“A quick examination was reassuring: for the moment, Aysha’s baby was stable.” Anne Marie Pegg Médecins Sans Frontières

NORTHWEST SYRIA—It’s raining again.

True, it’s not snow (that, fortunately, hasn’t made an appearance in several weeks). But it’s still cold. The absence of central heating and the dampness means the cold settles in deep.

My bedroom is heated (I use the term loosely) with some type of diesel-burning furnace, which I admit to being somewhat afraid of. I fear it is going to a) explode in the night and kill me instantly, or b) leak some kind of toxic gas and kill me slowly. Neither of which has prevented me from using it, as it does permit a degree of warmth necessitating only four blankets and two layers of clothing to sleep.

I have forgotten what it feels like to be warm, to climb into a bed at night with sheets that aren’t cold and damp. I dream of unrestricted access to a hot shower.

Yet, I am fortunate.

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Médecins Sans Frontières (Doctors Without Borders) has been running a trauma hospital here since June 2012. I am here as the hospital medical referent, responsible for the overall function of medical activities, as well as outreach.

Fewer than 10 kilometres away is a camp for internally displaced persons, and it is growing bigger by the day.

People who fled their homes — often with just what they could carry — find themselves installed in a tent, which they likely share with their entire family. Possibly they are fortunate enough to have received some blankets and a heating implement. Plastic sheeting and canvas, however, offer little protection from the wind and rain.

The lack of adequate heat affects more than just the camp population. Fuel shortages abound and prices have skyrocketed. People will burn almost anything to stay warm — and they will burn it in anything. The result? An epidemic of burn patients. Multiple times a week they arrive at the hospital, their faces and hands always the most severely affected. Often it is children, who were huddling close to sources of heat, or playing with fuel.

We do our best: our hospital is small, but we are able to provide proper dressings to decrease the chances of infection, and some physiotherapy services to maximize the chances of a functional recovery.

And we hope it will soon get warmer.

Médecins Sans Frontières also supports a number of outlying health posts and field hospitals by donating medications and supplies and, in some cases, by providing training to personnel.

One of these health posts is set up in the basement of a mosque, which provides a measure of protection against the shelling that still happens almost daily. Here, a group of young men are providing first-line health services for the war wounded, while also caring for those with routine health concerns, such as children with respiratory infections

I have visited several times to provide basic training. They are eager to learn — and have much to learn. You see, none of them are actual medical personnel. Before the conflict they were students: in law, tourism, engineering. One of them was a medical student, two were dentists. They are now “nurses” and “doctors.” Each visit we focus on a different topic. It is slow going, made all the slower by my inability to speak Arabic. Yet, despite the violence and the cold, certain aspects of regular life continue.

Aysha arrived in the hospital shortly before 5 a.m. recently. She had been in labour for hours. The baby’s head wasn’t in the usual delivery position, Aysha was tired, and baby’s heart rate was changing. Aysha had spent hours in a nearby clinic, where the sole female physician in the area runs a small delivery service. She isn’t able to perform a caesarean, however, and was unable to contact an ambulance to transfer Aysha to a hospital 25 kilometres away. She knew we were a trauma hospital, but she also knew we had a surgeon on staff — would it be possible to send the patient to us?

So Aysha arrived. Exhausted and in pain, with her mother and sister at her side. Their worried faces were not particularly soothed by my likely confusing words and gestures. Yes, there it was again, the language barrier — yet this time I was essentially on my own: cultural restrictions prevented the presence of a male translator to assist me.

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A quick examination was reassuring: for the moment, Aysha’s baby was stable. But it was also clear she would unlikely be able to deliver in a normal way. Without the space, trained staff, or appropriate equipment to monitor her labour, it was decided a caesarean was likely the safest option.

So off we went to the operating room; 30 minutes later emerged the first baby ever born in the hospital. I was given the honour of naming him. He is Arshad, which means “honest” and “well-guided.”

I hope he grows up to know peace.

Canadian family doctor Anne Marie Pegg has been working with MSF since 2008, doing missions in Ethiopia, Haiti and Pakistan, among others. She joined MSF's emergency pool this January.

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