Dr Anas Al-Kassem sneaks into the Turkish-Syrian border at night with truckloads of equipment. He and his colleagues takeover houses and set up clandestine facilities, risking arrest or worse from armed forces and police.
He performs dozens of secret surgeries each week, sewing up horrific blast and bullet wounds, treating concussions and often amputating damaged limbs. When he's not saving lives, by smuggling medical supplies and expertise into his native Syria, the 38-year-old doctor lives in the sprawling suburbs of Toronto, where he works as a trauma specialist at a state-of-the-art Canadian hospital near his home.
Every few weeks, for much of this year, Dr Al-Kassem has been commuting to his native Syria from his adopted country, Canada. He leads efforts to set up field hospitals in war-torn areas, makeshift clinics that offer basic trauma treatments so wounded people survive long enough to get to well-equipped medical facilities in neighbouring countries.
"They're [the field hospitals] are inside ordinary houses," he says. "We do triage in the living room, sterilise instruments in the kitchen. There's an OR [operating room] in a bedroom and upstairs, some rooms for patients."
Al-Kassem and his team have treated hundreds of injuries, from liver and spleen trauma to concussions and limb damage so severe that amputation was necessary.
|Dr Al-Kassem uses clandestine operating rooms to treat wounded Syrians [Anas Al-Kassem/Al Jazeera]
"It's mostly civilians," he says. "Sometimes, rebel fighters and few times, (government) soldiers. They're young and elderly and lately more and more blast wounds from air bombardment and shells."
It's humanitarian work for sure, but by necessity it's also clandestine; crossing from Turkey and carefully avoiding contact with the government of President Bashar al-Assad.
That's why he and his team make sure their clinics are concealed inside houses that fit into their surroundings. Disguised ambulances arrive at night and medical personnel wear ordinary street clothes. "Regime forces, if they knew where we were, they would target us," he says. "They have destroyed seven of our field hospitals already."
A quiet, thoughtful man, he was moved to get involved in Syria by a late night cell phone conversation last year, an unexpected call from an old friend in Damascus. "Basically [my friend] said he was looking at an 11-year-old boy who'd been shot in the abdomen, twice actually," Dr Al-Kassem says, sitting in the living room of his town home in a Toronto suburb.
"I asked which hospital he was in, what treatment he was getting," the 38-year-old surgeon recalls, "and my friend said there are snipers, government snipers, near the hospitals so he's lying on my bed. Bleeding. What do we do?" Dr Al-Kassem admits to a sinking feeling at that point. "Two abdominal wounds and no medical treatment, obviously he's going to die," he recalls thinking.
But that was also the moment when a surgeon living a quiet life in Canada, raising his four children in a peaceful city, decided to act. He called fellow physicians and other contacts around the world and, last January, set up an organisation called Canadian Relief for Syria (CRS) to channel medical skills and equipment to his native land. They have set up more than 50 field hospitals so far.
Dr Al-Kassem and colleagues in CRS had hopes of getting funding to expand that network from the government of Canada, but fell victim to a local political and media firestorm.
Standing in a refugee camp in Jordan, Canada's foreign minister, John Baird, announced last week that his department would provide $2m to purchase medical supplies and set up more clinics.
But on Wednesday afternoon, Baird said he had instructed his department to "change course" because he wanted to make sure Canadian money directly reached "victims of the Assad regime and wasn't spent on such things as warehouses and infrastructure".
"We're a country of consensus. ... If Washington decides to openly provide arms, we'll likely also be involved."
- Professor Houchang Hassan-Yari
The government faced criticism in some media reports for giving public money to a new, unproven aid group that hadn't yet acquired charitable status. There were also questions about the group's ties to Syrian rebel fighters, who help Dr Al-Kassem and others move through the country and reach clinic locations.
Dr Al Kassem described the minister's decision as "frustrating" and said the Canadian government money was only ever intended for the purchase of medical supplies, not the "warehouses or infrastructure" referred to by the foreign minister.
"We'll keep going. This is a relatively small amount of money and we'll find more," he said. Even as the minister was announcing the change of policy towards CRS, Dr Al-Kassem said, his group had purchased and arranged delivery of another field hospital in northern Syria. "It'll be operational soon," he told Al Jazeera.
The episode does raise importance questions about Canada's foreign policy ambitions towards the Syria conflict. Canada is in effect taking sides by providing humanitarian aid and calling diplomatically for the Assad government to end violence and step aside.
"We are not contemplating any military assistance at this time," a spokesman for Foreign Minister Baird told the Toronto Star earlier this week. But analysts say Ottawa may just be waiting for the US and others to take the lead.
"We're a country of consensus," says Professor Houchang Hassan-Yari of Canada's Royal Military College. "But there's no doubt that this [possible military support] is a matter of intense discussion for the government, for many governments.
"If Washington decides to openly provide arms, we'll likely also be involved."
For his part, Dr Al-Kassem says he is not joining the debate about what sort of intervention is needed in Syria. He wants to focus on treating patients. It is time, he says, to consider what happens when the conflict eventually ends and how tens of thousands of severely injured Syrians need treatment. "We hear on the media all of the time, hundreds killed here or there. What I'm most interested in is how many people are disabled, how many people have permanent injuries that will take years and years to heal.
"I'm confident that this regime is going to fall, but how many people will be affected, who's going to take care of them. That's what I want to know."