
First published December 2015.

A few years before the war, Damascus residents were starting to sell their houses in the capital and move out to places including the nearby city of Douma where hospitals, schools, restaurants and parks were thriving.

As the conflict began, life in Douma was turned upside down. Amid continuous shelling of the city in the past three years, medical services have deteriorated.

Medical staff that has stayed on is making enormous efforts to keep on working in the battered city, which is controlled by rebels battling to topple President Bashar al-Assad. Although Douma’s hospitals were serving civilians, they were struck regularly in government air strikes. The doctors transformed basements and shelters into makeshift medical facilities. The Unified Medical Office for Douma runs these centres and provides them with medical equipment.

I first visited the makeshift field hospitals in 2014 after I was injured in the face when the city of Mleha in Eastern Ghouta was bombed in fierce battles between the Syrian army and insurgents over control of the town. I was cared for by one of the last ophthalmologists in the region. Then I started to work at the medical centres as a photographer for the Unified Medical Office, witnessing cases I’ve never seen before.

The body of a dead man lies inside a field hospital after what activists said were air and missile strikes. The Syrian Observatory for Human Rights said unidentified warplanes hit Douma on 13 December, and surface-to-surface missiles fired by the Syrian army also hit the surrounding areas, including Eastern Ghouta. When I was there after this attack, dozens of victims, mostly women and children, were brought in.

The loud cries of pain from patients who had lost their limbs or eyes rang in my ears during the night. These were the events of only one day during three years of continuous shelling of Douma.

Medical treatment happens in makeshift facilities across the city: an emergency centre, other facilities for operations, incubators, an intensive care unit and clinics. Moving between these sites is not easy because of continuous shelling.

The Unified Medical Office in Douma runs the facilities and provides medical equipment sourced locally since the start of the siege that has prevented delivery of medical supplies to Douma from government-held areas. All equipment was taken from hospitals that operated in the city before the war; however, the equipment becomes less efficient with every passing day.

The medical staff in Douma is comprised of the few doctors who haven’t left the country and medicine students who couldn’t carry on with their studies because of the war. Retired medical staff lends a hand, as do new nurses being trained on the job.

Shrapnel injured a woman, eight months pregnant, before the 13 December attack. After being rushed to the emergency centre, she died during treatment. Her baby, moved to the incubator unit, survived. As the recent shelling targeted the incubator unit, the baby’s dad cried bitterly, saying that he feared for the future of the newborn child.

Witnessing the medical work in the city made me wonder how the doctors can keep working in these incredibly harsh conditions. When I asked them they would answer that no doctors faithful to their profession would ever refrain from doing this humanitarian work.