A doctor's letter from the besieged Syrian city of Homs

A Syrian surgeon describes his struggles to treat the wounded in Homs and calls on the international community to intervene.

I am a doctor working under siege in Homs, performing surgical operations in a basic hospital set up in an underground basement. The conditions in this field hospital are very bad, and it is especially hard to keep the hospital sterile. We have only basic surgical equipment and expired anaesthetic medication to treat the wounded. Patients who need blood transfusions are given blood directly from donors, and it is transfused without medical screening.

It has been five hundred days since a siege was imposed on Homs by Assad’s forces. Over 500,000 people have fled or died, but 3,000 people are still living here. Among the 400 families still here, most of the remaining family members are women, children and old people, and the injured who cannot move. These thousands of women, children, elderly and wounded survivors of this war are being denied access to the basic necessities of life.

For the past year and a half, this has been our life here: we have to drink from polluted wells and wash in sewage water. Food is restricted to lentils and bulgur wheat, and has been for months. There is no flour or milk or any kind of meat because of this siege.

We eat leaves and rotten rice. We have had no electricity for 500 days. We don't even have baby milk due to the siege. I see babies’ mothers who cannot breastfeed them due to stress and malnutrition: infants who should be healthy are starving and dying.

As for my job as a surgeon, we must transport patients through gaps in the walls across the neighbourhood because there are snipers outside. People move between neighbourhoods through underground tunnels. Many of the injured have died because it has been impossible to reach them. Our small medical facilities are frequently targeted, which has forced us to move our operations many times. 

Of the patients we see and treat, many initially improve after surgery but then die a slow death during recovery because of poor nutrition and the lack of serums to keep them hydrated. Those who do survive often experience poor wound healing as a result of medical shortages. 

Homs, my city, was one of the first places in Syria that hosted a UN delegation before the siege. The people of Homs gave them their best hospitality. My people stood in the streets risking their lives, all to get their voice heard. They are still waiting, five hundred days later.

We need to get this important message out and call upon the world’s media, the UN, NGOs and politicians to help break this slow killer, this inhuman siege. If you keep Assad in place, do not bother about withdrawing chemical weapons because at least, given the alternatives I see, it is a merciful way to die.

Please help us. Get us the deliveries of food and medicine that we need to survive, this is our basic human right. Does anyone hear the screams of women and children or feel the pain of the injured? Your brothers and sisters in the besieged neighbourhoods of Homs are right now screaming for your help. I hear them all the time. Isn't there any reply?

Dr Mosab is a surgeon in Homs. We have not used his full name to protect his identity.

 

The Syrian flag flying next to destruction in the Baba Amr neighbourhood of Homs in May 2012. Photo: Getty.
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Qatar is determined to stand up to its Gulf neighbours – but at what price?

The tensions date back to the maverick rule of Hamad bin Khalifa al-Thani.

For much of the two decades plus since Hamad bin Khalifa al-Thani deposed his father to become emir of Qatar, the tiny gas-rich emirate’s foreign policy has been built around two guiding principles: differentiating itself from its Gulf neighbours, particularly the regional Arab hegemon Saudi Arabia, and insulating itself from Saudi influence. Over the past two months, Hamad’s strategy has been put to the test. From a Qatari perspective it has paid off. But at what cost?

When Hamad became emir in 1995, he instantly ruffled feathers. He walked out of a meeting of the Gulf Cooperation Council (GCC) because, he believed, Saudi Arabia had jumped the queue to take on the council’s rotating presidency. Hamad also spurned the offer of mediation from the then-President of the United Arab Emirates (UAE) Sheikh Zayed bin Sultan al-Nahyan. This further angered his neighbours, who began making public overtures towards Khalifa, the deposed emir, who was soon in Abu Dhabi and promising a swift return to power in Doha. In 1996, Hamad accused Saudi Arabia, Bahrain and the UAE of sponsoring a coup attempt against Hamad, bringing GCC relations to a then-all-time low.

Read more: How to end the stand off in the Gulf

The spat was ultimately resolved, as were a series of border and territory disputes between Qatar, Bahrain and Saudi Arabia, but mistrust of Hamad - and vice versa - has lingered ever since. As crown prince, Hamad and his key ally Hamad bin Jassim al-Thani had pushed for Qatar to throw off what they saw as the yoke of Saudi dominance in the Gulf, in part by developing the country’s huge gas reserves and exporting liquefied gas on ships, rather than through pipelines that ran through neighbouring states. Doing so freed Qatar from the influence of the Organisation of Petroleum Exporting Countries, the Saudi-dominated oil cartel which sets oil output levels and tries to set oil market prices, but does not have a say on gas production. It also helped the country avoid entering into a mooted GCC-wide gas network that would have seen its neighbours control transport links or dictate the – likely low - price for its main natural resource.

Qatar has since become the richest per-capita country in the world. Hamad invested the windfall in soft power, building the Al Jazeera media network and spending freely in developing and conflict-afflicted countries. By developing its gas resources in joint venture with Western firms including the US’s Exxon Mobil and France’s Total, it has created important relationships with senior officials in those countries. Its decision to house a major US military base – the Al Udeid facility is the largest American base in the Middle East, and is crucial to US military efforts in Iraq, Syria and Afghanistan – Qatar has made itself an important partner to a major Western power. Turkey, a regional ally, has also built a military base in Qatar.

Hamad and Hamad bin Jassem also worked to place themselves as mediators in a range of conflicts in Sudan, Somalia and Yemen and beyond, and as a base for exiled dissidents. They sold Qatar as a promoter of dialogue and tolerance, although there is an open question as to whether this attitude extends to Qatar itself. The country, much like its neighbours, is still an absolute monarchy in which there is little in the way of real free speech or space for dissent. Qatar’s critics, meanwhile, argue that its claims to promote human rights and free speech really boil down to an attempt to empower the Muslim Brotherhood. Doha funded Muslim Brotherhood-linked groups during and after the Arab Spring uprisings of 2011, while Al Jazeera cheerleaded protest movements, much to the chagrin of Qatar's neighbours. They see the group as a powerful threat to their dynastic rule and argue that the Brotherhood is a “gateway drug” to jihadism. In 2013,  after Western allies became concerned that Qatar had inadvertently funded jihadist groups in Libya and Syria, Hamad was forced to step down in favour of his son Tamim. Soon, Tamim came under pressure from Qatar’s neighbours to rein in his father’s maverick policies.

Today, Qatar has a high degree of economic independence from its neighbours and powerful friends abroad. Officials in Doha reckon that this should be enough to stave off the advances of the “Quad” of countries – Bahrain, Egypt, Saudi Arabia and the UAE - that have been trying to isolate the emirate since June. They have been doing this by cutting off diplomatic and trade ties, and labelling Qatar a state sponsor of terror groups. For the Quad, the aim is to end what it sees as Qatar’s disruptive presence in the region. For officials in Doha, it is an attempt to impinge on the country’s sovereignty and turn Qatar into a vassal state. So far, the strategies put in place by Hamad to insure Qatar from regional pressure have paid off. But how long can this last?

Qatar’s Western allies are also Saudi Arabia and the UAE’s. Thus far, they have been paralysed by indecision over the standoff, and after failed mediation attempts have decided to leave the task of resolving what they see as a “family affair” to the Emir of Kuwait, Sabah al-Sabah. As long as the Quad limits itself to economic and diplomatic attacks, they are unlikely to pick a side. It is by no means clear they would side with Doha in a pinch (President Trump, in defiance of the US foreign policy establishment, has made his feelings clear on the issue). Although accusations that Qatar sponsors extremists are no more true than similar charges made against Saudi Arabia or Kuwait – sympathetic local populations and lax banking regulations tend to be the major issue – few Western politicians want to be seen backing an ally, that in turn many diplomats see as backing multiple horses.

Meanwhile, although Qatar is a rich country, the standoff is hurting its economy. Reuters reports that there are concerns that the country’s massive $300bn in foreign assets might not be as liquid as many assume. This means that although it has plenty of money abroad, it could face a cash crunch if the crisis rolls on.

Qatar might not like its neighbours, but it can’t simply cut itself off from the Gulf and float on to a new location. At some point, there will need to be a resolution. But with the Quad seemingly happy with the current status quo, and Hamad’s insurance policies paying off, a solution looks some way off.