Q&A: A Doctor From Aleppo Speaks on the Systematic Bombing of Hospitals by Assad and Putin
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Q&A: A Doctor From Aleppo Speaks on the Systematic Bombing of Hospitals by Assad and Putin
Assad and his allies have escalated their attacks of rebel-controlled areas, once again killing and injuring civilians.
Since the start of the Syrian Civil War in 2011, Russian forces and the Syrian regime led by Bashar al-Assad have systematically bombed hospitals. The scale of the attacks is immense. According to Physicians for Human Rights, from 2011 to 2022, 601 attacks on 400 separate facilities and documented the killing of 942 medical personnel; 542 attacks have allegedly been committed by the Syrian government and its allies.
Since the beginning of October, Assad and Russia have bombed northwest Syria -- the last remaining part of the country not controlled by the regime -- in the most intense escalation in nearly three years. Northwest Syria also suffered a magnitude 7.8 earthquake on February 6, worsening the already serious humanitarian situation. A political solution to Syria's war remains distant as Vladimir Putin has given its full backing to the Assad regime.
Last week in Berlin, I spoke with Dr. Bachir Tajaldin, who is Turkey Country Director for the Syrian American Medical Society, which has supported field hospitals, clinics, and surgical centers in Syria and assisted Syrian doctors, nurses, and health workers. A doctor of internal medicine originally from Aleppo, Syria, he now resides in Gaziantep, Turkey, near the border. He oversees the organization's programming Turkey and northwest Syria, and before that worked as a physician inside Syria, providing treatment to victims of the war. Our conversation follows, condensed and edited for clarity. Evan Barrett, the group's press officer, also joined in the conversation.
Luke Johnson: Can you start off by talking about what your work is?
Dr. Bachir Tajaldin: I am a medical doctor in practice with a master's degree in internal medicine. I have been working on the humanitarian response in Syria since 2012, in different capacities and in different locations. I started as a service provider at one of the field hospitals. During the last seven and a half years, I have been working with the Syrian American Medical Society, now as a country director in the Turkey office, which is responsible for supervising our programs in Turkey, targeting Syrian refugees, and inside in northwest Syria.
Our health programs consist of around 40 facilities with different levels of care and staffing, from community health programs to very specialized health services including cancer treatments, cardiac treatments, cochlear implants, primary health care services, maternity and reproductive health, surgery, and internal medicine.
LJ: Explain the situation in northwest Syria, and what changed on October 5.
BT: The Syrian people have experienced all types of violence, including airstrikes, chemical weapons, [disease] outbreaks, and the deprivation of essential health services and education. Millions of Syrians have fled the country. Hundreds of thousands have been killed, detained, or arrested. Thousands and thousands of people are missing. There is no nation. [According to the last annual report published on Syria by the UN], there are more than 15 million people in need in Syria. For northwest Syria, there are more than 4 million people living in very harsh situations lacking shelter and food, and the poverty rate is more than 98%. That population is dependent on humanitarian aid, which is also decreasing, especially after the earthquake. Southern Turkey was the backup health system for northwest Syria, which has been heavily affected by the earthquake.
During the first week of October, there was an escalation in northwest Syria by the Syrian government and its allies, mainly in Idlib, which targeted many locations, even some close to the Turkish border. This escalation and increasing violence against civilians caused an additional 420,000 people to be displaced. Out of 4 million people in northwest Syria, there are 2.8 million internally displaced people. We are preparing for the Syrian winter. Every day there are more challenges and more harsh situations [inflicted] on the population.
LJ: What do you think the political motivations behind this escalation are?
BT: There is a failure of the international community to stop the violations against civilians in Syria for more than 12 years, with hundreds of documented attacks on health facilities, schools, marketplaces, and vital infrastructure that has pushed people to be displaced time after time; some families have been displaced for more than 20 times.
It's a failure of the political situation. So far, the international community has not been able to prevent civilians from being affected by this conflict. Everyone agrees that the solution for the Syrian crisis is a political solution. But still, it seems that there is no political will. The escalation is not the first. Even after the earthquake, there has been bombardment of civilians.
In the last month after the escalation, based on the WHO reports, more than 30 health facilities have been suspended. Either they are being attacked by the escalation or affected by the escalation. We have a couple of health facilities that have been affected by the bombardment, or the people are afraid to go to the health facilities or even because the staff doesn't have access to the health facilities due to the conflict. Our facilities received hundreds of injured people, including casualties. We lost a lot of people of all genders and ages. We have maternity hospitals; we were forced to evacuate them and move the services to safer places, although there is no safe space in northwest Syria.
LJ: So the bottom line is that Assad is trying to attack [Northwest Syria], because he does not control it.
BT: Yeah.
LJ: Your organization wrote that hospitals are among the most dangerous places in Syria. Why? Explain to somebody why the Assad regime and its allies like Russia attack them.
BT: The health facilities are where the people can receive treatment after they have been attacked, or where the population feels safe when they can access health services. Imagine a family with children, if they are displaced to an area without a health center or a hospital, if their children get sick or are injured. They will notice that people are more stable living around health facilities. We are working on a detailed report, documenting every single attack on health facilities and we are participating in the deconfliction mechanism [of the U.N.], which [now is] a notification system. We are sharing the coordinates of our health facilities with the U.N.
LJ: So you share your coordinates with the U.N. and these health sites are attacked anyway?
BT: Yes. [It stays] the same, because the attacks on the health facilities are not dealt with [by the international community]. We face the same situation in Ukraine; the first attack was on a pediatric hospital. Now in Gaza, [health] facilities have been attacked.
Evan Barrett: To give an example of the failure of the international systems that would normally be used, there used to be something at the U.N. called a deconfliction mechanism where you could report civilian infrastructure to the U.N., and they would supposedly try to deconflict with Russia. But all the sites that were deconflicted still got hit. Now, they call that system a notification system, because they know they can't deconflict but they'll try to share information about what's getting hit. The deconfliction mechanism failed.
I think the long term goal of the Assad government and Russia is for these 4 million people [in Northwest Syria] to leave to go to Turkey, Lebanon, or Europe. The [Assad regime] doesn't want to deal with them in the future. One of the reasons you might destroy civilian infrastructure is because it's what makes it possible to stay there. Now, there are new waves of immigration of people trying to get to Turkey. So the government doesn't want to deal with this population.
BT: Or people are trying to go through Turkey, to Europe. In Turkey, there were more than 4 million refugees, now, it's less than 3.5 million. In Syria, there is no safe space for people to remain. There are about 30,000 people who returned to Syria. There are lots of cases of people who return to the government-controlled area, either they have been arrested or disappear.
But from our personal experience, we have friends and people that we know who are trying to reach Europe through formal or informal ways. We see the fishing boats going to Europe. I can't believe that anyone can put himself or his children in danger and go through this death trip, unless they're desperate to. We think that the best way is to keep supporting and localizing the services in northwest Syria as a humanitarian organization, but also it's the responsibility of the international community to find a political solution for the long term.
LJ: How has the 11 year hospital bombing campaign affected your work as a doctor?
BT: Every day, there is a doctor or health care worker who is saying goodbye to his family because there is a possibility that he or she will not go back to see their family. In Syria, less than 10 percent of physicians have stayed. I have tons of friends who are doctors in Germany and they are practicing. But we also have a lot of colleagues, doctors, nurses, midwives have been either killed or arrested or have passed away in attacks.
LJ: Arrested for?
BT: For being a doctor in Syria. It's like a crime; and you cannot treat the people injured. It's a strategy started by targeting the hospitals -- the big hospitals and the referral hospitals. Then there was a chemical attack. And then, the troops advance. It's a systematic way of targeting hospitals.
LJ: Through aerial bombardment?
BT: Yes.
LJ: Then a chemical attack?
BT: I can't remember to be specific. Yes, with chlorine. This attack caused a lot of injuries; an orthopedic surgeon was operating in an underground hospital.
LJ: These hospitals are literally underground?
BT: Yes. He continued the operation because he is trying to save the patient's life. But as soon as the chemical agents, which are heavier than the air [enter] the operation room, he passed away. After the chemical attack targeting the facility, the emergency route to the nearest facility is long. So there are more casualties among civilians.
LJ: What can the international community be doing right now?
BT: Working towards a political solution that provides dignified life to the Syrian people in all areas of Syria, a democratic system in Syria, and allowing Syrians to rebuild the country for the future. But still, we have those vetoes and objections even for delivering humanitarian aid. It's a huge failure. Even now, the Security Council can't agree on a way to deliver humanitarian aid.
LJ: How do you get to a political solution when Russia will veto any UN resolution and sees Assad as a client, what intermediate steps could be taken?
BT: As a humanitarian worker who represents a humanitarian NGO, I can ask for avoiding civilians from conflict. Health facilities should not be affected by attacks or war or any kind. Access to health services should be maintained all the time, as well as access to education, regardless of any political agreement or disagreement. Keep the humanitarian system away from conflict.
Correction: An earlier version of this story erroneously said that Dr. Tajaldin’s master’s degree was in journalism. It was in internal medicine.