Syrian Field Hospitals Struggle to Treat Wounded

Raafat al-Ghanem

At a March 2011 demonstration in the town of Muaddamiyya outside Damascus, a participant had fallen behind the rest of the crowd when a member of the pro-government militias known as the “shabbiha” tried to hit him over the head with a stone.

He was saved by fellow-demonstrators, while other protesters beat up his assailant.

Abu Aram, a doctor who was on the demonstration, got the injured shabbiha member to safety, and provided first aid to him.

Asked whether he would also help a soldier from the regular army, Abu Aram replied, “I would treat anyone. I’m a doctor, bound by a medical oath.”

Abu Aram was eventually arrested by government security forces because of his work in field hospitals.

“It’s human to be scared, but we have to take risks because of our [commitment] to save lives,” he said.

After being released, Abu Aram fled the country and now lives in the Jordanian capital Amman, where he and other Syrian refugees work to send medical supplies across the border.

“A field hospital offers the first phase of treatment to the injured,” he said. “In general, a field hospital needs equipment for conducting critical surgery, so we equip it with a respiratory device, sterilising kit, and instruments for abdominal and orthopaedic surgery.”

The supplies are transported into Syria via a network of smugglers. Aside from the security risks, carrying large items can be difficult. But it is even harder to transport supplies onwards once inside Syria. It can take several weeks to get supplies past checkpoints to their destination, Abu Aram said.

The doctor first began working in field hospitals after he heard that injured opposition activists were being tortured by members of the security forces.

The regime’s control of the healthcare system led to the formation of the Damascus Doctors’ Coordination Committee, DDCC, in April 2011. Medics set up makeshift centres in areas close to the fighting. They had were able to operate in greater safety once the Free Syrian Army, FSA, was in control of large areas.

Normal health centres are almost non-existent in areas that have witnessed heavy fighting between government troops and the FSA.

Journalists and opposition activists have also reported that government troops are deliberately targeting field hospitals. United Nations Secretary-General Ban Ki- Moon has expressed concern that medical facilities and teams are being targeted, without naming which side is behind such acts.

Most of the injuries that Abu Aram dealt with resulted from sniper shots to the head or spine. The victims often suffered permanent disability, if they survived at all.

“Young men in their prime suffered quadriplegia,” the doctor recalled.

Random shots fired at protesters typically resulted in limb injuries, often requiring amputation.

Abu Aram and his colleagues worked under harsh conditions. As well as the constant risk of arrest, they struggled to provide care given the shortage of medical resources and money. Convalescent treatment after surgery was hard to provide.

Most of the volunteers working in field hospitals were medical students with neither the qualifications nor the experience to deal with serious injuries.

Iyyad, a young doctor who was part of the DDCC, has also been forced to flee to Amman.

When popular protests first broke out in Syria, Iyyad was working in a government hospital. After taking part in several demonstrations, he was arrested himself. He then decided to offer medical help to those wounded in the unrest. He used his connections to deliver medicines to field hospitals, and treated “cold cases” – a term that meant journalists and activists who could not go to state hospitals for fear of arrest.

Iyyad recalls one case where members of the security force brought an injured man to the government hospital where he was working. The patient, whose medical file named him only as “anonymous no. 1”, was placed in intensive care.

The security force members guarding the man stood outside his room, smoking and behaving vulgarly. When one doctor reproved them, they responded with insults.

Iyyad’s most painful memory from his time at a field hospital was when he and his colleagues were unable to offer the necessary treatment to an adolescent who had been shot in the back, and who ended up paralysed.

“If we had been able to move him to a regular hospital, he would have been saved from paralysis,” Iyyad said.