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The Meager and Gruesome Options For Syria’s War Wounded

REYHNALI, Turkey—“We had 600 wounded men in Homs, and no doctors,” says Ahmet, a young Free Syrian Army fighter, his speech slightly muddled, the legacy of a bullet that had grazed his neck and shattered his chin. “Sometimes, because we didn’t know any other way to treat our men, we had to amputate arms and legs ourselves. Sometimes we asked a carpenter or a butcher to do so.”

We are standing outside a hospital in Reyhanli, Turkey, less than four miles from the Syrian border. Ahmet arrived here two weeks ago, he says, but insists he will return. “I came here for treatment, and I am coming back to Homs to fight.” The wounded among the Syrian opposition have had no choice but to make a refrain of such stoicism. But it is increasingly impossible to ignore how the rebel fighters' meager options for medical treatment are taking a growing toll on their well-being.

In Syria, proper treatment for the rebel soldiers like Ahmet is unattainable. FSA men who end up in state hospitals, as well as the doctors who treat them, are said to face torture or execution. With makeshift rebel-run clinics short of adequate medical equipment, many of the wounded, particularly from the country’s north, are ferried across the border to Turkey.

Yet even Turkish hospitals, which initially rose to the challenge, have found it increasingly difficult to cope. Just as the number of Syrian refugees arriving in Turkey has started to swell out of control (from 11,000 in March to 50,000 at the beginning of August to well over 70,000 today), so has the influx of wounded civilians and fighters. Until this spring, Turkish hospitals received an average of roughly 170 Syrians per month, a Ministry of Foreign Affairs official told me; that number now hovers around 700 people. Last Wednesday alone, around 100 residents of a rebel-held border town were sent to Turkey for treatment following a Syrian army airstrike. Fifteen of them died.

“Conditions are miserable, and getting worse,” Talal al Abdallah, a Syrian doctor, told me in his rented two-room apartment in the Turkish city of Antakya, a half hour’s drive from the border. There isn’t enough room in the hospitals here, enough staff, or enough expertise, al Abdallah explained, then paused, as footage of the shelling in Homs and Deir al-Zor rolled across the screen of his TV. “The Turkish hospitals are familiar with civilian cases, but not with severe war injuries,” he said. “They’re overwhelmed.” (The Turkish official I spoke to acknowledged as much, noting that hospitals along the border were not prepared to deal with the kinds of injuries suffered by Syrian victims—at least not on such a scale.) 

Given the shortage of beds, said al Abdallah, the gravely wounded were often being discharged within a few days of surgery, or even less. “But you can’t send them back to the refugee camps like this, because post operation care is sometimes more important than the operation itself,” he insisted. It’s possible, he said, “that many deaths have already resulted from this kind of neglect, from people being kicked out of the hospital early, from not getting the proper care.”

An FSA fighter, most of his left leg missing, hobbled across the flat on a pair of crutches. He had been injured in Hama, al Abdallah explained, and then brought to Antakya. Doctors at a local hospital treated the man’s other wounds but failed to look after his damaged knee. It was only when al Abdallah arranged for his patient to undergo surgery in Istanbul that specialists there realized that gangrene had begun to spread inside the leg. “They had to amputate,” he said, pointing at what was left of the limb. “If they had only treated him earlier, he would have kept it.”

Along with a number of Syrian medics scattered across Turkey’s border provinces, al Abdallah has taken matters into his own hands, converting his flat into a temporary clinic for FSA rebels. (“I have anywhere from one to ten patients staying here,” he said.) Others, including a Syrian-American woman who left her home in Cincinnati to join the relief effort, have recently gone a step further, transforming a girls’ dormitory in Reyhanli into a rehab facility. Yet while the exiles are able to provide care for some of the rebels, there simply isn’t enough room for everyone. As a result, many fighters are forced to look for refuge in safe houses near the border, where conditions range from inadequate to woeful.

In one of these, an apartment on the outskirts of Reyhanli, I tiptoed my way through groups of wounded men sprawled out across a carpeted floor, often sleeping more than a dozen to a room. “Usually we have between 30 and 50 people in the flat, sometimes even up to 100,” Abdullah Nakami, a Bosnian war veteran, said, showing me around. One of the men told me he had had his knee smashed in with rifle butts by members of a pro-Assad militia; another exposed a calf shredded by shrapnel. “They get treated in 30 minutes,” Nakami said, “and then they get kicked out of the hospitals because the doctors tell them there’s no space.”

Emad Hassan Khalid, 36, shares a 150-foot room with seven other men—his body, almost all skin and bones, stretched out atop a heap of pillows and a thin, worn out mattress. “We were sitting in my courtyard, the whole family, when the shell fell,” Khalid recalled, the words, barely audible, dribbling out onto his thick, black beard. By the time he came to, he said, his five children, wife, and five brothers were all dead. Khalid himself was left paralyzed from the waist down. He has been lying here for five months.

The day before, Abdullah Nakami told me, there’d been a breakthrough. A few of the men had picked up Khalid and helped him stand up. With their help, he was apparently able to take two short steps. They had all celebrated, Nakami said, and laughed like children. 

Piotr Zalewski is a freelance writer based in Istanbul.