Years of fighting have undermined much of Syria’s infrastructure, and many parts, especially the Damascus suburb of Daraya, have been reduced to rubble. Syrian health care’s been caught in the crossfire, with dozens of hospitals across the 17-million-strong nation damaged and thousands of doctors fleeing the violence.

A health-care system once dubbed “the envy of the Middle East” and touting an average life expectancy of 75 is now at risk, not to mention Syria’s once-thriving pharmaceutical industry. Yet universities and other educational institutions are still operating in parts of Syria under the regime’s control. Secondary education is free and provided for by the state through university, with some private alternatives available. Damascus University is the largest and operates eight hospitals across the capital. Many Syrians still study here, including roughly 6,000 in the field of medicine, and the medical school continues to churn out new graduate doctors each year. These brave young physicians are crucial to the survival of Syrian health care, and their training must be met with optimism. But living in a war zone, studying and planning for the future are far from easy.

I was walking from the university hospital to the medical school when a suicide bomber blew himself up near the college. Mahmoud Alkhatib

We talked to Mahmoud Alkhatib, a senior medical student at Damascus University, about the dangers he and his classmates face in completing their studies. The Damascus native is focused on neuroscience and has been ranked among the top 10 students at the university over the past five years.

What daily hardships do you face? Is the university still fully functioning?

Alkhatib: It is now harder for us to travel and do extracurricular activities in neighboring countries, like clinical rotations at the American University of Beirut. Financial matters have also become a great concern because the mean income for the vast majority of Syrian citizens is between $50 to $150 U.S. a month. And for a medical student who is planning to take international exams to be able to continue his studies abroad, he will need more than $3,000, about 30 times the mean [monthly] income. Due to the economic sanctions … we are having a lot of difficulty affording study expenses like books, examining tools or international-examinations costs. Even transportation costs are way more expensive than before.

Also, even though Damascus is safer than some other cities in Syria, we still feel unsafe when we travel to school due to possible, unpredictable terrorist bombings or shelling. The university does still function, and many of its hospitals are being used to treat casualties from the war.

Can the health-care system be restored to its former glory?

Alkhatib: I think that the health-care system in Syria will keep standing tall in the storm, despite all the hardships and obstacles. We as Syrian students are responsible for rebuilding the future, and we will. New hospitals can be built without too much difficulty, and I think it’s important that new doctors are still being trained, so they can run the hospitals. This destructive war won’t stop us from continuing our studies and training so that we can have a hand in shaping our new future.

Have any of your family members been killed or injured in the conflict?

Alkhatib: Thank God, no one in my family has been affected like that by the war. But I had some relatives who left the country because of how hard life has become here — namely, the poor living conditions and constant risk of death.

Has the conflict ever put you directly at risk?

Alkhatib: I remember something that happened and was extremely scary. I was walking from the university hospital to the medical school when a suicide bomber blew himself up near the college. There were two of them, but the other one was discovered and killed before he could detonate himself. This happened around December 2015, quite close to the medical school, and there’s also been shelling near our university a few times.

Have you considered quitting your medical studies because of the dangers?

Alkhatib: That attack — let’s say the whole situation — has made me think of traveling and continuing my studies abroad, or maybe not continuing in medicine at all. But every time I thought like that, I also thought that I could and must stay put, and succeed. I have always had a passion for medicine, and at some point I realized that nothing will ever stop me. Besides, these circumstances are motivating us to finish what we started and to help rebuild our homeland.