May 04, 2012

Testimonies from Syrian patients and doctors point to a coordinated crackdown on the provision of urgent medical care for people wounded in the ongoing violence.

Syria 2012 © MSF

Syrian patients treated by MSF. Screen capture. Patients syriens traites par MSF.

While Doctors Without Borders/Médecins Sans Frontières (MSF) has been unable to work directly in Syria it has collected testimonies from wounded patients treated outside the country and from doctors inside Syria. The testimonies, which come from people hailing from various parts of the country, point to a coordinated crackdown on the provision of urgent medical care for people wounded in the ongoing violence.

Patient 1: 29-year-old male

In the situation that we have in Syria, you cannot go to a hospital, because if you do, they either amputate the limb that you are suffering from or they take you to prison.

I was detained twice and what we saw is that some of those in prison are left to have their wounds rot. Their injuries rotted and they were not taken to hospital. Some died next to me, while others were urinating blood from the internal bleeding they were suffering from.

And no organizations or doctors or MSF are allowed to go into prison. The field hospital [is normally in someone’s house, moving from one house to another]. There were no ambulances; any ambulance was targeted and shot at. And the doctors who are brave enough are also watched or arrested, or they rape his wife in order to prevent him from taking any action. Or they place them under house arrest.

Patient 2: 34-year-old male

I was detained during a demonstration against the president…. They beat me badly, to the point that I was about to faint... After that, they covered my eyes and spread my arms and tied them (like a crucifix), and they taped something to my hand. I didn’t know what it was but later found out that it was an electric detonator.

They put up some sort of a shield and they blew it up. Within less than a minute, I felt something warm on my feet. It was my blood. I was bleeding heavily and I lost consciousness. 

I woke up in the hospital, I wasn’t totally conscious, but my friends found out I was there. They kidnapped me from hospital and took me to a house, and they brought doctors who came and treated me in that house. 

In detention: they curse and insult and were constantly beating us and they tie up people’s arms like [they’re on a] crucifix. Some guys were subject to the removal of their fingernails. Others were flogged, and there are others who had their backs broken….

Patient 3: 24-year-old male

We were in a peaceful demonstration and were demanding reforms. They started firing tear gas bombs, and shrapnel hit me in the chest… so the guys carried us and took us to a mosque.

I needed an operation, but I could not go to hospital because it was filled with security people. They used basic material for treatment, like bandaging and antibiotic pills. The security was surrounding all the hospitals and anyone who goes there will be detained. Now, the impact of the shrapnel hit my chest, where there is excessive tissue, but this tissue needed to be removed according to the doctor. [But] I have gone without treatment for seven months.

I was also detained. That happened on the twenty-seventh or twenty-eighth day of Ramadan. I went out after the Eid. Tortured? Yes. They took me at 1 a.m., and they kept beating me until 4 a.m.

No, there was no medical treatment in detention. We barely got food. There were 60 people in a room, some sleep standing up, others sitting down. Those who have their names called out go out, but we don’t know where to. After one or two hours they come back exhausted from the beatings and the torture. They put us in a yard and make us take off our clothes, and they spray us with water and they stand far or on top of a chair, and they electrocute the wet floor.

Doctor 1:

There were three kinds of cases. The first were those that could be treated in the clinic. This is mainly treatment of those injured by bullets fired by hunting rifles. This kind of rifle bullet produces a lot of shrapnel and a lot of shell wounds. Wound treatment, as well as treatment for broken bones like putting a cast on can also be done at the clinic—the simple stuff. 

There are the cold cases, like a bullet lodged in someone’s leg. This, we can keep the case for two or three days before we send them to hospital. And we coordinate with the hospital to remove the foreign object from the body in a clandestine way, because if we send someone to hospital and the security finds out, they will be detained. So for the cold case, we would sustain the wound, then under a false name or medical report make arrangements for the patients to be operated on in the hospitals. 

The third kind of case are the acute cases. With these, we have no other option but to take them to hospital, and it depends on luck if the patient is picked up by security or not. But all the info of the patient will be recorded by the security, like who treated him and how they were injured and all the details….

In public hospitals there is equipment and drugs, but the problem is up to 95 percent of the injured do not go to the public hospitals. They are often treated in a field hospital, where the people of that neighborhood agree on a certain house to place the wounded and decide what to do with them.… 

What we do is: the patient is taken to a house, then some people take the patient after they blindfold them to another location to be treated. Even the doctors do not know where these field hospitals are. They are also blindfolded and taken by the guys to treat the patients. Neither patient nor doctor knows where the field hospital is located. 

We try to prepare these field hospitals, but they do not have the proper standards. No proper ventilation, sterilization. We are using rooms in houses. So whatever you try to have, it will not fulfill the required requirements to carry out surgical operations. But this is the utmost that we can do.

Doctor 2:

Some of our people were detained. Some doctors are well known who have been in detention for months. [We have seen] different forms of injuries [including] bruises due to beating, electric shock, which led to the death. One case was electrocuted in the mouth and they kept electrocuting him until he died. I saw this…

A doctor now is considered more dangerous than those fighting with the [rebel group, Syrian] Free Army, and anyone caught with drugs in his possession, the charges against him are more grave than being accused with possession of weapons. The average person is normally taken for days or up to a week, but doctors are detained for months.

Doctor 3:

At the beginning, we used to go down to the street. Those who were shot in the head by snipers or the cases we know cannot be treated, we leave them or send them to the hospitals without their families….

Other cases, like shell wounds, are taken to the field hospital and are treated. We put them in a house and we visit them and monitor their injuries…. 

The first time there was violence, there were no ambulances. The second time, when the ambulances came, we sent them away because they can easily take all the injured and transport them to the security station, or security personnel can come out of it. So they are not safe. 

To take these patients to the public hospitals is impossible, not just because there are doctors and nurses working for the regime in these hospitals, but due to the fact that in each hospital there is a police unit and they are on the door, and they belong to the different branches of the security apparatus and they apprehend the injured.

Doctor 4:

But despite that risk, many doctors are putting their lives in danger in order to fulfill their medical oath.

Makeshift hospitals tend to be one or two rooms somewhere near a demonstration area. In addition to that, there’s all the security pressure and difficulty in reaching certain areas. Doctors who treat the wounded are also being harassed by security forces…. 

But despite that risk, many doctors are putting their lives in danger in order to fulfill their medical oath. It is difficult to find sterilized medical materials. Due to our limited means and the numbers of wounded, we have to resort to rudimentary medical practices….

Doctor 5:

In each region there is a medical team including doctors and nurses to take care of the wounded in that region. However, we cannot transport the sick from one region to another because the regions are isolated from each other. Each person is treated in his or her region, in his or her neighborhood…. 

In addition to the hospitals, we also have what we call emergency medical stations. There are more of these than the hospitals. Each region has one or two hospitals. There are more medical stations. They are installed in houses, in rooms inside the houses, and equipped with emergency medical equipment such as gauze, cotton, serum, the essentials…. 

The medical stations are mobile. They are different than the field hospitals. The items of equipment in the field hospitals are also mobile. We transport them from one area to another as much as possible…. We are people just like others. The situation is unacceptable. I got involved in this work from the first day. I can’t even imagine not being involved….

This is the reality. People are still dying in the streets. We can’t leave them.

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