In Syria, doctors, hospitals and patients are increasingly targeted in attacks, adding to the brutality of a conflict that already has claimed more than 110,000 lives.
In Aleppo, where front lines weave across crowded areas where civilians live and work, British doctor Saleyha Ahran remembers “the smell of burning flesh” when a clinic in Reef Aleppo where she worked was hit by what she believes was an incendiary device, further injuring about 40 patients who were being treated for other wounds and ills. “It burned the clothes off their back, that blast,” said Ahran.
The World Health Organization estimates that, in the course of the two-and-a-half-year conflict, more than a third of Syria's hospitals have been destroyed. In the course of September alone, the government air force bombarded the hospital in Al Bab in the north of the country, killing 11 civilians, including a doctor.
In Deir Ezzour, a city in the eastern part of the country, just one of the city’s two hospitals is still standing. But it may not be for long. Running on power from a generator, it is constantly mortared and is a frequent target of airstrikes.
But attacks also include targeted killings committed by the rebels. Earlier in the month, Dr. Muhammad Abyad, a 28-year-old surgeon working in a hospital in Aleppo was killed. The Syrian Observatory of Human Rights, a group affiliated with the opposition, blamed the al Qaeda–linked rebel group the Islamic State of Iraq and al-Sham (ISIS) for his death. "ISIS killed the young doctor Mohamed Abyad after his abduction on Monday at dawn in Sejou village, where he was working,” the group said in a statement.
Abyad's death is not an isolated incident. Since the beginning of the conflict in early 2011, at least 20 Red Crescent volunteers have been killed, in some cases by sniper fire, while attending to the wounded or delivering medical supplies.
In a special report last week, the United Nations observed that the “denial of medical care as a weapon of war is a distinct and chilling reality of the war in Syria.”
The report documents how government forces have led what appears to be a deliberate and systematic campaign of attacks on hospitals throughout the country. Doctors have been arrested and tortured after treating those injured during fighting.
“Government forces deny medical care to those from opposition-controlled and affiliated areas as a matter of policy,” the report states.
The report also blames rebels for the violence, but to a lesser degree. “Anti-Government armed groups have also attacked medical facilities,” says the report, citing an attack last year on the National Hospital in Homs city, during which no attempt allegedly were made to “avoid civilian casualties or to protect the sick and wounded,” the report said.
“The targeted attacks on medical facilities and personnel are deliberate and systematic, not an inevitable nor acceptable consequence of armed conflict,” read a recent open letter in the medical journal The Lancet. The open letter, which was signed by 55 doctors and medics, including two Nobel laureates, was an appeal for “medical neutrality,” which requires medical professionals to treat anyone in need to the best of their ability.
Peter Kassig, a medic who works in Deir Ez Zour, a city in central Syria where clashes have been ongoing, recently witnessed how some medical professionals abide by this code—even under the most challenging circumstances. For a long time, a government sniper had been taking shots at everyone who passed over the single bridge in and out of the city, but during one battle, the sniper was badly injured and rushed to the hospital where Kassig works. The sniper’s leg was amputated, but doctors at the hospital, some of whom had had family members who had been killed by the sniper, “worked silently through it all and saved his life.”
Because of the near-constant attacks and strain on medical facilities in Deir Ez Zour, secret field hospitals have been set up. Those who sustain life-threatening injuries, however, are evacuated to Turkey, a drive that can take more than 12 hours and carries with it enormous risks for patients and medics alike.
In Aleppo, at another field clinic run by the Syrian Red Crescent and the Syrian American Medical Service, doctors have taken shelter with their patients on the first and second floors. The third floor is within the line of a sniper position and the shooters aim directly at the hospital, its staff, and patients. Medics sleep at the hospital, and one doctor hasn’t been home to see his family in more than eight months. Most patients have serious trauma injuries or have had arms or legs amputated. And since doctors can’t access a regular blood bank, the fridge in the staff’s break room is used to store bags of blood.
Abu Muhammadeen, one of the surgeons, said the hospital is critically understaffed. “The first challenge is the number of surgeons,” he said. “There aren’t enough, and we suffer from fatigue.” In Syria’s largest city, Aleppo, which has more than 2 million inhabitants, there were more than 5,000 doctors before the war. Now, with doctors having been targeted or having fled, and with no one being educated into their ranks, only 36 remain.
There, as elsewhere, the health-care system has been brought to its knees, despite the heroic efforts of doctors and medics.
“I really [feel] for my colleagues,” says Ahran, the British doctor. “They've kept something going on their own. I admire and respect them.”