Stories from Aleppo: Medical Workers under Siege

By Marge Dwyer

The stories told by health workers from Syria were heartbreaking.

They spoke of making desperate attempts to save people injured in a chemical attack on a hospital… of struggling to save people’s eyesight after they were hit in the face by shrapnel and rocks… of delivering babies, only to have them die later because they needed crucial medicines that were not available because of war conditions.

These were some of the experiences described by two Syrian doctors and a hospital administrator from the war-torn city of Aleppo at a March 20, 2017 talk at Harvard T.H. Chan School of Public Health. The trio had traveled to Boston to request training for medical students and other volunteers who are helping with the sick and wounded in Syria, and to recruit nurses, midwives, specialists, and other volunteers to help rebuild the country’s fractured healthcare system.

The program, held in Kresge G1, was sponsored by the School’s FXB Center for Health and Human Rights and the Syrian American Medical Society (SAMS), a nonprofit, non-political organization representing Syrian-American medical professionals in the United States that provides humanitarian assistance to Syrians.

“Many times we had to choose which patient to treat and which to leave to die,” said one of the panelists, a hospital administrator who had directed a large trauma facility in Aleppo that was a frequent target of airstrikes and artillery shelling. (He and his colleagues did not want their names used because of safety concerns.) He was among the last medical staff to remain in Aleppo during the siege of the city by Syrian government forces last November and among the last to leave the city when a temporary ceasefire occurred in December so that civilians and others could be evacuated.

“We want to train a new generation of doctors for Syria,” said Mahmoud Hariri, who is part of the Harvard Scholars at Risk program (see a profile in the Harvard Gazette) and is being hosted by Harvard Chan School and the Harvard Humanitarian Initiative. He hopes American universities can help provide courses in Syria and in nearby countries and help aid workers learn new ways to provide care in wartime conditions.

Jennifer Leaning, François-Xavier Bagnoud Professor of the Practice of Health and Human Rights and director of the FXB Center, provided background on the six-year-old Syrian conflict, which grew out of a popular uprising quashed by President Bashar al-Assad. By February 2016, the war had claimed at least 470,000 lives, according to a report by the nonprofit Syrian Center for Policy Research, and spawned a refugee crisis described in 2014 by the United Nations High Commissioner for Refugees as the biggest humanitarian emergency of our era. During the conflict tens of thousands of health care workers have fled and an estimated 900 have been killed, said Leaning. Medical students and others have stepped in to help but lack training, she said.

A March 14, 2017 paper by the Lancet-American University of Beirut (AUB) Commission on Syria, which Leaning co-chairs, suggests that the Syrian regime is deliberately targeting health workers and facilities as a weapon of war—a serious violation of humanitarian law. (For more on this topic, read a Harvard Public Health magazine profile of pediatrician Annie Sparrow, MPH’04, who trains Syrian health workers.)

The speakers showed heart-wrenching photos and video footage from the conflict and described what it was like to provide medical care under fire in Aleppo last fall, when many of their colleagues fled or were injured or killed. One speaker, who was a hospital director, the only ophthalmologist remaining in East Aleppo, and one of several doctors who helped arrange the medical evacuations of the city, said that during 200 operations on patients with facial injuries, he had to remove 50 eyes.

Another panelist, who by December had become the last remaining female obstetrician/gynecologist in East Aleppo, said that after the midwives she relied upon had fled or died, she quickly had to train nurses to step into the role. Like the other doctors, she said she is eager to return to her country in a few weeks. “I miss my country. They need us there. It’s our duty. If I save one baby, it will be worth it,” she said.

Marge Dwyer is Media Relations Manager in the Office of External Relations for the Harvard T.H. Chan School of Public Health.

This story originally appeared on the Harvard T.H. Chan School of Public Health website.

photo: 2012 Aleppo surgery by Scott Bobb for Voice of America, in public domain