A Single Day at a Hospital in Northern Syria

“Women are the revolution” and “I will not emigrate”. The two signs greet us as we enter northern Syria. Along both sides of the roads, you see the fields of wheat and olive trees, grown and harvested by locals. At first, you don’t realize that you are driving through a conflict zone – at least not until you’ve driven for some distance, that you start to see the many pictures and posters of those who have died during battles. From then on, it becomes impossible to ignore the signs: we drive by a large wall that was recently built to separate Turkey from northern Syria, other walls are gashed from bombs, and ruined buildings can be seen everywhere. Some towns and villages have been almost totally destroyed over the past years of war. Yet despite the devastation, Syria has a particular smell that reminds me of my childhood; one of fresh soil and newly baked bread. I am on my way to visit the Tal Abyad hospital, in Raqqa governorate, just south of the Turkish border. Around the corner from the hospital’s entrance, I see the rubble from a building that was obliterated during battles in the area. The same bomb that destroyed this building also affected the hospital. For a couple of months, the hospital was barely functional, after the core of the building was damaged, and most of the medical equipment either destroyed or looted. When the fighting stopped, the hospital had to be renovated before it could start to operate again. MSF197731_Medium Over the past few months, Médecins Sans Frontières (MSF) has been providing support to the hospital’s pediatric, maternity, and surgical wards. People come to the hospital from nearby towns and villages, or from places within the surrounding 120 km, including Raqqa, Maskaneh, Hazeema, Deir Ezzor, and Al Tabqa. The surrounding streets are full of rubble, half-renovated buildings, and the echo of barking stray dogs. The sheer number of dogs in the area surprised me at first, later I discover that most people here were sheep-farmers, and farmers would have a dog or two to protect their livestock. When people fled the war for safer areas, some managed to take their livestock with them, but others left their animals behind, thinking they would return in a few days or weeks. Syrians tell me that these dogs have become very dangerous now. They were left behind with no food, and when the streets became filled with dead bodies, the dogs started to eat the bodies. “Now, they are uncontrollable and dangerous,” one man tells me, “but we can’t kill them because we already have so many dead in this country.” The main reason I am visiting this hospital for is to see and speak with the vaccination teams. Generally they work in the hospital once a week, and the rest of the time, they move around with mobile clinics to vaccinate children under five in the various villages circling Tal Abyad. The vaccination team is made up of three people; they work from eight in the morning to three in the afternoon every day, vaccinating almost 100 children per day in each location they visit. The main challenge they face is that sometimes there are limited vaccines. Some of the children haven’t been vaccinated before, either because of the lack of vaccines or because their parents were unaware of how important vaccines are for the health of their children. Walking around the hospital, I enter the X-ray room and see a child lying on a bed. One of his eyes is covered with a white bandage; he has injuries all over his upper body, and his shirt is drowned in blood. Two men and a doctor stand next to him. I ask what happened to the boy. The father replies, tears in his eyes, “he was playing with a battery that he found in the garden. It turned out to be an explosive device and it exploded in his hand.” The boy, who is eight years old, lost his eye, and has an abdominal injury and shrapnel wounds all over his upper body. “His younger sister was standing next to him but her injuries were not as serious,” says the boy’s father. The family is from Tishreen, an area recently left behind by the conflict, but which is still full of mines and unexploded remnants of war. “They cleared the area, but apparently not fully,” the boy’s father tells me. “We went back to our houses thinking the area was fully cleared, but it seems there are still devices that attract kids without knowing that it will hurt them. This is not the first time a child in town has been injured by an explosive device.” In the end, the man couldn't hold his tears back and they went flowing on his cheeks. The child screams in great pain and, with every scream, his father loses a little more of his strength. In some parts of Syria, you can see and hear the sounds of war. Other areas are silent, with no sign of active battle, yet there is still a great deal of suffering and exposure to traumatic events. At a later stage, the boy will need an eye surgery, which is unavailable in Tal Abyad; so he will have to be transferred to Qamishli or to a hospital outside Syria. That’s the best scenario. But if his family cannot afford the surgery, the child will live with this injury for the rest of his life. This war is unfair to him and his whole generation. I walk around the hospital some more, seeing the MSF teams running around, fixing or installing machines, training medical teams, treating patients, organizing the pharmacy and supplies. Everyone is working around the clock, desperately trying to make the hospital as functional as possible in a warzone, where medical supplies and equipment can take ages to arrive, and where delays and challenges are a fact of life. I bump into one of the hospital’s medical team. He is from Raqqa and fled the city a year ago by paying a smuggler to sneak him out. He decided to flee because there were not enough medical supplies or equipment left in the area for him to continue working. There used to be almost 66 surgeons in Raqqa, but now only three are left, he says. He and his family initially went to a town in the western part of Syria, before deciding to come to Tal Abyad, where he knew there were limited numbers of medical staff, and the need for doctors is extremely high. He tells me, “We receive emergency and surgical cases every day, whether war-related or not. We receive injured people from explosive devices, mines, and booby-traps almost everyday.” I leave him to his work and continue to walk through the hospital. Both the inpatient and pediatric wards are bursting with patients and their caretakers, coming from different parts of northern Syria. Many are suffering from acute watery diarrhea and respiratory infections. Walking some more in the corridors of this hospital of tears, I arrive at the adults’ ward. Most of the patients are asleep but, at the far end, one young man is awake. I notice that his leg has been amputated. Hesitantly, I approach him and ask what happened. MSF197611_Medium “I stepped on a mine while I was on a motorbike with a friend,” says the young man, who is 21. “My friend died and I got injured. Earlier that day, my friend had come to my house to tell me about a house that was bombed by an airstrike, killing 14 members of one family. We needed to see if we could save anyone. We hopped on my bike, my friend sat behind me, and we drove towards the bombed house. That’s when a mine exploded underneath us.” He is silent for a couple of seconds before continuing, “he wanted to save someone’s life but he lost his own.” A long silence fills the room after he tells me his tale. I wish him a fast recovery, offer my condolences, and quickly make my way out of the hospital; I couldn’t bear to see or hear any more stories of war and tragedy. Between my own memories of living under occupation in a warzone, and these people’s mental and physical wounds, I am lost for words. For a couple of minutes I lose control over myself. As I walk out, I hide my tears behind my sunglasses, which I use as a shield in such moment. Before leaving the building, I turn to take one final look at the hospital. The medical teams are still busy, treating patients, distributing medicine and installing machines. This is just a single day at a hospital in northern Syria. I cannot begin to conceive what it must be like to have lived through seven years of war.