DOUMA, Syria – Abu Ahmad was working as a tailor when a Syrian government rocket attack on his neighborhood left him with a spinal injury, paralyzing him from the waist down. Three years later, the 22-year-old helped organize – and participate in – the first wheelchair race in the besieged area of Eastern Ghouta.

For the past four years, opposition-held neighborhoods in the Damascus suburbs have endured a government siege and bombings, as well as violent clashes between rebel and pro-government forces. A report by Doctors Without Borders (MSF) found that 93,162 people were treated for war wounds in 35 MSF-supported facilities across opposition-held areas around Damascus in 2015 alone. For those whose injuries have left them with limited mobility, reintegration into the community is a challenge, and job opportunities are scarce in a war economy largely dependent on physical labor. While some find work with aid organizations, internet cafes and tailors, most are left unemployed and without hope for their future.

“My back was injured after a mortar attack. I could not walk any more, and I stayed home, watching life moving forward and leaving me behind,” said 22-year-old race participant Muhammad, a former restaurant employee who asked not to disclose his last name for security reasons. “When we learned about the race, my friends and I began to exercise daily. The race meant a lot to us.”

Participants trained for the race in parks and streets sheltered out of sight from military aircrafts. The original race date was postponed due to heavy bombardment on the city, but eventually took place in September. Some 60 participants and their wheelchairs took part in the 20-minute race that started outside a popular market in the city of Douma. Shoppers and passersby lined the street, cheering on participants. After the race, a celebration ceremony took place in the market, where winners were awarded commemorative medals and a small amount of money.

The idea of holding a wheelchair race was born when Abu Ahmad was receiving treatment at the al-Wafa Center, an organization in Eastern Ghouta that provides physical and psychological therapy for those injured in the war. The organization, the principal funder of the race, also provides free lunches and shelter for patients who have lost their homes.

Participants wait at the starting line for the first wheelchair race in Eastern Ghouta. (Syrian Revolution Network)

During his stay there, Abu Ahmad noticed that many of the other patients were suffering from depression, and were disengaging with the outside community. “This is how the idea of the race was born. We wanted to encourage people with injuries, and help them to get out from under the depression that is a heavy weight for many of us,” he said.

The ongoing conflict and stifling siege exacerbates the situation for people with war injuries. The lack of specialized physicians and official hospitals in opposition-held areas means many are treated by medical staff with limited experience, time and supplies.

Cases of amputations and paralysis are common in Eastern Ghouta. The Syrian American Medical Society (SAMS) told Al-Jazeera that there are at least 5,000 amputees in Eastern Ghouta. In Douma alone, there are roughly 1,200 amputees and 550 cases of permanent paralysis, Zein al-Atar, an official with Health Touch, a community organization that provides care for individuals with special needs in the city, told Syria Direct.

Not all those in need of wheelchairs or prosthetic limbs can access them, however, according to Dr. Bassam, a physical therapist working at Wafa Center, who asked not to disclose his full name for security reasons. The government-enforced siege limits supplies needed for local production, and many factories were damaged or destroyed in clashes. “We make wheelchairs and prosthetic limbs, but we suffer from not having enough of the required supplies because of the siege,” said Dr. Bassam. “We are still trying to ensure them for all those in need.”

Abu Ahmad said the Wafa Center is trying to plan another wheelchair race, in addition to other activities for the injured, like basketball and badminton. Concrete plans have yet to be made, however, due to limited funding and the lack of safe places to hold such events. “The government’s military aircraft keep monitoring the city,” Abu Ahmad said.

For participants, however, the benefits of holding such events are much greater than the risks.

“We now go out in the street with pride,” Muhammad said. “People’s encouragement and cheering gave us a dose of hope and optimism.”