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

The Alternative
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"I won't do this forever": meet Alternative leader, Uffe Elbæk – Denmark's Jeremy Corbyn

The Alternative party leader speaks frankly about his party's journey from being seen as a comedy sideshow to taking nine seats in the Danish elections.

In Britain, popular anti-politics sentiment has engulfed the Labour party, through Jeremy Corbyn. In Denmark's splintered, assorted political landscape, it has created a party called the Alternative. The barely two-year-old party was depicted as a comedic sideshow before June's elections. But with nine of 179 seats, they embarrassed all electoral predictions, including their own. Their rise owes to a growing European gripe with politics as usual, as well as to growing chasms within Danish politics.

"I don't want to do this forever. I want to be a pensioner, lay on a beach somewhere, write books and make money from speeches." Embracing his maverick figure, the 61-year-old witty, self-deprecating leader, Uffe Elbæk, has become one of the most resonant voices in Danish politics. As an ex-culture minister he was tarred by conflict of interest accusations leading to him to voluntarily step down as minister in 2012. He was later cleared of wrongdoing but the ridicule in the media stuck. His re-emergence in Danish politics is no longer trivial. His party has struck a match on a sentiment he claims is not European but international.

"What we see across Europe is a growing divide between politicians and their electorate. We are trying to bridge that divide and move from a representative democracy to a far more involving democracy. You see the same in the Scottish Referendum, in Syriza, in Podemos, in a way in Bernie Sanders and, of course, in Jeremy Corbyn".

In tandem with the rise of populist parties in Europe, they've capitalised on a discontent with mainstream politics, perceived spin and sound bite. In the last elections, the Alternative refused to directly persuade the electorate to vote for them, instead encouraging them to vote on their convictions.

“We are critical of the neoliberal doctrine from Thatcher and Reagan and growing inequality," explains Elbæk. "But I believe deeply in human potential and creating a more entrepreneurial, creative society based on progressive values".

The party decides its policies in what they call "political laboratories" where members and non-members are invited to share, hone, and develop policy ideas. The party is in many respects what it says on the tin. Despite flinching away from left and right political categories, they are staunchly pro-environment and pro-immigration.

"A lot of progressives do a lot of good things in the grassroots, but the reality is that few want to go into the big party machines." The Alternative has been a huge grassroots built campaign, attracting exactly those types of voters. It has gained over 6,000 members in its first two years, a remarkable feat as membership across Danish political parties steadily declines.

The party appeals to a desire, more prominent on the left of the Danish electorate, for a straight-talking, green party not overtly party political but reminiscent of conventionally Scandinavian values of tolerance and consensus. It is hawkish about whether socialist-inspired thinking is condusive to modern challenges, but similarly it believes in harnessing public support directly. They are a growing albeit slightly hippy and unconventional vehicle for political expression.

The migrant crisis has exposed chasms in Danish politics. Controversial proposals to advertise anti-refugee adverts, by integration minister Inger Støjberg, have sparked widespread concern. From across politics and from business, there has been a steady reel of expressed concern that Denmark risks creating a perception of intolerance to foreigners.

A private Danish group called People Reaching Out, published adverts in the same four Lebanese newspapers that ran the anti-refugee ads. Crowdfunding over £16,000, they replicated the original ads writing, "sorry for the hostility towards refugees expressed here. From people's to people's we wish to express our compassion and sympathy to anyone fleeing war and despair".

Michala Bendixen, who heads the campaign group, Refugee's Welcome, wrote an op-ed in The Daily Star, one of the Lebanese papers which carried the ad. She stated that, "the adverts give a completely distorted picture of the situation", clarifying that the Danish asylum process was amongst the fastest in Europe.

Støjberg's reforms to immigration and almost 50 per cent cuts to refugee benefits have made her a controversial figure but despite much criticism, topped a recent poll of ministers in the current government that voters felt were doing well. Largely on the back of a hardline position on immigration, the Danish People's Party won 21 per cent of the popular vote in this year's elections. Similarly to many countries across Europe, the migrant crisis has been emotive and polarising. On that divide, the Alternative has been categorical.

"In Denmark there is one thing happening in politics and another in the streets," says Elbæk. "There is a disgraceful lack of empathy from politicians but the reaction from the Danish people has been really touching. Suddenly we were seeing hundreds of refugees on our motorways, and it came as a reality shock to the Danish people. But they responded to it by offering shelter, food, water, and blankets."

Denmark's new government is hardening its position on immigrants and refugees. The split reaction reflects a more polarised terrain. There is a debate about what Denmark's values really are, and whether the migrant crisis betrays or protects them. Within it, the Alternative, partly motley, but with a non-trivial and rising electoral appeal, are an increasingly influential voice.