'I Will Not Leave Syria': One of Aleppo's Few Remaining Doctors Is Defiant

Very few doctors remain in the eastern part of Aleppo, Syria. Usually they must work under the constant threat of aerial shelling in substandard conditions. In this November 20 photo taken in Nawa, in the Syrian province of Deraa, a doctor inspects the damage wrought on a hospital by barrel bombs dropped by the Syrian government, according to activists. Alaa Al-Faqir/Reuters

Like many of Syria's doctors, Dr. Rami Kalazi, a neurosurgeon in the city of Aleppo, spends most of his time these days trying to save patients pierced and pummeled by shrapnel from barrel bombs.

Kalazi also does preventative medical work, including examining patients with headaches and back pain, but neurosurgery is difficult to perform during a war and without electricity, he says. Injuries from barrel bombs—canisters full of shrapnel such as nails, glass and pieces of metal, as well as gas or chemicals—vary depending on where the bomb falls. But Kalazi says he and his colleagues face "too many injuries we haven't seen in books, referrals or work," like a "splinter," or fragment from the weapon, entering the body and causing massive internal damage.

"We need too many large pieces of equipment and we need too many medicines," Kalazi says in a phone interview. "We don't have the space to move in. So I help my colleagues and I do operations with general or vascular surgeons. Anywhere I can help, I can."

The empty, abandoned house next to Kalazi's house in Aleppo, Syria. Dr. Rami Kalazi

Kalazi and his colleagues work in a building that, to most people, isn't recognizable as a hospital. Seen in a photograph sent via messaging service WhatsApp, the hospital has worn metal bars covering two holes at the front of the beige three-story structure, where glass windows are supposed to be. Wires dangle down past exposed brick and around a dozen barrels containing concrete debris that are lined up outside. The sidewalk in front of the hospital has mostly been destroyed and the two-story clinic next door is in a similar state of disrepair.

It's hard to imagine these buildings as places that could save someone's life, yet this is the reality for the remaining hospitals in rebel-held eastern Aleppo, Syria, where roughly 80 doctors remain, down from 1,500 in 2010. Nearly all the doctors—95 percent—in the eastern part of the city have fled, been detained or been killed, according to a startling report from international humanitarian organization Physicians For Human Rights. Around 680 medical personnel have been killed in Syria since the start of the war, the majority of them by Syrian government forces, and more than 300 facilities have been attacked, according to Physicians For Human Rights.

A view from Kalazi's neighborhood shows a hole in the road caused by a barrel bomb dropped a year and a half agao. Kalazi describes it as "one of the most horrible attacks." Dr. Rami Kalazi

At Kalazi's request, Newsweek is not publishing photos of the hospital where he works, in order to protect his safety and that of his colleagues.

Kalazi returned to Aleppo with his wife, who is an internist, and their 1-year-old son in April after relocating to Gaziantep, in southern Turkey, for a year and a half after the Syrian city became too dangerous. He works a grueling schedule, alternating 15-day shifts with an Egyptian neurosurgeon—and he once spent a 40-hour stretch treating victims, the longest time he remained on his feet at once.

Despite knowing that they could be targeted at any time, Kalazi and his colleagues at the hospital, which he says has been hit 35 times by barrel bombs and aerial shelling in the past several years, somehow remain upbeat and full of hope, says Kalazi. After their hospital was first hit by an airstrike in February 2014, staff moved their operations underground.

"We have been here for about three years, so we are used to this. Every day we know, we might die today," he tells Newsweek by Skype. "We're always laughing, smiling, always looking how we can rebuild our country."

The Syrian uprising reached Aleppo in 2012, but the city was still safe in 2013, says Kalazi. In 2014, "the city began to be empty, people began to move away because of the barrel bombs and airplane shellings," he said. "Now, we have Russian airplanes, which are contributing [to the attacks] with regime airplanes," he says during a phone call after day 11 of his 15-day shift. "The situation is horrible, actually."

Some patients have lost limbs after being hit directly by barrel bomb splinters, he says. The number of patients depends on how many attacks occur each day and whether barrel bombs are dropped in residential areas. On some days, Kalazi's hospital can receive as many as 10 or 20 victims of aerial attacks.

The day before Newsweek spoke with Kalazi, he treated a woman in her 30s injured by a barrel bomb splinter. It entered her thigh and punctured her pelvis and abdomen, damaging her bladder and organs. "We tried to stop the bleeding," said Kalazi. "In the end, she died."

The recent addition of Russian airstrikes into the mix of fighting in Syria has made life for Syrian civilians, including its doctors, riskier still. Since Russia began airstrikes in late September, nearly a dozen of them have hit Syrian medical facilities, according to Physicians For Human Rights.

While Kalazi says Russian airstrikes are louder, more accurate and deadlier than airstrikes by the Syrian government: "In our daily lives, it's not a big difference."

"Both of them are attacking civilians and attacking health facilities," says Kalazi.

Every day, Kalazi must balance the safety of his wife and son with the need to treat injured civilians. But he feels a powerful obligation to stay and serve his country.

"I will not leave Aleppo, certainly not leave here," says Kalazi. "I will not leave Syria."