Salma Daoudi behind new report on Syria’s fragmented health system

DPIR DPhil student Salma Daoudi is the lead researcher of a report on 'a Post-Authoritarian Future for Syria’s Healthcare System' published recently by the Foreign, Commonwealth and Development Office XCEPT programme. 

The project was developed under the X-Border Local Research Network (XCEPT), for which Salma was one of the MENA Women Research Fellows (WFR). She was awarded the XCEPT Women Researchers Fellowship by The Asia Foundation last year. 

We caught up with Salma to find out more about the report, what was involved and the importance of her research: 

Can you tell us in a bit more detail what the report is about? 

The report explores how Syria’s fragmented health system was governed through more than a decade of conflict, marked by the targeted destruction and weaponisation of health. It further discusses the implications of such health governance experimentation for rebuilding the health sector after the fall of the Assad regime. It focuses specifically on the Gaziantep cross-border coordination hub in southern Turkey and the network of local health directorates in northwest Syria, which became the operational backbone of healthcare delivery once the state turned its own system into a weapon. The study traces how these hybrid arrangements of humanitarian and local governance sustained care under siege and conditions of duress and what it entails for experimentational sovereignty. It argues that these mechanisms, often dismissed as temporary or exceptional, hold crucial lessons for reconstruction, not only in terms of restoring services, but also in reimagining the relationship between health, power, and localisation in a post-authoritarian Syria. 

What was involved? 

The project was developed under the X-Border Local Research Network (XCEPT), for which I was one of the MENA Women Research Fellows (WFR). It combined interviews and focus groups with Syrian doctors, coordinators, and humanitarian professionals during fieldwork in Gaziantep, Turkey, conducted shortly before the fall of the regime on the 8th of December 2025. Many of them have been working across the border for years, navigating bureaucratic and political constraints to ensure the delivery of essential services and aid to over four million Syrians in the northwest. The co-participants of this study were centred as actors of governance in their own right. Acknowledging the political agency of humanitarian and health workers, the project attempted to capture how in a context where institutions have long ceased to function, individuals and networks maintain fragile but critical infrastructure. 

Why is it important? 

Because it unsettles the conventional narrative that governance collapses during war and re-emerges only after peace. In Syria, new forms of coordination and authority have evolved in the vacuum left by state violence and intentional neglect. These systems, local health directorates, cross-border NGOs, and technical committees, may not fully resemble formal state institutions, but they performed many of the same functions, often with more trust and accountability than the structures they replaced. Understanding these models matters for Syria’s reconstruction, and for the global conversation on how societies rebuild after systematic destruction. The report argues that effective reconstruction must acknowledge and derive lessons from the governance arrangements that have kept healthcare functioning over the past decade. Starting from these existing structures and the people who operate them offers a more realistic and legitimate foundation for recovery than any externally imposed framework. 

What difference does this research make — what does it mean in the real world? 

In a region where health is increasingly weaponised, the findings have both analytical and practical significance. They demonstrate how the reverberations of violence can be amplified by the destruction of hospitals and the persecution of medical personnel, causing mass displacement, death, and disability. They also shed light on the alternative initiatives that can emerge in certain contexts to sustain access to basic services and how reconstruction efforts can draw from the experiences and skills acquired. Their continued relevance depends on ensuring that the decentralised practices they embody are not subsumed by externally imposed frameworks or donor-driven models disconnected from local realities. In contexts like Syria, rebuilding hospitals or critical infrastructure cannot be separated from the work of restoring trust, establishing legitimacy, and renegotiating the social contract between the state and the citizens. 

How do you feel about it? 

This project greatly matters to me because it captured the very last weeks of the localised governance dynamics in Syria before the fall of the former Assad regime. More importantly, it reflects the kind of scholarship I believe in, producing knowledge that is grounded in experience, attentive to local agency, and capable of informing more just and accountable forms of governance. This research examines how power operates in crisis while giving space to those who sustain collective life when institutions fail. Witnessing the work and commitment of the community of doctors, nurses, and humanitarian workers working across the Syrian-Turkish border reinforced my belief that reconstruction fundamentally requires recognition, including by recognising the people, structures, and forms of knowledge that have held society together through collapse. 

What’s next? 

The next step for this work is to continue sharing its findings more widely among key stakeholders invested in Syria's reconstruction and recovery planning. The hope is that it can contribute to ongoing conversations about how to rebuild Syria’s health sector in ways that are fair, inclusive, and informed by the realities of those who have kept it functioning and of those whose lives depend on it. Relatedly, I’m conducting further research on how war-acquired disabilities, both physical and psychological, are essentially political questions that influence claims to justice, belonging, and participation in the post-conflict landscape. The aim is to understand how societies rebuild after systemic violence, what it means to reclaim political agency, and what repair entails.