Saving Lives in a Clandestine Hospital in Rebel-Held Syria

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This story is based on a radio interview. Listen to the full interview.

Audio Transcript:

Marco Werman: I'm Marco Werman; this is The World. Turkey is urging the creation of a buffer zone inside Syria. That's a safe area where the United Nations could protect people displaced by the Syrian conflict. Turkey has a lot at stake in the matter. Some eighty thousand Syrian refugees are already in Turkey, and U.N. officials say up to five thousand more have crossed the border each day in recent weeks. The Turkish proposal for a buffer zone was quickly dismissed, though. In a rare TV interview today, Syrian President Bashar al-Assad called the idea impractical. Those refugees are fleeing a conflict that has killed an estimated eighteen thousand people since it began last year. Many thousands more have been wounded, and those who care for the injured in rebel-held areas take huge risks to do so. Anesthetist Rachael Craven, of the Bristol Royal Infirmary in England, used her holiday leave this year to go to Syria. She worked there for the relief group Doctors Without Borders, also known as Médecins Sans Frontiéres. For security reasons, she can't describe exactly where she treated patients.

Dr. Rachael Craven: All I can really say is that we're in the north of the country in a rebel-held area, and that we're working in a house that's been converted into a hospital, but from the outside it just looks like a normal house.

Werman: And remind us why this secrecy on where you were?

Craven: We're there illegally and must haveââ?¬ ¦ Doctors Without Borders contacted the Syrian government and did ask for permission to work within the country, but that was refused. However, we felt that the needs within the country were such that we couldn't really accept that. It's something that Doctors Without Borders does very occasionally, maybe three times in the last thirty years, but in this case they felt that it was necessary.

Werman: So this hospital looks on the outside like a home. What's on the inside? How well equipped was it?

Craven: So on the inside, downstairs, there are reception rooms that have all been ,converted. So one is an operating theater. We have a resuscitation room, a recovery room. The kitchen has been converted into a sterilization area for all of the surgical instruments. We have an emergency room in the courtyard. And then upstairs, the bedrooms have all been converted into wards. All the equipment has been smuggled in over the border, and it's basic equipment, but it's very well suited to the environment given the problems of electricity supply, and it does allow us to really perform most types of surgery that are necessary in that context.

Werman: The U.N. estimates the number of people who've died in the Syrian uprising to be over twenty thousand. There'll be many more injured. Were you worried about what you were getting into, and is what you saw at this hospital suggestive of the casualty rate?

Craven: The flow of patients into the hospital would be very variable from day to day. That was partly due to just what was happening. So if there was a battle locally, if there was shelling locally, then you would obviously get a big influx of casualties. There's no ambulance service, or a very limited one. Most of the patients were arriving, you know, on a mattress on the back of a pickup truck. So you can only imagine that perhaps quite a large proportion of people who might otherwise be saved, are actually dying en route to facilities such as ours. You can't really plan, because you don't know what you're going to have in the next few minutes. And there's always an edge of insecurity. You don't knowââ?¬ ¦ Are you going to be able to stay there? You always have to think, if you had to evacuate, which patients can be discharged? Who do you need to take with you? So this is a quite different range of problems.

Werman: And sometimes, I gather, it's not just logistics. A lot of Syrians have stopped going to hospitals, apparently. Why is that?

Craven: There's a lot of fear that ¦ Certainly, if you go to one of the government hospitals and you have injuries from either shelling or gunshot injuries, especially if you're a young man, you might be considered to be a rebel and then, you know, you could be in danger.

Werman: Were you treating a mix of fighters and civilians?

Craven: Yeah. I would say it was probably around about fifty/fifty.

Werman: You do sound like a doctor who, you know, has to get into these situations, and has to remain calm and objective, but maybe you can just tell us about one case, one individual, where you kind of stopped in your tracks.

Craven: There was a young man who was brought into us. He'd come in on the back of a pickup truck. It was late at night. He had been shot in the neck. The story we were told was that he'd been trying to escape from Aleppo with his family. When he arrived, he was very distressed, and semi-conscious because the gun shot to his neck had caused a lot of bleeding, which was swelling and pressing on his airway, so he was having a lot of problems with his breathing. And he also had, unfortunately, an injury to his C-spine from the bullets. So even though we were able to save his life, from the point of view of his breathing, you know, he had an extremely severe injury. We eventually managed to transfer him out of the country, but you know, he was there with his wife and a very young child, and you know, you realized that the future for that family had really just been wiped out.

Werman: Dr. Craven, what would have happened to you and to this undercover hospital if it had been discovered? I mean, did Doctors Without Borders have a contingency plan for you?

Craven: We had an evacuation plan. If we had been discovered, it's very hard to know what would have happened, or what would happen. And, I mean, you hope that you'll just be left alone. [laughs] But you don't know. You know, the rumors on the ground are that hospitals are a target. Obviously, we're not taking any risks there, and we're trying to keep extremely quiet about the location of the hospital.

Werman: I just want to know, while your colleagues go off on summer vacations and sit on beaches, why did you go to Syria? Why did you do this?

Craven: For me, personally, I find it extremely rewarding and challenging. Whilst obviously there are very grim aspects to the job, there are also very positive aspects to it as well. So I find, for me, it adds quite a lot.

Werman: Anesthetist Rachael Craven of the Bristol Royal Infirmary in England, speaking about her work in Syria with Doctors Without Borders. Thank you very much for your time.

Craven: Thank you.