[Marxism] WSJ profile of Syrian doctors

Andrew Pollack acpollack2 at gmail.com
Fri Dec 20 07:28:01 MST 2013


full text because subscriber-only
odd that they don't mention the doctor whose murder is the obvious reason
for this story

  Middle East News<http://online.wsj.com/public/search?article-doc-type=%7BMiddle+East+News%7D&HEADER_TEXT=middle+east+news>
Syria's Civil War Forces Doctors to Choose the Rebels or the Regime Physicians,
Medical Residents Open Secret Clinics to Fill Void Left by Conflict
   By
Nour Malas
  Dec. 19, 2013 10:31 p.m. ET

Dr. Adnan Ismail was on duty for the worst chemical weapons attack in the
last 25 years. When bodies began arriving at his hospital near Damascus, he
filmed the carnage, then fled the country so he could show the world. WSJ's
Nour Malas reports.

Adnan Ismail worked as a doctor in a Syrian government hospital. But civil
war led him to a farm field where he and friends labored nights in secret
to build a makeshift rebel-run clinic.

For a year, Dr. Ismail helped dig walls and stairs to fashion an
underground bunker that was eventually equipped for surgery, he said.

Dr. Adnan Ismail led a secret life tending to Syrian rebels and civilians
hurt by government forces. Ayman Oghanna for The Wall Street Journal

In wheat fields and olive groves, at private homes and in the backs of
trucks, Syrian doctors like him have cobbled a health-care network of
medical students, nurses and civilians to supplement hospitals lost in the
conflict. Most of these workers aren't trained for the trauma injuries they
see. They are short-handed, lack supplies and are targets of government
forces. But without them, according to medical organizations monitoring the
crisis, many more Syrians would have died in a conflict that has claimed an
estimated 125,000 lives.

"I always requested from God an adventurous and fulfilling life," said Dr.
Ismail, a 29-year-old man of slight build who wears the neatly cropped
beard common among Syria's rebels. "I think he may have taken me too
seriously."

Samer Attar, a Syrian-American orthopedic surgeon, saw some of this work
firsthand during a leave from Northwestern Memorial Hospital in Chicago to
volunteer this fall at a hospital in the rebel-held section of Aleppo.
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  Syrian medical residents were essentially teaching themselves trauma
surgery, Dr. Attar said. "They function as full-time surgeons," he said,
recalling the stream of wounded: "People missing limbs…faces pebbled with
shrapnel. A few times, people holding their bowels in their hands."

Makeshift clinics have proliferated in the rebel-held north, but shifting
battle lines have made it harder to keep them hidden from government forces
or separated from rebel operations, said Syrian doctors and international
medical groups.

Five of the six field clinics in the north were hit by government
airstrikes this fall, doctors at three of the hospitals said.

The al-Bab Hospital, which sits in a town in Aleppo province now controlled
by al Qaeda-linked rebels, has been bombed five times, medics at the
hospital said. Its medical staff has relocated from one building to another
so many times they now keep much of their equipment in ready-to-move boxes.

Aftermath of August gas attack Shaam News Network/Reuters

Some 50 international doctors, including the heads of global medical
bodies, warned that Syria's health services were at "a breaking point," in
a letter published in the medical journal The Lancet in September. The war,
doctors said, is restricting medical care for millions of Syrians on all
sides.

"Systematic assaults on medical professionals, facilities, and patients are
breaking Syria's health care system and making it nearly impossible for
civilians to receive essential medical services," the letter said.

Attacks on hospitals in rebel-controlled regions were described in the
letter as "an unconscionable betrayal of the principle of medical
neutrality."

Attacking hospitals violates the Geneva Conventions and constitutes a war
crime, said international experts on human-rights law. United Nations
investigators said both sides have targeted hospitals, with no regard for
civilian casualties.

The U.N. Commission of Inquiry, which documents abuses in Syria, said in a
September report: "Evidence collected by the Commission leads to an
overwhelming conclusion: Government forces deny medical care to those from
opposition-controlled and affiliated areas as a matter of policy."

   A Syrian government official said hospitals in rebel-held areas, usually
located in battle zones, aren't appropriately marked as medical facilities
and are often used by rebels to store ammunition or launch attacks.

"It's the rebels taking advantage of it being a hospital and saying to the
media: 'Look, they are shooting at a hospital,' " said Reem Haddad, an
official at the information ministry in Damascus. "There is no way the
Syrian army will know whether this is a hospital or not."

Ms. Haddad said opposition forces have targeted clearly marked hospitals in
government areas, including Tishreen Hospital in Damascus and al-Kindi
Hospital in Aleppo, which she said were hit by mortar shells on Wednesday.

Dr. Ismail is among thousands of doctors who faced an agonizing choice:
Treat only patients approved by the government of Bashar al-Assad, or throw
their lot in with the opposition.

For a time, Dr. Ismail did both, he said. By day, he worked as a
gynecologist at a government hospital. At night, he treated wounded rebels
and civilians under the nom de guerre, Dr. Abulqa'qa'.

He is now in Turkey, his cover blown, anxious to return home, where, he
said, his skills are needed. He said his mother and two brothers were
recently hurt in government attacks.

"My whole life, everyone would call me doctor," said Dr. Ismail, the oldest
of eight children. He recalled being first in his class growing up in
Qasamiyeh, a village about nine miles outside Damascus in the Ghouta
region, the agricultural suburbs now under government siege.

The high expectations of his family and neighbors, he said, motivated him
to become the only medical student in his village of 7,000 people.

Dr. Ismail studied medicine in southeast Ukraine, where he lived for seven
years. He learned Russian and some English. In his spare time, he taught
Arabic and played soccer. Living abroad, he said, helped shape a more
critical view of his country.

During visits home, he was greeted by honking horns from a convoy of cars
filled with family and friends. The doctor-to-be often stole the limelight
at village events. He got a standing ovation when he arrived as a guest at
one wedding and some people mistook him for the groom, he recalled with
embarrassment.

Dr. Ismail returned home after completing medical school in 2010, and he
specialized in gynecology at the Greater Damascus Mujtahid Hospital.

His life changed the following year, when demonstrations erupted against
the Assad government. On April 22, 2011, protesters gathered near a mosque
in Qasamiyeh and surrounded a statue of Hafez al-Assad, the former
president and Mr. Assad's father. Dr. Ismail joined the protest despite
pleas from his parents, and the crowd brought the statue down. Security
forces fired; eight people died and more than 50 were injured.

That day, Dr. Ismail said, his parents' living room "practically turned
into a field hospital," with the administering of stitches and sutures to
the injured.

As protests spread in the Ghouta suburbs, the number of deaths and injuries
grew. Dr. Ismail and a friend—a first-year medical student—turned a vacant
farmhouse into their first field clinic. The doctor and antigovernment
activists collected antibiotics, gauze, splints, suture kits and other
supplies. Villagers would ask Dr. Ismail to make house calls because they
feared arrest if they ferried injured loved ones to the clinic.

Five days after the first patients were treated, Dr. Ismail said, the
clinic was bombed.

For much of 2011, Dr. Ismail worked at a hospital in a government-held
region of Homs, sneaking out to protests between shifts. He met local
rebels and volunteered with the Free Syrian Army, treating injuries and
delivering milk and medicine to besieged neighborhoods.

As Dr. Ismail went on riskier assignments, he adopted a rebel name, Dr.
Abulqa'qa', after a legendary Islamic fighter known for bravery and
physical prowess. He said he would overhear medics talking about a
mysterious rebel doctor who secretly crossed the front lines to treat the
injured. During those conversations, Dr. Ismail said, he would nod or
pretend to be preoccupied.

In January 2012, rebels launched attacks on the capital from the suburbs
and government forces responded. As casualties grew, Dr. Ismail began his
most ambitious project with two men, a friend and the owner of a plot of
farmland. They pooled funds to start building the underground clinic and
drew the first outlines in the dirt one night with tree branches. "We
worked painfully slow," Dr. Ismail said, to avoid detection.

Their first patient was a man who needed eye surgery to remove shrapnel.
Dr. Ismail recruited two eye surgeons, two anesthesiologists and a nurse.
The volunteers arrived blindfolded, he said, to keep the clinic's location
secret.

In a different part of the Damascus suburbs, Dr. Ismail worked at a clinic
in a building that also housed the local rebel military council. The clinic
was later struck in a rocket attack.

By midyear, Dr. Ismail had quit his job at the government-run hospital in
Homs, and was working with a first-year surgery resident to serve 10
villages in rebel-held areas. He said they took on more difficult
surgeries, including chest operations and amputations.

Around that time, Dr. Ismail negotiated with a driver working for a private
hospital in Damascus to secure an ambulance. The doctor arranged for the
man's family to move to a neighborhood guarded by rebels. The ambulance was
guided slowly through a minefield. Then rebels beat the man, Dr. Ismail
said, so authorities would believe the vehicle was taken by force.

By the start of 2013, Dr. Ismail had only the ambulance and the underground
clinic, still under construction. Between February and May, the front lines
moved closer.

They performed three eye surgeries before government forces retook the
region in June. "We just needed two more months and a little more money,
and we would have been able to finish it," Dr. Ismail said. He moved to a
small clinic nearby, one of the last working medical facilities in the
Ghouta region.

On Aug. 21, he was winding down his shift when bodies began arriving from a
chemical gas attack that killed more than 1,400 civilians, according to
U.S. estimates. The first patient that night was a 5-year old girl in
cotton pajamas whose limp body was dumped into his arms. "She was dead," he
said. "I just couldn't absorb that."

Working with a medical student and 15 nurses, Dr. Ismail turned on garden
hoses to flood the clinic floors. They dragged the bodies through the
water. Soon, the dead filled the clinic's two rooms. About 4 a.m., Dr.
Ismail passed out from the chemicals. He said he was revived with an
atropine injection.

By 10 a.m., the doctor said, he had tallied 200 dead. "The worst part was
the wailing" of grieving families, he said.

Dr. Ismail recorded videos on his Sony Ericsson cellphone. In one viewed by
The Wall Street Journal, a veiled woman in a brown trench coat is seen
stepping over bodies. "Where is God?" she is heard saying. "Where are you
my children?"

The doctor said he spent the next two weeks in a daze. Activists reached
him on Skype, saying Western governments, particularly the French, wanted
witnesses to give testimony about the gas attack. Several countries,
including the U.S., were debating a military strike against the Assad
regime.

On Sept. 10, Dr. Ismail left with hair and blood samples, traveling through
the deserts of Deir el-Zour in the east and then north to the border with
Turkey. He and two travel companions were hosted by tribal families for
most of the 10-day trip.

Dr. Ismail crossed the border in a truck smuggling fuel and generators. He
said he was held by Turkish authorities for two days over a
misunderstanding over who should get the samples, and whether his
companions—who didn't carry passports—could cross into Turkey.

Turkish intelligence eventually took the samples, he said, which were
destined for the French Embassy in Ankara. One French official said
national intelligence agencies coordinated efforts to get survivors and
witnesses of the sarin-gas attack out of Syria, and the details were
largely kept secret. A spokesman for Turkey's foreign ministry didn't
return a request for comment.

As Dr. Ismail waits to return, he moves among various homes of activists
and rebels. He has crossed into Syria three times but has been forced back
by the constantly shifting battle lines.

He assumes if he is caught by government forces, he will be killed. Yet he
said he was eager to again tend to the wounded—disappointed that his
mission took him out of Syria and failed to draw Western intervention.

"I'm not a taxi driver. I didn't come out here to deliver samples," Dr.
Ismail said. "I came out because I thought I was serving a greater cause
than the one I was serving inside."

—Mohammad Alakraa
in Beirut
and Sam Dagher in Damascus
contributed to this article.

*Write to * Nour Malas at nour.malas at wsj.com

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