BERLIN (AP) - Thousands of Syrian doctors work in Germany, and the fall of Bashar Assad is raising concern over the potential consequences for the health sector if many of them were to return home.
Germany became a leading destination for Syrian refugees over the past decade, and some politicians were quick to start talking about encouraging the return of at least some after rebels took Damascus earlier this month. Others noted that the exiles include many well-qualified people and said their departure would hurt Germany - particularly that of doctors and other medical staff.
"Whole areas in the health sector would fall away if all the Syrians who work here now were to leave our country," Interior Minister Nancy Faeser said last week. "For us it is important that we make the offer to the Syrians who are here, who have a job, who have integrated, who are crime-free, whose children go to school, to stay here and be there for our economy."
Syrians have become a factor in a health sector that struggles to fill jobs, part of a wider problem Germany has with an aging population and a shortage of skilled labor.
The head of the German Hospital Federation, Gerald Gass, says Syrians now make up the largest single group of foreign doctors, accounting for 2% to 3%.
An estimated 5,000 Syrian doctors work in hospitals alone. Health Minister Karl Lauterbach, who puts the total number of Syrian doctors at over 6,000, says they are "indispensable" to health care.
Gass said the picture hospital operators are getting from Syrian doctors so far is "very varied." Some - particularly those with many relatives still in Syria - are considering a quick return if the situation proves stable, while others feel at ease and well-integrated in Germany and want to stay. But "no looming mass movement toward Syria is recognizable" at present.
"It's certainly not the case that patient care would collapse in Germany if all Syrian doctors returned now," Gass said. "But of course we have the situation that these people often work in smaller groups at individual sites" - whose quick departure could force temporary local closures.
"We are well advised to treat these people respectfully," Gass said. "And yes, hospital owners are giving thought to how they could fill these jobs."
Dr. Hiba Alnayef, an assistant pediatric doctor at a hospital in Nauen, just outside Berlin, said she has been asked in the last 10 days, "what if the Syrians all go back now?"
"I don't know - some want to, but it's very difficult and uncertain," said Aleppo-born Alnayef, who has spent much of her life outside Syria and came to Germany from Spain in 2016. She said it's something she thinks about, "but I have a homeland here too now."
She said she and other Syrian doctors and pharmacists would like to build cooperation between Germany and Syria.
"The Germans need specialists, Syria needs support ... renovation, everything is destroyed now," she said. "I think we can work well together to help both societies."
Alnayef said the German health system would have "a big problem" if only part of its Syrian doctors decided to leave - "we are understaffed, we are burned out, we are doing the work of several doctors." She said Germany has offered "a safe harbor," but that discrimination and racism have been issues and integration is a challenge.
Dr. Ayham Darouich, 40, who came from Aleppo to Germany to study medicine in 2007 and has had his own general practice in Berlin since 2021, said that "as far as I have heard, none of my circle of friends wants to go back."
"They have their family or their practices here, they have their society here, they are living in their homeland," Darouich said. German concerns that many might return are "a bit exaggerated, or unjustified."
But he said Germany needs to do more to persuade medical professionals it trains to stay in the country, and that it could also do more to make itself attractive to foreigners needed to fill the gaps.
"We see that the nurses and medical professionals in hospitals earn relatively little in comparison with the U.S. or Switzerland," Darouich said, and poorly regulated working hours and understaffed hospitals are among factors that "drive people away."
Associated Press journalist Pietro De Cristofaro in Berlin contributed to this report.