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Chronicle of Care: Providing Health Services for Millions of Syrians

In the first in our series of diary entries from Syrian doctors, Mahmoud Mustafa, director of the Independent Doctors Association, explains how he went from being an eye surgeon in Aleppo to providing emergency care amid attacks, sporadic aid access and exhaustion.

Written by Mahmoud Mustafa Published on Read time Approx. 4 minutes
Mahmoud Mustafa, field ophthalmologist and the director and founder of Independent Doctors Association (IDA)Photo by Independent Doctors Association (IDA)

I had always wanted to be an ophthalmologist. It’s what I set out to do when I decided to become a doctor. I first studied general medicine in Belarus and then specialized in ophthalmology back in Syria. I liked that medicine is so specialized: Not all doctors can become eye surgeons.

I started my practice in 2007 as a resident in the Aleppo Eye Hospital, the province’s only facility of its kind. I opened my own clinic in Aleppo in 2010 but continued to work with the Aleppo Eye Hospital, as head of the ophthalmology residency program.

But when the war started everything changed.

The revolution began in Aleppo in the summer of 2012, and soon the uprising turned violent. Government aerial bombardments damaged the Aleppo Eye Hospital.

At the time, I kept working as an eye surgeon in other hospitals. But as the situation in the city spiraled, I had to put some of my ophthalmology work aside to serve people on a larger scale.

I started to oversee healthcare management in al-Shifaa Hospital in east Aleppo and in a field hospital in Soran, a town in Aleppo’s northern countryside.

One moment that affected me the most during that period was an attack near the al-Shifaa Hospital in September 2012. I was bringing medicine to the hospital when an airstrike hit the al-Sakhour neighborhood where the hospital is located.

Most of the victims of the attack were brought to the al-Shifaa Hospital, and I decided to stay in the medical center to assist the injured. I had never seen anything like it. There were dead children all around me, their body parts scattered everywhere. All my senses and emotions were jolted awake. It was a civilian target.

This early incident was only one of many horrific and deliberate attacks on civilians that would eventually take place throughout the conflict. The war is now close to entering its seventh year, and such attacks have continued unabated, and the international community has yet to take significant measures to protect civilians in Syria.

International inaction and the huge gap in civilian access to medication and doctors led me to join forces with a number of medical workers (general surgeons, orthopaedics, gynaecologists, neurosurgeons and pharmacists) in Aleppo to save what remained of the province’s battered healthcare system.

Together, we founded the Independent Doctors Association (IDA) in 2014, a Syrian humanitarian organization of Syrian medics providing healthcare services to the population of Aleppo.

We repurposed buildings to be used as make-shift medical centers and worked on providing vital medical services to Aleppo’s residents. We also set up a warehouse to carry medical supplies and established a blood bank in Aleppo city. But the lack of humanitarian access and relentless bombardment made our work very difficult.

Right now, we are working in areas of northern Syria that have been recently liberated from ISIS. We are focusing on bringing healthcare to areas that have been deprived of these services for around three years. There is much work to be done in rectifying the population’s medical problems and reintroducing medical awareness to the public.

Currently, our network of clinics and facilities cover almost 1 million people in the region. IDA runs two major hospitals and 17 clinics: a surgical hospital, a pediatric hospital, maternity units, mobile clinics ambulances, centers treating child malnutrition, psychosocial and nutritional support spaces for pregnant and lactating women, a community health worker team, wide-scale vaccination campaigns, a central blood bank and a medical oxygen generating station.

Most of our patients are part of a large displaced population living in squalid conditions in camps near the Turkish border. They have been displaced from their homes by fighting, airstrikes and sieges. Some of them come from places as far away as the northern Iraqi city of Mosul. They suffer from child malnutrition, complicated births, skin diseases and war-related injuries. All of them depend largely on the services of Syrian medics who stayed in Syria. This is why I feel personally invested in these health facilities, and I want to make sure we provide the best services possible without interruption.

One can easily feel so exhausted. There’s always a billion things on a person’s mind when they run a network of hospitals. I’m always thinking about how to improve our work and how to increase our activities. What keeps me going is seeing how much we’re helping these people in the camps. Sometimes I make a quick stop in the incubator room of our hospital just to look at the newborn babies. When I see them, I feel more hopeful, and that life is continuing.

For five years now I’ve been working like this, fixing what I can and expanding where I can.

I miss practicing ophthalmology. It’s what I set out to do when I first decided to become a doctor. I miss it so much that I’m planning to work two days a week in the ophthalmology department in our hospital in Syria, the Dr. Muhammad Wassim Maaz Hospital.

As a doctor, my vision for the future of Syria is to have a strong modern healthcare system. After the conflict, my hope is for us Syrian doctors to be part of rebuilding it.

Syrian civil society groups like us have been working throughout Syria to ensure that people have healthcare, education, safe places to live, adequate nutrition and a support network to nourish and protect them. We are doing our best, but these are only shallow solutions. Stopping the violence before our entire generation is lost is the most urgent need we have.

This diary entry has been recorded in writing by Maya Hautefeuille, responsible for Media and Advocacy at the Independent Doctors Association (IDA) in Gaziantep, Turkey.

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