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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“Journalists are too scared to come”: Refugees on the forgotten war in Yemen

Only the few who have managed to flee the war-torn country can reveal the suffering of those left behind.

Last weekend’s BBC Our World report on the humanitarian crisis caused by the Yemen civil war highlighted that not only is the conflict a forgotten war, it is also an unknown war. Since war broke out 18 months ago in March 2015, surprisingly little has been written about the conflict, despite its similarity to ongoing and widely-reported other conflicts in the region, such as the Syrian crisis.

The main conflict in Yemen is taking place between forces allied to the President, Abdrabbuh Mansour Hadi, and those loyal to Zaidi Shia rebels known as Houthis, who forced Hadi to flee the capital city Sana’a in February. The loyalties of Yemen’s security forces are split, with some units backing President Hadi and others his predecessor Ali Abdullah Saleh, who is seen as the leader of the Houthi forces.

While these two forces have been at war, separate terrorist groups have been gaining more and more influence on the ground. Opposed by both the Houthis and Hadi’s forces, al-Qaeda in the Arabian Peninsula (AQAP) have staged deadly attacks from strongholds in the south and south-east. They are also opposed by Islamic State, which has claimed responsibility for a number of suicide bombings in Sana’a.

After rebel forces closed in on the president's southern stronghold of Aden in late March, a coalition led by Saudi Arabia responded to a request by Hadi to intervene and launched air strikes on Houthi targets.

I have spent the last couple of months working in the “Jungle” refugee camp in Calais, home to refugees from Sudan, Afghanistan, Syria, Iraq, Eritrea, Somalia – to name just a few. Having heard very little about the civil war, I was surprised to meet a handful of Yemeni men living inside the camp.

Hussein*, 28, is a film producer and dancer from Yemen who fled the country two years ago and has travelled through 11 countries to reach the Calais camp, where he has been living for just over a month. In a mixture of English and French, he tells me how groups of Houthi militia forcibly try to confiscate cameras and notebooks from both local and international journalists. He knows local journalists, friends of his, who have been threatened, tortured and even killed by Houthi forces.

He pulls out his phone and shows me a picture of his friend, Mohammed, who worked as a photojournalist, documenting brutality as a result of the war. Mohammed’s friends and family have not heard from him since April; the best-case scenario is that he is being detained, but Hussein seems pretty certain that he is dead. As a result, many who otherwise would have reported on the conflict have fled from besieged cities such as Sana’a, Aden and Taiz to the relative safety of the countryside in the north of the country, or have left Yemen altogether.

His friend Jamil, with whom he shares a tent, adds: “from other countries journalists [they are] too scared to come”. He claims that there are only “five or seven” foreign journalists in the capital city, Sana’a and tells me about journalists from the UK, France and the US who, after spending days being held up by countless militarised checkpoints while trying to reach the main cities, are then interrogated and detained by Houthi forces. If they are let go, they are harassed throughout their visit by National Security officers.

After watching his mother die during an airstrike in the city of Hodaida in January, Jamil took the decision to flee Yemen and claim asylum in Europe. He is worried about his father and his friends who are still in Yemen, especially after hearing reports that random border closures and cancelled domestic flights have been preventing crucial aid convoys of food, medical supplies and trained aid workers from accessing the citizens who are desperately in need of humanitarian assistance. Jamil reminds me that Yemen was in economic crisis even before war broke out, with widespread famine and limited access to healthcare or clean water.

Movement within the country is restricted and dangerous, and in the last twelve months alone, four Médecins Sans Frontières (MSF) facilities have been attacked and destroyed by airstrikes. Writing on 15 September 15, MSF head of mission in Yemen, Hassan Bouceninem spoke of:

“Other health centers, schools, markets, bridges . . . [that] have been attacked and destroyed by airstrikes, shelling, or bombs. Such attacks create direct victims but the war (economic failure, access problems, closing of hospitals, no health staff etc.) also causes a lot of indirect victims within the population.”

Such widespread instability and the resultant lack of access for journalists and aid workers means that it is difficult for the world to know how much Yemen is suffering. Only by speaking to the few who have managed to flee can even begin to grasp the realities of daily life for those left behind.

*Names have been changed to protect the identities of our sources.

Neha Shah has been volunteering in the Calais camp.