Children’s Orthopedics Ward, Al-Mouwasat Hospital, Damascus
It was about 11 in the morning on Tuesday August 2, 2016 when two sisters, ten year-old Ghina and her eight year-old younger sister Nagham were walking a short distance from their home in the town of Madaya to its “field hospital” in order to acquire serum for their anemic mother Sahar whose body was very deficient in calcium because of 18 months existence with very little food. Sahar explained to this observer a couple of days ago that she and her four babies, lived at times with nothing more than a watery soup made of grass, or sometimes black peppers, but most often made from the pink and white flowers of thistle plants she gather from a nearby field.
For more than a year, after having fled from their own Sunni village of Zabadani due to fighting, the family has been living in surrounded Madaya, a mountain town of 40,000, now with four times its pre-war population, about 30 minutes northwest of Damascus. Military forces encircled Madaya in July of 2015 as part of a broader offensive to recapture the nearby Qalmoun Mountain villages and the town of Zabadani, held by rebels since 2012. Residents of Madaya have been trapped ever since.
Having made their medicine purchase, the girls started their short 60 yard walk home. A claimed eye-witness says that a sniper near al-Asali checkpoint took aim and fired at the youngsters. One explode-on-impact bullet entered Ghina’s upper-left thigh, shattering her leg bone and thigh.
For an instant, not realizing what had happened, Ghina’s younger sister 8 year old Nagham, noticing that Ghina had dropped the small plastic medicine bag to be given to their mother at home, instinctively picked it up and began to scold her big sister for dropping it. The little heroine, by now instantly covered in her sister’s blood, tried to pull badly bleeding and screaming Ghina off the road to a secure location- the roadside ditch. The sniper took aim a second time. This time, shrapnel from the bullet struck Nagham’s right arm and hand. The two young girls lay on the side of the road until minutes later passersby were able to pull them out of the line of fire and transport them to the towns nearby “field hospital”.
Over the past year, snipers have killed seven people in Madaya, according to a report published on 7/13/2016 by Physicians for Human Rights, a US-based organization that has provided medical assistance to thousands in Syria since the civil war erupted in March of 2011. The PHR findings were confirmed in a separate Report from the Madaya Medical Commission published on 7/23/2016. The following week, snipers shot and wounded three more people, a Madaya resident reported last week by telephone to a relative of the girl’s family.
The sniping of civilians continues until today in Madaya as some try to escape the siege imposed on their town. So also do deaths mount from the approximately 6,000 additional landmines recently placed around the southern and eastern sides of the town, by militia in order to further imprison residents inside.
Such indiscriminate use of landmines in a populated civilian area violates international humanitarian law and, as with sniping civilians, constitutes a punishable war crime once the conflict ends and hopefully the global community insists on full accountability under the law for all who have targeted the people of Syria.
Several dozen people have also died from starvation in Madaya, despite surrendering in exchange for relief from the siege. With almost nothing and no one allowed in or out, the town continues slowly dying from the inside.
At Malaya’s “field hospital” whose medical staff consists of two heroic dental students and an animal veterinarian, Ghina was diagnosed with a displaced fracture, a badly shattered leg bone and a severed nerve in her upper left thigh.
Before long, Ghina’s leg and thigh became badly infected and a tentative decision was taken to amputate it. As one of the MDs reported at the time via “What’sUP” to medical colleagues abroad, Madaya’s health workers today are only able to perform emergency surgery, mainly amputations. As Dr. Darwish, a dentistry student and one of three health professional still in Madaya insisted, they did not have the equipment or the training to repair the damage to Ghina’s leg and thigh or most other serious injuries brought to the “Field Hospital.” However, amputation of Ghina’s leg was something they could perform. Time was running out for Ghina shown below shortly after she was evacuated from Madaya to Al-Mouwasat Hospital, Damascus
Madaya’s severely wounded, like Ghina, have only one way to get out of the besieged town and thru the 65 checkpoints, countless landmines and snipers, and to receive the lifesaving treatment they need. It is through a painstakingly negotiated reciprocal agreement between rebel and regime forces, brokered by Iran and the United Nations last year. In theory it provides for the evacuation of some wounded people from Sunni Madaya in exchange for a parallel evacuation from two Idlib Shia towns of Foah, and Kafraya, besieged by rebel forces.
Unfortunately, there are a number of additional bureaucratic hurdles which result in very few in need of urgent medical aid being allowed to leave Madaya through one of the 65 checkpoints which also surround adjacent Zabadani. A major one being that snipers regularly shoot residents if they approach Madaya’s periphery from any direction.
Fortunately in Ghina’s case, as with the case of the conjoined twins from the Damascus suburb of East Ghouta, Nawas and Moaz (the subjects of Part II of this article) a social media campaign led by Amnesty International pressurized the powers that be to allow the Syrian Red Crescent Society (SACRS) to enter Madaya at night, so as not to attract the attention of many other families with severely injured members who surely would demand evacuation for their loved ones in critical condition, and rescue the girls and move them for urgent emergency medical intervention.
The metal rods must remain deep inside Ghina’s leg and thigh for three months and she must stay in a hospital bed for two months. The sniper bullets were designed to explode on impact and they did much nerve and muscle damage.
Until the past few days, there has also been great concern about the risk that Ghina’s muscles in the left leg will be permanently shortened, causing walking abnormalities. That erstwhile grim likelihood is now largely discounted.
Today Ghina and Nagham are recovering at Al-Mouwasat Hospital in Damascus and eating plenty of nutritious food including three pieces of fresh fruit daily for which Syria is blessed and famous, on specific instructions from their new American “uncle”, their mother Sahar and their new “big sisters”, Rima and Raraf, both from Damascus. And the girls can have each have two pieces a day (maximum!) from their growing supply of admittedly less nutritious treats arranged by their new friends. This morning this observer was advised by the girls Dr. that Nagham’s hand and arm stitches can be removed in five days. And then the little one will for sure head to the fine swimming pool at my hotel.
On Sunday (the first of the week end) September 18, 2016, the public schools across Syria will open for the next academic year. Arrangements have been made by MSRCL, which also helps specific cases in Syria itself, for 7 year old Nagham, who her mother explained has been an average student last year in Madaya-when classes could even be held- to begin classes. She was lectured today by her American uncle that is was important to start off the school year well, to sit in the first two rows of her classroom (to be separated from the “antics and distractions of the boys in the back of the class!”) and to make eye contact with her teacher and not to be shy about asking questions if there is something she does not understand.
With respect to Ghina, her proud mother Sahar explained today that she is an excellent student but cannot attend school this year for at least two or three months. Arrangements were made today for Ghina to receive home schooling by tutors Alaa and Nadine until she can join the new school year.
MSRCL is still working to get permission to bring Sahar’s two other babies, Manal age 3 and Mohamad-Kamal out of Madaya. The little ones were unfortunately not allowed to leave as part of Ghina’s evacuation. Again, for bureaucratic reasons.
Ghina and Nagham were very lucky to survive the sniper’s bullets last month and are today out of harm’s way. But this is not the case for the 40,000 entrapped residents of Madaya who remain imprisoned by the war in Syria, as do nearly one million other besieged civilians across Syria today.
To provide a meal to a Syrian refugee child in Lebanon: Please visit: