Dr. Souheil Saba traveled last year to a family residence in Homs, Syria, a city that was battered early in the Syrian civil war, but he could barely get past the rubble that had been blasted from the cement walls of people’s homes and blown into the streets.

When he finally arrived, the home he found was a gray shell with blackened holes that once held windows and doors. Crumbled stairs cascaded onto the first floor.

For Saba, a Wayne resident who moved to the United States 35 years ago, the house is a war relic — a reminder of the destruction that has ravaged Syria during an eight-year civil war that has abated, though has not quite ended.

Elsewhere, Saba had a more promising view.

In the rolling green hills of Wadi al-Nasara, or Christian Valley, he is overseeing the rise of an eight-story hospital, with its lustrous new machinery, white-linen surgery beds and bright pediatric rooms. When it opens later this year, the hospital will be linked to a medical school that Saba helped found three years ago.

“I feel I owe my people, my friends, my colleagues,” said Saba, the general director and CEO of the Al-Hawash Private University Hospital, in an interview with NorthJersey.com and the USA TODAY NETWORK New Jersey at his home in Wayne. “[I feel a need] to give back to the country where I was born and raised. This feeling — it was with me for a long time, even during the war.”

His efforts come as Syrians, international organizations and world leaderstry to figure out how the country can recover from a war that has wrought devastation, death and displacement on a scale so massive it’s hard to fathom.

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As it stands, fighting has subsided in much of Syria as President Bashar Assad’s military, with Russian and Iranian support, has recaptured land from rebel groups, who remain concentrated in northwestern Syria. While small-scale rebuilding projects are underway, political strife, financial troubles and fighting continue to hamper the path to recovery and reconstruction.

While he’s doing his part to help, Saba is also pessimistic — or maybe realistic — about rebuilding a broken nation.

“Recovery is far from happening,” he said. “It needs too much time for recovery. Eight years has passed for the war in Syria … Even the Second World War happened for only six years.”

A return to Syria

Saba grew up in Damascus, the Syrian capital, where he went to medical school and became a surgeon. In 1984, he moved to the United States, continuing his medical education on Staten Island and switching his focus to obstetrics and gynecology.

For 22 years, he ran a private practice in Clifton, and estimates that he delivered close to 3,000 babies during that time. He and his wife, Ragheda, also a medical doctor, raised three children in Wayne. One is a neurosurgeon, another a lawyer and the youngest a law school student.

Saba attends St. George’s Church in Little Falls, which caters to a mostly Syrian Christian Orthodox community, and has been active with the Syrian American Will Association, a group that lobbied against U.S. involvement in Syria and forced regime change.

As the family prospered, they worried about relatives and friends in their native country — like others in New Jersey’s Syrian-American community, which the U.S. Census Bureau estimates to be around 12,000 people.

So a year ago, when Saba retired, he returned to Syria to devote his time to the development of the medical school. It is adding a class each year in the seven-year program and now has 600 students. The hospital, which will serve as a training facility for the medical school, is expected to open in three to four months, Saba said.

He said his cousin, who lives in Syria, asked him to be a partner in the venture. The Christian Valley, where the university is located, remained largely untouched by fighting during the war. Because of that, many people from other parts of the country moved there seeking safety.

The university also runs an organization called Ibni, or My Child, which provides a monthly stipend and free college education to local orphans, said Saba, who also serves on the university board of trustees.

For Saba, the medical school is a way to give back. He was able to become a doctor because of free education in Syria, and his medical school tuition there cost just $30 a year, he said.

“I wouldn’t have been able to be a doctor, in reality, without help from the government,” he said. “It did something in my way of thinking that I have to do whatever I can to help my people, who are in real need.”

Homes, hospitals destroyed

Nearly eight years into the war, political stability, refugee return and reconstruction remain elusive.

The conflict in Syria began with pro-reform, anti-government protests in March 2011 amid the Arab Spring uprisings across the Middle East, and spiraled into a full civil war after a military crackdown. It was later exacerbated by the arrival of foreign fighters who fueled groups like Islamic State and the Al Nusra Front, formerly an al-Qaida offshoot.

The war grew more complex as nations including Russia, Iran, Turkey, Israel and the United States intervened directly and indirectly in military campaigns.

Today, Assad's Russia-backed government forces have largely beaten back foreign fighters and rebel groups, althoughfighting and airstrikes continue in part of Syria. The United States had offered support to rebels against the Assad government and led a coalition in the fight against the Islamic State group.

Overall, the loss of life and devastation during the war has been immense.

Half a million people have been killed, according to the U.K.-based Syrian Observatory for Human Rights. More than 5 million fled the country, and 6.6 million were internally displaced, according to UNHCR, the U.N. Refugee Agency.

In parts of Syria, whole neighborhoods have been demolished during bombing campaigns. The World Bank reported in July 2017 that a third of the housing stock and about half of medical and educational facilities were destroyed in the war. It estimated economic loss at $226 billion.

“The war in Syria is tearing apart the social and economic fabric of the country,” Hafez Ghanem, World Bank vice president for the Middle East and North Africa, wrote in the report. “The number of casualties is devastating, but the war is also destroying the institutions and systems that societies need to function, and repairing them will be a greater challenge than rebuilding infrastructure — a challenge that will only grow as the war continues.”

Thousands of doctors also fled the country during the war, leaving a tremendous need for institutions like Al-Hawash.

“There is a big need for doctors,” Saba said. “Actually, Syria needs everything. It needs electricity. It needs gas. It needs food. It needs clothes. It needs doctors and engineers. We have a shortage in professors that teach in the university, especially the pharmacy school.”

Fractured country, fear of return

Projects have begun to rebuild houses and businesses in government-controlled areas of Syria, but some countries don’t want to invest as long as Assad, backed by Russia and Iran, remains in power. As a result, the United States and its European allies have imposed economic sanctions that have made rebuilding more difficult.

“What’s taking place is relatively small-scale,” said Alexander Bick, who was a National Security Council director for Syria under President Barack Obama. “It’s really hampered by the sanctions and by the fact that the United States and European Union have said they will not put money into Syria unless there is some sort of political resolution.”

For groups that supported the Assad government, it’s easier to build and even secure investments from Russia or China, but others likely won’t have the same opportunity, said Bick, a research scholar at the Henry A. Kissinger Center for Global Affairs at the Johns Hopkins School of Advanced International Studies.

Despite difficulties, some refugees have started to go back. Around 200,000 returned last year, and the United Nations estimates that 250,000 will return in 2019, Bick said.

A myriad of issues prevents more from returning. People are concerned about lack of services, personal safety, damaged homes and the ability to work. Others are afraid of imprisonment, interrogation or mandatory military service. Assad has offered amnesty deals, but in some cases people have still been arrested, Bick said.

“They’re afraid their property won’t be secure and don’t see prospects for rebuilding their lives yet,” he said.

Fear remains

Among New Jersey’s Syrian community, which includes generations of immigrant families and recently arrived refugees, there are no signs that people want to move back. Saba himself does not plan to stay in Syria, saying that his family and his life are in the United States.

He understands the reluctance that people have, given the damage in the country. But he believes the government will welcome people back and said some have returned and lived there peacefully.

“The government is welcoming anyone to come back,” he said. “They need them. In Syria, we lost too many people.”

The recovery, he said, is more than buildings.

“We have to think about the people in Syria,” he said. “What happened to the child who was 7 or 10 years old in the beginning and is now is 15 or 18 years old? What happened to his mentality? What did he see in his life for eight years? How is he going to cope with the situation?”

He hopes projects like the medical school and hospital will be a step toward helping and healing.

"We are trying," Saba said. "Our project — we like to use it as a way to connect the people to their country. We are providing an opportunity for the people to work in Syria and not to go somewhere else, and this is very important to us.”