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Just 400 meters from the front line in Aleppo, gunfire and mortar blasts echoed through the streets as the wounded and desperate were wheeled and carried to the Dar al-Shifa hospital in the ancient Syrian city. While located in the Free Syrian Army-held zone, a doctor said hospital workers tended to both FSA fighters and government soldiers, but that a full 80 percent of those treated were civilians, many of them children.

Formerly a private clinic owned by a local business man loyal to President Bashar al-Assad, the hospital was transformed into a field station where the desperately understaffed medical personnel tended to between 100 and 150 patients per week. With limited supplies and medical specialization, the volunteer doctors and nurses and even veterinarians worked to patch up the wounded and sent those who needed special attention, such as surgery, to the Assad-held part of the city to be treated at better-equipped hospitals.

Dar al-Shifa was a target for frequent bombings by government forces, but through the fighting the medical staff stayed put, continuing their work to help the grievously injured on hospital floors littered with debris and puddled with blood. Chief Doctor Osman al-Haj Osman, 30, told Vice that the reason Assad forces aim for the hospital is that “when you kill one doctor, it is better than killing 1,000 fighters.”

Since the fighting began on March 15, 2011, Syria’s conflict, initially inspired by the Arab Spring, has steadily turned into a civil war. As the conflict enters its 21st month, the death toll is climbing towards 40,000. The UN refugee office says 414,838 Syrians are in neighboring countries registered as refugees.

The rebels have managed to take hold of an area between Aleppo and the Turkish border, which they have dubbed “Free Syria.” Low on supplies and heavy weapons, and up against a regime thought to be receiving assistance from Russia, Iran, and even Hezbollah, the FSA rebels have endeavored to break a stalemate and are desperate for something that could tip the balance in their favor.

On November 21, Assad’s troops succeeded in leveling the Dar al-Shifa hospital with a missile strike, killing at least 15 people including four members of the volunteer medical staff. Photographer Niclas Hammarström was at the hospital in the month prior to its destruction, documenting the work of those who put their own lives on the line to save others in the heart of the death zone.