As an emergency doctor I was integrated into one of the most challenging medical environments I have ever worked in. Would there be reprisals? Would Assad unleash chemical warfare? It was a significant fear among the majority of us, as we checked our dwindling atropinesupplies and thought through mass casualty decontamination plans.
How different things look today. The threat of international military intervention against the Syrian regime has metamorphosed instead intoa plan to remove Assad's hefty chemical weapons arsenal. And yet some things remain the same. Assad still poses a significant risk to civilians, doctors, the injured and those seeking medical attention, largely in areas lost to the regime's control.
In this current climate of diplomacy, attention is turning to another international standard, enshrined in humanitarian law, and yet recurrently breached in the Syrian crisis – the access to humanitarian relief and safe access to healthcare.
The Lancet this week published a letter signed by over 50 prominent doctors from around the world calling for protected access to healthcare in Syria. It describes a limited healthcare system with 37% of Syrian hospitals having been destroyed and outlines the universal responsibility shared by doctors to speak out against attacks against healthcare workers caring for those affected by war.
The UN has acknowledged that humanitarian aid, in particular healthcare, is being hampered. "Intentionally directing attacks against hospitals and places containing the sick and the wounded and against medical units using the Red Cross or Red Crescent emblem is a war crime in non-international armed conflict," read their recent report.
Working in the hospital, we found ourselves in the middle of a mass casualty situation when a nearby school was hit by a napalm-like bomb. Thirty students were severely burned, three of them fatally. One doctor said to me that this attack was not the worst, not the first and wouldn't be the last – the difference this time would be the cameras showing the world what Syrians have to face.
Access to healthcare in Syria is grossly disrupted. Healthcare workers and the injured are protected entities within international humanitarian law but here they are deemed high value targets. Hospital locations have to remain a secret and field hospitals move from place to place to avoid being compromised. After the attack on the school, four members of staff collapsed and needed attention themselves. Overworked, exhausted and with little outside support how much longer can they continue like this?
Although most doctors stay outside the political debate, they share a common desire for a safe humanitarian corridor and to be able to carry out their medical work without a fear of being targeted or their hospitals being hit. The Lancet letter outlines that a staggering 469 doctors have been imprisoned by the Syrian regime. A repeat tactic, breathtaking in its calculated cruelty is the targeting of healthcare workers as they enter an area following a strike. This is how Dr Isa Abdur Rahman, 26, a British medical volunteer working in a field hospital in Idlib, was killed in May.
Some doctors who had supported international intervention have had their allegiance to the Hippocratic oath questioned. It is actually their dedication to the oath that keeps them in Syria, despite the daily risks they face. What they need is protection, as promised, through international humanitarian law, to be able to do their job safely and to be supported by the international community instead of hampered by its bureaucracy.