November 30, 2017

Six weeks after Raqqa was retaken from the so-called Islamic State, former residents of the Syrian city and its surrounding areas are returning to find their homes in ruins and their streets and fields littered with the dangerous remnants of war, including booby traps, landmines, ammunition, and rockets. From November 19 to 28, 49 patients with blast injuries arrived at the Médecins Sans Frontières/Doctors Without Borders (MSF) clinic in a neighborhood in eastern Raqqa.

“When we first visited the Al Meshlab neighborhood, it was pretty much deserted. But on our latest visit, people were returning slowly to check on their houses,” says Craig Kenzie, leader of MSF’s Raqqa emergency response team. “Some have found their homes in ruins; others have found dead bodies and explosives in their houses, gardens, and streets. Everyone fears setting off booby traps when entering buildings or stepping on something that may explode.”

People with critical injuries face immense difficulties accessing adequate stabilization and trauma care. With many roads damaged or blocked, it can take up to two hours by ambulance to reach the nearest functioning hospital with surgical capacity. As a result, people with significant injuries are at risk of dying before or during the journey.

An Impossible Choice

Since the fighting drew to an end in Raqqa in mid-October, MSF teams in Tal Abyad hospital—the nearest hospital with surgical capacity to the city—have treated more than 85 patients with blast injuries. In that same period, MSF teams in nearby Kobane hospital treated 23 more.  

“People we met in Al Meshlab told us that they had fled the neighborhood months ago, as airstrikes increased and the fighting intensified,” says Kenzie. “Some were forced out when their houses were used as fighting positions. They have bullet marks, shattered windows, and holes from explosions. The streets are full of rubbish and personal belongings. Many buildings have been ransacked and there are numerous roads blocked with burnt-out cars.”

In addition to the destruction, the remnants of the conflict pose a serious threat to returning residents. “There are all kinds of explosive devices amongst the rubble,” says Kenzie. “The fighting may have stopped, but people are still getting wounded. It’s devastating to see people who have experienced fighting, insecurity, and displacement—who have already lost so much—still at risk of injury and death. They face an almost impossible choice: either stay on uncertainly in temporary shelters, often shared with many other families, or return to their own houses in Raqqa. Those who return have to accept the risks and challenges of living in a recent battleground, surrounded by explosives. Educating people about mines can increase their awareness of the dangers and help them weigh up this difficult choice.”

“Living in Your Own Damaged House is Better Than Living in a Tent”

Despite the risks, many former residents are returning. “I came back two days ago to find my house had been badly damaged,” said a 45-year-old woman from the Raqqa area. “I tried to at least get rid of the rubble before bringing the rest of the family back. We still need to rebuild our house, but living in your own damaged house is better than living in a tent, even when the temperature drops below zero and there’s no roof over your head.”

“Two airstrikes hit our house,” said a 28-year-old man. “It’s going to take us months to rebuild it. We have babies in the family and we can’t make them live in these conditions.”

“I heard that my house had been hit, but I didn’t know it was destroyed,” said a 33-year-old man. “I came back yesterday to find that all that’s left is rubble. I can’t afford to rebuild it, so I’ll carry on living in a tent until I can find a way to build my house again.”

Returning residents are doing their best to make Al Meshlab habitable again, says Kenzie. “We see people and families returning every day here, starting the enormous job of cleaning up, helping each other to remove the rubble and the barricades of piled-up earth from in front of their doors left over from the street fighting. Our medical teams are ready to respond to the surgical needs of people with catastrophic and life-threatening injuries.”  

But Al Meshlab is just one of many neighborhoods across Raqqa governorate that need to be made safe and rebuilt so that people can return home without risking their lives. The active fighting in this part of Syria may be over, but the health and humanitarian consequences are likely to be felt for years to come.

More from Syria: Bombing and Shelling in East Ghouta Overwhelm Medical Services

MSF Activities in Raqqa Governorate

In Tal Abyad hospital, MSF supports trauma care, surgical services, and overall operations in partnership with local health authorities. For people around Raqqa who are injured or in need of emergency medical care, ambulances provide referral services to hospitals that supported by MSF in Kobane/Ain Al Arab and Tal Abyad.

MSF teams also work in advanced medical points in Hazima and Tabqa, in the north of Raqqa city, and in Al Meshlab, in the east. In Tabqa, MSF also provides mental health care and physiotherapy.

MSF vaccination teams work across Raqqa governorate, including in the Ain Issa camp for internally displaced people. MSF also runs an outpatient department in Ain Issa and provides nutrition support for infants and children under five years old, physiotherapy, and health promotion activities.

In Kobane hospital, MSF supports the emergency room, intensive care unit, general hospital surgical unit, maternal health unit, and a community mental health center, as well as six clinics in the district.

Read More: Syria: “Nobody Cared About the Civilians” During Raqqa Offensive

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