Intensified airstrikes targeting Islamic State in Syria take heavy toll on civilians

MSF is concerned that the conduct of hostilities may violate the basic rules of war

A patient injured by an airstrike in the al-Dashisha area, in northeast Syria, receives treatment at an MSF hospital in Hassakeh governorate. The airstrike killed 14 other people.
SYRIA 2018 © Cecile Arondel/MSF
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A surge in airstrikes against the Islamic State group in northeast Syria’s Hassakeh and Deir ez-Zor governorates is resulting in increasing numbers of war-wounded patients at the Hassakeh hospital supported by Doctors Without Borders/Médecins Sans Frontières (MSF). There are multiple parties involved in the air war targeting IS in the region, including the United States, Iraq, Russia, and Syria.

“Unknown to many, northeast Syria is still a battlefield,” said Olivier Antonin, MSF head of mission in Syria. “After a period of relative quiet, airstrikes have recently intensified. And based on what we hear from patients who arrive at our hospital in Hassakeh, we are concerned that the conduct of hostilities might be in violation of the basic rules of war. We hear that civilians and homes are being hit incessantly. It’s outrageous that a strategy supposed to bring peace and stability is causing so much suffering and bloodshed."

From June 4 to 14, the hospital in Hassakeh received 17 people injured by airstrikes, including six children and three women. All of them had been inside or near their homes when the airstrikes hit. By contrast, MSF received seven people injured by airstrikes over the previous six months, from January to June 2018. 

“First [the bombing] was around the school we were living in, so we ran out to our neighbors’ house,” recalled a patient who was treated at the hospital. “There were several children [and] old and handicapped people. I was trying to take the kids outside so the plane would see them and realize we were civilians. They attacked us anyway. Fourteen people got killed, including four children, three women, and two elderly men. Eight people got wounded, but one died on our way to [the hospital].”

Manal* arrived at the hospital with her injured sister. “If you had seen our dead children . . . one was cut in half,” said Manal. “Another one had the heart out of the body. No legs or arms . . . burned corpses . . . we could not even bury them.”

Many people travel for hours to reach Hassakeh hospital. The shifting front lines between clashing armed groups can turn what should be a one-hour journey into a six-hour trek, as people often must take detours and travel through rural parts of Deir ez-Zor governorate to avoid checkpoints. What’s more, the few remaining and functioning health centers in the region are either private and very expensive or lack specialized teams able to deal with the complex injuries caused by airstrikes. 

Manal and her sister came from al-Dashisha, near the Iraqi border and about two-and-a-half hours from the hospital. “There are no doctors in al-Dashisha,” Manal said. “There are only pharmacists who can do [wound] dressings and sell medicines.”

Khaled is taking care of his 20-year-old nephew, who was injured in the Al-Bukamal area. Reaching care was difficult. “After six or seven hours of travel [in a relative’s vehicle] we reached a [private] clinic in Shaeil,” he said. “The journey was long because we cannot go directly from our village … we have to go through the desert.”


*All names have been changed for security reasons at the request of the patients and caretakers.