Running a Hospital in a Syrian Village Under Siege

— -- After rebel forces entered the rural Damascus village of Zabadani in 2012, the regime placed it under siege, blocking all entrances to the town and encircling it from the surrounding mountains. Two years later, residents say the government is still bombarding them with rockets and barrel bombs.

Like other besieged villages, Zabadani has been closed off from the outside world, and from any medical assistance. Abdulhamid, 30, is one of the few remaining doctors in the area. A 30-year-old graduate of Damascus University, he has a diploma in Anesthetization and Resuscitation, and was completing his orthopedics residency at the city's Mujtahed Hospital before the conflict began.

He is now the head of Zabadani's Medical Organization, created because the transport of injured or sick civilians to nearby state-owned hospitals had become too dangerous. The organization has since built a field hospital and several clinics in the town. Here, he discusses the challenges of operating a hospital in a village cut off from the world:

The medical situation in Zabadani is awful. There is no health system. The only medical institution in the town is our organization's hospital, clinics center and free pharmacy. We have eight doctors and 10 technicians working in anesthetization and resuscitation, laboratory, physical therapy and surgery. We also have three nurses, an accountant, a legal adviser and two cleaning workers.

The field hospital started as a group of newly graduated doctors and activists trying to aid the injured with simple equipment and little support. Our doctors paid for their equipment themselves; sometimes we were able to buy additional supplies from pharmacies.

In late 2011, after the regime started targeting the city with rockets, we started developing the hospital. We were able to get some medical aid from the Syrian Arab Red Crescent, and some doctors were able to smuggle some medical supplies over from state-owned hospitals. We started with a few beds. Now we have have an operating room. And there is a clinic for orthopedics and internal diseases.

Most cases we see are emergency cases, resulting from the war in the area, as well as orthopedic traumas and internal diseases. The most common diseases among civilians include TB, typhoid fever, brucellosis, diarrhea, respiratory and urinal infections and some polio cases. The number of patients coming to the hospital and the clinics center varies, but we see an average of 125 cases in the hospital everyday, and more than 15 patients in the clinics center. At the hospital, we issue a monthly report that documents and explains each case we saw.

The clinics center includes a pediatric clinic, an internal disease clinic and a dental clinic. The latter treats only emergency cases, since dental treatment is highly expensive and required equipment is extremely difficult to obtain, due to the siege. The clinics center works for specific hours and in organized shifts. Emergency patients are referred to the hospital, which is open 24 hours per day. There is a small physical therapy center and a laboratory for urgent cases.

Medication is offered to patients, free of charge, either in the center pharmacy, or the hospital pharmacy, which also is open all day. The medications we provide include insulin, both for children and adults, and medications for heart diseases, diabetes, epilipsy and pediatrics.