In a collection of dozens of rural villages scattered throughout the Islamic State-held east Hama countryside, 90km northwest of Palmyra, residents feel forgotten.

“Nobody pays attention to us because we are in an Islamic State-held region,” Abu Mahmoud, a 52-year-old father of four living in the village of Uqayrbat, tells Syria Direct. “It is as though we are not human.”

Five months ago, in mid-December 2016, an alleged chemical attack hit a handful of villages in the Uqayrbat region, killing up to 100 people and injuring hundreds more.

The substance used in the attack, which was reportedly carried out by air, has not been identified.

Today, conventional airstrikes are picking off residents in the underserved community of 40,000 people. On Tuesday, two villages in the area were bombed by unidentified warplanes, killing 15 residents.

It is difficult and dangerous for residents of Uqayrbat to speak to outside media. Syria Direct’s Noura Hourani spoke to Abu Mahmoud by relaying voice messages through a relative of his who lives outside the IS-held area. He has been granted anonymity, and is referred to here by a nickname.

Pro-opposition Syrian media sites have reported days of airstrikes on villages in the Uqayrbat region this week. Syrian state media reported strikes on “IS vehicles” last week and in recent months, but has not reported on the latest attacks.

IS-held areas are not included within the de-escalation zones established under a Russian-led, international agreement earlier this month.

A flattened building in the Uqayrbat village of Souha on Wednesday. Photo courtesy of Abu Mahmoud.

Unlike in many opposition-held areas, where Civil Defense teams respond to the scenes of bombings and take victims to field hospitals, Uqayrabat’s wounded have few options, Abu Mahmoud tells Syria Direct.

The underserved, rural area has only one medical center, which Abu Mahmoud says is “reserved for IS personnel and their families.” When bombings such as Tuesday’s happen, residents load the wounded into residents’ cars and set off for the hospital in IS-held Mayadeen, nearly 300km to the east.

Because of the rugged roads, the distance to a medical facility and the use of civilian cars for transport, says Abu Mahmoud, “we know that they will die on the way.”

Q: What happened on Tuesday?

At 11am, a warplane bombed a market where civilians were gathered. Some 15 people were killed, and approximately 10 injured. The planes were probably Russian.

This area has been bombed for the past two days. The planes have hit civilian houses, and on Tuesday two children—Azzam al-Ali, 12, and Bustan al-Ali, 9—were killed when their home was bombed.

There are no IS headquarters in the area. They’re afraid of the bombing, so they stay in caves. The geography of the area helps them to protect themselves.

Q: How many civilians live in the Uqayrbat area?

There are around 150 small villages in the Uqayrbat area, with approximately 40,000 residents. All of the villages are under Islamic State control. There is little media coverage of the area because of the fear of IS and communicating [with outsiders].

I am able to contact my relatives living in a village [in opposition-held territory to the north], to check on them and tell them what is happening here.

Q: What is the medical situation like, and where are the wounded taken?

There is only one medical facility in the area, and it is reserved for IS fighters and their families. They have their own doctor, and ambulances that only they can use.

[When a bombing happens,] the wounded are moved to al-Mayadeen, in the IS-held Deir e-Zor countryside. IS only allows people to move around inside the areas it controls. This is a tragedy, because the distance to al-Mayadeen is around 300km.

When the wounded leave for al-Mayadeen, we know that they [probably] won’t get there. They’ll die on the way because of the distance, the rugged road and the basic cars that people here have.

We can only move the wounded in civilian cars, not ambulances, which means they [often] die. IS fighters do not help us.

The aftermath of a reported airstrike in Souha on Tuesday. Photo courtesy of Abu Mahmoud.

[Ed.: Abu Mahmoud says that IS leadership in the area are not Syrian, but that rank-and-file members are, and treat residents somewhat better.]

Medical and humanitarian organizations aren’t allowed to work here. We can’t bring in medicine, not even through relatives in neighboring villages. Last year, after the chemical attack, we tried to bring in some anti-sarin medication, but it was not permitted.

[Ed.: In mid-December 2016, nearly four months before the Khan Sheikhoun sarin attack, nearly 100 people were killed and hundreds of others reportedly injured in a reported chemical attack in the Uqayrbat area.

While the substance used in the December attack is not known, the high death toll led the Organization for the Prohibition of Chemical Weapons (OPCW) to describe the incident as “of serious concern.”]

Our situation is catastrophic, and nobody pays attention to us because we are in an IS-held region. It is as though we are not human. Isn’t it enough that we are suffering from [both] the regime and IS?

Q: You said that IS does not allow civilians to leave the area. Couldn’t civilians flee on the road to Deir e-Zor?

IS considers civilians to be fourth-class people. The last thing they care about is whether we live or die. We have asked for a humanitarian corridor [out of IS areas] to be opened more than once, but they have refused.

There is no way out. The closest opposition-held area to us is near the city of a-Saan, and that is 35km away [to the north]. If we sought refuge with the regime villages, [we believe] they would kill us, too, because in their eyes we are Daesh.

Every so often, some people try to flee through difficult smuggling routes, but the chance of success is slim. It is a risk, especially for large families with children, and it could cost them their lives.

[However], there is an opposite displacement, of people coming into the Uqayrbat area from IS-held areas in Raqqa and the east Aleppo countryside.

We are caught between the hammer of IS and the anvil of the regime, which is trying to launch a military campaign near this area. Civilians are afraid of additional massacres by the planes, which intensify bombings before each military campaign.

[Ed.: Syria Direct could not immediately find confirmation of an impending regime campaign in the Uqayrbat area. However, in late March state media agency SANA reported that Syrian armed forces had destroyed tanks and armored vehicles “belonging to IS and Jabhat a-Nusra” in Uqayrbat. Pro-regime daily al-Watan reported a regime airstrike in the same area last week. ]

I hope to get out of here any way I can. If there were a way out, you would see all the civilians fleeing. They are fed up with IS oppression.