Today, they said, was a “quiet day”. There was a child with shrapnel wedged in her neck, a man in the ICU with amputated limbs and an FSA fighter with gunshot wounds to his leg.
The emergency room was filled with patients, and relatives searching for loved ones. The smell of blood was overwhelming. Outside the hospital dust filled the air as those without limbs sat in their wheelchairs chuffing on cigarettes. Generators worked non-stop to provide electricity. The two ambulances didn’t stop all day.
Al-Qaeda-linked rebel groups such as Jabhat al-Nusra and ISIS were present.
This is Bab al-Hawa Hospital in northern Syria, just a few kilometres from the border with Turkey. What was once an immigration and customs building, now serves Syria’s wounded.
Depending on the situation, the hospital treats about 40 patients a day, mainly as a result from shelling and bombings in the Idlib province. Eighty per cent of patients are civilians – the majority children. The rest are wounded FSA fighters.
“Doctors usually use the floor to treat patients because it’s often full,” Amer Alfaj, who works at the hospital, said.
“This is happening on a daily basis.”
It is here where doctors have been propelled into dealing with injuries they have only read about, on a scale they never imagined.
“They cover all types of injuries. Everything,” Munther Bulad, secretary of the hospital, said.
“If people arrive in good time, then there’s hope. But with shelling, shrapnel just goes everywhere.”
The hospital, compared to those still standing further inside Syria, is well resourced. But despite this, they’re still stretched to the bone. A constant influx of patients with challenging injuries, coupled with difficult working conditions, has left doctors exhausted.
For fear of reprisal, doctors are forced to work undercover at the hospital. They travel to-and-from work using fake names and pretending they are not treating the wounded.
“Yes, we live in regime areas undercover,” one doctor from Aleppo said.
“I travel to the hospital using a fake name.”
The doctor, who specialises in vascular surgery, told Middle East Monitor he previously worked at a field hospital before being asked to help out at the border.
“Some days I will do seven operations. I also usually do two by myself with no one helping,” he said.
“The hardest thing is when we cannot find blood while we’re under the knife. Patients also come in with several problems and I don’t know what to do first. Amputating children’s legs is always very difficult.”
A severe lack of blood led the hospital to launch a campaign to encourage people from villages close by to donate blood. Each operation requires seven units of blood. Bab al-Hawa also transports blood to other local hospitals and makeshift field clinics.
“This situation is normal for us now,” Bulad said.
“We have been living like this for three years.”
While walking around the hospital, not only did the complexity of people’s injuries become apparent, but their injuries became real – no longer stories of a far away place.
In one room filled with patients, there was a five-year-old girl in the corner with shrapnel in her neck. She had been in hospital for four days after shelling in her neighbourhood in the Idlib countryside. Not even a tickle would illicit a smile.
“Seventy per cent of civilian patients are children. They don’t care who is bombed,” Bulad said.
To the left there was a wounded FSA soldier. He was shot in the leg a few days ago. In another room there was a 13-year-old girl with shrapnel wedged in her abdomen. Downstairs there was a little boy going through a scanner checking that his brain was all right after he fell when his neighbourhood was bombed.
We entered the ICU and there was a young man with amputated limbs.
Today, again they emphasised, was a “quiet” day.
“Right now this is quiet thank God,” Alfaj said.
“I mean, this is all we have. If people get shrapnel stuck in their brain or heart, we just don’t have the means for that.”
For those patients the hospital can’t treat, if possible, they are transported across the border into Turkey.
But since another car bomb exploded on the Syrian side of the crossing, killing seven and injuring many more last month, tensions have continued to rise, making the journey across the divide painful and increasingly dangerous.
“Sometimes it takes three hours to get through the border – it can be a disaster,” Bulad said.
But for the patients back at the hospital, there is hope, as doctors, often with limited training and no formal qualifications, work tirelessly to keep the situation under wraps.
“Considering the situation we are in, we can say this is good but not great. You have to just accept it,” Bulad said.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.