The Washington PostDemocracy Dies in Darkness

How Aleppo’s dwindling network of hospitals is adapting under the bombs

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BEIRUT -- These days, hospitals feel like the most dangerous places to be in east Aleppo, doctors say.

Throughout the city’s rebel-held districts, medical facilities are in the Syrian government’s crosshairs. The medical charity Doctors Without Borders has recorded 33 hospital attacks since the area came under siege in July, and the pace has only quickened.

On Monday, al-Bayan Hospital was hit, its staff members choking on dust as they processed what had happened. The sound of the warplane had been clear. That they were its target was not.

In video footage from the attack's immediate aftermath, workers cried out for their colleagues as the air turned white. 

“The ambulance driver, where is he?”

“He’s here.”

“Is anyone hurt?

An hour later, the Omar Abdulaziz hospital was bombed, just as it was preparing to reopen from an earlier attack. “Our new maternity unit has been destroyed. We hadn’t even used it,” said Farida Muslim, a gynecologist there.

As the Syrian government mounts an all-out offensive to retake east Aleppo,  the health network there is makeshift, and easily movable.

Most facilities operate out of basements to minimize the impact of airstrikes. When there is an attack, staff members jump into action, taking everything they can grab below ground or moving equipment to a safe location as colleagues stay behind to repair the damage. Facilities forced out of action in a moment can be back online within hours.

But as the government siege starts to bite -- no aid supplies have entered the city since July -- this process is becoming harder by the day. The underground facilities have a limited  number of beds, and shrinking staff numbers mean specialists must work at multiple hospitals to serve as many patients as possible.

Supplies are also dwindling. Doctors make emergency trips to deliver drugs to sister hospitals, only to find that they need them again for their own patients. Equipment also requires backup fuel supplies, which are running out. "There are days when I feel like a useless repairman," said one doctor, speaking on the condition of anonymity because his hospital had told him not to speak to the media.

"One day I'm mending a child ripped by shrapnel, even though I know he could be back in my clinic tomorrow. The next day I'm picking up parts of my windows and I just feel they'll shatter again."

In the children's hospital -- bombed five times now -- doctors are getting used to scrambling to protect newborns already underground. On Friday, the staff shared photographs of babies placed on the floor of the basement, bundled together in blankets.

Government bombing and shelling of east Aleppo in the past week have left more than 300 people dead and almost 1,000 injured. With the rise in hospital attacks, wounded residents are opting to stay away from medical facilities, heading instead for nearby houses in the hope that a doctor will reach them there.

For Wissam Zarqa, an English teacher from Aleppo, this new practice led him to spend hours Monday accompanying a friend in search of his father, thought to have survived a barrel bomb three days earlier.

"We went to many houses where people have been moved," Zarqa said. "He couldn't find him and now he is looking for other houses where his father might be."

According to Doctors Without Borders, what remains of east Aleppo's health system hangs by a thread.

"The consequences of indiscriminate bombing are very clear," said Luis Montial, the organization's deputy head of mission. "What is not clear is how much longer the health system, already on its knees, can carry on.”

Heba Habib in Istanbul contributed to this report.

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