Friday, November 22, 2013

Syria's children in the crosshairs

 Rama, 15, quadriplegic. Reyhanli, Turkey.

Rama Korabi, 15, was walking to her elder sister's home in the Idlib town of Ariha, Syria, on July 9, 2012. A sniper shot her through the neck. She awoke in the Ariha hospital, where she had been taken immediately after the shooting. The bullet was removed, and she was transported to Aleppo to undergo an operation to remove bone fragments. Her injury had rendered her quadriplegic--unable to move her legs, arms, and torso, and unable to walk.

(To learn more about Rama's hometown, read a recent report here about the long siege of Ariha, a key settlement along an important Syrian government resupply route. By McClatchy's Roy Gutman.)

Even in societies not experiencing brutal conflict, where excellent medical care is readily available, people with spinal injuries are susceptible to serious complications. Rama returned to Ariha with her family, but developed pressure sores on her back. Her parents managed to get her out of Syria for another operation and further treatment in the Turkish border town of Reyhanli, which is where I met her.

Several rehabilitation clinics have sprung up in Reyhanli, where injured Syrians can recover after operations performed at Turkish hospitals. The accommodations are meant to be temporary. One recuperates, gets back on his feet, and leaves the clinic to make room for the next patient.

But as more and more Syrians endure shelling, sniper fire, and other lethal weaponry, the clinics are filling up with severely injured patients, including many who are paraplegic and quadriplegic, with no place else to go. People who have spinal injuries need access to specialized, long-term medical care and living spaces. The health care system in Syria has been nearly destroyed, and affordable, wheelchair-friendly housing is difficult to find in rural Turkey.

(Watch a great interview with volunteer conflict zone surgeon David Nott here. He returned from a five-week posting in northern Syria in October and talks about Syria's broken medical care system, injuries caused by snipers, and what he thinks the international community can do to help. From BBC's HARDtalk.)

Increasingly, the residents of these clinics are children and teens like Rama.

Rama's mother, left, and a friend lift her from bed to wheelchair.

The United Nations estimates that 7 million Syrians have fled their homes and at least 10 million require emergency humanitarian assistance. More than 100,000 people, and at least 6,000 children, have been killed since Syria's uprising began in March 2011.

If they can, the most severely injured seek medical care across the border in Turkey. Rama was staying in this particular rehabilitation clinic with around 80 other patients, 31 of them with some level of paralysis due to spinal cord injury. The director of the clinic, a Syrian lawyer named Yasir Alsyed, told me they see an additional 80-100 outpatients daily.

Rama's mother helps her with her hijab, the Islamic veil.

Rama and her family came to the clinic three months ago. She needed a procedure to drain the fluid from the sores on her back, and was also doing physical therapy sessions. Shy but friendly, Rama was incredibly positive and good-natured.

"I want to take her home [to Syria] but there is nothing for her there," said Rama's mother, who declined to give her name.

The United States and other western countries give millions of dollars in critical humanitarian and medical aid to organizations like the United Nations and the International Committee of the Red Cross, which then distribute the lion's share of western aid to Syria. Unfortunately, for mostly political reasons, that assistance generally does not reach civilians in rebel-controlled areas. Both organizations recognize and continue to work through the government of Bashar Al-Assad, which allows the regime to control distribution of the aid. (There are other organizations like Doctors without Borders and the Turkish IHH, among others, working in rebel-controlled areas.)

Rama in the room she shares with another patient.

Patients stay in the rehabilitation center for free. Sometimes one or more family members stay with them. This recovery center is funded almost entirely by Syrian expats.

Alsyed, the director, said a longer-term care house for people who have been paralyzed is desperately needed. "If we continue like this, the whole facility will be paraplegic patients," he said.

Rama, at right, attends the rehab clinic's school--an improvised classroom. All of the children are different ages and academic levels, and some of them haven't been in school for a year or longer. The school is mostly a chance for them to get together and do something constructive, to bring a sense of normalcy and routine to their days.

Nadal, 13, is in the foreground of the above photo. His home in Idlib was bombed, fracturing his legs in multiple places.

Rama matches English words for colors with their Arabic equivalents. She said she enjoys school and wants to continue her studies, despite the difficult situation.

Saleh, 13, from Idlib, in the classroom. He became paraplegic when he was injured in a rocket attack near his home. 

Patients and their families gathered in the clinic's courtyard to chant anti-regime slogans on the second anniversary of the Syrian uprising, March 15, 2013. At left is Malik, an 11-year-old amputee. He was in the early stages of learning to walk again with the aid of a prosthetic.

Later in the day, the children and teens from the recovery center were invited to a kid's celebration, organized by a group of exiled Syrian opposition activists. Above, Maysa, 12, puts barrettes in her hair while getting ready for the party.

Maysa, second from right, was shot in the back by a sniper in her village Kafr Rouma, in the Idlib countryside. Her father was also shot and killed. Intense fighting forced Maysa, her mother, and her siblings to hide in a cave for a whole month, until her mother was able to smuggle her into Turkey to get medical treatment. Maysa was so traumatized by all that had happened that she stopped speaking, but with time and therapy at the rehabilitation clinic, she started to talk again, and to smile.

Maysa's roommate in the clinic is Khadija, at left in the above photo. Khadija, 18 and recently married, was injured when her town in the Hama countryside was shelled. She is also paraplegic.

Rama winces in pain while being carried a bit too roughly down the stairs. She has some sensation in her back and can feel her wounds.

Rama, at left, and the other teens and children living in the rehabilitation center waited outside the gates for the Syrian exiles to send transportation to take them to the party, where they would join other Syrian refugee children living in Reyhanli.

They waited and waited. There was a sinking feeling as the time passed. Someone went back inside to ask if a van from the rehab center could transport them to the party, but there wasn't one available.

Finally realizing that they had been forgotten, that no bus was coming to take them to a party, they went for a walk instead.