In encircled East Ghouta, volunteers and medical students become doctors

“If I fall in a hole and someone extends me his hand, I’m not going to ask him to show me his credentials—what’s important is me getting out of the hole.”

That’s how sixty-year-old Abu Zaheer describes the lack of certified medical personnel in Damascus’ rebel-held East Ghouta suburbs. Residents have accepted that those administering treatment are often volunteers with no formal background in medicine.

The regime has deliberately targeted doctors, medical students, and healthcare professionals since the beginning of the revolution. It has killed some, and forcibly disappeared others in detention centers.

After the Syrian army and its allies encircled East Ghouta at the end of 2012, it bombed hospitals and medical infrastructure during its aerial and artillery attacks on the suburbs, pushing some remaining medical personnel to leave. A small number of doctors elected to stay and serve civilians inside.

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The suburb’s lack of doctors has pushed volunteers, many without any formal medical training, to step in and fill the gap.

“In East Ghouta a medical degree is an invaluable guaruntee for your future,” Dr. Khalil Abdullah, who was not able to finish his residency and went into field medicine because of local need, told The Syrian Voice.

“But field work has raised my medical experience, and improved my performance— particularly with surgery. Day after day the specialists and nurses are becoming more confident in our work,” he added.

“If there were specialists people would go to them for treatment, and that’s their right. But unfortunately we’re the only ones here.”

The Syrian Voice sat down with Dr. Seif al-Din Khabiya, a medical expert with the opposition local council in Douma city, headquarters of East Ghouta’s most powerful rebel group Jaish al-Islam.

“Before the revolution there were 300 doctors in Douma, not including those working in public and private hospitals, and 150 dentistry clinics—keep in mind these numbers encompass just Douma, not all of East Ghouta,” said Dr. Khabiya.

“Now, there’s one doctor of every specialty, and some specialties are not represented. Sometimes, one doctor is doing the work of ten,” he added.

“Deteriorating living conditions in East Ghouta pushed a lot of doctors to leave. Local doctors provided for themselves and their families, and endured the physical toil of their work until their savings ran out after they stopped receiving compensation.”

The medical situation in East Ghouta has encouraged doctors to devise strategies to raise existing practitioners’ skill levels, and train new personnel in the hope that they might secure degrees in the future from organizations that recognize them as practicing doctors.

“Some doctors start working in hospitals and get trained by specialists, then begin to practice in field hospitals, and afterwards do the work of specialists,” said Dr. Khabiya.

“Not to mention the medical students who finished their clinical years but hadn’t graduated yet—they train for more than a year and a half on first response and start working in field hospitals.”

The Free Syrian Board, an opposition organization made up of doctors inside Syria and abroad, gave a class of these students specialists’ degrees that are valid in rebel-held areas, after they completed their exams.

In addition to medical students, volunteers with no previous background in the field have begun practicing.

“My brother started working as a first responder with the Red Cross in Douma” East Ghouta resident Muhammed Abu Yaser told The Syrian Voice.

“But with the sheer number of bombings and injuries, he started taking on a nurse’s duties, and developed himself professionally until he basically became a doctor without a degree: he diagnoses peoples’ illnesses and prescribes medicine, and doesn’t even have a high school diploma.”

Unlicensed doulas have reappeared in Douma city due to a lack of obstetricians.

“Giving birth with the help of doulas was a common practice decades ago in Douma, but disappeared as a phenomenon in the years preceding the war, only to return during the encirclement,” Um Suleiman, a Douma city resident, told The Syrian Voice.

“Field work has developed the skills of Ghouta’s untrained, or volunteer doctors considerably,” said Dr. Khabiya.

“A single massacre that occurs in East Ghouta will leave behind a number of injuries, and all of them could be taken to a medical point where one medical student is on duty, so circumstances force him to deal with all of the cases.”

The opposition University of Aleppo opened its doors recently to students from encircled areas who wish to complete their technical degrees in medicine and engineering.

East Ghouta has been encircled since the end of 2012. Roughly 600,000 residents live in the suburbs, serviced by no more than 20 licensed doctors.

“The regime arrested five doctors in Douma city,” says rights activist Mohammed Thaer.

“Four others were detained and killed.”

translate by: Dan Wilkofsky

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