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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After Article 50 is triggered, what happens next?

The UK must prepare for years, if not decades, of negotiating. 

Back in June, when Europe woke to the news of Brexit, the response was muted. “When I first emerged from my haze to go to the European Parliament there was a big sign saying ‘We will miss you’, which was sweet,” Labour MEP Seb Dance remembered at a European Parliament event in London. “The German car industry said we don’t want any disruption of trade.”

But according to Dance – best known for holding up a “He’s Lying” sign behind Nigel Farage’s head – the mood has hardened with the passing months.

The UK is seen as demanding. The Prime Minister’s repeated refusal to guarantee EU citizens’ rights is viewed as toxic. The German car manufacturers now say the EU is more important than British trade. “I am afraid that bonhomie has evaporated,” Dance said. 

On 31 March the UK will trigger Article 50. Doing so will end our period of national soul-searching and begin the formal process of divorce. So what next?

The European Parliament will have its say

In the EU, just as in the UK, the European Parliament will not be the lead negotiator. But it is nevertheless very powerful, because MEPs can vote on the final Brexit deal, and wield, in effect, a veto.

The Parliament’s chief negotiator is Guy Verhofstadt, a committed European who has previously given Remoaners hope with a plan to offer them EU passports. Expect them to tune in en masse to watch when this idea is revived in April (it’s unlikely to succeed, but MEPs want to discuss the principle). 

After Article 50 is triggered, Dance expects MEPs to draw up a resolution setting out its red lines in the Brexit negotiations, and present this to the European Commission.

The European Commission will spearhead negotiations

Although the Parliament may provide the most drama, it is the European Commission, which manages the day-to-day business of the EU, which will lead negotiations. The EU’s chief negotiator is Michel Barnier. 

Barnier is a member of the pan-EU European People’s Party, like Jean-Claude Juncker and German Chancellor Angela Merkel. He has said of the negotiations: “We are ready. Keep calm and negotiate.”

This will be a “deal” of two halves

The Brexit divorce is expected to take 16 to 18 months from March (although this is simply guesswork), which could mean Britain officially Brexits at the start of 2019.

But here’s the thing. The divorce is likely to focus on settling up bills and – hopefully – agreeing a transitional arrangement. This is because the real deal that will shape Britain’s future outside the EU is the trade deal. And there’s no deadline on that. 

As Dance put it: “The duration of that trade agreement will exceed the life of the current Parliament, and might exceed the life of the next as well.”

The trade agreement may look a bit like Ceta

The European Parliament has just approved the Comprehensive Economic and Trade Agreement (Ceta) with Canada, a mammoth trade deal which has taken eight years to negotiate. 

One of the main stumbling points in trade deals is agreeing on similar regulatory standards. The UK currently shares regulations with the rest of the UK, so this should speed up the process.

But another obstacle is that national or regional parliaments can vote against a trade deal. In October, the rebellious Belgian region of Wallonia nearly destroyed Ceta. An EU-UK deal would be far more politically sensitive. 

The only way is forward

Lawyers working for the campaign group The People’s Challenge have argued that it will legally be possible for the UK Parliament to revoke Article 50 if the choice is between a terrible deal and no deal at all. 

But other constitutional experts think this is highly unlikely to work – unless a penitent Britain can persuade the rest of the EU to agree to turn back the clock. 

Davor Jancic, who lectures on EU law at Queen Mary University of London, believes Article 50 is irrevocable. 

Jeff King, a professor of law at University College London, is also doubtful, but has this kernel of hope for all the Remainers out there:

“No EU law scholar has suggested that with the agreement of the other 27 member states you cannot allow a member state to withdraw its notice.”

Good luck chanting that at a march. 

Julia Rampen is the editor of The Staggers, The New Statesman's online rolling politics blog. She was previously deputy editor at Mirror Money Online and has worked as a financial journalist for several trade magazines.