SLAUGHTER OF THE INNOCENTS
It’s the picture that stunned the world. Now, with raw emotion, the hero British surgeon who operates on Aleppo’s wounded children as bombs rain down pleads: in the name of humanity, the West MUST act now
THE small boy with a grievous stomach wound was one of hundreds who processed daily through the hospital in Aleppo where I was working as a trauma surgeon. ‘Am I going to die?’ he asked me quietly. Ali was just four years old, and it was the fact that he could speak with such calm self-awareness about death that frightened me.
Death is now so commonplace in Syria’s largest city that even the youngest children live daily with the reality of it. And this is an awful and abiding tragedy.
A child of four should not understand the meaning of death, much less have the prescience to foretell his own.
I thought about little Ali, who did indeed die from shrapnel wounds, when a surgeon friend phoned me last week from the underground M10 hospital in Aleppo, where I had also worked. He told me he had treated Omran Dagneesh, a fiveyear-old boy who had been admitted with a deep scalp wound.
At the time I did not know who Omran was, or realise the significance of my friend’s remarks — after all, he was treating many child casualties every day.
But, of course, within minutes, I, along with millions of others worldwide, was faced with Omran’s picture on my television screen. The image of him sitting in an ambulance — shell-shocked, covered in dust, dazed and bloodied — became iconic.
Perhaps the world had become so inured to awful images of death that it took a living child, a boy who had actually survived his injuries, to symbolise so powerfully the horror of the conflict in Syria.
Omran has spent the entirety of his short life living under a constant bombardment from the skies. The attack is relentless and unimaginable. As a result, he and the other children of Aleppo are wise beyond their years.
FIRST, Omran’s home was destroyed in the air strike from which he was rescued. Then, a day later, his ten-year- old brother — another Ali — died as a result of injuries to his kidney and liver, as well as fragmentation wounds sustained during the blast.
His distraught parents did not even have a home in which they could receive mourners.
But these losses are commonplace. Civilians in the rebel-held district of the city where Omran and his parents live endure incessant attacks from rockets, barrel bombs and high-energy explosives which rain down from russian jets and Assadregime helicopters.
Children play in the rubble of bomb blasts. Their schools, if they ever had them, have been destroyed.
Now there are napalm and chlorine gas attacks, too.
A friend, another fellow doctor, rang to tell me last week of around 20 patients who were admitted to his makeshift hospital after a chemical weapon attack with chlorine.
His emergency department was full. He had neither enough masks nor oxygen cylinders available to treat the majority. He was not able to ventilate any of the seriously ill patients because he simply did not have the equipment to do so.
As a result, two died after the chlorine combined with the water in their lungs to produce hydrochloric acid, which then dissolved their lungs. My friend was utterly devastated.
It is now 23 years since I first volunteered to work as a surgeon in the world’s worst trouble spots. Every year, I spend a couple of months away from my NHS posts at three London hospitals (Chelsea and Westminster, the royal Marsden and St Mary’s where I work in vascular, general and cancer surgery) to operate on the wounded and dying in conflict zones.
After all that time, you may wonder if I have become anaesthetised against shock.
Actually I have not. And on the three occasions I have volunteered in Aleppo, in 2013 and 2014, the emotional trauma I felt has never abated.
Each time I see a child die — and more than 70 per cent of the casualties I treated in Syria were children — I feel heartbroken. Each time I hand a small corpse to a grieving parent, I mourn with them.
I have seen many children, brought to hospital by distraught parents, who appear not to be wounded at all. They bear no evidence of trauma or distress, but their bodies are lifeless because they have been killed by the shockwaves from bombs and are literally drowning internally in their own blood.
ONE mother tried fruitlessly to feed her lifeless child who had died in this way. She failed to take in the fact that he was dead because to her his body still seemed perfect, unscathed, and she would not believe he could not be revived.
To see her trying to spoon food into his mouth was pitiful. It was a desperate task breaking the news that nothing I could do could help her son.
Other children bear only too obviously the awful evidence of trauma. One day in Aleppo, seven children from a single family were brought into the hospital where I was operating.
Their mother was dead, and one of her little sons had had his buttocks blown off. He was still alive and he had white blobs on his face. These were his sister’s brains. It was the most dreadful sight I’d seen in all the years I have been operating in war zones, and the vision of it stays with me today.
I could not save the boy. All I could do was comfort him and hold his hand as he died.
Yet he is not unusual. The grim list of dead and dying continues to grow remorselessly, and what fills me with as much horror as the deaths is the fact that our senior politicians in the West do no more than wring their hands.
The time has past, I believe, for empty platitudes. The stream of infant and child deaths, of innocent civilian casualties, shames us all.
And actually it is our problem, too, as a tide of refugees — an estimated ten million in the next five years if the conflict is allowed to continue unabated — streams out of the country.
What we are witnessing in Syria now is a holocaust, an unparalleled humanitarian disaster, and it is time for our
Prime Minister to show her mettle. I implore Theresa May to show the same resolve as John Major did in the Gulf War in 1991. He created a safe haven for the Kurds, when they were being attacked by Saddam Hussein’s chemical weapons, by enforcing no fly zones and sending aid. If he could do this autonomously, so too can Theresa May.
She must demand a no-fly zone to stop Assad’s and Putin’s bombers from wreaking further death and destruction. And there must be a humanitarian corridor so help reaches the beleaguered people of Aleppo.
The answer is not military action. A temporary cessation of hostilities is not the solution either, but it is better than doing nothing, and inertia condemns us as both weak and heartless. If the war is allowed to continue for another five years, one million people will be dead.
Meanwhile, the intensity of the assault on the innocents of Syria escalates. When I first packed my gas mask and went to Aleppo for six weeks in 2013, I spent much of my time there teaching surgeons how to perform complex trauma surgery from gunshot and fragmentation wounds. On average, we treated a dozen or so wounds a day.
When I returned to the city in September 2014, the rocket attacks by Syrian jets had been joined by helicopters dropping barrel bombs packed with TNT.
These were being dropped indiscriminately on the most densely populated areas. Every day had become a mass casualty event.
SINCE the Russians intervened in 2015, at the request of Assad, the air strikes have escalated. Every civilian — children included — in the rebel-held areas is now regarded as a terrorist. And so cynical are the attacks that the most dangerous place to be in Aleppo now is a hospital. Twenty-nine in the north of the country have been attacked, and now they are being bombed on average every 17 hours.
There are now just three makeshift hospitals operating in Aleppo, codenamed M1, M2 and M10.
Even the latter, which is underground, has been targeted. These hospitals have just six trauma surgeons between them, dealing night and day with a constant stream of casualties.
Every doctor in Syria who speaks in public now does so using an alias, because they also fear for their lives. I, as a humanitarian going to Syria to operate and save lives, am also regarded as a terrorist and am therefore a target.
Indeed, my friend and colleague Abbas Khan, a British orthopaedic colleague who volunteered in the same hospital as I did, is one of the many who were killed two years ago.
Today, as a father — I have a beautiful one-year- old daughter called Molly — I am sharply aware of the contrast between her blessed life with my wife Elly and me in London, and the constant pall of fear under which the children of Aleppo live. Truly, it breaks my heart.
As Stephen O’Brien, the United Nations’ humanitarian chief said this week, the callous carnage that is Syria has long since moved from the cynical to the sinful.
He has urged all parties in the conflict to heed a call for a 48-hour pause in the fighting to allow humanitarian aid to be delivered to every area of Aleppo.
I share his anger at the cataclysm and I endorse his call for a safe passage for aid, because now even basic and essential medical supplies have run out.
An abiding memory — one that haunts my dreams still — is of the screams of children on whom I was forced to operate without adequate pain relief or anaesthetic.
‘I kiss your hand, uncle, please stop,’ begged a 12-year- old boy, polite but crying in pain when a tube was inserted into his chest by a colleague who had no anaesthetic to numb the pain.
The doctors and nurses — now a dwindling number — who remain in the city working until they are beyond the point of exhaustion, and imperilling their own lives, are nothing short of heroic.
Many are my friends, and every night, when I finish work, they often call me so we can talk through the process of an operation together.
I have set up a foundation, too, to train surgeons in trauma surgery. But the best place to learn is in the thick of the conflict.
The other night, a fellow surgeon called to ask for advice. He was operating on a little girl whose shoulder had been blown off. It is an everyday injury in Syria, and one I had already encountered.
I talked him through the process of cutting out the shattered bone and moving a flap of skin from the child’s back to cover her missing shoulder. Together — me in London, he in a makeshift underground operating theatre in a primitive, illequipped hospital in Aleppo — we sent messages to each other on WhatsApp. We got through it.
This is how surgery is carried out in a war zone; on a wing and a prayer. The little girl survived. Many others are not so fortunate.
And when I think about the many casualties I have treated, those who lived and those who died, I feel not just sadness but an intense and burning anger.
The world must join me in being outraged. Silence and inaction are not merely inexcusable, but sinful.
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