.

"We are restricting transportation access, shuttering some shops and closing schools to combat the spread of the coronavirus," Sanharib Barsoum, co-head of the Syriac Unity Party, told CNS. "We have also received some personal protection equipment and testing kits from Iraq's Kurdistan region."

The international medical humanitarian organization, Doctors Without Borders, is working with local health authorities and other groups in northeast Syria to prepare for an increase in patients infected with COVID-19, following the first confirmed death from the illness.

"We are deeply concerned about the lack of laboratory testing, the absence of contact tracing, inadequate hospital capacity to manage patients and limited availability of personal protection equipment," said Crystal van Leeuwen, the group's medical emergency manager for Syria. "The response in northeast Syria at this time is not nearly enough. A significant increase in assistance from health and humanitarian organizations, and donors are essential."

Doctors Without Borders said nine years of conflict and military operations in northeast Syria have left the region with a broken health system. Many health facilities can no longer function, and those that remain open were already struggling to respond to the existing medical needs before the COVID-19 pandemic. Delays in testing and border closures have made it nearly impossible to adequately respond to a COVID-19 outbreak, it added.