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Syria: MSF staff on working at Al Salamah hospital, Azaz

14 May 2017
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“I had the opportunity to work in Germany but I refused,” says Thurayia Zein Al Abideen, a paediatrician at MSF’s Al Salamah hospital in Azaz district, northern Syria. “I want to work in Syria, because people need us and we are facing a huge shortage of doctors.”

Thurayia who has worked with MSF since 2013, is one of the nearly 150 Syrian staff who manage the hospital. It is the largest MSF medical facility still inside Syria.

Azaz district lies 32 km northwest of Aleppo city, close to the Turkish border. The MSF hospital operates against a backdrop of constantly shifting frontlines and fighting among numerous armed groups, including the government of Syria, opposition forces, the so-called Islamic State group and Kurdish forces.

When operating at full capacity, the hospital provides outpatient and inpatient care, including maternity care. It has an emergency room, an operating theatre, an X-ray department and a laboratory. A small team of international staff support the Syrian team from across the border in Turkey.

Azaz district was already home to thousands of displaced people before renewed fighting in February, and again in April and May, led to new waves of people arriving. Tens of thousands of people, including women, children and the elderly, arrived in the district, all desperately seeking sanctuary from the relentless conflict.

Today an estimated 100,000 people are trapped in the area, caught between active fighting and a closed border with Turkey. The waves of displacement take place in an environment where attacks on civilians, including targeting of hospitals and medical staff, have become terrifyingly commonplace.

“The number of wounded people is not decreasing. On the contrary, it is increasing as frontlines around Sijo and Azaz area approach the hospital” explains anaesthetist assistant Osama Haj Irhayyem.

As hospitals in the surrounding areas are bombed and medical staff flee, the MSF hospital - itself hit by machine gun fire in 2013, has become one of the only options for people in critical need.

“You are shocked when you go to move the wounded people and you don’t know if you should take the serious cases or the simple ones. However, it is up to the medics to decide on that” says Bakri Jallat an ambulance driver. “What really broke my heart was a woman that I transferred to Bab Al Salamah, who gave birth in the car. This broke my heart more than blood, bombing or killing.”

It’s not just medical care. We also have a team dedicated to emergency response operating from the hospital. Since February, they have provided essential items including tents, blankets and hygiene kits to more than 54,000 people, as well as improving water and sanitation conditions for displaced people.

In April and May as the security situation deteriorated we had to reduce some of the activities and staff. A small “skeleton” team working around the clock did everything they could to continue providing medical care and emergency relief to people in need. At the end of May, as Islamic State group frontlines came as close as 3km, MSF closed the hospital temporarily. Frontlines have now retreated somewhat, and the hospital reopened in June, but is still limited to emergency, surgical and lifesaving cases.

We hope to reopen fully soon, but for now the situation remains too unstable.