In March 2013, a group of Aleppo residents began the first Civil Defense Unit (CDU), a civilian emergency-response team. Through shellings, barrel bombs and other violence, CDUs—now with hundreds of staff and volunteers across rebel-held Syria—work as first responders to extinguishing fires, evacuating the wounded and transporting victims to nearby medical centers.

Since the formation of the Syrian Civil Defense, deliberate attacks on CDUs have killed 106 personnel, according to last week’s Syrian Network for Human Rights report.

It is not only air strikes and arbitrary arrests on the ground that are deadly for civilians, three Syrian Civil Defense leaders in Homs, Latakia, and Idlib provinces tell Syria Direct.

“People die because the Civil Defense does not have the necessary equipment,” Mohammed Thikra, head of the Maarat a-Numan Civil Defense in Idlib province, tells Syria Direct’s Nisreen A-Nasser.

In the encircled northern Homs neighborhood of Waer, for example, fuel shortages paralyze the local Civil Defense. Ambulances do not run except for the most urgent circumstances while emergency blood donations spoil in freezers that have no electricity.

“It’s triage,” says Abu Hamza Al-Homsi, spokesman of the Waer Civil Defense.

“These shortages are real, the consequences are dire, and they keep us from doing our job.”

Abu Hamza Al-Homsi, spokesman of the Waer Civil Defense in rebel-controlled north Homs province:

Q: What equipment is in short supply?

While we lack certain emergency medical equipment, the most pressing concern is the serious shortage of fuel, which has effectively paralyzed the Civil Defense. As a result, we can only tend to the most serious cases and are unable to perform our work properly.

Civil Defense personnel search for survivors underneath the rubble of a recent bombing. Photo courtesy of Mohammed Thikra.

Q: How do you manage emergency situations?

Given the fuel shortages, we can only use the ambulances in the most serious circumstances. It’s triage. Donated blood will spoil because we don’t have the electricity to run the freezers. Ambulances will run out of gas in the middle of the street. Just imagine how dangerous this is. Female CDUs can suddenly be stranded in the middle of delivering a baby because our ambulances don’t have fuel.

Q: Has anyone ever died because the Civil Defense did not have the requisite medical resources to treat the injured?

While we have never lost someone for this reason, people have certainly died at hospitals and medical centers because of the crippling shortage of medical supplies. If this siege continues and we are unable to get fuel or other needed supplies, our work will be next to impossible. The total lack of fuel has already kept our units from being able to do their jobs. We have also lost cars and ambulances because we simply do not have the resources to repair these vehicles.

Q: What do you ask of the humanitarian relief organizations?

We have asked these organizations for help before, and we will continue to do so moving forward until we receive the help that we so desperately need. If help doesn’t arrive then it isn’t just the CDU that will suffer. The entirety of Waer will face a humanitarian disaster. These shortages are real, the consequences are dire, and they keep us from doing our job. It is only a matter of days until we reach our breaking point.

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Mohammed Haj Asaad, leader of a Jabal al-Akrad CDU in Latakia province:

Q: What equipment is in short supply?

The Syrian Civil Defense administration supplied our unit with search-and- rescue equipment; however, we still need fully stocked ambulances and other first-response supplies. If we had these resources, our ability to save lives would increase dramatically.

We are also in need of much better firefighting equipment. Our current fire trucks can only carry 10 barrels of water when we really need to be carrying 90 barrels at a time. This is especially important in the camps, which are prone to fast-spreading fires. Without these supplies, we run the risk of facing a humanitarian crisis.

Civil Defense personnel work to put out a fire in Idlib province’s Maarat a-Numan. Photo courtesy of Mohammed Thikra.

Q: How do you manage emergency situations?

Our personnel go through first-responder medical training courses, which focus on how to transport the injured to the nearest medical location.

Q: What do you ask of the humanitarian relief organizations?

The Civil Defense personnel are the sons and daughters of those who have been killed and displaced by the Assad regime and its supporters. All that we ask is that these organizations ensure the safe delivery of food packages to our Civil Defense personnel and their loved ones.

Q: Can you recount any specific stories or difficulties that you have faced while on the job?

On April 6, 2016, a fire broke out in Khirba Al-Baqr near the camps for the internally displaced. After the fire caught hold of a large forest, our men faced a challenge given the low water-carrying capacity of the fire trucks. The blaze came dangerously close to the camps, but thankfully the firefighters were able to put it out at the last second. If our fire trucks could carry more water, we would have been able to control the fire far more easily.

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Mohammed Thikra, head of the Maarat a-Numan Civil Defense in Idlib province:

Q: What equipment is in short supply?

We have a shortage of heavy engineering equipment such as hydraulic shears and cranes, which are used to cut metal and to lift large piles of rubble.

Q: How do you manage emergency situations?

The injured are taken to nearby medical locations while those who are seriously injured are taken to Turkey. The Civil Defense, however, can only bring patients to these nearby medical locations.

The biggest challenge is when we are targeted while in the process of trying to save lives. Many members of the Civil Defense have died in the line of work for this reason.

Q: Has anyone ever died because the Civil Defense did not have the requisite medical resources to treat the injured?

Yes, people die because the Civil Defense does not have the necessary equipment to perform their duties.

Q: What do you ask of the humanitarian relief organizations?

Above all else, we ask that the regime and the international community stop the killing of innocent civilians at once. We ask for support for the Civil Defense and medical units, namely in providing up-to-date emergency and firefighting equipment.

We have urgently asked for fuel, but, unfortunately, help hasn’t come. Fuel is a major issue because, without help, the Civil Defense will have to stop operating its vehicles and equipment. The price is so prohibitively expensive; today a barrel sells for SP115,000 [roughly $520].

Q: Can you recount any specific stories or difficulties that you have faced on the job?

Russian warplanes bombed a Doctors Without Borders hospital, killing more than 25 people, most of whom were medical staff. Even though we lacked much of the needed heavy machinery, we were still able to save four lives from underneath the rubble. This whole process took more than 72 consecutive hours.