In the district of Salaheddine in Aleppo, Syria, a foreign doctor picked out sniper shot from the buttocks of a crazed and screaming man, under continuous overhead gunfire and with explosions sounding only blocks away.
In this war zone, medical supplies are scarce, hospitals are marked as targets and doctors are considered enemies of the state. The surgery — performed on a street corner on a used mattress — reflects a hard reality about the desperation of the situation in Syria. It also reflects the humanistic drive many volunteers have in administering medical care at the front lines.
“Doctors don’t refer civilians or fighters to public hospitals and civilians don’t dare go there themselves. If you show up with a shrapnel or bullet wound, it means you are coming from Salaheddine or nearby neighborhoods, and that means you are a ‘terrorist’,” said Abu Shamal, a 38-year-old British-Syrian surgeon who volunteered to return to his homeland to treat the victims of the Syrian Civil War, to Reuters in 2012. “We are all terrorists.”
A need for help
In Syria — where more than 90,000 have been killed in the two-year conflict — a once state-of the-art health care system has been systematically eradicated. As reported by Doctors Without Borders, who have opened three hospitals in the opposition-held north, “Accounts from doctors and patients revealed that hospitals were being scrutinized by the security forces, and that people were being arrested and tortured inside them. Doctors risked being labeled “enemies of the regime” for treating the injured, which could lead to their arrest, imprisonment, torture or even death. People hurt at protests therefore stopped going to public hospitals with similar fears of being tortured, arrested or refused care, and were essentially forced to entrust their health to clandestine networks of medical workers.”
With upwards of 70 percent of the nation’s health workforce gone, at least 57 percent of all hospitals are damaged and 35 percent destroyed, the World Health Organization (WHO) has declared the nation highly vulnerable to epidemic from waterborne disease — including hepatitis, typhoid, cholera and dysentery. In light of this humanitarian nightmare, doctors continue to head to Syria to offer whatever help they can.
“A missile landed about 50 meters from the hospital. The windows were blown out,” said “Dr. K,” a Doctors Without Borders volunteer stationed in a 30-bed private hospital in northern Syria. “The army had been targeting the hospital. This is the only functioning hospital in this city, and it also serves 15 other towns and villages. A population of 200,000 rely on this facility. We’re able to work and there are enough doctors, but there’s a lack of drugs and medical supplies. Our stocks have run out. Right now we need X-ray films, external fixators. . . . We can’t do lab analysis here anymore so people have to go elsewhere.”
“The army’s positioned about 20 km [12 miles] away from here,” “Dr. K” continued. “They took over the city twice last year. When they came, I had to leave because they arrest doctors who treat the wounded. For them, doctors are as good as terrorists. They came into the hospital and took a patient right from the ward. Why do I keep on with this? Because if I leave, nobody else will care for the sick. I’ve had multiple threats but I’ve managed to escape so far because I’ve had friends who warned me.”
On May 22, a field hospital in the northwestern province of Idlib was shelled by the Syrian Army, killing Hand in Hand for Syria volunteer Isa Abdur Rahman, according to Sky News. Rahmann, a resident of North London, was working as a field medic, serving refugee camps and underground clinics. In November of last year, at least 40 were killed in an airstrike on the Dar al-Shifa Hospital in Aleppo. The hospital was held by the rebels, as reported by CNN.
While the rebels accused the Syrian government of attacking its hospitals, the Syrian government has accused the rebels of the same atrocities. Doctors Without Borders has been denied permission to enter Syria from the government, and only currently operate in rebel-held territory.
In Iraq and Libya, ambulances and medical personnel have been specifically targeted by attacks. “But what is certainly different in Syria is that these attacks have been openly conducted and over a constant period of time,” said Frank Dörner, managing director of MSF at its annual conference in Berlin.
Going where help is needed
Swiss-based Médecins Sans Frontières (Doctors Without Borders, as it is known in North America), has since 1971 been a leading force toward offering international medical relief in the world’s war zones and disaster areas. Over its more than 40 years of operations, MSF has mastered the art of emergency care. “I was able to do whatever I did only because they did 99% of the hard work,” said Stephen McElroy, a veteran of several Doctors Without Borders missions, describing the supplies, medications, facilities, water and sanitation set up in Liberia. “All of it in the middle of a civil war.”
It is in that last one percent, however, that many volunteers’ mettle is tested. “We are forced to work in a place like this where we are exposed either to shells or artillery or tanks. We have to be among the civilians to treat them,” Shamal said, in reflection of the difficulties he faced in treating his patients. “Why is the government trying to target these people? Is it because they are poor or because they embraced the resistance? Some days I wonder why I’m doing this. I’m very scared for myself, but what can I do? This is my duty. I have to help how I can.”
Throughout the world, the call for help is greater now than it has been in recent memory. In Jordan, nearly 500,000 Syrian refugees live in camps without access to electricity, adequate water or health care. In Iraq, the realities of nearly a decade of continuous war has created a large population in the nation who are now vulnerable to psychological stress and mental health disorders. “Many Iraqis have been pushed to their absolute limit,” said Helen O’Neill, MSF’s head of mission in Iraq. “Mentally exhausted by their experiences, many people struggle to understand what is happening to them. The feelings of isolation and hopelessness are compounded by the taboo associated with mental health issues and the lack of mental health care services that people can turn to for help.”
In South Sudan, attacks on medical facilities — including MSF’s — have left nearly 100,000 people without medical access as the rainy season begin. Fears of outbreaks of malaria and pneumonia ravaging the population are now ever-present. “It is unthinkable that there will be no health care whatsoever for the next six months for some 100,000 frightened and vulnerable people hiding in the swamps,” said Richard Veerman, MSF coordinator for South Sudan. “Unless we can return to resume medical activities and have the freedom to move to wherever people need assistance, this unthinkable scenario may become the horrific reality.”
A never-ending call for international aid requires the commitment of those that can sacrifice comfort and security toward the honoring the Hippocratic Oath — to offer aid and comfort and do no harm — despite overwhelming challenges, near-impossible odds, the mind-boggling tedium of a never-ending stream of the wounded and ill, and the horrors of war and death. “I have to focus on my patients and ignore the outside environment, which is so difficult,” said Mutwali Adam, a MSF volunteer stationed in Sudan’s North Darfur state. “I have someone’s life in my hands, and so I’m left with two choices: to try to save the patient’s life, or to leave them and know they may die. My motivation to save their life keeps me going.”
“In times like this, I often have a verse from the Quran running in my head: ‘If anyone saved a life, it would be as if he saved the life of the whole people.’”
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