Aleppo, Syria - Abu Bakr begins making his rounds inside the intensive care unit at Syria's al-Quds hospital, in the rebel-held part of Aleppo, at 8am each morning, and he often works late into the night. Although he specialises in internal medicine, he had to cut his studies in that field short due to Syria's war.
"This isn't working as a doctor under normal circumstances," Abu Bakr told Al Jazeera. "It's the most dangerous city in the world."
Aleppo, Syria's largest city, is split between pro-regime and rebel forces. Gripped by fighting and regular air strikes, the city has managed to maintain a functioning health sector, but there is a dire need for resources and additional manpower, health workers say.
We've had to put sandbags outside to fortify [the hospital] in case of any future strikes.
There are currently 10 hospitals operating in Aleppo, although many have been damaged in the war. Another hospital, Dar al-Shifa, has been bombed nearly a dozen times and has since ceased operating, while the Shawki Hilal hopsital closed at one point due to bombing damage but has since reopened.
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Health workers and patients say conditions in the city's hospitals and ambulances are less than ideal. Abu Bakr says there is no one available to fix equipment, such electrical power converters, that gets damaged in the war.
"We have enough [equipment] to fulfill our necessary requirements… but it's not at an ideal level," he said, adding that the lack of available engineers and technicians throughout Syria has created a serious problem. "When something gets damaged, it will sometimes cease working for two months or longer, until a specialist can be called in to fix it."
Abu Qusay, an ambulance driver in Aleppo, says that working in a war zone has made his job exceptionally challenging.
"Work conditions are difficult, especially during bombings… We need to get [victims] out from under the rubble quickly," Abu Qusay told Al Jazeera, noting that ambulances have also been targeted. "One time we were in the ambulance when it was hit by [the regime's] barrel bombs. Thank God we weren't injured."
Al-Quds hospital has been hit twice by bombs, both times from regime planes - including a recent strike during the holy month of Ramadan, Abu Bakr said. The attack damaged the hospital's second floor, causing it to close for 10 days, he said.
"We've had to put sandbags outside to fortify it in case of any future strikes," Abu Bakr said.
The lack of qualified medical professionals remaining in Aleppo poses additional problems for the city's hospitals.
"We suffer from a shortage of nurses and paramedics because so many have left due to the bad conditions," Abu Bakr said, noting the turnover has compelled the hospital to "regularly re-train its ambulance workers and physicians to make up for the shortage of qualified workers".
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Patients told Al Jazeera they have been satisfied with the care they have received in local hospitals, despite the chaotic situation and the chronic lack of resources. Majd, a taxi driver who was admitted to al-Quds after shrapnel injured his head and feet this summer, said "the nurses and doctors were great".
But being inside a hospital while war rages outside is an unpleasant experience, he added. "The sound of bombs outside was terrible and caused a panic in the hospital due to the presence of women and children," said Majd, who did not provide a last name.
Khalid, who was hospitalised at al-Quds for two months earlier this year after suffering a heart attack, agreed that the "service was very good, considering the circumstances". But he acknowledged the extra strain on Aleppo's medical workers.
"The doctors and paramedics have a lot of responsibilities, as patients are admitted daily… and some of the medicine was not always available," Khalid told Al Jazeera. "I was afraid that the planes would target the hospital at times, but the paramedics always took us to shelters."
Source: Al Jazeera