The civil war in Syria feels far away for many Americans. But it hits close to home for one Chicago doctor and has pulled him, and many of his colleagues, to the front lines.
Tell Me More host Michel Martin spoke with Dr. Zaher Sahloul, a practicing critical care specialist in Chicago and president of the Syrian American Medical Society.
Sahloul says that for safety reasons, local physicians in Syria have established an underground health care system.
"In every area in Syria," Sahloul notes, "there is what's called field hospitals or medical points. These field hospitals and medical points are usually hidden in the basement of buildings or sometimes in natural caves. I've seen a field hospital in the mountains of Latakia that is made in a cave — natural cave — because it's hidden from the authorities. It cannot be bombed and shelled."
On the type of injuries he sees
"Many of the conditions are related to shrapnel. ... There is a phenomenon in Syria called barrel bombs. These are barrels that are stuffed with bomb powder and dropped on populations.
"We are also treating more and more patients who have infectious diseases related to the disintegration of the health care system. We are seeing more resurgence of measles, for example, because of lack of vaccination in Syria."
On the possible use of chemical weapons
"One of the things that we have been doing is trying to track these incidents of chemical weapons exposure, and so far we have documented seven attacks of what looks like chemical weapons.
"We collected samples from the patients who died due to the exposure and handed them over to the authorities in the American Embassy in Turkey. We also provided antidotes ... to the physicians in Aleppo and Damascus to help them.
"When I went to the city of Aleppo a couple of weeks ago it looks like the medical community over there have a plan to deal with future attacks. ... In front of every hospital you have decontamination tents for the patients to come through before they enter ... the hospital."
On the tough cases he's dealt with
"I remember one of the younger patients I've seen. And she's 4 years old. Her name is Maram. Her house was shelled in the city of Idlib, and she sustained a spinal cord injury. So when I saw her, she was laying in the bed of the hospital. And she was very depressed. You know usually children smile when you try to have a joke with them, and she was not smiling. So I brought her some toys and tried to have a smile on her face, but she could not. This is one of the patients that is imprinted in my mind. And every time I think about Syria and what's happening in their life, I think about her.
"We were supporting one rehabilitation unit that she was taken to, and this rehabilitation unit is in Turkey right now. So [she and her family] moved to Turkey. And we are supporting that rehab by financial resources."
On Syria's future
"Syria is very unique country. It can be a model in the Middle East. We have a very diverse population; we have an educated middle class; we have a diversified economy in Syria. And I believe that at the end of the crisis, we will have a model in the Middle East that others can follow."
MICHEL MARTIN, HOST:
I'm Michel Martin and this is TELL ME MORE from NPR News. We're going to talk about some issues that have been percolating in the news lately that you might have wondered about. In a few minutes we'll talk with our money coach, Alvin Hall, about the Dow Jones Industrial Average. It hit an all-time high recently and we'll talk about what, if anything, that really means.
But first we turn to Syria, where a civil war between forces loyal to President Bashar al-Assad's regime and those opposing him has headed into its second year. It's claiming more lives every day. President Obama talked about that yesterday during his press conference with British Prime Minister David Cameron.
(SOUNDBITE OF PRESS CONFERENCE)
PRESIDENT BARACK OBAMA: Together we're going to continue our efforts to increase pressure on the Assad regime, to provide humanitarian aid to the long-suffering Syrian people, to strengthen the moderate opposition, and to prepare for a democratic Syria without Bashar al-Assad.
MARTIN: And one of the more gruesome aspects of the conflict - and there have been many - is that medical personnel have apparently been targeted. It's been reported by a human rights group operating in Syria that more than 100 doctors have been killed along with an equal number of medical aid workers and nurses. Hundreds more have disappeared into Syrian jails.
And so doctors in the Syrian diaspora have been trying to fill the gap. One of them is with us now. He is Dr. Zaher Sahloul. He is president of the Syrian American Medical Society. He's a clinical care specialist. He's made a number of trips into the country within the past year and he's with us now in our Washington D.C. studios where he's visiting. Thank you so much for joining us.
DR. ZAHER SAHLOUL: Hi, Michel. Thank you for raising this issue.
MARTIN: How did it start that you started going into Syria, you and other doctors?
SAHLOUL: From the beginning of the crisis there were many patients who were dying because of lack of medical care. Our colleagues in Syria, they were contacting us and asking for help. We started to send medical supplies to our colleagues in Syria. Many of the doctors who were working in Syria had to flee. Some of them were tortured and detained.
So according to the World Health Organization, about 50 percent of the physicians in Syria have left Syria. So there's a shortage of physicians. And in some of the areas you don't have any surgeon or critical care specialist or anesthesiologist. So because of that, we felt that there is a need for us to go and help our colleagues and help treating the patients.
MARTIN: It has been a long-standing sort of tradition of warfare that medical personnel are considered non-combatants. It is your understanding and that of this group that doctors are specifically being targeted. Do you have any idea why?
SAHLOUL: From the beginning of the crisis in Syria, physicians and hospitals were targeted because the authorities in Syria did not want hospitals and doctors to treat wounded demonstrators. When demonstrators, especially in the beginning of the crisis, were taken to hospitals - public hospitals - there were many reports of some of them being snatched from the operating room, doctors being detained and tortured and sometimes killed because they are treating patients. And that was systematic; it was reported by human rights organizations, by the United Nations, a special report on Syria. And according to the World Health Organization, about 56 percent of the hospitals in Syria are not operating because they are bombed and shelled by the Syrian authorities.
MARTIN: It is your understanding that these abuses, or that the targeting of medical personnel, is mainly directed by the regime. As a way to further suppress the opposition.
SAHLOUL: It's basically a way to prevent doctors and hospitals from treating what the authorities believe their enemy. Some of the doctors who were detained and tortured told me that when they are interrogated by the security, they were telling them you are aiding the terrorists. You are aiding the enemy and you are undermining national security.
MARTIN: And the physicians' response to that is what?
SAHLOUL: The physicians who left, they say no, we did not treat any patients and we did not send medical supplies to these hospitals. We did not give medications to these patients. So they had to deny that they helped patients.
MARTIN: And from a standpoint of persons who are in your field, it's my understanding that you feel an ethical, a moral obligation to treat people regardless of their politics.
SAHLOUL: Oh, definitely. You know, medical neutrality is something that is part of the international humanitarian law. Every physician knows that they have to treat a patient who comes to them, regardless of their ethnicity or religion or political affiliation. I am a critical care specialist in Chicago. So when I have a criminal coming to the hospital who has asthma attack, I had to treat that criminal.
But what's happening in Syria is much more than that. So people who are, for example, injured during demonstrations - and we're talking about civilians - or children who were bombed and had shrapnels when their house is shelled, when they come to the hospital and the physicians are treating them, they are considered that they are criminals because they are treating civilians. And this is something which never happened before.
MARTIN: If you're just joining us, we're talking about how medical personnel and facilities are coming under fire during the Syrian conflict, which is ongoing. We're speaking with Dr. Zaher Sahloul. He's president of the Syrian American Medical Society and he, along with a number of other physicians, has been making surreptitious trips into the country to treat patients who have not been able to be served by doctors within the country.
Do you mind telling us, to the degree that you can without compromising the safety of the people who are doing this work, how do you actually go about treating patients?
SAHLOUL: Local physicians in Syria, because of the fact that they cannot treat patients safely in public, they established an underground healthcare system. In every area in Syria there is what's called field hospitals, or medical points. These field hospitals and medical points are usually hidden in the basement of buildings or sometimes in natural caves.
I've seen a field hospital in the mountains of Latakia that is made in a cave, natural cave, because it's hidden from the authorities. It cannot be bombed and shelled. So we know these field hospitals and we usually send an anesthesiologist or surgeons or vascular surgeons to help the local physicians there.
In the city of Aleppo, which is about 50 percent is under the control of the opposition, there are 10 functioning hospitals. And we usually send also physicians to help in these hospitals.
MARTIN: What are some of the conditions you are seeing there?
SAHLOUL: Well, many of the conditions we are seeing are related to shrapnels. Many of the areas in Syria, unfortunately, are being shelled by missiles or from the sky by fighter jets. There are phenomena in Syria called barrel bombs. These are barrels that are stuffed with bomb powders and then dropped on the populations.
And these, by the way, are documented by many human rights organizations like United Nations. And because of that, you have many injuries among civilians with shrapnels and wounds and so forth. And these cases are taken to these hospitals, field hospitals, and we are treating them. We are also treating more and more patients who have infectious diseases related to the disintegration of the healthcare system.
We are seeing more resurgence of measles, for example, because lack of vaccinations in Syria. We are seeing more of the patients who have chronic diseases untreated because of shortage of medications. There is plenty of conditions that we are treating right now that were not there before the crisis.
MARTIN: Do you mind if I ask, is there a case that you've treated since you've been making these trips into Syria that had a particular impact on you that you don't mind sharing?
SAHLOUL: Many cases, but I remember one of the younger patients I've seen. And she is four years old. Her name is Maram(ph). Her house was shelled in the city of Idlib and she sustained a spinal cord injury. So when I saw her she was laying in the bed of the hospital and she was very depressed. You know, usually children smile when you try to have a joke with them and she was not smiling.
So I brought her some toys and tried to have a smile on her face but she could not. This is one of the patients that is printed in my mind and every time I think about Syria and what's happening, I think about her.
MARTIN: Were you able to help her?
SAHLOUL: We were supporting one rehabilitation unit that she was taken to and this rehabilitation unit is in Turkey right now. So her family and her moved to Turkey. And we are supporting that rehab by financial resources.
MARTIN: Why do you keep going back?
SAHLOUL: I think it's our duty as physicians when there is a conflict area and there is a need for our help, that we help our colleagues, and I am Syrian also. I was raised in Syria and had my medical education in Syria, so I feel indebted to the patients there and to the physicians there. It's my duty. And also when there is large scale humanitarian conflict like what's happening in Syria, with huge consequences in the population and there is a need for our help, I think we need to help.
MARTIN: Before we let you go, I do have to ask about an issue that's been very much in the news, which is the question of whether or not chemical weapons have been used against the civilian population, which would be a very severe violation of human rights, as well as international law. And I just have to ask if you saw any evidence of that personally on your trips to the country.
SAHLOUL: Oh, definitely. One of the things that we have been doing is trying to track these incidents of chemical weapon exposure, and so far we documented seven attacks of what looks like a use of chemical weapons. We collected (unintelligible) due to the exposure and handed them over to the authorities in the American embassy in Turkey.
We also provided antidote medications to the physicians in Aleppo and Damascus to help them. When I went to the city of Aleppo a couple of weeks ago, it looks like the medical community over there have a plan to deal with future attacks, so in front of every hospital you have decontamination tents for the patients to come through before they enter to the hospital, because in the previous two attacks in the city of Aleppo, members of the treating teams had similar symptoms because they got into contact with the patients.
So we're trying to help also physicians by training them on how to deal with patients who are exposed to chemical weapons. This is not something that in the medical community we deal every day, and of course with the limited resources in Syria, physicians over there need our help.
MARTIN: Just one final question, you know, if I may. You talked about this young girl who made such an impression on you and how disturbing it is to see a four-year-old girl who's not just injured but depressed. And how about you?
SAHLOUL: I'm doing OK. I feel that I'm doing my duty. I feel that, by going to Syria and Turkey and Jordan and helping my colleague, at least I'm not feeling that I'm helpless. Sometimes I feel depressed, like many of my colleague, but most of the time I feel that I'm optimistic about the future, because Syria is a very unique country. It can be a model in the Middle East. We have a very diverse population. We have educated middle class. We have a diversified economy in Syria. And I believe that at the end of the crisis we will have a model in the Middle East that other countries can follow.
MARTIN: Zaher Sahloul is a practicing critical care specialist in Chicago. He's also president of the Syrian American Medical Society and we caught up with him on a brief visit to Washington, D.C.
Dr. Sahloul, thank you for speaking with us.
SAHLOUL: Thank you. Transcript provided by NPR, Copyright NPR.