AMMAN: Years of aerial bombardment are crippling the medical infrastructure of Syria’s largest city, with five out of eight hospitals in rebel-held east Aleppo now restricted to offering no more than basic medical care, often in the rubble of bombed-out facilities.
The most recent attacks against Aleppo city’s hospitals came on Saturday, as a spate of reported regime and Russian strikes hit five hospitals and a blood bank, all in the central rebel-held a-Shaar district, over a 24-hour period.
The a-Shaar district, located in central Aleppo, two kilometers northeast of the city’s historic citadel, is controlled by Al-Qaeda affiliate Jabhat a-Nusra and its ally Ahrar a-Sham. Several of the hospitals in the district treat rebel fighters wounded on the frontlines.
“But the children’s and women’s hospitals in a-Shaar were also targeted and they don’t treat fighters,” Abdelbasset Ibrahim, director of the Free Aleppo Health Directorate, tells Syria Direct.
Earlier this month, regime forces and allied militias established fire control over the last road leading into east Aleppo, effectively transforming the 64 rebel-held districts, with a combined population of 300,000 people, into one of the most densely populated besieged areas in Syria.
Medical workers on the ground tell Syria Direct that the pace of regime attacks against hospitals increased both during and after the Russian-backed offensive to encircle the city that began in late May.
The Daqaq Hospital in rebel-held eastern Aleppo on Saturday. Photo courtesy of The White Helmets.
“In the past three months, every single hospital in [east] Aleppo has been bombed at least once,” says Ibrahim.
Two of the city’s hospitals have sustained “irreparable” structural damage and “could collapse at any moment,” according to Ibrahim, while others have stopped housing inpatients out of fear the facility will be the target of further attacks.
The result, a half-dozen east Aleppo medical workers tell Syria Direct, is that five of the city’s hospitals have been reduced to basic field clinics, only capable of stabilizing and transferring patients to the three hospitals still able to conduct advanced medical procedures.
“We have to transport the injured across the city,” Ahmed Suweid, an Aleppo paramedic, tells Syria Direct. “This is dangerous because of the constant bombardment.”
“Whenever possible, we remove the patients from the hospitals as soon as they are ready because we know the hospitals are always a target,” the paramedic said.
“All of the windows and doors were blasted out and part of the roof caved in,” says Abderrahman al-Mohamed, describing Saturday’s attack on the Al-Hakim Children’s Hospital, where he works as an administrator.
“One of the neonatal intensive care units was damaged and we lost a two-day-old baby,” he said.
A physician at the Al-Bayan Surgical Hospital, located across the street from Al-Hakim, described a similar scene following Saturday’s attacks.
“The strikes damaged the operating rooms and completely destroyed the central elevator,” says Hussein Rabia al-Haj, an anesthesiologist who has worked at Al-Bayan for two years.
“We are still accepting emergency cases,” says al-Haj. “We provide basic first aid right in the rubble of the hospital.”
Pro-regime media has not commented on Saturday’s strikes on Aleppo's hospitals.
After stabilizing patients, medical staff at the bombed hospitals transport the injured several kilometers away to better-functioning hospitals in other rebel-controlled districts.
“We are overcrowded with patients from Al-Bayan and the other targeted hospitals,” Yassin, a nurse at the A-Zarzur Hospital, located 6km away in the southeastern Ansari neighborhood, tells Syria Direct.
None of the hospitals struck in Saturday’s attacks were located in “hot” military zones, said Ibrahim.
All of the hospitals “are in civilian areas.”
After rebel forces gained ground in Aleppo’s eastern neighborhoods in early 2012, regime aircraft began conducting bombing raids over the city, with strikes consistently hitting non-military targets including hospitals and clinics.
Between June 2012 and April 2016, regime forces and their allies allegedly conducted 50 aerial attacks against medical facilities inside Aleppo city, according to a report published in April by the US-based advocacy group Physicians for Human Rights (PHR).
In the same time period, opposition groups attacked three regime-held Aleppo hospitals, according to PHR data, which does not yet include the months of May, June or July.
Since regime forces completed their encirclement of east Aleppo on July 7, rebel fighters have repeatedly shelled residential regime-held neighborhoods in west Aleppo and the Kurdish-majority pocket of a-Sheikh Maqsoud, killing dozens of unarmed civilians, multiple Arabic media outlets reported.
Starting in 2012 with the siege of Old Homs, the Syrian regime has consistently sought to destroy civilian infrastructure in rebel-controlled territories in order to coerce local populations into accepting unfavorable ceasefire agreements.
[Ed.: The Assad regime, rebel militias and the Islamic State have all used sieges and the indiscriminate bombing of civilian areas as a weapon during the Syrian civil war. However, the regime, with its technological superiority and support of allies Iran and Russia, has been the most successful in implementing this strategy. See Syria Direct reporting on siege tactics here, here and here.]
The strategy of attrition, which the regime openly calls “kneel or starve,” has arrived in Aleppo, and the results are grim.
“There are only 30 doctors left in the rebel-held Aleppo,” says Ibrahim, who has been in Aleppo since the start of the war.
“With all of the airstrikes, they just can’t cope anymore.”