Bioethics Forum Essay

Syria’s War Against Medicine

On Monday, the Global Post published Inside Syria: One Hospital’s Story, which offers a glimpse into an emergency room in Aleppo, Syria, flooded with wounded Syrians.

“I didn’t see this amount of blood in my entire life,” says Osman al-Haj Osman, the doctor running the emergency room. “Our army kills us randomly.”

A thin man with deep circles under his eyes, Dr. Osman says he is at the hospital 24-hours a day. “We are tired,” he says. “We are tired of seeing people dead.”

Dr. Osman says his hospital in Aleppo, Syria’s largest city, has only 10 nurses working there. There are no specialists. Most of the staff are volunteers — teachers, lawyers, and medical students.

“Many of our children die because there is no intensive care unit. There is no intensive care specialist. There is no cardiac surgeon,” says Dr. Osman. “We cannot do everything.”

Yet, the wounded keeping coming in.  The violence continues unabated and unchecked by the international community.

As Syrian medical professionals struggle every day to treat the wounded, they also risk their own lives. The al-Assad regime has made medical professionals a target of state-sponsored violence and murder.

Dr. Osman reports being arrested twice and detained for a three months. Two of his friends, who were medical students, were executed, their bodies burned. “We don’t understand why the Al-Assad considers us a perfect target,” says Osman. “We save lives . . . We don’t take guns and fight.”

A recent Lancet editorial cites an Amnesty International report from Aleppo, which suggests that Osman’s experience is shared by many medical professionals. “A disturbing feature of modern conflicts and, indeed, the Arab uprisings,” the editorial says. “has been the flagrant disregard for the Geneva Conventions, including targeting of civilians, persecution of health workers, and attacks on hospitals, alongside the failure of the U.N. system to prevent these violations.”

In Syria, many medical professionals have fled to neighboring countries, compounding the suffering of those who stay. Dr. Osman says Aleppo used to have 6,000 doctors, but most have left.

“They are rich men. They escaped to Turkey, to Lebanon, to Eygpt. They betrayed us.” Dr. Osman says, emotion rising in his voice. He looks down, away from the camera. “Just in simple words — they betrayed us.”

Should more Syrian doctors have stayed and risked their lives to care for the wounded? The World Medical Assembly’s Regulations in Times of Armed Conflicts states, “Physicians have a clear duty to care for the sick and injured,” which would suggest that physicians are ethically obligated to offer apolitical care to the wounded.

However, the Geneva Conventions also require the al-Assad regime and other warring parties to recognize the neutrality and protect the safety of medical professionals caring for the wounded. These internationallyagreed upon conventions have been flagrantly ignored, and clearly, medicine’s contract with society is badly eroded on both sides.

There is no doubt that Dr. Osman and colleagues should be honored for their bravery, loyalty, and deep commitment to saving lives. But I cannot fault those Syrian medical professionals who did not stay.

Instead, I would extend Dr. Osman’s charges of betrayal well beyond the Syrian medical community to international community at large, which has ignored its obligations to take action in the face of gross human rights abuses.

Three times the United Nations Security Council has voted on taking in action in Syria, and each time Russia and China have vetoed the resolution. Earlier this week, President Obama addressed the United Nations, saying, “We again declare that the regime of Bashar al-Assad must come to an end so that the suffering of the Syrian people can stop and a new dawn can begin.” But, the president outlined no clear plan for action.

Guardianarticle reports that British Prime Minister David Cameron took aim at China, Russia, and the U.N. Security Council, saying that “no one of conscience” can ignore the suffering in Syria. Cameron went on to say, “If the United Nations charter is to have any value in the 21st century we must now join together to support a rapid political transition.”

It has been 18 months; 20,000 Syrians are dead, and the gross violations of human rights in the country are well documented. What will it take for the international community to take action?

Many would argue that the United Nations, and the United States specifically, cannot afford another war. From an economic standpoint, this may well be true. But can we afford to live in world that turns a blind eye to a regime that tortures doctors, attacks hospitals, and executes unarmed civilians?

Susanna Smith is a freelance writer, editor, blogger, and activist. She writes on global health, sexual and reproductive health and rights, mobile health and technology, and ethics. Follow her on Twitter @susannajsmith.


Posted by Susan Gilbert at 09/27/2012 10:18:57 PM |

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