Inside Aleppo’s medical nightmare, and why we must act

Syrian Civil Defense-White Helmets. From the Associated Press

There are only 30 remaining doctors in Aleppo, and they have been describing an unimaginable situation, some of which I have seen firsthand. They have to perform amputations on children on the floor of their rudimentary emergency rooms without anesthesia or proper sterilization. They are running short on blood products, intravenous fluid, antibiotics and pain medications.

The doctors have been struggling to provide health care for a traumatized population of 300,000, while their hospitals are bombed daily and their medical supplies and medications are depleted.

They have been working nonstop for the past three months, dealing with the influx of a large number of polytrauma and crush patients suffering from horrible injuries, pulled from under the rubble.

Hospitals are targeted frequently in Syria, especially in Aleppo, mostly by the Syrian government and lately by Russian jets. Physicians for Human Rights has recorded 382 attacks on medical facilities, of which 344 were carried out by the regime and Russia; they were also responsible for the deaths of 703 of the 757 medical personnel killed in the war so far. Most of Aleppo’s doctors have left.

My organization, the Syrian American Medical Society, reported that July was the worst month for attacks on health care since the beginning of the conflict. There were 43 attacks on health facilities in the month – more than one a day. By comparison, this number of attacks occurred over six months in 2015, with 47 attacks from January to May.

A few months ago, two of my colleagues and I made the dangerous trip from Chicago to Aleppo in order to volunteer in a medical mission with the Syrian American Medical Society. We worked in a hospital that was built 20 meters underground because it was targeted a dozen times in the past four years.

We worked, lived and slept in the hospital, while hearing the sounds of earth-shaking explosions nearby. The hospital was operated by a diesel-run generator and connected to the world through satellite internet and a tele-medicine unit.

Using sewing thread for medical sutures

A bombed hospital in Aleppo. From The Associated Press.

It was so surreal for me, a critical care specialist from Chicago, to witness nurses and doctors in an underground hospital in a besieged Mideast city. M10 was the largest trauma hospital in Aleppo, performing 4,000 life-saving surgeries every year. In its intensive care unit, I treated innocent victims of the Russian and Syrian airstrikes. I still remember vividly Ahmad Hijazi, who was pulled from under the rubble of his destroyed house after a barrel bomb thrown by a regime helicopter exploded while he was asleep.

Ahmad sustained a spinal cord injury and lung contusion. Doctors struggled to manage his case with very limited resources. We were unable to evacuate him to Turkey for lifesaving surgery because the only road leading from the city was bombed every day by regime forces trying to encircle the city. A few days later, Ahmad gave up. He suffered cardiac arrest and was pronounced dead.

He is only one of thousands of innocent civilians who could have been saved in any other conflict or disaster area with simple means. His death and those of tens of thousands of civilians occurred because they lacked access to proper medical care constitute a war crime.

Since we left, the situation became more dire because of the ensuing siege. The only female obstetrician in the city told me that she has been using sewing threads to suture her patients after C-sections because of a shortage of surgical sutures.

She has been delivering mostly children with very low birth weight as pregnant women have no access to fruits, vegetables, milk, meat or vitamins. Food and baby milk are becoming scarce, so predictably, and for the first time in its modern history, Aleppo is witnessing children with severe malnutrition.

We can do more than cry

Shedding tears about the pictures of the injured children of Syria is not enough. Hugging your children is not enough. The expected human response when seeing someone in distress is to exert our utmost effort to relieve their distress. Syrian children are not dolls to cry over and then move on.

We are accountable, as are our political leaders, if we don’t act when we watch videos of Syrian children crying in agony because war criminals are bombing them or snipers shooting at them. Tweeting and Facebooking about them, although necessary to spread the word, does not absolve us from doing what matters most – which is saving their lives and building a better future for them!

Every person can do several things right now to help Syrian children like Omran Daqneesh, the five-year-old boy from besieged Aleppo – whose photo showing his dust- and blood-covered face after being rescued following an airstrike captured the world’s attention – and millions of other Syrian children affected by the conflict in Syria.

Advocate now and call your political leaders and president demanding that your country must exert its moral leadership to stop the genocide and save Aleppo now. In the U.S., we should not wait for the next president to take office. By that time, it will be too late. We should place ending the genocide at the top of the national agenda.

This would mean specific plans for stopping the genocide and bringing peace, not merely applying band-aids. What is happening in Aleppo is affecting all of us, wherever we live. The refugee crisis, the rise of Xenophobia, Islamophobia, anti-refugee sentiment and terrorism are all consequences of the crisis in Syria. Our national leaders should muster the political will to end it.

  • Organize with faith and civic groups in your city to form a broader coalition that can force our political leaders to act. This is the American way and this how democracy works. If we said “Never Again,” we should mean it, and we should have political leaders responsible if they failed the genocide test.

  • Speak up in medical societies and meetings. Invite speakers to your hospitals to address the attacks on medical neutrality and health care. The medical community should not tolerate a new normal where 150 years of Geneva conventions and International Humanitarian norms are thrown under the bus and undermined every day. The medical community can play a major role in forcing political leaders to listen to the pleas of Aleppo nurses struggling to save lives while being bombed by the most advanced war machine.

  • Volunteer in medical missions to help refugees. There are many NGOs, including SAMS Global Response, that provide medical relief to Syrian refugees in neighboring countries and in Europe. Join a life-changing experience when you extend a hand of healing to a desperate refugee living in a tent thinking that the world has forgotten about her.

  • Form a chapter to help resettling Syrian refugees in your city following the steps of the Syrian Community Network. More than 13,210 Syrian refugees have been resettled in the U.S. so far, and more are expected to arrive in the next few years.

  • Give generously. We are a country of giving, so let us do what we do best by donating to charities and NGOs that are touching the lives of thousands of refugees or Syrians in distress in places including Aleppo.

The bombing of besieged Aleppo has become perhaps the most critical event, besides the Ghouta chemical attack, in Syria’s genocide, which has killed more than 450,000 people since 2011. UN Special Envoy for Syria Staffan de Mistura warned that “between now and December, if we cannot find a solution, Aleppo will not be there anymore.” When the dust settles and facts are fully established, the bombing of Aleppo will be viewed as one of the worst war crimes since World War II.

As Charles C. Haynes, the director of the Religious Freedom Center, put it recently, “What future generations will long remember about this moment in history is not bombastic rhetoric about border walls or deleted emails. Future generations will remember us – and judge us – by what we did or did not do to stop the genocide.”