Since the start of the Syrian civil war, hospitals have been targeted and destroyed. Many health practitioners have lost their lives or fled the country. The country’s health system has collapsed.
Dr. Nassif Sarraf*, a pediatrician, decided to stay.
“If I leave, if my fellow doctors leave, there will be no one left to help the children” he says. “I believe in humanitarian values. I want to help the people of my province. So I must stay.”
Below, Dr. Sarraf shares with us the challenges of working in a war zone at a Relief International-supported hospital, what keeps him motivated, and his hopes for the future.
The Only Doctor Left
Shortly after the war broke out, I started volunteering at a Hospital for Women and Children. They didn’t have a doctor – I was the only one.
Patients had to pay for their treatment, which meant that many poor families couldn’t access care at all. This was particularly true for people who fled their homes due to conflict and were living in temporary in camps.
Relief International took over the management of the hospital and I am now one of 20 doctors here, and I am the Medical Manager of the hospital. We have 140 staff members, and healthcare is free for all. We see about 9,000 patients a month, including inpatients, outpatients, and those in our intensive care unit. We also run vaccination services for children.
The services we provide have improved, but we still face many challenges due to ongoing conflict.
A Typical Day
In the morning, I examine about 130 children in the pediatrics inpatient ward. Afterwards, I make my rounds in the other children’s wards. We have a nursery ward, an intensive care unit, and an out-patient clinic.
The illness we see depend on the seasons, but most cases are related to gastroenteritis, diarrhea, and meningitis. In the winter, we see pneumonia and a lot of respiratory problems.
Recently, we have had an increase in cases of malnutrition. This is especially critical for children, and is most prevalent in the communities who have been displaced from their homes and are living in poverty. We see stunted growth in children, and in women malnutrition can mean they are unable to breastfeed. Milk is not widely available, so babies also suffer.
In the afternoon, in my role as Medical Manager of the hospital, I supervise the gynecology department, radiology department, and the laboratory. I also review reports and other documentation relating to patients.
A lot of women are facing gynecological problems that are indirectly caused by the war due to stress. There are a lot of cases of anxiety and depression. We are also seeing high levels of miscarriage in displaced communities due to stress factors.
The hospital is the only children’s hospital left in our district, which has a population of about half a million people. There are very few hospitals remaining in the wider province. So our hospital is under a lot of pressure.
Medicine is in Short Supply
The security situation continues to be dangerous. There have been lots of attacks, including one recently right outside the hospital. Two people were killed and we treated a third.
All medical supplies and drugs are now hard to obtain. The hospital is not fully equipped. We have 150 beds but its not enough.
Two or three children often share one bed, and sometimes we have to transfer patients to other hospitals, even in neighboring countries (when we can), since we don’t have the right facilities or medicines. It’s far from ideal.
One of the drugs that is in short supply is Immunoglobulin, which is important for mothers with Hepatitis B. Another is the drug we use to help premature babies breathe.
I have to decide who we can accept and treat and who we have to send home. It's incredibly difficult to make those decisions.
The needs on the ground are immense. So many women and children need medical care for conditions both related and unrelated to the war. Sometimes we receive between 200-300 children a day, but we don’t have enough beds for them.
I have to decide who we can accept and treat and who we have to send home. It’s incredibly difficult to make those decisions.
We want to extend the intensive care unit and the nursery ward, and hope to move to a new building if we have the funding.
I am grateful to everyone who supports Relief International’s work – you are helping so many people.
*Name changed to protect identity.