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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With the Greek summer at an end, the refugee crisis is just beginning

Refugee camps are battling floods – and even arson. With each passing day, the chances of a fatal incident increase.

The Greek summer came to an abrupt end at the start of September. Nowhere was spared the storms or the floods. At the Katsikas refugee camp, near the north-western city of Ioannina, the effects were dramatic. The site, formerly a military airport, flooded. The gravel turned to mud, swamping the floors of tents that were completely unsuitable for this terrain or weather.

Hundreds of people were relocated to hotels in the city. Officials from the municipality and the UN High Commissioner for Refugees scrambled to find families suitable shelter. A former orphanage on the outskirts of the city was supposed to have been renovated to house the refugees, but bureaucracy has held up the work.

Autumn falls heavily in the western region of Epirus. The danger of refugees being caught outside is real.

“We all know that when the morning fog from the lake [of Ioannina] comes in, the tents will rot away,” Filipos Filios, a former mayor of the town and now the co-ordinator between the state and the charities in the region, tells me. “They [Europe] need to relocate 20,000 people from Greece. That would have solved pretty much all of our problems. Instead, they’ve taken 3,000.”

Around Epirus, the facilities available to refugees are in good shape. Empty civil-service buildings have been repurposed to host families or single people separately. Special measures are in place for Yazidi refugees, who are in danger from others in the camps. As at the other centres across Greece, however, the problems here are not organisational.

“We have 500 people living in tents with bathrooms available, grills and cleaners, with a fully stocked food storage space and doctors always present. There’s even a centre for creative activities for the children,” Filios says. “It’s the very existence of the camp, and the need for more like it, that is the difficulty.”

On 19 September, tents at the overcrowded Moria detention centre on the island of Lesbos were set on fire. False rumours had been circulating that large numbers of Afghans were about to be sent to Turkey. Four thousand people were evacuated and a night of anguish followed. Refugees slept on the streets and local people, who oppose the presence of the camp, seized the opportunity to attack refugees and activists.

The Greek far right, led by followers of the Golden Dawn party, is stirring up anti-refugee sentiment. Attacks on journalists on Lesbos and the nearby island of Chios have become more frequent. There is talk of vigilante-style citizen patrols around the camps, staffed by residents worried about their livelihoods.

During an anti-refugee demonstration in Chios on 14 September, Ioannis Stevis, the editor of the Astraparis news website, was attacked.

“No trouble had started when the representative of Golden Dawn attacked me,” he told me. “The invitation [to march] wasn’t from the far right, but the direction of the demo once there was very specific; they had the upper hand. Some who had gone in good faith left when they heard chants like ‘Greece of Christian Greeks’.”

The march in Chios took a nasty turn when extreme elements headed to the Vial refugee camp. There, they were confronted by riot police. The refugees also fought back, throwing stones at the marchers from inside the camp.

“There was no plan to attack the camp and not everybody followed that march,” Stevis says. “We have 3,700 people here in inadequate conditions, and there is some small-scale delinquency – we can’t hide that. But there are people who try to magnify that. There definitely is a desire for citizen patrols, and not just from the far right. Especially in the village near the camp, people want to organise without being [associated with the] far right.”

With every passing day, the chances of a fatal incident increase. It has become clear that the relocation programme, designed to distribute refugees proportionally across European Union member countries according to population, is not working. These refugees are now stuck in Greece. Mere dozens leave every month for other EU countries, and fewer still depart for Turkey.

The rumours that they will be sent back to the places they have fled are no longer just rumours. On 5 October the EU and Afghanistan announced an agreement to repatriate Afghans who have been turned down for asylum. EU data shows that in 2015, 213,000 Afghans arrived in Europe, and 176,900 of those claimed asylum. More than 50 per cent of these applications were rejected. Later, a leaked memo from the negotiations showed that Afghanistan was threatened with a reduction in aid if the country did not commit to accepting at least 80,000 returning refugees.

What does all of this mean in the camps? It is the most vulnerable refugees to whom we must look to understand.

At the Moria detention centre on Lesbos, four teenagers have been arrested for allegedly gang-raping an unaccompanied 16-year-old Pakistani boy. The actions of these children, who are perhaps the ones receiving the most direct support, expose how stretched and inadequate the system is.

Even for unaccompanied children, the focus of much international attention, conditions are terrible. Officials have been saying for months that the Moria camp, which has no private rooms or locks on its doors, is unsuitable for children. An activist there, who didn’t want to be named in order to protect their work, told me that they had witnessed a teenage girl being confined in the same space as 80 boys for weeks on end.

Back at the Katsikas camp, autumn is settling in. Rain, humidity and cold have replaced the warm summer days. There is word that this camp and the others like it might soon be evacuated permanently, though there is no hint where the people might go. If they are deported to the war-torn countries they have escaped, as the EU wishes, there is little to prevent them making the journey back here. They are desperate, and many are barely surviving. Yet the message from the EU governments is clear: we’re hoping they won’t make it. 

Yiannis Baboulias is a Greek investigative journalist. His work on politics, economics and Greece, appears in the New Statesman, Vice UK and others.

This article first appeared in the 13 October 2016 issue of the New Statesman, England’s revenge