Aleppo, Syria - With hospitals in rebel-controlled eastern Aleppo coming under fire, the most severely injured patients in the besieged city have - until recently - been transferred to Turkey for better, safer care.
But now, with the city under siege, such transfers have become impossible.
"We can't send the wounded to either rebel parts of the countryside or Turkey, because the city is completely besieged," Hassan Fattouh, a paramedic at Zarzour hospital, told Al Jazeera on Saturday. "There's no way out."
One of Zarzour's warehouses was bombed in June, destroying much of its stock of medicines, while other hospitals in eastern Aleppo have been targeted by government and Russian bombs in an attempt to drive opposition groups out of the city.
The situation has trapped seriously injured people in a city whose conditions are deteriorating rapidly.
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"The siege of eastern Aleppo has left people trapped and struggling to survive, with the only road into non-government-held areas cut off," Doctors Without Borders (MSF), which works with Zarzour and other hospitals in Aleppo, noted in a recent news release.
"Now the population, and crucially the war-wounded and seriously ill, have no way out, while vital food and medical supplies cannot get in."
On Sunday, conflicting reports emerged about whether the Syrian government had opened humanitarian corridors to allow residents to leave Aleppo. But some residents said that even if such routes opened up, they feared mistreatment by the army if they were to flee.
Majd Ghazi, who was a patient at Al-Quds hospital earlier this week after being injured when a bomb hit his street, said that even if he wanted to leave Aleppo, he does not feel he could do so safely.
"I was arrested before by the regime for protesting in 2011. If I went to regime areas, I'd be arrested again," Ghazi told Al Jazeera.
For now, the city's health workers are making do as best they can, but some fear the worst.
"It's dangerous. We're working with the equipment and materials we have, but we could lose control [of the situation] at any moment and face death," Fattouh said, noting that in recent days he has been treating more and more seriously injured people who would have benefited from being transferred to Turkey.
"During times of heavy shelling, we have more than 50 patients a day with varying degrees of injuries, ranging from superficial to life-threatening," he said.
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Compounding matters, a number of hospitals in Aleppo were struck and shut down last week. With no safe way to transfer patients out of the city and hospitals closing, Aleppo's wounded may soon be left to fend for themselves with little to no available care.
Some health workers believe there is a real risk that the situation could deteriorate to that point.
"[If we reached that point], we would depend on available medical points in the city for ambulance patients. We'd provide what we could," said Ismail al-Abdullah, a member of the White Helmets, a group of emergency service workers that operates throughout Syria.
Eastern areas of Aleppo have been under siege for several weeks, with the government cutting off the rebels' main Castello Road supply route.
"Other than that, transferring patients out of the city is impossible," Abdullah said. "The regime bombs everything heading towards Castello Road."
Source: Al Jazeera