Life Inside the Syrian War: Through the Eyes of an Indian Doctor

A doctor from Delhi who has worked with Syrian refugees sheds light the lives the Syrian war has torn apart.

“Every patient in Syria suffers because of war they were never a part of,” says Dr Mukul Singhal, an orthopaedic surgeon.

(Photo: Harsh Sahani/The Quint)

Video Editor: Puneet Bhatia

Video Footage Courtesy: Associated Press
Photographs Courtesy: Associated Press, AFP, Doctors Without Borders/Médecins Sans Frontières, United Nations

Do you remember what you were doing in 2011?

In March that year, Syria felt the first few tremors of unrest, as clashes between the President Bashar al-Assad government and the rebels threatened to wreak havoc. Over the next few months, Syria descended into a bloody civil war. Cut to March 2018, and the conflict in Syria is still raging, now dubbed "the worst man-made disaster since World War II" by the UN Human Rights Council.

Children are the worst hit in Syria, with several reportedly displaying toxic stress as a result of prolonged exposure to violence and bloodshed. 

“People in Syria have been facing these difficulties for years now. Every patient there suffers because of a war that they were never a part or or ever supported,” says Dr Mukul Singhal, an orthopaedic surgeon who has worked in Syria on missions with the global humanitarian medical NGO, Doctors Without Borders/Médecins Sans Frontières (MSF).

“I no longer know how to work anywhere else,” Dr Singhal says, staring out of the window of the MSF office in his hometown, New Delhi. The Quint caught up with the doctor while he was on a short break in the national capital before leaving for another mission – this time, in conflict-ridden Yemen.

When asked about the volume of patients that he tended to at medical facilities in Syria and neighbouring Jordan, he says:

Airstrike injuries, shrapnel injuries, every patient there has injuries like this... It takes months to remove the shrapnel. Sometimes, you can’t remove it all because there’s so much of it.

Dr Mukul Singhal

Some patients would come in without having had food or water in days. And many patients still want to go back to Syria after treatment, he says.

“There was a 20-year-old young man who had lost both his eyes in an attack. We wanted him to stay and rehabilitate, but he wanted to leave because his father died on the other side of the border. He left without completing treatment. Who knows where he is now,” Dr Singhal says. “This is just one story out of millions”.

Forced to Choose Between Death & Dignity

Sand artist Sudarsan Pattnaik works on a sculpture depicting Aylan Kurdi, who reportedly drowned in 2015 as his family tried to cross the Mediterranean Sea to flee Syria.

Some lose their lives in the conflict, others lose their loved ones and homes. Some are left with life-changing injuries. There are a handful who struggle to escape – often via perilous methods like using small boats to cross over into Europe.

Refugee camps have had to take in more than they can provide for, with overcrowding putting “a heavy burden on sanitation that is contributing to disease outbreaks and tension between camp residents” as the UNCHR pointed out in 2013.

There is a high incidence of sexual violence in the refugee camps, which is never to be underestimated.

Dr Mukul Singhal

The Quint could not independently verify these claims. Dr Singhal did not specify a camp or go into further detail but says he has heard these horror stories from locals and patients. These could be dismissed as rumours, but refugees are vulnerable to sexual violence – a concern echoed by the likes of United Nations and Amnesty International, who have reported such instances from refugee camps in countries like Greece.

“It can happen any time. There are camps that are open tin sheds, where people can enter and exit any time. There is no privacy, nothing”. “Some camps don't have electricity or food. There's no water sometimes”.

He said he has also heard stories about a camp “where soldiers shoot in the air for fun after they are drunk”.

‘When You Don't Know What Tomorrow Can Bring’

The problem is that most good doctors have left Syria, he says. “Our facilities there are minimum. We don’t have as much as we do in India,” he says. Everyone works really hard because there are many, many patients, he says, adding, “India, Pakistan, Philippines, Ukraine, people from all around the world are volunteering there to help”. “My roommate was a Pakistani,” he says and smiles. “We used to share Coke Studio songs”.

In Tal Abyad, our guard was a geography teacher, our translators were mathematics teachers. If you do surgery at 4 am, they’ll be there. They have their own families and children waiting for them, but they spend hours on end helping out.

Dr Mukul Singhal

The few surgeons there are work day and night, he says. “The local volunteers and support staff are always there to help,” he says.

“It takes four hands just to transfer a patient to the bed. There are many patients, and not enough hands”.

“The strength of the people there,” he says, when asked about what struck him the most about working in a war zone. They have suffered so many troubles, but I think they are happier than most of the people there.”

But they can’t cross the border. In that situation, they stay there, living their lives, joking around, having fun, giving us food... I think that happens when you don’t know what the next day will bring.

Dr Mukul Singhal

There's lots to do in Syria, he says. “Either there are no doctors, or the price of surgery is very high, or there is no equipment or documents.”.

There is need for a facility within Syria, he says. “We [MSF] plan to move inside Syria, because if you are there, you are more helpful. It’s better if we go inside and work. Now the plan is to go to the centre of Raqqa, where the last fighting happened, and build a hospital there... That's the area where all the landmine blasts happened”.

A Lost Generation

Dr Singhal's face turned pensive when asked to talk about Zehra* (name changed), a young Syrian patient he treated during his first mission at the MSF medical facility in Jordan.

The eight-year-old had lost her father and siblings to an airstrike near her home in Homs in June 2016. “Zehra couldn't tell her story herself, because it was too painful to describe. So she drew a sketch for me. Every colour and every pencil stroke has a meaning here. Imagine an 8-year-old drawing this... she describes it as the sun having turned red, and then black”.

“Hers is a story that shows us how cruel war can be,” says Dr Mukul Singhal.

He holds Zehra’s painting up, as he says, “She had multiple shrapnel injuries – forehead, chest, abdomen. Her right leg had been amputated when I met her. It took around 40-50 operations and three, three-and-a-half months to treat her wounds. Her mother survived the attack and delivered a healthy baby in the facility”.

“Look at these small details: Her leg is crushed and she was bleeding in the ambulance... The (coloured windows) represents the wards where the friends she made at the hospital had been admitted. Her friends were other girls like her, who had undergone amputations”.

“On my last day there, she was upset. She told me I reminded her of her father and that she had lost so many people and that she did not want to lose one more... It made me feel so weak,” he says.

When asked about her whereabouts, he said Zehra has managed to get a residency in another country. “She cannot go back to Homs, her entire village is destroyed. There are no relatives left”.

When you see so much trauma at a very young age, it affects your psyche. She said she has nightmares of the incident. She cannot sleep, she cannot eat.

Dr Singhal

The impact of years of exposure to violence has manifested into a massive mental health crisis among Syria’s children, with a study by Save the Children stating that several children in Syria displayed toxic stress, a condition that can cause changes in brain architecture and brain chemistry – effects that will be felt for years to come.

“These kids are still battling life with their terrible injuries, they don't know about their future,” Dr Singhal says.

No one knows where they will be. Their villages and whole families are gone... This war has been going on for [eight] years now. Some people have been born there. Some have never seen life outside a camp. A whole generation is lost.

Dr Singhal

Statistics, or the Lack Thereof

Syria is “bleeding inside and out”, is how UN Secretary General Antonio Guterres described the conflict... in April 2018, one month after the Syrian war entered its eighth year.

How many lives has this conflict already claimed? To be honest, no one really seems to know. In 2014, the UN said it had stopped updating its death toll estimates of the war, citing its inability to verify the information. At the time, the UN had said that an estimated 4,00,000 people had been killed in Syria. In March 2018, the oft-quoted Syrian Observatory for Human Rights said that the death toll in Syria stood at 5,11,000. How credible is the information from this ‘one-man band’, as the Associated Press describes the London-based body? That's a story for another day; but this brings us to some important questions: Does no one know the exact death toll of the war in Syria? Does anyone really know what's going on in Syria? Does anyone really care?

Intervention by multiple global powers and several vested interests – like USA, Russia, UK, Turkey and Saudi Arabia and France – have complicated an already complex war to make it a "free-for-all war” and a “playground for major powers”, as foreign affairs commentators describe it. This tug-of-war now threatens to prolong the conflict, and char what’s left of Syria. And caught in the crosshairs of a war nobody asked for are the people of Syria, who as UNICEF puts it, are “drained and exhausted from” years of bloodshed.

While a few like Dr Singhal volunteer to help pick up the pieces, the rest of us continue to watch Syria burn. What will we say when future generations ask us what happened here?

(With inputs from Doctors Without Borders/Médecins Sans Frontières, United Nations, UNHRC, Al Jazeera, The Guardian, Reuters, Associated Press, The New York Times,The Atlantic, CNBC, BBC,Jordan Times, NPR, The Conversation, Save The Children.)

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