In Syria, doctors are dying before they can save lives

Health care is being hampered by those involved in the conflict because of the Assad regime’s willingness to target doctors and hospitals.

People in Syria have become proficient in gazing at the sky. It’s not clouds or stars they are looking out for but government fighter jets. One recent afternoon, we were standing outside a field hospital in northern Syria, close to an area captured by the Free Syrian Army. The momentary shimmer of silver as a wing caught the sun pinpointed a plane in the vast blue sky. A finger tracked it while the rest of us squinted into the sun. Up there, a pilot was looking for his target.
 
“It’s doing a wider circle so maybe it’s not coming for us,” one of the doctors explained. Nonetheless, we were hurried inside.
 
Crowds attract air strikes and so do hospitals. I have recently returned from working with the NGO Hand in Hand for Syria, as its work was being filmed for a BBC Panorama. It proved to be one of the most challenging medical environments I have ever worked in.
 
The Independent International Commission of Inquiry on Syria (ICIS) recently published a report that concluded that health care is being hampered by those involved in the conflict because of the Assad regime’s willingness to target doctors and hospitals. It described such practices as a “weapon of war”.
 
A hospital to which I had earlier transferred a gunshot patient was hit by an air strike in which six people were killed – one of them a doctor. Ali, a medical student working there, lived next door to the hospital. His family was building a bunker because of the persistent air strikes.
 
The ICIS report also contains harrowing accounts of torture taking place within medical facilities. It describes testimonies of alarming patient treatment, including children being subjected to torture that exploits pre-existing injuries at al-Mezzeh military hospital in Damascus.
 
An open letter published in the Lancet on 21 September, signed by 55 prominent doctors from 25 countries, outlines the “deliberate and systemic” targeting of medical personnel and facilities without respect for staff’s professional neutrality.
 
Dr Omar Arnous, who is 33, was arrested on 6 October 2012 after he ignored warnings from government forces to stop treating the war wounded in Rural Damascus province. He remains in detention, his exact whereabouts unknown.
 
The Lancet letter states that 469 health workers are being detained. Up to 15,000 doctors have fled the country, leaving a hugely reduced health-care infrastructure in place to deal with medical conditions that range from complex war trauma to deteriorating chronic illnesses.
 
The letter explains that 37 per cent of Syrian hospitals have been destroyed, and has prompted support via Twitter from both David Cameron and William Hague. Pledges have been made to raise the issue at the UN General Assembly.
 
A repeated tactic in Syria, breathtaking in its cruelty, is to target health-care workers as they enter an area following an air strike.
 
Dr Isa Abdur Rahman, a British medical volunteer working at a field hospital in Idlib province, was killed in May as he ran out of a hospital to retrieve casualties. He was hit by a second, waiting strike.
 
Chemical weapons are central to the intervention debate but other lethal weapons are being used by the regime in civilian urban areas.
 
A few weeks ago, a nearby school was hit by a napalm-like bomb causing mass casualties. Forty students were severely burned, three of them fatally.
 
I first came to Syria in December 2o12 to meet medical professionals working in defiance of the obstacles placed in front of them. A week before my arrival, a missile had hit outside the perimeter of our hospital, killing one person. After that, we slept fully clothed, prepared to evacuate in the middle of the night should there be another air strike.
 
Nine months later, the pressure of working in possibly the world’s most dangerous places for a doctor is taking its toll. Health-care workers and the injured are protected entities under international humanitarian law – but in Syria they are deemed highvalue targets.
 
As we tended to our burns patients, with limited resources and personnel, four members of staff collapsed and needed attention. Traumatised and exhausted, they run a high risk of burnout.
 
The ICIS report states that “government forces have abused the vulnerable, the wounded and the sick, exploiting their need for medical aid to further military aims”, and it describes intentional attacks against hospitals as a war crime.
 
But at the moment all that makes little difference to those in the direct line of fire.
 
Saleyha Ahsan is a practising accident and emergency doctor at a hospital in London
Smoke rises from buildings in Syria's eastern town of Deir Ezzor on August 13, 2013 following an airstrike by government forces. Image: Getty

This article first appeared in the 30 September 2013 issue of the New Statesman, The Tory Game of Thrones

Photo: Pablo via Creative Commons
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Is Lithuania still homophobic? My girlfriend and I held hands to find out

The Lonely Planet guide warned that for gay and lesbian travelers, "small displays of public affection can provoke some nasty responses".

It’s midnight somewhere on the greyish outskirts of Vilnius, and my girlfriend has just burst out laughing. Our Uber driver starts laughing too. Nonplussed, I scan the oppressively functional Soviet-era architecture we’re driving past for literally anything funny.

Then I see them. A series of panels above the stairway to a basement bar; photos of topless blonde men with glistening six packs. This is – as is usually the case – either a tribute to the most homoerotic scenes in Leni Riefenstahl’s Triumph of the Will, or something deliberately gay. And 99 out of 100 it’s the latter, this being no exception.

Soho Club is the most out-of-context gay venue I’ve ever seen. It sits on a poorly lit street on the edge of Lithuania’s capital, almost as if it’s been plucked out of the city centre and dumped there.

Given the staunchly Catholic and formerly communist Baltic state’s uneasy relationship with its LGBTQ community, this wouldn’t be particularly surprising.

According to the Lonely Planet guide to the Baltic States for gay and lesbian travelers, "small displays of public affection can provoke some nasty responses".

Homosexuality was only decriminalised here in 1993. And, any legislative victories aside, a 2009 poll found that attitudes amongst the population were much the same as the pre-1993 days. Eight in ten respondents considered homosexuality to be anywhere between a perversion and a disease. 

Such a gay-hostile place probably seems like an odd choice for a romantic getaway with my girlfriend, on my birthday weekend. Then again an itinerary like ours, which includes a visit to the both the Museum of the Victims of Genocide, and the Holocaust exhibition at the Jewish museum, is hardly "gondola ride in Venice" or "Eiffel Tower at sunset". This is a stark, ex-Soviet, mostly-raining introduction to being gay outside of the liberal London bubble. Which is to say: dreamy.

Having said that, Vilnius’s cobbled old town is beautiful and, compared to other more mainstream Eastern European capitals, decidedly less stag night-y. Same-sex couples, it turns out, can be drawn to a city for features other than its queer nightlife. 

On the short walk from Vilnius’s central train station to our Airbnb, we passed a mural of Donald Trump smoking a spliff and giving Vladimir Putin blowback. A definite tribute to the gay kiss between the USSR's Brezhnev and East Germany's Honecker depicted on the Berlin Wall.

It was hard to tell what this said about the area’s attitude towards queers, but it was on the side of a bar that’s blasting out Black Lips and full of Lithuanian hipsters in their twenties. Say what you like about hipsters, they are not known for gay-hate. It was difficult to imagine anyone in there giving much of a shit about our sexuality.

At the Airbnb, we were greeted by one such Lithuanian hipster. She was about 20 and seemed a little nervous speaking to us, even though her English was near fluent.

The flat – an immaculate new build – was decked out in Ikea classics. Like the bar with the homoerotic Trump/Putin mural, anywhere with a Malm just seems to radiate gay-friendliness. It’s both sterile and PC. Like the Lib Dems, or a free sachet of lube.

Our host gave us a brief lesson in how to work the flat, before saying a polite goodbye. We’d just started unpacking when there was a knock on the door. It turned out the host had done a 180.

"One last thing," she said, "Do you need an extra duvet, or are you… sharing the bed?"

OH GOD, I thought. This is it. This is the kind of shit you read about. You never do read about anything good.

"Yeah, we’re sharing," I said, feeling both – I hate to say – embarrassed about being in a same-sex relationship, and embarrassed about being embarrassed about being in a same-sex relationship.

"OK, cool. No questions!" said the host, before disappearing into the afternoon at the speed of sound.

"No questions," I repeated, "Hmm."

Just to be clear, no, this wasn’t exactly a hate crime. I’m also reluctant to judge a 20-year-old from a very religious country for – well – judging us. And anyway, maybe "no questions" meant "no judgment". Who am I to… judge?

We’d been in Lithuania for about an hour before my girlfriend and I decided to really test the water and hold hands in the street. Mostly, we were starting to wonder if we were being xenophobic by assuming Lithuanians were probably homophobic.

This, I suppose, is the point at which bigotry really starts to eat itself. Unfortunately though, almost the moment we held hands, a group of...shaven headed individuals, who wouldn’t look out of place in a modern day pogrom, walked past, staring us down as if we’d stopped there for a spot of mid-street fisting.

I made brief eye contact with one of them as I let go of my girlfriend’s hand as fast as a bottle of water at airport security.

"Oh," I said to her, when – as far as we knew – Vilnius’s only out homophobes were at a safe distance. "Yeah…" she said.

There are parts of the world – Uganda, Russia and, most recently, Chechnya –  where both socially and legislatively speaking, things are actually getting worse for queer people. But, the overarching narrative is "it gets better". Visiting anywhere with less good attitudes towards The Gays than I’m used to feels like a step back in time.

I wonder, in terms of acceptance of, say, two women holding hands, which decade in London is reflected in 2017 Vilnius. The 80s? The 70s? I’ve only been gay in London since 1989. And back then – as far as I know – I wasn’t a particularly dykey baby. 

So began a weekend-long game of political PDA. We walked through the cobbled streets of the old town, admiring baroque churches and wondering if we were allowed to be a couple near them.

Without a strict set of rules, every stranger’s glance is open to interpretation. My interpretation being, "Let’s just not make a scene, OK?", my girlfriend’s interpretation being, "Stop being paranoid and xenophobic. No one cares."

In the evening, as we sat in a busy restaurant eating zeppelins (remarkably dense Lithuanian potato dumplings, not airships) we spotted – lo and behold – what we (homophobically?) thought might be another gay couple.

Two men in their twenties stood waiting for a table. They had professionally shaped eyebrows. One of them had earrings. In Nineties terms, they were gay as fuck. At a dumpling joint in Vilnius, at ten at night, who the hell knows? And, more to the point, why the hell should they care? Well, when your relationship has been reduced – via queer invisibility – to a handholding battle, you’re kind of desperate to find another same-sex couple.

"Are they…" I said.

"They must be," she said.

"Should we…?"

"NO."

I’m not even too sure what I was asking we "should" do (speak to them? Buy them drinks? Demand a gay tour of Vilnius?), or why I was shut down without finishing my sentence. Whatever we should or shouldn’t have done, we didn’t.

But back to Soho Club. The car stops and we leave behind our bewildered and slightly too amused Uber driver. Tentatively, as if approaching an ancient Egyptian tomb by lamplight, we walk down the stairs past the muscle man panels.

The complete silence – not even interrupted by passing traffic – doesn’t exactly say "buzzing" or… "Soho". Inevitably, almost, the bar is closed. In fact, it’s arguably the most closed bar I’ve ever seen. We’ve turned up, ready to party with Lithuania’s finest gays, at a giant lead box. What’s more, we look around us and realise we’ve strayed into Murder Town.

On our way to the nearest bus stop, we pass a life-size fiberglass cow devoid of any explanation, and a lit-up poster that looks startlingly like an ad for dead babies. The streets get wider and desolate-er until we’re at a petrol station, holding hands out of pure fear. On my part at least. If this is Vilnius’s gay scene, I’d like to give it some kudos at least for quite strongly resembling a David Lynch film.

Having somehow not been sawn into pieces and turned into outsider art, we find ourselves back at Vilnius airport the next day. While idly internetting on her phone, my girlfriend notices our Airbnb host has reviewed us as guests.

"Leonore and her friend are very friendly people!" she wrote.

In all fairness, I have shared beds in Airbnbs with friends. And whether or not someone is tiptoeing around my sexuality like a puddle of something that may or may not be wee, it’s always nice to be considered friendly. And to have "friends".

Eleanor Margolis is a freelance journalist, whose "Lez Miserable" column appears weekly on the New Statesman website.

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