Rebel fighters walk along a street in the Salaheddin district in Aleppo on Sept. 23, 2013. Lacking support from the West and battling on two fronts, moderate rebel groups are quickly losing fighters. (Salah al-Ashkar/AFP/Getty Images)

In a medical clinic packed with injured Syrian rebels, 23-year-old Mohammed Hadhoud lies waiting for an operation to remove a machine-gun bullet lodged in his spine. His family cannot afford the bill, and the moderate Islamist brigade he fights with has refused to fully cover the cost.

Down the corridor, two fighters for al-Qaeda-linked Jabhat al-Nusra rest, their treatment paid for. One reaches under his pillow to show the $100 he has been given in spending money.

“In case we need anything extra,” he says.

The starkly contrasting scenes highlight the predicament for the moderate Syrian rebel factions that the West has vowed to support. Struggling for funding, rebel leaders complain that they are unable to stem a constant loss of fighters to hard-line Islamist groups that enjoy free-flowing streams of money from donors in oil-rich Persian Gulf states.

Some factions have grown so frustrated by what they call a lack of meaningful support from the United States and its Western allies that they have changed their rhetoric and shifted their alliances in hopes of winning paychecks from Saudi Arabia and Qatar.

The Syrian civil war is taking a toll on the region. The Post’s Zoeann Murphy looks at how Lebanon is handling a constant stream of refugees that has increased its population by 25 percent. (The Washington Post)

Moderate rebel leaders had thought they might see a substantial increase in Western support after an Aug. 21 chemical weapons attack that has been widely blamed on the government of Syrian President Bashar al-Assad. But after a deal between the United States and Russia to destroy Syria’s chemical weapons stockpile, that support failed to materialize.

The result has been a sense of confusion and demoralization among moderate rebel factions even as Assad and his allies present a united front.

Hadhoud and his three brothers have fought with the relatively moderate Ahfad al-Rasoul Brigade since its formation soon after the uprising against Assad began in 2011. But now they are looking elsewhere for patronage.

Doctors have told the family that Hadhoud can make a full recovery — if he receives treatment from a specialist who can remove the bullet.

The family eagerly relayed that news to the leader of his battalion, expecting the $4,500 in medical bills to be covered. But the commander said he could pay only half.

“I was surprised and disappointed,” said Mohammed Hadhoud’s 24-year-old brother, Hadhoud Hadhoud. “Nobody from Ahfad al-Rasoul has come to see us. I will leave for another battalion that takes care of its soldiers. I won’t leave the revolution, but I will tell my friends and family that they need to think about the future.”

Asked where he plans to go, he was quick to reply: “Islamic State of Iraq and Syria.” He later added that he plans to research the group first. An al-Qaeda affiliate, the ISIS is known for its brutal methods and the promulgation of a strict interpretation of Islam.

“I don’t agree with them completely,” he said, “but they offer good care and I have no problem in joining.”

Hadhoud Hadhoud said he believes that Ahfad al-Rasoul could have afforded more assistance for his family.

Meanwhile, injured fighters with smaller rebel groups say they get no support at all.

Lt. Col. Mohammad al-
Abboud, a top Free Syrian Army commander for the war’s eastern front, estimated that as many as 70 percent of the fighters in his region with the radical factions ISIS and Jabhat al-Nusra used to be with the FSA but “moved to the other side in search of material support and salaries.”

As the migration of fighters bolsters groups such as the ISIS, it creates more pressure on the moderates, who are fighting the extremist group in cities such as Azaz and Aleppo.

FSA commanders say that for more than a year they have been warning that such a situation could arise.

“Our hell cries fell on deaf ears,” Abboud said as he sipped coffee in a hotel cafe in the Turkish town of Antakya.

He said the FSA’s leadership is doing what it can to counter the rise of the ISIS, including trying to unify moderate groups. He spoke of newly signed mutual-defense agreements and new legions of fighters, but he didn’t appear hopeful.

“To be honest,” he said, “this is all still theoretical.”

Meanwhile, groups with a more Islamist bent, such as the al-Tawhid Brigade, one of the country’s most powerful rebel factions, are moving away from the Western-backed rebel leadership, Abboud said. He cited a new Islamist alliance, announced last month as a repudiation of the Western-backed leadership, which brought together al-Tawhid, Jabhat al-Nusra and nine other rebel groups.

Rebel leaders were once concerned that teaming with extremist factions would reduce their chances of receiving support from the West, he said. But without significant Western support, he said, that concern no longer exists.

While the rebel leadership, known as the Supreme Military Council, blames lack of funding, some rebels say the problem lies within the organization itself.

They are hopeful that the Islamist alliance might be able to muster more support from the gulf region and distribute it more efficiently.

“The council is useless,” said Mohammed al-Qusair, a Turkey-based activist. “Anything that replaces them will be better.”