“Please don’t cut off my leg,” a Syrian man pleaded. He had been shopping when a missile hit a crowded market. The blast seared off his hair and charred his face. He could not see that his leg was hanging by a thread of flesh and could not be saved. His screams were amplified by the echoes of the dozens just as horrifically injured around him.
I am an American surgeon who recently spent two weeks working in an underground hospital in eastern Aleppo, Syria. I have been there a few times, and each time I go, I descend into lower depths of hell. It’s shocking how the very same inhuman conditions have been allowed to continue for years.
The path to this hell is Castello Road — which was the last remaining road leading into rebel-held Aleppo when I was there. The road smells of burned metal and rotten flesh, and it is littered with charred vehicles. Plumes of smoke scatter the horizon. Gutted homes with pancaked roofs, exposed wires and twisted rebar line the sides. At every moment, you feel you may be hit by a bomb or a rocket.
Inside the city, the screech of jets, the whirring of helicopters, the vibrating blasts of mortar shells and barrel bombs, the incessant ricochet of bullets — these sounds and sensations rarely stop. Civilians still manage to live there. They would rather die at home than live in a tent or drown in a boat, or they are simply too poor, too crippled, too sick or too defiant to leave their homes.
The hospital where I worked has been attacked so many times by airstrikes that it has been driven literally underground — with a ramp leading into the basement. Scalpels are dull, anesthesia is a luxury, sterility is an approximation.
Inside, the scenes are grim.
The screaming never let up. Children covered in blood and dust and pockmarked with shrapnel screamed for their parents and siblings. Some would be reunited whole; others would learn whom they had lost, or which of their children’s limbs were missing or mutilated. Some had the bone shards of disintegrated bystanders embedded in their skin – routine findings after such attacks.
I saw a child, breathing but silent, with severe burns and his intestines protruding from his belly. His skin and hair were burned off. He died a couple of days later. A five-year-old had just died before him due to respiratory failure — shrapnel from a bomb cut his spinal cord and paralyzed him from the chest down. One surgeon cut open a man’s chest in a last-ditch effort to clamp a bleeding vessel near the heart. It worked temporarily, but the man had lost too much blood, and there was no more blood to give him. Two children would later bleed to death in the operating room for similar reasons. I did an above-knee amputation on a stretcher in a hallway because all the operating rooms were full. Others whose limbs were traumatically amputated in the attack had to sit with tourniquets until an operating room opened. We later learned that a child had been decapitated by the blast.
Such slaughter occurred daily. Here, innocent civilians being blinded, amputated, burned, paralyzed, crushed and mutilated by bombs is the routine. Here, the world has shown little solidarity with innocents being massacred. This was not the work of the Islamic State. The terrorism I saw in Aleppo came from helicopters and jets in the sky.
I asked one nurse if he ever gets scared and how he manages the exhaustion. He replied, “This is Aleppo. We don’t have time to be scared. We are being crushed like bugs daily, and the world has abandoned us. Pretty soon we may be permanently sieged, cut off. But it is our duty to be here, and who will help these people if we leave them?”
A few days after I left, the Castello Road was cut. Russian jets and Syrian government soldiers bomb and shoot anything that moves. Before, passage was a roll of the dice. Now it is a death sentence.
I had to say goodbye to my Syrian friends and colleagues knowing that soon they would be cut off from the outside world, left to suffer and starve. I have no other words to describe the fear, the horror and the urgency of what I witnessed there.
I plead with the Obama administration to act. It must boldly confront Russia to halt the bombardment of Aleppo and Castello Road, the only humanitarian supply line to hundreds of thousands of people in eastern Aleppo. It must pressure and threaten the Syrian government to do the same. It must enforce a no-fly zone, using coalition air power already in place and in force against the Islamic State. All sieges must be lifted in accordance with U.N. Security Council resolutions. The Castello Road must remain open.
Innocent people are dying on all sides in Syria, but it is time to let the Syrian government know that the world will act upon a red line against its disproportionate crimes and atrocities.