East Aleppo: “We try to sleep for half an hour to gain the strength to perform another surgery”

With intensive care units full and medical supplies running out, east Aleppo’s seven hospitals cannot cope for much longer, says surgeon Dr Abu Huthaifa

“We’ve got used to the daily scenes following a mass bombing, when the hospitals are so crowded with the wounded that we have to step over them to reach other patients in need,” says Dr Abu Huthaifa, one of the few remaining surgeons in east Aleppo. “At these times, we ask for help in the emergency room from everyone who is available – caretakers and cleaners as well as health workers – to put pressure on patients’ bleeding wounds, apply basic dressings, move patients to the operating theatre, triage patients according to the severity of their injuries, and move those who can be saved into the operating theatre.”
The three-month-long siege of east Aleppo and the relentless bombing of the city over the past three weeks are taking a deadly toll on the estimated 250,000 people trapped in the besieged area. Medical care has also been a victim of the blockade and the bombs, with just 35 doctors remaining, and only seven hospitals still functioning. Three weeks ago there were eight, but one hospital has since closed after being hit several times during the aerial bombing campaign.  
“There’s a shortage of medical staff,” says Dr Abu Huthaifa. “Many were visiting their families and relatives outside Aleppo when the siege started, so they got stuck outside Aleppo. There is also a lack of fuel, which we need to keep the hospitals’ generators running 24/7, as there is no electricity supply in east Aleppo. There’s a shortage of medical supplies, as well as of drugs and intensive care beds.”
Before the siege, says Dr Abu Huthaifa, many patients in need of long-term intensive care were referred to other cities in Syria, or else to Turkey. “Now, under the siege, we cannot,” he says. “Sometimes we are forced to turn off life support for a hopeless patient in order to admit another one with a better chance of survival.”
For the past three weeks, the situation in the city’s hospitals has been desperate, with services overwhelmed by the number of injured. “We received a patient wounded in an airstrike and he needed a laparotomy,” says Dr Abu Huthaifa, “but all the operating theatres across Aleppo were full. We had to put him on hold until one became available. He died because there was no space in any operating theatre for us to perform the surgery.”
In these circumstances, just finding time to eat or sleep can be a struggle, says Dr Abu Huthaifa. “When one patient leaves the operating theatre, and as another is brought in, we do things like praying or eating,” he mentioned. “We’ve been working almost 24/7 and we’ve been receiving wounded people around the clock. Sometimes we try to steal a nap between two surgeries – we try to sleep for half an hour to gain the strength to perform another surgery.” 

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