“They either leave, or they die”: Residents battle kidney failure in besieged Madaya.

By Abdelwahhab Ahmed and Justin Clark

DAMASCUS: In the besieged, rebel-held town of Madaya, less than 50km northwest of Damascus, two dozen people are slowly dying of acute kidney failure.

Ali Ghassun, a 28-year-old former grocery store owner, is one of the sick. Today, he can’t get out of bed on his own and relies on his sister and mother to give him the intravenous drip that provides his body the basic nutrients that keep him alive.

Medical supplies are running thin in Madaya and, before this week’s shipment of aid, painkillers had run out. Ghassun’s mother was forced to give him anesthesia to fight the pain and help him sleep.

“It’s painful to watch your son die in front of you,” Ghassun’s mother tells the Syrian Voice. “I can’t do anything for him”.

“If it weren’t for God Almighty, he’d be dead already.”

“They either leave Madaya, or they die”

The recent spread of kidney failure is a direct result of the regime’s siege of Madaya, says local doctor Muhammad Darwish.

Darwish was trained as a dentist, and he, along with another dentist and one veterinarian, are the only medical professionals tending to Madaya’s 40,000 residents.

Though at one point Ghassun had a treatable form of kidney disease, it’s now devolved into deadly total kidney failure, explains Darwish.

“Ghassun was urinating about half of what he drank,” the dentist-turned-doctor tells the Syrian Voice “But in the last few days, liquids have become trapped in his body and he is not able to urinate at all.”

Symptoms of kidney failure include an inability to urinate, swelling of the legs and arms, vomiting, coma, and eventually, death.

Ghassun’s existence is painful, and doctors tell his family his “days are numbered”, says his sister, Rula.

Aid arrives infrequently to the area, most recently on Monday, but the shipments are packed with high-starch, low-protein foods. Without the vitamins, minerals, and other nutrients that the kidneys require to operate, cases of kidney disease and failure are becoming more and more common, says Dr. Darwish.

Madaya and the nearby besieged town of Zabadani are linked to two rebel-encircled pro-regime towns in Idlib, Kafraya and al-Fuaa, by a complex ceasefire agreement brokered by Iran and Jaysh al-Fatah, the leading opposition coalition in Syria’s north.

The so-called “Four Towns Agreement” requires that all aid deliveries and medical evacuations to the besieged towns occur simultaneously. Dozens of sick and injured left the towns in early October, but the parties to the agreement have yet to approve further evacuations.

For Ghassun and the two dozen other patients suffering from acute kidney failure, staying in Madaya, where dialysis is unavailable, is a death sentence.

“They can’t be treated here,” Darwish tells the Syrian Voice.

“They have two options: they either leave Madaya, or they die.”