It is completely unacceptable. Outrageous.

After many years of civil war in Syria, hundreds of thousands of lives have been lost, houses and infrastructure have disappeared during conflicts. The devastating consequences include the loss of specialized personnel, the destruction of institutions and forced migration. The prolonged conflict has resulted in considerable destruction of health infrastructure and workers at levels never seen before comparable only to the numbers of the Second World War.

The exit of qualified personnel has left junior health care workers working beyond their capabilities. The lack of trained personnel and the destruction of health infrastructure have also resulted in an increase in communicable and non-communicable diseases and an increase in mental health incidents. The increase in morbidity and mortality among the Syrian population is also a severe consequence.

The conflict in Syria that started in 2011 has resulted in a complex humanitarian emergency. This has led to a serious public health crisis, which has further affected people's health. The bombing of health facilities despite many efforts to make the geographical coordinates of the hospital available to all parties in conflict has failed.

Having realized that the need for care and concern for the Syrian people was very urgent, many decided to focus their efforts on new channels. They started exploring new ways of expressing our concern and helping reorganize the relief situation in Syria by taking into consideration the enormous needs of the suffering population. More specifically, the medical needs of the affected population are obviously significant and pressing. But so are the need for security.

Tremendous difficult work to combine them, but also necessary. Their research proved finally successful: the answer is related to a new national telemedicine system. Within the framework of the ''Arab Advanced Telecommunication System'' or ADRATS, a decision was taken to analyze the disaster response in Syria and find ways to implement combined health/safety convoys.

But what is telemedicine and how is it implemented?

The proposal to use telemedicine units in Syria as part of an expanded telecommunication system requires a closer look at the term telemedicine. Telemedicine stands for "remote healing" and emphasizes the use of ICT in patient outcomes through access to advanced care and medical information.

But one has to be careful to distinguish telemedicine from telehealth. Telemedicine is used for physicians only, while telehealth covers services provided by healthcare professionals generally, including nurses, pharmacists and others. However, for Syria and health under ADRATS, telemedicine and telehealth are synonymous and used interchangeably.

Telemedicine applications may be categorized into two basic types, depending on how the information is conveyed and how the people involved may interact. Most telehealth services are based on diagnosis and clinical management. In addition, biometric measurement devices such as pulse, blood pressure and glucose are increasingly being used. Patients with acute and chronic illnesses can now be tracked and managed remotely.

Experience has shown that telemedicine modules have improved the quality and accessibility of healthcare. By enabling remote providers to assess, diagnose, treat and provide follow-up care to patients, their health needs may be fulfilled. We must also make the distinction between delayed telemedicine and real-time telemedicine. The first relates to the delayed exchange of prerecorded data between two or more individuals at different times. The second concerns the exchange of data involving the simultaneous presence of data subjects for the immediate exchange of information. In both forms of telemedicine, relevant information can be transmitted in a variety of media, such as text, audio, video or still image.

The choice for Syria seems very good, but it is necessary to clarify the role and meaning of telecommunication and telemedicine in this case. We know that the ADRATS system employs modern information and communication technologies, such as computers, the Internet and mobile telephones, in the field of disaster. In the case of Syria, we believe that these technologies have a great potential to help solve contemporary global health problems. But the destruction of health care facilities and the absence of numerous health professionals using telemedicine have created a significant gap. When it comes to Syria, we realized that we had to address the lack of health care services as a result of the ongoing war. So, the use of information and communication technologies to share information on the diagnosis, treatment and prevention of disease can be a good option.

In our case, telemedicine is designed to overcome geographic and war barriers in a difficult area. This means inviting patients from remote areas not only to improve their health outcomes but also to do so in a safe manner. Access is the first thing health consumers in Syria have to do, and this is a major problem. The lack of security in Syria creates an enormous obstacle.

The proposal is to set up telemedicine units in Syria as part of a larger convoy offering increased security to that unit.

As in Syria, the infrastructure is limited, telemedicine applications are ideal for linking local health care providers in the chaotic ground with specialists, referral hospitals and tertiary care facilities abroad. Our experience with similar cases shows that telemedicine applications have proven to be feasible, clinically useful, sustainable and evolutionary.

Of course, a complex set of human and cultural factors in Syria must be analyzed before deciding. The very difficult linguistic and cultural differences between local patients in Syria and service providers should be taken into account.