Sunday, July 15,2012

by Amal Hanano

Medical Neutrality: a principle of noninterference with medical services in times of armed conflict and civil unrest: doctors must be allowed to care for the sick and wounded, and soldiers must receive care regardless of their political affiliations. . . . The principles of medical neutrality derive from international human rights law, medical ethics and humanitarian law. Violations of medical neutrality constitute crimes outlined in the Geneva Conventions.

Mohammed, an internal medicine physician, and his brother Omar, an orthopedic surgeon, are from Idleb. Since the Syrian uprising began sixteen months ago, they have worked in hospitals and make-shift field clinics in Hama, Idleb, Deir al-Zor, Raqqa, and al-Hasakeh. They joined the Free Syrian Doctors Union in May 2011. The union is a network of Syrian doctors who deliver medical care and emergency relief in field hospitals to scores of wounded protesters and opposition fighters. This is dangerous work, because as Dr. Mohammed says, “Any doctor who becomes known by name for working in a field hospital or taking care of the wounded who cannot be treated at a government hospital is wanted by the regime.”

Last month, two medical students and a first-aid medic had become known by their names. The three young men, Basel Aslan, Mus’ab Barad, and Hazem Batikh were wanted by the regime for treating protesters who had been shot by security forces. They were arrested at a checkpoint in Aleppo on June 17, 2012 and detained at an Air Force Intelligence branch. According to an Amnesty International report, the bodies were found in a burned car in the outskirts of Aleppo on June 24. Their charred corpses were marked with signs of torture. As the report indicates, Basel Aslan “had a gunshot wound to the head and his hands were tied behind his back. One leg and one arm were broken, several teeth missing and the flesh was missing from his lower legs, leaving the bone exposed. Some of his fingernails had been removed.” The report continues, “As casualties from the current unrest have mounted, so President Bashar al-Assad’s government has intensified its hunt for the wounded and for those who provide life-saving emergency treatment to them.”

Government hospitals in Syria have become centers of death and torture for Syrians who have been wounded by government bullets and shells. While some of the injured are armed defectors belonging to the Free Syrian Army, the majority of the people in need of emergency care are civilians, including thousands of women and children. There is no separation between attending to the severe humanitarian crisis and the regime’s brutality in quelling the uprising — in fact, the latter is the cause of the former.

In the absence of functional (and safe) medical institutions, under-equipped and underserved makeshift field hospitals — in homes, places of worship, or abandoned buildings — have become the main source of medical care in areas of conflict (the destroyed city of Homs being an extreme example). In other areas, doctors have been able to use private facilities, as Dr. Mohammed explains, “If an area is occupied by the revolutionaries, then the private hospitals can be used freely. For example, in Idleb, the Syrian Army only controlled the government hospital, so we were able to care for the wounded and conduct medical operations within the private hospitals.”

Even within these private hospitals, the medical teams found themselves struggling to meet the needs of the critically wounded. He says, “In Idleb we had an average of ten injured daily. Once, we received thirty wounded within half an hour. There was not enough space for us to walk between them. Most of the wounded had severe limb injuries. There was not enough medical staff to take care of them. We had five doctors; two of them were surgeons and the rest had non-surgical specialties. My brother Omar and I were able to work in the Red Crescent Hospital which was protected by the FSA for three months and until three days after the city of Idleb was under siege by Assad forces. We worked until the army was half an hour away from the hospital, then we left. We were wanted men.”

Dr. Mohammed left Idleb weeks ago and moved across the Turkish border where he works managing the trickle of medical aid delivered to the field hospitals in the northern region of Syria. He  risks his life to enter Syria once every two weeks or so and visit the field hospitals. He records the needs of the doctors and clinics, and delivers emergency kits.

He is well aware of the risks these Syrian doctors and medical personnel face every day for treating patients. Today, there are hundreds of physicians detained in intelligence centers. He explains, “We receive news of the detained doctors, and their condition is dire. There are four detained doctors in Damascus. One of them suffered congestive heart failure (CHF) while he was tortured. Security forces transferred him to the military hospital and when he was returned, they tortured him again. Some of these doctors were detained just for transporting medical equipment and aid in their personal cars to Idleb.”

He continues, “Dr. Mohammed Bashir Arab from Aleppo has been in prison for seven months. Some of the doctors who enter prison are not released at all. These doctors have done nothing but do their work: treating the wounded.” This is their unforgivable crime.

Arab is a 32-year-old pathologist. He was arrested on November 2, 2011 during an activists’ meeting. All the activists were detained, but later released. Except Arab, who has a long history of political dissent. In 2004, he was imprisoned for eleven months. Today, he is currently detained in the Air Force Intelligence branch where he was tortured under interrogation. He was not subjected to a trial or even an accusation. His detention has lasted for more than sixty days — which is the legal period for a citizen to be held without trial in Syria. Arab has become the face of the international campaign to release Syrian doctors from regime torture centers.

One Syrian American doctor has made a personal mission to fight for these imprisoned doctors. Dr. Hazem Hallak attends international human rights conferences to shed light on these cases. Even within the circle of countries known for their gross human rights violations, attendees and diplomats are always shocked to hear the extent of the abuse of physicians in Syria. In a recent conference in Taipei, Hallak was impressed with coordinated efforts of Bahraini doctors who arrived to the meetings prepared with detailed, documented cases of abuse. Then he found out that these doctors were sent by the Bahraini officials to represent their country. They asked him, “Can’t you go back to your country?” He replied, “No, I would be killed.”

As a practicing physician in the U.S., Hallak understands every physician’s ethical obligation to his patients. Unfortunately, he also has firsthand knowledge of the Assad regime’s torture tactics; his brother, Dr. Sakher Hallak, was tortured to death in Aleppo last May. He was a successful, practicing physician in Syria. Sakher did not treat wounded revolutionaries nor was he a protester; he was killed for the mere accusation of dissent.

Various human rights organizations have compiled a list of over five hundred doctors who have been detained since March 15, 2011. Hallak explains that when Syrian doctors are in jail, the community is deprived of desperately needed health services, while the doctors themselves suffer untreated injuries of their own from the torture. Some of them have suffered irreparable brain damage. He asks international ambassadors and diplomatic officials to demand the right to visit these physicians. He says, “Most of these doctors are not charged with a crime and all of them are non-violent. The only thing they have done is provide medical care for the injured. I know the government told the doctors not to treat protesters, but their actions cannot be considered criminal because as a physician you have an obligation to treat patients without discrimination.”

He requests that international human rights organizations appeal for the doctors’ immediate release and help them leave Syria. “We would like a United Nations or Red Cross delegation to put pressure on the Assad regime to visit these doctors in prison. It is imperative to expose what these doctors are enduring. Recently a doctor in Aleppo was detained. He was one of the most active doctors we had. These doctors are tortured regularly. Our goal is not political. Our goal is to release the doctors, or demand they are at least treated humanely in prison.”

In Syria, every mother dreams of her sons becoming doctors when they grow up. It is the most esteemed profession in the country and only the best students are able to attend medical school. These young, idealist doctors — some of the brightest minds of Syrian society — are now in dark cells being punished for doing their job: saving lives.

They are being tortured for practicing medical neutrality.

The Hippocratic Oath that states “Do no harm,” has ancient roots almost as old as Syria itself. But for the past sixteen months, the Assad regime has shown no respect, much less neutrality, for the basic rules of humanity. Hallak considers his pleas as a last resort, to possibly save a doctor like himself from torture, to perhaps save an innocent doctor from his brother’s devastating fate. “Bashar al-Assad himself is a physician, that is what’s ironic about this. He is killing his own profession.”