A small charity-run medical center in this northern Lebanese city is quietly providing healthcare to a rising number of Syrians, civilians and combatants alike, who have been wounded in the nine-month confrontation against Syrian President Bashar al-Assad's regime.

Many of those recovering in here are from Qusayr, a town of some 44,000 residents lying five miles north of Lebanon and close to the flashpoint city of Homs. Their accounts paint a grim portrait of a town under siege by Syrian security forces with no electricity, no telephone communications, and dwindling food supplies – illustrating the perils that many Syrians face as the Assad regime cracks down on an increasingly violent uprising.

Abu Ahmad, an engineer’s assistant, was hit in both legs by machine gun bullets when leaving a mosque after prayers to join in a demonstration.

“They shot at us as we coming out of the mosque. I was hit by three bullets in the legs,” the thickly bearded man says, lying in his hospital bed. “We were only asking for our freedom, but they consider us terrorists.”

Bystanders attempted to give him medical assistance but he had to wait for four hours until it grew dark before he could risk the journey to the Lebanese border. The bullets had shattered a knee cap and a bone.

“They gave me painkillers and wrapped me in a blanket and placed me the back of a truck. We moved from village to village in the darkness and then crossed the border where the Red Cross was waiting for me,” he says.

Safety concerns even in Lebanon

A floor of the Tripoli hospital has been turned over to Syrian casualties who are forced to undertake the hazardous journey across the border with Lebanon that is patrolled by army troops and laced with land mines.

“We are receiving a lot of people. The rate of casualties is increasing,” says Abu Bashir, a volunteer who helps coordinate the treatment of casualties and, like others interviewed for this article, used a pseudonym due to the sensitive nature of the center’s work.

Indeed, the refugees are not guaranteed safety even once they cross the border.

Syria exerts a pervasive influence in Lebanon through a network of Damascus-backed allies and a sympathetic government in Beirut. Several Syrians have been abducted in Lebanon since the uprising began in mid-March, and anti-Assad regime activists are forced to live in hiding, moving from one safe house to another.

Some 5,000 Syrian refugees are scattered across northern Lebanon, many forced to rent accommodation or stay with friends and relatives given the lack of assistance from the Lebanese state. Turkey, in contrast, has established a number of camps along its southern border with Syria – where as many as 12,000 Syrian refugees have crossed – and is catering to the needs of those remaining in the country.

Escaping Syrian soldiers

Most of the casualties being treated at the medical center are from Syrian towns and villages which, like Qusayr, lie close to the Lebanon-Syria border.

Fawzi, a young ironsmith from Tel Kalakh, two miles north of Lebanon, was shot in both arms two months ago by Syrian security forces who burst into his home after he had returned from an anti-regime protest.

“They pushed their way in past my mother, told me to raise my arms in the air and one of them fired four bullets from his rifle into my arms. After I fell to the ground, they stomped me with their boots,” he says.

Faisal, a thin wide-eyed 24-year-old from Qusayr, recalls an incident in November when he and several of his friends were trying to escape Syrian soldiers who were conducting house-to-house searches.

“We ran away from the houses and hid in some trees,” he says. “I fell asleep after a while but when I woke up I saw soldiers very close to me,” he says. “They shot at us and a tank fired a shell at us. Four of my friends were killed in the explosion and I survived only because I was crawling on the ground.”

One of his friends attempted to hide again from the soldiers but his location was betrayed by the ringing of the friend's cell phone.

“The soldiers found him and shot him dead,” Faisal says.

Although Faisal escaped unharmed, he was shot in the arm days later when taking part in a protest.

Army defectors also take refuge

But it's not just protesters who fill the Tripoli hospital floor.

Among the refugees sitting around a small smoke-filled room crammed with bunk beds are Syrian Army defectors who joined the rebel Free Syrian Army (FSA). One defector serving with the Free Syrian Army in Qusayr was shot 14 times in the chest and stomach by regular soldiers.

“I made a mistake of having my rifle slung over my shoulder so I could not shoot quickly enough,” he says, displaying some of the pockmarked wounds across his chest and stomach. “But my friend shot and killed all three of them,” he says.

Hassan, originally from Homs, says he served in one of the Syrian army’s elite commando units before defecting with another soldier five months ago. He made his way to Qusayr where he joined up with a FSA unit and engaged in clashes with security forces. One afternoon in mid November, Syrian troops opened fire against demonstrators in Qusayr.

“When I heard the people yelling ‘God is Greater,’ I forgot all my training. Instinct kicked in and I was filled with rage and a desire to fight and protect them,” he says.

Hassan and his comrades flanked the soldiers and took cover behind a barricade of sand some 400 yards away.

“We cannot get too close because they have tanks and anti-aircraft guns which they use against us. When we open fire, we move to another spot quickly before they can shoot back,” says Hassan, who has grown a thick beard and wears a bandana around his head with the Arabic inscription, “There is no God but God and Mohammed is his Prophet.”

After the initial clash, Hassan says he was running to a new position when he was hit in the legs by a burst of machine gun fire.

“I fell to the ground and a friend tried to pull me up but he was shot in the arm,” he says.

Wounded Syrians 'treated as terrorists' inside the country

Hassan and the other wounded refugees in the Tripoli medical center are the fortunate ones who were able to escape to Lebanon. Most injured Syrians have no choice but to stay in Syria and run the risk of arrest or worse if they admit themselves to hospitals or try to recuperate at home.

“We ask the international community to help protect the hospitals in the Homs area because they have been turned into military compounds,” says Abu Ahmad. “If a wounded man comes to hospital, they kill him at the front door. Even people who go for normal treatment are treated as terrorists.”

Even in Lebanon, the main government-run hospital in Tripoli only accepts critical cases from Syria and only if they are delivered by a Lebanese Red Cross ambulance, according to doctors at the medical center.

“They operate on them and then they are sent to us for recuperation,” says the chief doctor at the center.

Political pressure on hospital

The authorities at the medical center say they expect to receive many more casualties from Syria in the coming days and weeks and have drawn up plans to construct temporary extra accommodation on the roof of the building to house them.

But they worry that the Lebanese authorities could place pressure on the hospital management to stop receiving Syrian casualties. The chief doctor said that Lebanese military intelligence had wanted to establish an office in the center to take the name of all those Syrians admitted for treatment.

“The owner refused and told them that this was a humanitarian institution,” the doctor says. But he is pessimistic about how much longer the center can hold out.

“Lebanon is not a safe place, and we have no political cover,” he says.