A doctor in Idlib: 'It cannot get more evil than this'

My name is Dr Tarraf. I was born in Al-Mash'had, one of the urban slums of Aleppo, on February 1, 1982 - the day the terrifying Hama Massacre began. Over 27 days, Syrian soldiers razed the city, killing 20,000 people, to put down a rebellion against the rule of President Hafez al-Assad, the father of current President Bashar al-Assad.

My family is originally from a small village in Idlib province called Haas, about 10 kilometres (six miles) west of Maaret al-Numan. We moved back there in 1995 because our small apartment was not large enough for our growing family.

I was the second child in a large household of six boys and two girls. One of my brothers, Mustafa, has managed to move to Germany to start a new life. I call him the only survivor of the family.

Of the remaining five boys, two have been lost to Syria's war, two have had their lives and studies put on hold because of the fighting and detentions, and I no longer make plans for the future.

My work as a doctor has become unbearably exhausting - both physically and mentally - since the regime launched its Idlib operation last spring. At the time, I worked at two hospitals, Kafr Nabl surgery hospital and Maaret al-Numan central hospital. These facilities were the closest to the regime's front line, and came under intense bombing for a long period of time. There was a constant stream of casualties coming to the hospital. The medics literally did not get a chance to rest.

The choice

I remember one of the worst days, August 28, 2019, when the main vegetable market in Maaret al-Numan was targeted by an air raid from a Syrian army jet. We had six operating rooms in the hospital, and only eight doctors. Soon after the air raid, injured people began streaming in, along with dead bodies. Within five minutes all the operating rooms were full. I was the last surgeon to get there.

I walked in to find two patients, both needing immediate help. As a doctor, I had to choose which one to treat and which to transfer to another hospital some 30 minutes away - something we do when there are limited resources and many cases to attend to. The first patient was a man in his thirties who was in hemorrhagic shock. The other was a three-year-old-boy who was bleeding from shrapnel in his chest; he was also in shock.

It was a terrifying moment in which I had to make a choice; one which would help one patient but might lead to another dying on the way to the referral hospital. I had no other choice but to choose, so I chose the child.

It was a difficult choice. But I thought about my two-year-old son. I saw that child as if he were my own, and so I chose to help him. I started treating him, I opened his abdomen, tried to stitch blood vessels. But after 15 minutes we, unfortunately, could not save him, and the anesthesiologist declared him dead. I went out of the operating room to find that the man was still there, still waiting for an ambulance, as they were in high demand.

I got back to work, trying to save him as well. I started a blood transfusion in the waiting room; I opened his abdomen and made thoracentesis. But unfortunately, the man also died after 30 minutes of trying to help him.

I had just left the operating room, frustrated and exhausted, when a local man asked me about the patient. I told him he had died. He then asked me about the child, and I told him he was dead, too. He then told me: "You know, doctor. The two were a man and his son."

It was one of the worst, most traumatising, moments of my life. I will never forget it because I failed to save both the man and his son.

Saying goodbye

At the hospital, there were so many critical cases in urgent need of help. So I would always be under pressure and suffer from insomnia.

More than a month before that August day was another horrifying moment. It was after sunset on July 10 when Maaret al-Numan hospital came under attack. The facility was badly affected and the electricity generator was damaged.

I was the doctor on duty and, along with other colleagues, decided we needed to evacuate the hospital and all the patients. But the most worrying part was when we had to evacuate the newborn incubators. The hospital had six of them. All those babies needed to remain there; but we knew the regime might target the hospital again, so they had to be moved. We continued with the evacuation, but some of the babies died along the way.

Some of the patients, about 10 percent, refused to be evacuated. It was a very difficult moment. But as medics we decided to stay with them, accepting the potential risk of being hit a second time by the air raids. Two hours later, regime helicopters dropped barrel bombs on the town of Maaret al-Numan. The hospital received dozens of injuries. We managed to save most of them because we stayed.

After the regime's latest campaign in Idlib, I sent my family to the Turkey-Syria border where it is safer, while I remained working in hospitals in Idlib.

But for months before, every time I went to the hospital, I would say goodbye to my family as if I would never see them again. There was always the thought that I would go to the hospital and never come back.

It was mentally exhausting, because we had to work under constant bombing. Whenever I heard jets in the sky, I would think the hospital would be the next target. That put those of us in the medical field under enormous psychological pressure. And it made my family and loved ones worry constantly. They contact me every once in a while to make sure I am not hurt. Especially my parents, who have already lost two sons, Yusuf and Huzaifa.

Losing brothers

When we were young, our family did not have much. But my parents tried their best to provide a decent life for my siblings and I.

Although all eight of us were very good at school, life began to get harder when my brothers and I started college. My father's salary was hardly enough to cover basic family needs. My eldest brother, Yusuf, went to medical school in 1999 and I did the same in 2000. My father started to borrow money, and those debts began to accumulate. With more college bills as the years continued, my family remained in debt until my brother and I graduated from college and started to work overtime shifts in hospitals in addition to our specialisation internships.

In 2011 the Syrian revolution started. Yusuf was by then a doctor at the Tishreen Military Hospital, near Damascus. He was a resident doctor specialising in general surgery and I was in my last year of a urology specialisation at the Al-Muwasat Hospital in Damascus. Our brother Huzaifa was in his last year at medical school.

Soon after, Yusuf left Damascus and moved to Idlib. Then he left his government job and started to help people in our hometown, where people were being shot during protests and later killed by regime bombardment. I remained in Damascus until I finished my thesis and got my degree.

Then, Huzaifa was arrested in late 2012 at the university campus in Damascus. I did my best to get him out and paid huge amounts of money to get him released. I reached out to an intermediary involved in these types of transactions. However, when he found out Huzaifa was a doctor he said he could not help.

"It is easier to secure the release of a [opposition] militant or a protester from prison than doctors," he told me.

We found out two months later that Huzaifa had been tortured and killed in custody.

I moved back to Haas, our village, and the revolution had by then become militarised. Yusuf and I remained firm in our commitment to revolutionary principles by helping people in the field hospitals. Another one of our brothers, Qutaiba, was arrested during his last year of civil engineering college but later released, after which he decided to go back to the village and never dared to return to university.

Our youngest brother, Ubayda, finished high school and got into computer engineering college, but he did not dare to continue after his first year because he was afraid of being arrested. So we all remained in the village. All besides Mustafa, who went to college, where he started to study communication engineering, and then managed to move to Germany to continue his studies.

The village was bombed

In 2016, Haas was bombed. The regime targeted a complex of schools on October 26 in what later came to be called "the Massacre of Pens", since the regime deliberately targeted the schools complex and all the roads nearby. Most of the victims were children in elementary school.

Many medics were killed, too. My brother Yusuf was in the village and rushed to the place that had been targeted because he wanted to help those in need of medical assistance. The regime planes targeted the same place deliberately and he was among the victims.

Regime forces always do that. They would target a location with air raids and when people come to help any survivors, they would target the place again several minutes later. And a third time as well.

Our house had been targeted repeatedly throughout the entire revolution, but with the help of my brothers we had always managed to fix it. The last time it was targeted it was destroyed completely, as was my house.

Now, I have no plans for the future. We live day by day, here. I cannot even think of tomorrow. Just today another battle started a few hours ago, with non-stop air raids and artillery shelling, injuries constantly coming to the hospital in the city of Idlib, where I now work.

My worst fear is for the future of Syria. Syria is turning into the worst possible thing a state can be: A failed state plus a dictatorship, combined under occupation. It cannot get any more evil than that.

This account, as told to journalist Zakaria Zakaria, has been edited for clarity and brevity.