Dr Hussam Allahham sang to himself as he sawed through the bone. He was amputating the leg of an elderly diabetic woman.
General anaesthetics are often not used for leg amputations, and the patient was awake throughout the procedure. Amputations had become routine for Hussam, who had performed more than 40 in Syria’s crowded surgeries and field hospitals during the first 3 months of the revolution. As he operated this time, he forgot the patient was not sedated and could therefore hear his singing.
The nurse informed Hussam that the patient was silently weeping. She could hear his singing. After scrubbing out, Hussam stepped into the hallway and shouted: ‘I am a monster.’
Devoted to his Hippocratic Oath, Hussam spent the first 2 years of the Syrian revolution treating victims regardless of what side they were on – soldiers from the Free Syrian Army, forces loyal to the Assad regime and innocent civilians. Eventually, his impartiality caught up with him and he was forced to flee Syria.
He travelled from the Middle East to North Africa and Italy, witnessing the abuse, desperation and tragedy of fellow Syrians fighting to reach the safety and security of Europe.
His story poignantly highlights how European governments’ inaction forces millions of Syrian refugees to pursue illegal and often fatal routes to the West.
Now settled in Wales, Hussam was born in Saudi Arabia to Syrian parents. When he was 16, he and his family moved to Damascus. In 2002, he emigrated to Ukraine to study medicine.
Hussam returned to Syria in 2009 and secured a job with a hospital 60 kilometres south of Damascus, in the Golan Heights. Prior to the revolution, he had spent 2 years averaging 100 hours each week at the hospital. When the revolution broke out, Hussam began to treat civilian gunshot wounds in field hospitals and even made house calls.
‘They’re not allowed in the hospital because they are considered terrorists; it’s a crime to help those people,’ he said. During this period it was illegal to aid civilians caught in the violence because the government could not identify whether or not they were part of the resistance.
Hussam treated not only civilians, but also soldiers on either side of the revolution.
‘I treat everyone because that is the respectable thing to do,’ he said.
One of President Bashar al-Assad’s generals presented to Hussam with 5 gunshot wounds in his chest. The officer, responsible for the rape of men and women in a rural village, had been drawn into a trap. Fearing repercussions, residents of the village pleaded with Hussam to kill the General.
‘I am human; I cannot. We know he is very horrible, but we treat everyone,’ said Hussam.
For almost 2 years, Hussam treated the Assad regime by day and volunteered in Free Syrian Army field hospitals by night.
By early 2013, Syria was divided into those areas loyal to Assad and those loyal to the Free Syrian Army. Every day Hussam bounced between the two. While he believed in the ideals of the revolution, he knew that if he publicly supported them he could never return to his job at the state hospital.
‘You have 2 choices: either you live in free areas, but you live with the bombs, without electricity, without water – or live on the regime side and with the insults,’ he said.
Each night that Hussam worked with the Free Syrian Army he risked being caught by the Assad regime. The Free Syrian Army wanted Hussam to be their full-time surgeon. He declined because he knew the regime was becoming aware of his activities.
During this time, Hussam’s best friend was arrested and tortured – he eventually died in prison. Government soldiers brought the body to the hospital where Hussam was working. They threw it at his feet and began beating the corpse.
‘They did it just to provoke me,’ said Hussam.
Hussam and the other doctors working for the resistance safeguarded their anonymity, even among one another. Those involved only knew the name of one other doctor so that if caught and tortured they could not reveal the entire network.
‘I was optimistic this revolution would be successful, would change our lives, but there are too many things manipulating it’ - Hussam
In early 2013, a medical staffer he worked with was arrested and named Hussam as a co-conspirator. Immediately, Hussam pressed his family to leave Syria.
‘If they arrest me it would be easier; maybe I will die. But I have a sister and a mother. If they want someone, they arrest his sister. They torture her until he surrenders,’ he said.
The next morning, his parents and sister left for Egypt.
Soon, government soldiers came to the hospital and to Hussam’s home in Damascus, looking for him. This led to his third attempt to leave Syria. He had tried to leave twice before via Jordan, but the Jordanian border officials had refused to let him in because his passport identified him as a doctor.
This time, he was determined; his life was at stake. He bribed someone for a plane ticket to Jordan, out of Damascus airport. The only problem was getting to the airport. The sole road to the airport was controlled by the regime, while Free Syrian Army fighters occupied the land on either side. For the 2 weeks prior to his flight, the road was closed. The day of his flight was the first day the road was open to travellers.
Hussam flew to Jordan and met his older brother, Shadi, also a doctor, in the northern city of Irbid. The brothers would spend the rest of their journey together. After 2 months delivering medicine and aid across the border to Syria, Hussam and Shadi had drained their savings and moved to Amman.
The plan was for Hussam to find work in the capital; unfortunately, he could not because he had no certificate documenting his work in the Syrian hospital. The only work he could find was in a clinic, which required him to be on call 24 hours a day, for very little pay, and live in the basement.
‘When you are vulnerable, people will try to control you, try to take advantage of you. I said no,’ he said.
Hussam is not alone. The crisis for Syrians is desperate, says Bill Frelick, director of the Human Rights Watch refugee programme.
Prior to 2011, Syria itself was home to Palestinian and Iraqi refugees, in addition to the native population. Millions more refugees flooding an already-strained region have exhausted the capacity of neighbouring countries to absorb those fleeing conflict.
‘Part of the desperation is the unwillingness of neighbouring countries to continue to host and allow people to enter without end when they themselves are struggling,’ Frelick explains.
According to UNHCR, an estimated 4,015,065 registered Syrian refugees live in Jordan, Lebanon and Turkey.
Frelick says that the situation is overwhelming for these nations, especially Jordan and Lebanon: ‘They’re not oil rich, they’re not water rich and they have their own precarious democratic balances.’
Jordan and Lebanon until recently bore the largest number of Syrian refugees. Late last year, the burden finally exceeded their generosity. Border crossings in Lebanon were closed in October 2014 and Jordan followed suit, closing its informal checkpoints, the last route into the country, in March 2015.
Yet the conflict continued. Hussam and Shadi knew by the summer of 2013 there was no hope of returning to Syria in the near future.
‘I was optimistic this revolution would be successful, would change our lives, but there are too many things manipulating the revolution,’ said Hussam.
The brothers reunited with their family in Egypt, and spent 5 months travelling back and forth to the Turkish-Syrian border to aid transitioning Syrian refugees. During the longest stint, Hussam spent 10 days in volatile territory.
‘As a doctor, I will help, but I can’t carry a weapon. I can’t fight. I work with blood, but to save people, not to kill them,’ he said.
Hussam and Shadi next tried their luck in Yemen. In Sana’a and Aden, the only available hospital positions were in decrepit, unsanitary flats. As in Jordan, Hussam felt others saw him only as a Syrian refugee, not as a qualified medical professional.
Egyptian President General Sisi’s strict control over Syrian refugee movement into and out of Egypt kept the brothers from returning to their family. They decided Europe via Turkey was the next move.
For 8 days, they waited in the Aksaray neighbourhood of Istanbul, just long enough to obtain false passports. They boarded a flight to the Maldives that would connect to the UK. Hussam and Shadi made it to the islands, but the rouse was up quickly: false passports do not contain mandatory biometric data.
Having been grilled for 24 hours by the Maldives’ Border Control, Hussam and Shadi were sent back to Turkey.
The brothers were rounded up with other Syrians and taken to the police station. An officer asked Hussam if he had been smuggled into Turkey; Hussam nodded. The officer signed a form and welcomed the brothers back to Turkey.
‘They gave us a piece of paper identifying us as Syrian, welcoming us to Turkey, and that we are guests here so we can do anything we want,’ said Hussam.
‘They told us they understood what we are trying to do,’ he added.