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Aleppo becoming ’another Rwanda’: Forging a life amid Syria’s ruins

The unnamed man shown on CCTV, standing in a sunny courtyard and fiddling with his phone, could be any one of us whiling away a few minutes of the day.

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CCTV footage of an air strike on the M10 hospital in eastern Aleppo. Photo: Supplied/M10 hospital

Except that, in the city where this moment played out a few weeks ago, any notion of the ordinary has been turned on its head.

One second, the man is simply standing alone and looking down. The next, the wall behind him explodes and all trace of him is obliterated in a violent, catastrophic air strike that destroys everything around him.

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The wall was blown apart seconds later in an air strike. Photo: Supplied/M10 hospital

To many in the comfort of the West, the battle for Aleppo might seem like an abstract story of a faraway city, where statistics do little to portray the suffering amid the violence.

But, for people such as Mohamed Abu Rajab, a cardiologist at the M10 hospital where that air strike occurred on October 1, it is intensely personal.

The eastern part of the city could be completely wiped out by Christmas, the United Nations special envoy for Syria, Staffan de Mistura, warned last month. The scale of the human tragedy there is so great it risks becoming "another Rwanda", he said, and the conscience of the world is being tested.

"If we miss some type of opportunity to make a change, history will judge us," he said.

In 1994, about 800,000 people were slaughtered in Rwanda in a genocidal campaign by extremists of the Hutu tribe. Entire families were butchered.

Here, we take a look at what life is like for some of the 270,000 people whom the United Nations estimates are trapped in eastern Aleppo.

What is happening in Syria, and Aleppo?

Aleppo is a city in north-western Syria, about 50 kilometres from the border with Turkey. Five years ago it was Syria’s economic capital and its most populous city. The old section of the city is listed as a UNESCO World Heritage site. Now it is largely in ruins.

Nationwide pro-democracy protests against Syrian President Bashar al-Assad and his government began at the start of 2011 as part of the Arab Spring. The unrest soon deteriorated into civil war.

For more than a year after the start of the civil war, Aleppo managed largely to avoid the conflict that had engulfed the rest of the country. But in July 2012, fighting broke out there between the rebel groups and the Assad regime’s forces.

Neither side was able to claim victory and the city is now divided between the government-controlled west and rebel-held east.

Aleppo has now become the main stage of conflict between government forces, backed by Iran and Russia, and various rebel groups.

Fighting in the city has escalated significantly since rebel districts were encircled in July, and a new offensive was launched in September.

How many people still live there?
The United Nations estimates 270,000 people, including an estimated 100,000 children, are trapped in eastern Aleppo, where supply lines have been cut off and it’s a daily struggle to get food and water.

Dr Rick Brennan, from the World Health Organisation, said he had worked in humanitarian assistance for 23 years and had regularly visited conflict zones. Rarely had he seen conditions such as those being endured in Aleppo today.

"There has been a reduction in the number of health workers able to stay at their posts, and those who did are exhausted, drained physically and emotionally," he said. "The work they are doing is beyond heroic."

The exact death toll from the Syrian civil war is unclear, with estimates ranging from 300,000 to 470,000. In April, Mr de Mistura estimated that 400,000 people had been killed in the war to that point.

The United Nations Refugee Agency estimates that 4.8 million people have fled Syria since 2011, while a further 8.7 million people are thought to be displaced inside Syria.

What is life like?
Fairfax Media spoke to Dr Abu Rajab, to see what life was like for the city’s remaining citizens.

The love for his city is clear.

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Mohamed Abu Rajab is a cardiologist and was a co-ordinator at the M10 hospital in Aleppo.

"Aleppo, to me, is a story of love that never ends. I would never leave Aleppo. She is my land and my nation," said Dr Abu Rajab, who is also supported by the Syrian American Medical Society.

But the situation had deteriorated to the point at which it was "beyond dire", he said.

"The besieged parts of Aleppo are witnessing a real human tragedy," he said.

"These are poor areas to begin with. But with the advent of air strikes from the Russians and the Syrian regime, and the use of all sorts of internationally banned weapons, the civilians, who were too poor to flee to other areas, are killed. This is an unjust siege that has turned their lives into bombardment, destruction and death."

The Bab al-Nayrab water station in eastern Aleppo was damaged by air strikes on September 22, and could not be used until it was repaired about a week later.

Dr Abu Rajab said disease was rife in the city and many people were malnourished.

"Children are the most vulnerable. We don’t have babies’ milk. We can’t provide children with food," he said.

"Diseases are spreading because they drink [untreated] water from wells.

"People here are unemployed. They suffer from a shortage of food and vegetables.

"[The war] has had a huge negative impact on the medical sector as well. It suffers from shortages of personnel, medicine and medical supplies - not to mention the destruction of hospitals, clinics and fire brigade buildings.

"People here are helpless. All of them, regardless of their ages, are battling depression, psychological stress, poverty and lack of resources.

"As for education, we are confronted with an illiterate generation with no schools or kindergartens. There’s no education.

"And yet the world is not able to do a thing over the plight of this oppressed and besieged population."

When the air strikes hit the M10 hospital, Dr Abu Rajab and some of his colleagues survived by sheltering in the building’s basement.

"We live in constant fear. People are stuck under the rubble and we can’t get to them because of the intensity of the shelling. We are pleading for help to stop the bombing and the killing of innocent civilians. Let the people of Aleppo live. Let the children be children. Let medical personnel do their job."

Dr Abu Rajab was among the medical staff who treated five-year-old Omran Daqneesh, the young boy who was photographed in the back of an ambulance in Aleppo after surviving an air strike in the city. The image of his dazed and bloodied face was shared widely around the world, temporarily jolting the world to consciousness.

Omran’s case is by no means exceptional - rescue teams are finding children regularly under piles of rubble, medical workers there say.

Guide to survival
Omair Shaaban, a former student at the University of Aleppo, said residents lived in fear that they could be bombed at any time.

"If you want to stay alive in Aleppo, you have to find a way to keep yourself safe from explosions and starvation. Here’s how," he wrote in an article for The Washington Post, in which he outlined his rules for survival.

He said residents lived only on the lower floors of a building, which were "less likely to be hit than the upper floors".

"When a smaller bomb lands on top of a building, it often takes out just the top two or three storeys. A lot of people are living on the lower floors of buildings whose upper storeys have been destroyed," he wrote.

He stayed out of rooms near the street because "light in a window attracts bombers or snipers".

Any schools that were operating had been moved underground, he said, but not all children went because of the risks involved in getting there.

"Hearing bombs go off all the time is hard. They’re so noisy - the sound alone could drive you crazy. So now I try to ignore it. If bombs detonate nearby, try to forget them, try to be calm. Go save your neighbours instead of panicking," he wrote.

If you weren’t "killed by air strikes or shells, your big worry will be food", he said.

"Maybe you’ll try to grow vegetables in your garden. In my neighbourhood, people are growing eggplant, parsley and mint. Many gardens have become burial grounds, though, because there isn’t room anywhere else to bury dead bodies after four years of war. But if the alternative is starving to death, you might not mind eating food that’s been grown among corpses."

The hospitals were "absolutely miserable", he wrote. He had to visit a hospital once a week to have his bandages changed, after he was shot in the hand by a sniper.

"I don’t know how the doctors and nurses can stand all the blood, bones and bowels all over the floor. The smell is awful. Patients who can’t leave are constantly screaming in pain," he wrote.

’You never really leave Aleppo’
Samer Attar, a surgeon from Chicago, volunteers in Aleppo with the Syrian American Medical Society and the Aleppo City Medical Council.

In an opinion piece for The New York Times he recounted the intense weeks he spent in the besieged city, compared with his work at home.

"In Chicago, where I specialise in surgical oncology, I see one patient at a time. In Aleppo, I see 20 at once. You live your life one massacre to the next: of children at school, or of families sleeping at home or shopping at a market. We hear the jets screech by, the helicopters whirring in the sky, the mortars launching, then the bombs exploding. Followed by sirens and screaming.

"The screaming seems never to end, some days. So many people pushing through the entrance. There are never enough beds, so patients have to share gurneys or lie on the floor."

Dr Attar said that every time he left Aleppo, he was crushed by the stark differences in cities just a short plane trip away.

"One moment, I’m in an underground hospital shaking from the blasts of missiles, saving whom we can, watching those we can’t bleed to death. The next moment, I am at the airport coffee shop watching a man in a sharp suit cut the line or a woman berate the barista for putting too much ice in her tea.

"Nothing makes sense, and you feel like a ghost. Once you’ve been there, you never really leave Aleppo."


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