Turkey extends lifeline to wounded Syrians

Hospitals are struggling to deal with the large number of wounded crossing into Rayhanli, on the Turkey-Syria border.

In the distance, just out of the shade of trees, you could make out the shapes of two vehicles with figures walking to and fro. They were just a few hundred metres inside Turkey’s side of its border with Syria.

This is smuggling country. But, despite the seemingly clandestine appearance of what is going on, it’s broad daylight and the zoom of a camera lens tells one of the myriad stories of the thin line between life and death in Syria’s war.

A Turkish ambulance is parked in front of a beaten up old mini van. Eventually the outline of a stretcher can be seen carried into the ambulance.

This is the lifeline for some of the most seriously injured on the rebel side of a war that doesn’t recognise one of the most sacrosanct parts of the Geneva Convention – the basic human right of safe passage for the injured, doctors, nurses, and their support staff, from either side.

But this is an undeclared safe haven, and a ten minute drive away to a public hospital in the town of Rayhanli, medics in the emergency and recovery unit have become used to the difference between injuries caused by road accidents compared with those caused by shrapnel, bullets, blast wounds and burns. The trauma of warfare.

The wailing sound on approach, and a final blip of the ambulance siren on arrival, signals what’s in store. 

Medics inside are ready to make a very fast triage. They don’t hesitate to switch from Turkish patients to war casualties if the need arises. And invariably it does.

As the doors of the ambulance burst open the sight of a man with a blood stained bandage over his head, a hand pumped respirator alongside, has a sense of immediacy about it.

But this man has been on an extraordinary long journey, agonising in its complexity of dodging road blocks set up by Assad forces and avoiding helicopter gunships.

And this sort of drive is commonplace.

Daily flow of war trauma

The Free Syrian Army fighter was injured in a battle near Aleppo. As the crow flies Syria’s second city is only 50km away. But the journey – with stopovers for first aid – has taken a total of 12 hours.

Another casualty arrives within the hour. This time the fighter is conscious, a serious leg wound but he’ll be afforded the specialist surgery any Turkish civilian would expect.

We don’t find out if the serious head injury patient survived. The Turkish health service is reluctant to engage with the media – just as its military, while turning a blind eye to the relentless border passage of fighters, refugees and arms smugglers, won’t engage in explaining its remit.

But it is highly evident that Turkey’s border hospitals, deeply embroiled for a long time in the daily flow of war trauma through its public health service, is at a critical stage.

The numbers are increasing by the day, depending on the logistics of where the conflict is at its height.

In this part of the border that snakes along more than 900km of mountainous terrain the hospitals are full to overflowing.

In an effort to lessen the burden, medical charities have been setting up a network of centres aimed at treating the injured after hospital treatment and surgery. They’re in converted private residencies, hostels, dormitories and student accommodation in border towns.

The Union of Syrian Medical Relief Organisations, UOSSM, is attempting to co-ordinate humanitarian efforts. It is having some success. But 17 months into this conflict it appears surprising that the public, private and voluntary system to help victims of the Syrian conflict isn’t more streamlined and effective.

The UOSSM feels strongly that one of the solutions is to pour more money and humanitarian effort into setting up more field hospitals, clinics and medical centres within Syria itself.

Many lives are lost on the haphazard, dangerous drives to the border. And the most disturbing aspect is that civilians unsurprisingly find it much harder to take such a path.

They are in the minority compared with the number of fighters being admitted to the public hospitals. We visited two of the follow-up centres run by separate charities. In one, around 25 per cent of the 80 patients being treated were women and children. In the other they were all fighters.

The second hospital was lacking in resources – one voluntary physiotherapist to deal with more than 30 patients, some with complex conditions needing specialist care.

In the corner of one room, leaning forward in his bed to show his scar, Mohammed Al Zeer, called us over. Unlike the others, worried about being identified in the media when their families were back in Syria, Mohammed wanted to talk.

He was confined to his bed and a wheelchair because emergency surgery to three vertebrae in the upper part of his spine had saved his life but wouldn’t enable him to walk again.

Both Mohammed and his physiotherapist told me that a surgeon had recommended a highly expensive specialist operation which would be likely to offer him the chance of walking again. But there was no funding available for the surgery.

Mohammed was angry:

“I am injured and I fought for my country. You see me in this situation – why? Why can’t they use some of the money that comes from abroad – millions of dollars?”

His comment was addressed to a rebellious war machine and the poor aftercare for its volunteers.

Mohammed isn’t alone in thinking that more effort is going into raising money to make war in Syria rather than paying to rebuild the shattered lives it’s leaving behind.

Follow Andrew Simmons on Twitter: @simmjazeera