Anas Al Kassem leans slightly forward to his computer screen as the chime of the Skype call fills his home office in Ancaster, Ontario.
The surgeon is unsure if he can reach his friend at an orthopedic hospital in Idlib province in earthquake-damaged north-west Syria.
He’s lucky this time.
“Hi how are you?” asks Al Kassem.
On the other end, Dr. Sameah Qaddour said he and his medical teams performed up to 50 procedures a day and slept about four hours each night. Despite this, they are forced to turn away hundreds of other patients due to their inability to assess them or provide continuity of care.
The hospital where Qaddour operates was damaged by the quake. A video he shared with CBC News shows visible cracks in the ceilings and spots where rocks have fallen from the walls. The staff there don’t know if the building is secure, but they have no choice but to keep using it.
CLOCK | Cracks have appeared in the ceiling of this Syrian hospital:
“They have serious shortages of antibiotics, painkillers and anesthetics,” says Al Kassem, who translates for Qaddour.
Other videos show patients of all ages in chaotic, crowded wards, some even being treated on the floor. In the background, children can be heard crying and screaming while medical staff frantically go through case-by-case.
While aid has been pouring into Turkey, doctors on the Syrian side of the border told CBC News they have yet to see any aid or supplies.
Al Kassem is part of a small group of Canadian and American medical workers planning to enter Syria later this week and bring relief supplies and supplies through the Union of Medical Care and Relief Organizations-Canada (UOSSM). The group is also sending a container of medical supplies from Ottawa that it hopes to bring across the border.
Difficult situation even before the earthquake
According to Reuters, the earthquake near the Turkish-Syrian border on February 6 killed more than 33,000 people, with more than 5,700 deaths reported on the Syrian side.
Even before the quake, it was difficult to bring aid across the strictly controlled borders to Syria.
The area hardest hit by the quake in north-west Syria is largely controlled by rebels after years of a brutal civil war involving President Bashar al-Assad’s forces.
In 2020, Russia and China vetoed a United Nations Security Council resolution to continue allowing aid to flow into northwestern Syria from two crossings, reducing the viable crossings to just one in Bab al-Hawa.
On Monday, a week after the quake, the United Nations announced that Assad had agreed to open two new border crossings from Turkey to the northwest to facilitate improved delivery of much-needed aid, including equipment, for an initial period of three allow months.
A UN convoy with relief supplies such as blankets and hygiene items, which was supposed to come through Bab al-Hawa before the earthquake, only made it on Thursday. Those on the ground say it’s insufficient given the scale of the disaster.
On Sunday, Raed Al Saleh, the head of Syria’s civil defense (also known as the White Helmets), called for the immediate opening of more border routes into the disaster area and criticized what he called the slow UN response.
“Waiting for UN Security Council approval to reopen more border crossings into the North West is utterly misguided. This unnecessary delay will only cost more lives,” Al Saleh said in a press release.
“We urgently need the UN to open more border crossings into north-west Syria so cross-border humanitarian aid can flow freely. If the medical supplies don’t escalate quickly, the UN will leave even more blood on their hands.”
“No medical equipment, no food”
Muhaid Kaddour, another surgeon working at a field hospital in Idlib, confirmed he had not received any help as of Friday.
“When I say nothing at all, I mean nothing at all until now [has entered] across the border from Turkey or from people from another area,” he said in a video he recorded and sent to CBC News. “No medical equipment, no food. Five days after the earthquake: nothing.”
Kaddour added his voice to the chorus urging aid organizations and other countries to help and open the border to allow supplies to flow in.
“The disaster is very big and very hard. We need your support,” he said.
CLOCK | Syrian surgeon Dr. Muhaid Kaddour asks for help:
Hospitals in the region were already in poor condition before the quake and were largely dependent on help from relief organizations.
“The hospitals were built or built in the last 10 years of the war. So they are fragile hospitals. They are not very well equipped,” explained Al Kassem. “Turkey is more developed than Syria, if you will.”
He said the Assad regime and years of Russian airstrikes had greatly impacted the situation in north-western Syria.
CLOCK | The view from inside a crumbling and overwhelmed hospital in Idlib province, Syria:
“They don’t have a health system,” Al Kassem said. “They don’t have a government to support the hospitals and clinics. Actually, it is NGOs like ours that support these centers and clinics.”
The amount of aid that has flowed across the border is not enough, he said.
“I speak to the doctors and nurses on site every day. They perform hundreds of procedures.” He cited a small hospital that was taking 500 cases on the first day of the earthquake and was only able to take 120.
“Imagine the amount of supplies you would need for these surgeries. These are not easy operations. These are fractures and there is spinal and brain surgery.”
“You need advanced medical care”
Al Kassem has made numerous trips with the NGO during Syria’s civil war, but expects the upcoming visit to be different.
“I think it’s a lot more overwhelming because of the scale of the disaster and because of the short time it took [in which] it happened,” he said. “Imagine the area of Idlib and northern Syria has four million people. Almost three million are internally displaced.”
Al Kassem says many people have suffered “crush injuries” that require complicated care. Some need to have subdural hematomas drained, while others may have abdominal bleeding.
“They need advanced healthcare in an intensive care unit and on top of that, a crush injury can lead to a syndrome where the muscles are crushed and the kidneys are affected, which also leads to a type of kidney failure. So you may need dialysis units. “
CLOCK | dr Anas Al Kassem explains the extreme need for help in Syria:
For many, the risk of infections and diseases such as cholera, coupled with a lack of safe water and food, will further threaten survival.
Those immediate needs are being replaced by other longer-term needs, Al Kassem says, like reconstructive surgeries, rehabilitation and prosthetics. All of this, doctors say, requires a steady flow of help and an open border.
As his Skype call with Quaddour draws to a close, Quaddour takes a moment to ask Canada for more help.
“He’s asking the Canadian government, the Canadian people, to send supplies immediately and as quickly as possible,” Al Kassem said.
“He is counting on Canada as a good land of peace known for its significant humanitarian impact in this type of crisis to send immediate supplies to them.”
