I live in a small room in the hospital. It’s about three metres square, and has a small bathroom and sink. I live there with my wife. We are at the hospital 24/7. My wife teaches in the attached school, and I work in the hospital 24 hours a day. Sometimes I rest or sleep, but if someone needs surgery, I go and work.

Before I was the hospital director, I was a general surgeon. But during the Syrian revolution that started four years ago, I was forced to do everything. I had help from normal civilians who did not study medicine, and I had to teach them basic first aid, medicine and surgery. I had to do everything: vascular surgery, ortho surgery, urology and everything else, eventually even ob/gyn surgeries.

There wasn’t a team to do these surgeries, so when a case came in, I was obligated to work on it. There was no alternative, besides amputation perhaps. So I had to learn. YouTube helped a lot. And I have friends overseas who I would call on the internet and they would explain to me how to do certain procedures. I had cases I had never seen in my life, that I had no idea how to handle. But I had to do it with my own hands. So I asked my friends or looked at YouTube and thank God, it all succeeded. I had great results.

Right now the situation is calm because we’re in something like a ceasefire. It’s not a 100% ceasefire, but it’s partial. Sometimes there are clashes between the opposition Free Syrian Army (FSA), and Bashar al-Assad’s regime forces. I am speaking as a totally neutral party. I am a doctor and I work in development and health, I don’t agree with any oppression.

My hospital is the main one in a large opposition-controlled area in east Damascus. We serve 200,000 people with all medical specialties for whoever needs them. We have one section for conflict injuries, and also normal services for civilians: children, women, everything. We have a special section for ob/gyn, clinics, and laboratories.

I don’t lean toward any party. I work in the opposition areas because I can’t operate in regime areas, because I am wanted by the regime. If I go to regime areas, I will be caught and jailed. Also, regime areas are served well, they have everything. But the opposition has no medical services. So I serve people who are underprivileged and oppressed.

We are always short of medical supplies. Medicins Sans Frontieres doesn’t disappoint us, but they can’t keep up with all of our requests and demand. We are one of many hospitals they support. We lack many things, so we get on their waiting list. For example laparoscopy helps relieve the surgery a lot. We can put a camera inside a patient’s belly and can put medicine in the scope, without cutting the patient open.

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We also don’t have things like a CT scanner or MRI machine. That means if someone comes in and they have a brain hemorrhage or head injury, we need to give them a scan to assess how to treat the problem. The patient can’t go to a regime-controlled area because they might be wanted there. So the patient has two choices: die here on his land, or go to the regime area and be caught and possibly tortured. Many of them say, “I’d rather die here than be tortured in a regime prison”.

The hospital has about 50 staff, and there are about another 150 who work in the attached school and development projects. The school has 1,200 students. I helped build up a school before this one until it grew to 1,400 students, but then it was hit by two regime airstrikes and totally destroyed. Thirteen children died and 25 more were injured. It was a terrible time, but the students and parents said that their studies must continue, so we started building this new school in a more protected area.

The last hospital I worked at was also destroyed by regime airstrikes. This is because the FSA depends heavily on civil services. The hospital is a main player in the presence of the FSA. If there is no hospital, the FSA doesn’t stay there because they cannot keep up their resistance activities. Any injured person will die. If there’s a hospital, they can be treated and go on with their lives.

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One big problem we have is that all the doctors have left and gone to Europe. I had good doctors but they all left, until I was the only one, but now I have a urology doctor. The nurses and staff have stayed with me, though. I’ve had one team with me for three years. People are really happy, we all feel like family. The only difficulties we face are financial. Our pay is very low. But the staff say to me: “We stay with you until death. As long as you are here, we will stay with you”. They are my friends, and more than brothers.

I really don’t know how I’ve stayed here. The conditions are very bad. My friends tell me their work is so nice abroad. But there are very oppressed people here and I have to stay with them. That’s it.

I used to be with the cause, in the heart of the revolution. I was one of the people who used to go out and protest the regime at first. But the humanitarian work we are doing now makes me forget the cause. After I see the news, what’s happened to the country, what’s happened in Aleppo and Homs, the civilian work has become much bigger to me than the revolutionary work.

I’m very stressed. I take about six painkiller pills a day so I can get on with my work, but it’s just things like Ibuprofen or paracetamol.

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The difficult times are many. We might have a patient we can’t do anything for and we have to wait for them to die, knowing if they were abroad they could be saved. We watch them die slowly, and it’s very hard. Or we birth a newborn and the baby needs an incubator or special care, but because we are under siege, we cannot get this baby out to Damascus or to proper care. The baby might be 1-2 hours old. These babies have nothing to do with the war, but they meet their fate because of it.

I expect I’ll be here until I die. People here are poor, looking for someone to help, looking for some care. The patients here cannot get medical care anywhere else because they don’t have a penny. All the regime hospitals are for a fee. These 1,200 students will not have any studies without us. I am obligated to stay with these kids until they can be educated and have the same opportunity that I have as a doctor. It doesn’t feel right that I should leave to a life abroad while people stay behind.

My only hope is to teach children and the new generation so that they can build our country anew. That’s all.

As told to Lubna Takruri. The doctor, who works at a hospital supported by Medicins San Frontieres, asked to remain anonymous.

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