A medic near the front lines in Raqqa on treating civilians traumatized by ‘constant horror and fear’

As American-backed Syrian Democratic Forces (SDF) close in on central Raqqa city in the third month of battle for the Islamic State’s capital in Syria, the tempo of violence is only increasing.

Airstrikes and shells rain down on residential areas. A total blockade of the city means food, water and medicine are in short supply. IS snipers prevent civilians—held as human shields—from fleeing their areas into the 70 percent of Raqqa city currently held by the SDF. Landmines and IEDs line the roads used to flee.

An estimated 800 civilians have died since the battle for Raqqa city began on June 6, according to the UK-based Syrian Observatory for Human Rights (SOHR).

In late July, international medical humanitarian organization Doctors Without Borders (MSF) reported that a large number of sick and injured people were trapped inside Raqqa city, with little or no access to medical assistance.

MSF operates ambulances and a forward medical position outside Raqqa city, and supports hospitals in nearby Tal Abyad and Kobani, where patients are transferred after being stabilized.

One of the medics working at MSF’s medical position near Raqqa city is Omar al-Mousa. Before working near the Raqqa front lines, al-Mousa, who asked not to be identified by his real name, worked at the MSF-supported hospital in Tal Abyad.

Here, al-Mousa tells Syria Direct’s Alaa Nassar what he is seeing and hearing during his work: the desperation and trauma of adults and children alike, amputations virtually every day as a result of IS landmines, and a scramble to save the wounded.

“What matters most right now are the civilians who are fleeing the battles inside Raqqa,” says al-Mousa. “They must be protected.”

Q: What kinds of injuries are you seeing among the people who are fleeing Raqqa city? Where are they taken once they reach you?

We have been treating wounded people from Raqqa province for more than a year and a half, including the preliminary battles to isolate Raqqa city.

Most injuries are from the brutal and unorganized fight to liberate areas at the expense of unarmed civilians. Unfortunately, none of the warring sides cares about the people who can only flee into the unknown to escape these battles.

A Raqqa family that fled the city on Saturday. Photo courtesy of Raqqa Campaign.

 I have seen many patients during [the current] battle for Raqqa city. The case that stands out most was amputating a patient’s leg at the thigh after three civilians were wounded by a landmine as they were leaving Raqqa and coming towards us.

All I had with me was a basic surgical kit. The operation took two hours. I sewed the muscles, repaired the ligaments, and as luck would have it, the femoral artery was intact. Afterwards, I splinted the patient’s femur with a piece of wood. I used what I had. I gave IVs to the wounded and some antibiotics until they recovered, with God’s help.

We receive wounded civilians at hospitals in Tel Abyad and medical centers on the front lines. We initially treat them and then they go on to Kobani Hospital [approx. 75km northwest of Raqqa city], a more secure location.

Q: What have you heard about the situation inside Raqqa city from the people who have escaped?

Most people, when they are able to escape Raqqa city, it is as though they have fled from a prison to freedom and life. Even if their basic needs are not available. They tell us how they have suffered under Daesh [IS], tell us of the worst suffering, mistreatment on every level, both social and psychological. They describe difficult living conditions in light of the IS siege and its impact on them in recent days and weeks.

Q: In your personal opinion, what measures could the warring parties—on the ground and in the sky—take to protect civilians in Raqqa?

I don’t believe that my personal opinion will be taken into account. The warring parties on the ground and in the sky all find excuses.

I am not against eliminating that arrogant organization [IS]. But the other side must leave a chance for unarmed civilians to flee, help them as much as they can. They must intensify the siege on IS, not indiscriminately shell civilians.

What matters most right now are the civilians who are fleeing the battles inside Raqqa. They must be safe, with food, shelter, drink and medical and psychological treatment. They must be protected. The mines on the routes used by those fleeing the city must be removed to limit the amputations we are seeing virtually every day.

A child at an SDF-held medical position after leaving IS-held districts of Raqqa city on Saturday,  August 12. Photo courtesy of Raqqa Campaign.

Q: How does your work now, receiving the wounded from Raqqa, compare with your previous work as a doctor?

There is no comparison between working at a hospital and working near the front line. Injured people come to you from all sides.

The ugliest days I have seen were at the very beginning of the battle for Raqqa city [in June]. Daesh encircled us from all sides and we were short on medical supplies. It was extremely difficult to treat the wounded. Many times, I had to perform preliminary surgical procedures. They were successful, thank God. There is a lot I could say about this subject.

Before, I worked at a medical center and military hospital after the border city of Tel Abyad was liberated [from the Islamic State in June 2015]. Now, I work with the emergency department. I should have graduated with my medical specialization now, but because of the current security situation I still have not finished my second year at medical school.

Q: There have been media reports of shock among children coming out of Raqqa city, and strange reactions to the doctors treating them. That is, not fighting the doctor examining them as a child might usually do, or crying. Have you seen cases like this?

I really have sensed a kind of dullness with some of the children when I am examining them. It is the result of the constant horror and fear that they have lived in. That is why their reactions are not normal for their age. Some have lost their father or mother, maybe more than one member of their family. That will stay in their memory all their lives.