In besieged eastern Aleppo, where the few remaining hospitals are already overwhelmed by huge numbers of wounded patients, even reaching health facilities is now a deadly gamble. Repeated attacks on emergency responders and first-aid providers have left the region's ambulance services in shambles, with just 11 working ambulances remaining for a population of 250,000 people.
"Not only have hospitals been hit at least 23 times since the siege started in July, but ambulances that transport the wounded are being hit too," said Carlos Francisco, MSF head of mission for Syria. "And only today a health clinic in eastern Aleppo supported by MSF was also damaged by bombing. It’s a reminder of how the rules of war are continuously being violated in Syria."
From September 23 to October 8, hospitals in eastern Aleppo received at least 1,384 wounded patients, an average of 86 per day, according to the Directorate of Health. But reaching the wounded is becoming increasingly difficult. Five ambulances received direct hits from bombs in the past month and two were completely destroyed. Drivers and first-aid providers were also injured in the attacks, two of them severely, according to eastern Aleppo’s ambulance system, which is managed by the Directorate of Health.
Medical organizations in Aleppo report that "double-tap" strikes happen on a regular basis. "Once rescue teams reach the area, warplanes hit the same spot for the second time, which leads to higher numbers of wounded and killed, and more ambulances damaged," said Ahmad Sweid, ambulance system manager. "We are losing trained staff and vehicles. At the same time, the siege prevents us from bringing in replacement parts for our ambulances." As intense bombing continues, the condition of the roads is also deteriorating rapidly, forcing drivers to make constant detours.
Warring Parties Must Facilitate and Allow Evacuation of the Wounded
"Once we were trying to rescue people from a building when we were caught in a second strike," said Hasan Al Humsi, an ambulance driver who was slightly injured in the attack. "Luckily we came out fine. Our spirit to carry out our job is what allows us to rescue women and children."
"The whole world is witnessing the suffering of eastern Aleppo, a population trapped in a bloody battle without any chance to escape," said Pablo Marco, MSF operational manager for the Middle East. "Syria and Russia must stop the indiscriminate bombing of the city. All warring parties must facilitate and allow the evacuation of the severely wounded and sick."
The ambulance system run by the Directorate of Health in eastern Aleppo is staffed by a team of 35 drivers and first-aid providers. A number of other smaller services run by volunteers and nongovernmental organizations also facilitate emergency transport of wounded people.
MSF supports eight hospitals in eastern Aleppo, runs six medical facilities across northern Syria, and supports more than 150 health centers and hospitals across the country, many of them in besieged areas.