Opposition health official: Underground hospitals ‘best option we’ve got’ amidst continuous airstrikes

In the pre-dawn hours Tuesday morning, Dr. Manthour Khaleel received a phone call. An airstrike had destroyed another hospital in Syria’s northwestern Idlib province.

As a spokesman for the Idlib Health Directorate, the medical authority for the northern rebel-held province, this was not the first time Khaleel received such a call. The directorate funds and oversees 10 hospitals across the province; seven have been bombed since the start of the war.

On Tuesday, it was the Eman Speciality Hospital in Sirjeh, a town in the south Idlib countryside. Khaleel estimated $300,000 in damage. “The building collapsed, and it’s beyond the point of repair,” the doctor said of the Eman hospital, which formerly served 150,000 people across 20 towns. The attack destroyed operating rooms and medical supplies while injuring four staff members, Khaleel tells Syria Direct’s Alaa Nassar.

With hospitals now an increasingly common target, the directorate is moving hospitals underground, and no longer builds large, centrally located facilities.

“Typically, if an airstrike hits an underground hospital, it can remain in working condition.”

Q: After an airstrike, we frequently hear that a hospital has been knocked “out of service.” Sometimes that means that the hospital is temporarily closed for repairs. Is that the case for the Eman Hospital?

No, the building collapsed, and it’s beyond the point of repair. All the medical equipment that was inside is also either destroyed or in need of serious repair.

Now, the challenge comes in trying to find another location. However, even if we do find another location, we would still have to prepare and equip the new building. The trouble is that we simply don’t have the money to be doing this right now.

 The Eman Specialty Hospital in southern Idlib. Photo courtesy of Manthour Khalil.

Q: More than 150,000 residents from 20 towns rely on the Eman Specialty Hospital as their primary source of medical care. What do they do in the aftermath of an airstrike, one that is often the only hospital or medical center for dozens of kilometers?

This was, indeed, the only hospital in the region. Now, residents must travel about 20km to receive treatment, either in Ariha or Maarat a-Numan.

When a hospital goes out, it hits women and children the hardest. They need to travel through a mountainous region, one which is under fire day after day. In order to get the health care that they need, they have to make the journey on foot because public transportation is no longer available in the area.

In many cases, women go into labor very late at night. Their lives are in danger because their cars are targets for machine-gun fire. People usually travel at night without turning on their headlights, leading to accidents because of the hazardous mountain roads.

This just goes to show how crucial it is to reopen the local hospital. After an airstrike, people are suffering, and we need to respond.

Q: This isn’t the first time that one of your hospitals was bombed, correct?

That’s right. We partially fund 10 hospitals across Idlib province, and seven of these have been bombed. The Eman Hospital was just the most recent target.

Q: Walk us through the directorate’s response immediately after one of your hospitals has been hit.

When a bombing happens, we set out to document the scene as quickly and as fully as possible. We send this information to various UN organizations in the hopes that it can possibly move the internationally community to action and to stop the further bombings of Syrian hospitals moving forward.

Today, when we build new hospitals, we often build underground for security reasons. It certainly doesn’t guarantee complete protection for our doctors and nurses, but, quite frankly, it’s the best option that we’ve got. Typically, if an airstrike hits an underground hospital, it can remain in working condition.

The Amal Orthopedic Hospital—where I formerly worked—was bombed more than 20 times since the start of the revolution. On 18 occasions, the airstrikes hit nearby, but we were protected by virtue of working underground. However, there were two direct hits that did still inflict damage despite our best efforts.

We do certainly recognize that as we’ve gone underground, the Russians have taken to using bunker busters. Recently, these weapons have been particularly common in Aleppo as well as some areas in the Idlib countryside, and it’s perfectly evident that their only purpose is to destroy shelters and other underground, fortified locations.

But, unfortunately, we just don’t have any other choice right now. We work within the given constraints in order to try to provide medical services to people who are in need.

 Aftermath of airstrikes on the Eman Specialty Hospital. Photo courtesy of Manthour Khalil.

Q: Over the past year, hospitals have increasingly become targets for Syrian and Russian warplanes. How do you adapt given this reality?

The Idlib Health Directorate partially funds 10 hospitals and, in total, supervises the work of 40 hospitals across the province. By far, bombing is the biggest challenge that we face. It’s a threat that we encounter all too frequently, and one that deprives our residents of much-needed medical care. 

The specter of an airstrike is a daily reality in Syria. It prevents us from seriously investing in our hospitals because we know they can be bombed at any time, and we’ll have to go back to square one. As such, we no longer pursue long-term improvements or repairs to our existing hospitals across the province. We no longer build large, centrally located hospitals because gathering places for big groups of people could easily be a target at any point. We’ve lost so many medical workers as a result of the bombings. People have died, been injured or fled.

We’ve also lost hundreds of thousands of dollars in the damage done to our hospitals and medical equipment. Our funds are severely limited, particularly in comparison to what we realistically need in order to provide medical services to all residents in the province.