Underground hospital in Syria fills with earthquake victims

Dr Nehad Abdulmajeed thought he had seen the worst human suffering of his career as a surgeon in Syria. In 2016, he survived the siege of Aleppo, which left thousands dead or maimed amid a civil war.

After the town fell to government forces, Dr Abdulmajeed retreated to a town called Al Atarib in the northeast of the country, where he worked in a hospital dug deep underground to protect it from shelling. incessant Russians and Syrians.

“Our hospital has always been filled with tragedy,” he said in a phone interview from his operating room. But the carnage he and his team saw this week, from an entirely different enemy, was on a scale he had never encountered.

Hundreds of victims of Monday’s earthquake, which was centered nearby across the border with Turkey, arrived at his hospital this week from the Al Atarib area, and many were already dead when they arrived at the hospital. Staff members say they have counted 148 bodies in the hospital since Monday.

“Since Monday the bodies have been coming in all the time,” said Dr Abdulmajeed, 33, one of four doctors at the underground hospital known as the Cave. “Some arrive headless. Others without limbs.

After navigating more than a decade of civil war, Syrian doctors find themselves caught in the middle of a new post-earthquake humanitarian crisis, with rescue efforts hampered by the location of the quake area, which includes government and opposition controlled land in Syria.

It has meant a desperate scramble to rescue people trapped in the debris of collapsed buildings in hopes of getting them to hospitals like Al Atarib.

“People are digging through the rubble with their fingernails to reach the screaming voices on the other side,” said a doctor, Murhaf Assaf, who worked in the cave in 2018 and is in frequent contact with staff. He now lives in Wales.

Hospital staff members shared videos and images with The Times that showed the dead, wrapped in blankets, lining the hallways. Another video showed a van, stacked with bodies, arriving at the hospital.

“We cried over the children who lived through this war and now died for no reason,” Dr Abdulmajeed said.

On Tuesday, the hospital received three siblings – including 3-year-old Abdul Haseeb – who had survived in the rubble for 36 hours. “It is a blessing that they are still alive,” said Dr Abdulmajeed, who was eager to share what little encouraging news there was.

Dr Abdulmajeed was sleeping with his own children in a nearby village when the earthquake hit, causing tremors across the region. “I saw our lives flash before our eyes,” he said. His family huddled in the cold for hours to wait for aftershocks, before he could get to the hospital and start saving people.

“We kept looking skyward for jets,” said Dr Osama Salloum, who traveled to the cave from Idlib on Monday morning after receiving an urgent call for help. “My mind was playing tricks on me – telling me it was war again.”

A boy, who appeared to be about 6 years old, died while Dr. Salloum was performing CPR. “I saw life leave his face,” said the doctor, who also operated on patients during the siege of Aleppo. “All the traumatic images of my work during the war came back to me,” he added. “I felt like I was waking up in a recurring nightmare.”

Doctors said their wartime experiences had prepared them well for the human toll caused by the earthquake, especially the hard choices involved in such grueling work.

“There were days when we could only save a few – if you tried to save them all, you couldn’t save anyone,” said Dr Assaf, who worked in the cave in 2018.

Al Atarib Hospital was built in 2017 by the Syrian American Medical Society, or SAMS, a humanitarian group that supports 39 medical facilities in the country. Located near the fighting on a main road linking Aleppo to the city of Idlib, it was dug deep underground to escape shelling and shelling by Russian and Syrian forces in rebel-held areas.

But the hospital suffered a devastating artillery bombardment in March 2021 that killed seven patients and injured 15 people, including five medical staff, according to a joint report by SAMS and Physicians for Human Rights.

The attack was emblematic of one of the most brutal tactics employed by the Syrian regime since the start of the civil war in 2011. Physicians for Human Rights has documented 601 attacks against 400 health facilities since the start of the war.

The systemic crackdown on hospitals and clinics in opposition-held areas has devastated the Syrian healthcare system, drawing international condemnation and prompting up to 70% of Syrian healthcare workers to flee the country, according to a report by 2021 from BioMed Central in London.

“These doctors were uniquely trained by the war – but unfortunately only a few of them remain in the country,” said Dr Assaf, who left Syria in June 2019.

“They need all the help they can get,” he said. He said the cave’s staff, which numbered at least 11 surgeons when its doors opened, had dwindled to a few people at a time over the past five years.

Important resources, like gloves and dressing to dress wounds, were already dwindling, surgeons said.

In the days following Monday’s earthquake, aid to Syria was hampered, in part because roads surrounding a major border crossing between Turkey and opposition-held areas were damaged. And aid groups in Turkey have been affected by the earthquake. Any prolonged obstruction could pose a challenge for doctors at Al Atarib Underground Hospital.

“I thought maybe I had seen it all,” Dr Abdulmajeed said, “but these are the most tragic days I have seen in my entire life.”

Sangar Khalil contributed report.