Tag: conflict

Syria: medicine on the front line

Interview Part 2

Malnutrition takes its toll on undernourished children ©ECHO

Interview with Dr. Ziad Alissa, co-founder and President of UOSSM France and Prof. Raphaël Pitti, Head of Training of UOSSM France by Pierre Brunet.

Pierre Brunet : Let’s come back to the Covid situation, which was discussed in the first part of this interview by Professor Pitti. What has UOSSM France been doing? I know that you started to do special Covid trainings from last June. You have set up 13 isolation centers. You provide assistance to health structures. Can you develop this emergency aid linked to Covid in Syria ?

Ziad Alissa : For Covid in Syria, there were no specialized structures. Already there is a lack of everything on the medical level. With Covid, things became a little more complicated. We tried anyway, knowing that the local authorities were not able to set up the confinement or the social distancing. So we set up isolation centers, for fragile people, people at risk. They are sent to these centers so that they can be better cared for, because we were not able to confine them properly. People can’t isolate themselves in their homes. You can’t ask someone who has Covid or who is in contact with someone to stay at home when you know that their whole family is there. How can you talk about isolation in a tent, where there are 15-20 people under the same roof, or when there are 4-5 families in each house? There are no individual rooms for people. So we have replaced containment with isolation centers, and in those centers there are areas for confirmed Covid cases, and areas for contact cases. And that’s where we treat people. It’s a reverse containment, with everything you need available: masks, gloves, equipment, oxygen, medication… With the added difficulty that it is already difficult to get the vaccines in, and that despite the arrival of vaccination, there is still a refusal of vaccine, and a logistical difficulty to vaccinate everyone. Despite all the campaigns, we have not managed to vaccinate many people. Only 3% of the people are vaccinated in the northwest of Syria, and Covid is in danger of exploding. There are many complications, many deaths. We are trying to inform people, using all the means at our disposal, about the risk of Covid, about the interest of isolation, about the interest of being vaccinated. Then we set up this first Covid training in Raqqa with Professor Raphael Pitti. It was a first in Raqqa, to train health care workers in the management of severe cases of Covid-19.

Raphaël Pitti : It is important to know that the country is completely closed, they have internet in some areas and can look for information that can be found on the internet regarding Covid.  For us too, during the first wave in the hospitals, we were confronted with a pathology that nobody knew and we did not know how to treat it either. We had to be constantly on the lookout for scientific information, through webinars, every day, trying to compare ourselves with others, to follow the recommendations issued by learned societies, etc. So in the second wave, we were much more experienced in managing this disease. We knew it better, we knew the risks it could cause and we were able to respond. Syrian health care workers, on the other hand, have not had any continuing medical education for ten years… Ten years that they have not participated in congresses, that they have not developed their training. It seemed important to us to try to review the situation with them and we organized these training sessions in the Idleb area in particular. We did it by Zoom with them, explaining the evolutionary genius of this disease, the way patients had to be treated. In the Raqqa area, we went there to meet them, to set up this training with the idea that two anti-Covid centers could open, relying on these doctors. Out of the twenty doctors we trained, we selected some in each center to take care of Covid patients. We also trained midwives: with a fellow obstetrician, Dr. Zouhair Lahna, we went to our training center in Dêrik and brought together midwives to bring them up to speed, to give them the new recommendations on complications in the first, second and third trimesters of pregnancy and resuscitation of newborns at birth. It was really important and they felt the need to say “well no, this is not how we treat anymore, this is how we proceed”. When we met with the European Commissioner for Humanitarian Aid, we told him “the war situation is a little calmer, because the regime has reoccupied 60% of the territory, except for the Idleb area and the North-East area which are still subject to violence and bombing, and it is perhaps time to rehabilitate a health service in Syria, to be able to take care of chronic pathologies, to redo preventive medicine, to launch large-scale vaccination campaigns.

Bombing, attack, mine? This child has lost both legs. ©UOSSM

We need to rehabilitate the health structures to respond beyond the emergency, because we only respond to the emergency of the day”. And today the grants are starting to decrease, and we are told “Look, you need less money, there are many more difficult situations in Yemen and so on, the economic crisis we are facing is decreasing the international grants” even though we are trying to explain that we need much more money today than in 2012, because the situation has not stopped deteriorating. To prove this, we decided to launch a public health survey in the refugee camps that have existed for ten years, in which there are children aged 4-6, children who were born in these camps, who have no health follow-up. If you go into a refugee camp in Syria, no 4-6 year old child wears glasses! And we already had dental problems linked to malnutrition, a lot of cavities in these children, because of their diet, mainly made of sugars, with very few green vegetables able to bring the trace elements they need. It will be a complete survey to take stock of their health needs and to be able, from there, according to the results, to alert the international community, to alert the WHO, to alert UNICEF about the future of these children who have been living in these camps since their birth and in a country at war for ten years. How will we rebuild tomorrow a country like Syria, with children who are already somatically and psychologically disabled? Let’s remember that the medical examinations done in schools for children aged 4-6, every year in France (compulsory examination by the directorates of maternal and child protection), note that 40% of French children have problems detected at the time of these visits. When I say 40%, I mean all kinds of problems: caries, eye problems, hearing problems, language delay, behavioral problems, somatic problems: 40% in France! What about in Syria?

Pierre Brunet : Still on the Covid training, I feel that the main idea of these trainings is to “do the best with what we have”. That is to say that you start from the means available on the spot to “invent” protocols which are certainly based on the WHO guidelines, but which are adapted and feasible. You start from reality to produce a practicable theory instead of, as is perhaps done in the West, starting from theory to practice ?

UOSSM medical team visits IDP camp ©UOSSM

Raphaël Pitti : In a situation like Syria, with the shortage of drugs, the absence of resuscitation services, the lack of technical means, you would like us to train according to international recommendations, for countries with a high level of technology, developed? Would you like us to create a feeling of frustration, by telling them “this is what needs to be done, unfortunately for you, you can’t do it”? We are obliged to put ourselves at their level and say “what can we do, at best, in your situation, to manage these patients? Obviously, this implies that we are going to let some of them die, since there are not enough resuscitation services. If there is a sorting that is done, it is in this country. Our Syrian colleagues tell us “We used industrial oxygen”, with all that this presupposes, industrial oxygen is not pure oxygen, it can contain a certain number of elements that can alter the pulmonary alveoli and destroy them. But they did it! Did they sort it? Of course they sorted. There are people they left to die because of lack of resources, obviously. So we had to start from their daily life to find out how we could save people from this daily life.

Pierre Brunet : On training. I asked myself this question: do we train specialists, doctors, midwives, etc. at the same time, because it is urgent and because we must respond quickly to the needs, or do we say to ourselves that we will first train trainers ?

Dr. Ziad Alissa and Professor Raphael Pitti show the use of a chemical weapons protective suit. The photo was taken in 2017 at Bab Al Hawa Hospital in Syria following the chemical attacks on Khan Sheikhoun ©UOSSM

Raphaël Pitti : The important thing is to train trainers so that they can continue on their own. We wanted the training centers that we set up to be autonomous. The goal was: we trained the trainers and then the trainers, together with the directors, set up the training courses. We provided the logistical and financial support necessary for the functioning of these structures. In ten years, how could we have trained 31,000 people, travelling each time, to train how many? The Syrians, and the Syrian medical staff, during these ten years, have written a page in the history of medicine. Everything was done by the Syrians, inside Syria. We gave them the necessary help, but they were the only ones who maintained a health system despite the war situation during these ten years. We, the NGOs, have only provided them with the means. They are the real heroes of the Syrian conflict. We owe them recognition for their sacrifice. UOSSM France has counted 923 doctors who died during these ten years.

Pierre Brunet : You also emphasize what you call “community health”, i.e. proximity medical structures, primary health centers (17 created in Northern Syria), and mobile clinics. What was the need that led to the emphasis on these community health facilities ?

UOSSM Pharmacy ©UOSSM

Ziad Alissa : We started with this idea because it was difficult for patients to go to hospitals. The hospital was becoming a dangerous zone, people were afraid to go there because the hospitals were targeted by the bombings. So with this community health system, we go where there are people, especially where there are displaced people who settle, and we set up a health center as close as possible to them. The mobile clinics also allow us to go even further, inside the IDP camps, in the most difficult to access areas. Health centers are expensive and it is difficult for us to set them up as we would like. Hence the idea of a mobile clinic, because with the same human resources, they will go to areas where there is no open center. They travel with small vans in which there is a doctor, a midwife, a nurse, with what to do a medical examination, what to treat simple diseases. If the mobile clinic detects people who have serious illnesses, who are poorly followed up, who need to go to the center, they give them an appointment at the nearest center or at the hospital. With this system, we were able to get as close as possible to the people who needed us, while reducing the risks of accessing large hospitals. People were asking themselves, “What if I go to the hospital, will I make it home alive? Not to mention the difficulties and costs of transportation. We met with Raphaël people who are dialyzed 2-3 times a week, who, instead of going 3 times to the dialysis center, will go there twice or even once a week, because they cannot afford to pay the round trip or to buy the filters.

Pierre Brunet : You tell UOSSM France that testifying is also part of our action.

Raphaël Pitti : You cannot be a doctor, be on the spot, and just take care of victims who are innocent victims, caught between belligerents, borders now closed, with a wall that separates Syria from Turkey of more than 900 kilometers. These people are in a veritable concentration camp, where death and hunger loom large. How do you expect us to go there, to see this, and to go out and resume our quiet lives? It is impossible. The action of witnessing goes hand in hand with that of care, of humanitarian aid. It is concordant, it cannot be otherwise, otherwise we become accomplices of this situation. The action of witnessing imposes itself on the humanitarian and makes him say, and in particular to the Western governments, “look at what is happening, you try to turn your head not to see what is happening, and well, we are there and we can tell you, things are not as you think they are or as you want them to be, we bring you information which is that of the field, of the voiceless”. When we asked several times to see President Hollande, as we went to see President Macron, as we went to the UN, to New York, to Geneva, etc., we went with one goal: to help them find solutions. For the humanitarian action you can count on us, but for the political action, it is up to you. Politicians often tend to want to do humanitarian work when they are asked to find political solutions to allow peace. Politicians have the impression that by giving us money, by helping us in our humanitarian action, it exonerates them from not finding a solution. Well, no, everyone has their own job. Humanitarians should do the humanitarian work and politicians should find the political solutions.

Ziad Alissa : We doctors who go there, as well as our teams who treat every day, can testify to violations of humanitarian law and bring back evidence of our testimony. When people talk about victims in hospitals following a bombing, and some say “No, no, we bombed soldiers, terrorists in such and such an area, in such and such a city, in such and such a neighborhood”, we see that in hospitals it is children, women, civilians who come, of all ages. We have hospital records, we have photos, we have videos, we have the doctors who treated these victims, and we can demonstrate that the victims are civilians. When we saw the use of chemical weapons, we testified. We have seen the victims of chemical weapons, we have taken samples, we have reported evidence. This is where our role as witnesses is essential.

Pierre Brunet : One last question: why this specific commitment of UOSSM France to the Rohingya refugees in Bangladesh, so far from Syria ?

Raphaël Pitti : How many Rohingyas have fled Burma? More than a million people, in the poorest country in the world, 80 million inhabitants, Bangladesh, and who received this million Rohingyas fleeing Burma, in the Cox’s Bazar camp of a million people, in a situation of immense precariousness. We were really confronted with pathologies that I never imagined seeing during my 30 years of medicine. Facial cancers, patients who had fractures that had not been reduced and who were living in impossible conditions. We saw bladder stones, young women with infected vesico-vaginal fistulas from traumatic deliveries. A population that for years had been completely abandoned to itself without any possible care. So we rented a clinic and operated for two weeks. We were two teams and we operated non-stop, and we should have stayed much longer. We thought we were providing emergency help and we were confronted with a situation of chronic pathologies that had not been treated for a very long time, and for which we would have had to stay.

 

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Dr. Ziad Alissa, co-fondateur et Président de l’UOSSM France

As an anaesthetist and resuscitator, Dr. Ziad Alissa has been involved since the beginning of the conflict in Syria in the implementation of medical and humanitarian aid to the health care workers in Syria by co-founding the French and international medical NGO UOSSM, the Union of Organizations for Medical Relief and Care. He has carried out some forty humanitarian missions in Syria and in the neighboring countries of Turkey, Lebanon and Jordan. Trained in war medicine by Prof. Raphaël Pitti, he coordinates the implementation of training programs for health care workers in Syria, which have enabled 31,000 health care workers to be trained since 2012.

 

Professor Raphaël Pitti, Head of training at UOSSM France

aphaël Pitti is an associate professor of emergency medicine, anaesthesiologist-resuscitator, and army general physician. A specialist in war medicine, he joined UOSSM France in 2012 as head of training and has enabled the training of tens of thousands of caregivers. On March 1, 2021, he carried out thirty-one humanitarian missions with Syrian caregivers in the north of the country. In June 2021, he and Dr. Ziad Alissa conducted the first training in Raqqa to fight against COVID-19.

 

Pierre Brunet, writer and humanitarian 

Born in 1961 in Paris to a French father and a Spanish mother, Pierre Brunet found his first vocation as a freelance journalist. In 1994, he crossed paths with humanitarian aid and volunteered in Rwanda, which had been devastated by genocide. In early 1995, he left on a humanitarian mission in Bosnia-Herzegovina, then torn by civil war. There he took on the responsibilities of program coordinator in Sarajevo, then head of mission.

Upon his return to France at the end of 1996, he joined the headquarters of the French NGO SOLIDARITES INTERNATIONAL, for which he had gone on mission. He will be in charge of communication and fundraising, while returning to the field, as in Afghanistan in 2003, and starting to write… In 2011, while remaining involved in humanitarian work, he commits himself totally to writing, and devotes an essential part of his time to his vocation as a writer.

Pierre Brunet is Vice-President of the association SOLIDARITES INTERNATIONAL. He has been in the field in the North-East of Syria, in the “jungle” of Calais in November 2015, and in Greece and Macedonia with migrants in April 2016.

Pierre Brunet’s novels are published by Calmann-Lévy:

  • January 2006: publication of his first novel “Barnum” by Calmann-Lévy, a story born from his humanitarian experience.
  • September 2008 : publication of his second novel ” JAB “, the story of a little Spanish orphan girl who grew up in Morocco and who will become a professional boxer as an adult.
  • March 2014: release of his third novel “Fenicia”, inspired by the life of his mother, a little Spanish orphan during the civil war, refugee in France, later an anarchist activist, seductress, who died in a psychiatric institute at 31 years old.
  • End of August 2017: release of his fourth novel “The Triangle of Uncertainty”, in which the author “returns” again, as in “Barnum” to Rwanda in 1994, to evoke the trauma of a French officer during Operation Turquoise.

In parallel to his work as a writer, Pierre Brunet works as a co-writer of synopses for television series or feature films, in partnership with various production companies. He also collaborates with various magazines by publishing columns or articles, notably on international news.

 

To go further:

Syria: medicine on the front line

©UOSSM

Interview with Dr. Ziad Alissa, co-founder and President of UOSSM France and Prof. Raphaël Pitti, Head of Training of UOSSM France by Pierre Brunet.

Pierre Brunet: Let’s remember that UOSSM France is the Union of Organizations for Medical Relief and Care. It is a French and international NGO whose mission is to guarantee permanent access to free quality health care for the populations affected by the war in Syria.

Let’s start with some simple questions. How and why was UOSSM France born? At the beginning, you thought it was for the short term, and ten years later you are still doing regular missions, training health care workers in Syria and in the surrounding countries. Was the birth of UOSSM France a response to a call for help from Syrian health workers to which you replied, or a spontaneous awareness of doctors and health workers from the Syrian diaspora and French people who decided, in view of what was happening in Syria, to get involved, to found UOSSM France and to do everything to respond to the emergency? Subsidiary question: today UOSSM France represents how many people?

Docteur Ziad Alissa of UOSSM in Syria ©UOSSM

Ziad Alissa : UOSSM France was a response to the request of our Syrian colleagues. At the beginning it is true that we thought it was something short term. At the beginning, each of us in the Syrian diaspora, I am talking about Europe, the United States, I am even talking about the Gulf countries, tried to help in their own way. Many colleagues went back and forth individually, including me. We started to meet there, on the border, the colleagues who went to Turkey to try to help through the North of Syria, but also in Jordan, in Lebanon. After a few months, we felt that the disaster required a greater response than individual aid. We realized that we had to build a collective response. To meet the needs, because they exceeded individual means.

Pierre Brunet : In November 2021, how many people will UOSSM France represent?

Ziad Alissa : Most of the staff of UOSSM France is in Syria. Today, we have more than 1,100 employees in Syria, in Gaziantep in Turkey, in Erbil in Iraq and in France.

©UOSSM

Pierre Brunet : Let’s talk about the humanitarian and health situation in Syria today. The UN some time ago said that more than 350,000 people have been killed in ten years of war in Syria. The Syrian Observatory for Human Rights speaks of at least 500,000 killed, and perhaps another 200,000 dead. The UOSSM quotes the figure of at least 500,000 direct deaths, not counting indirect deaths, because chronic diseases cannot, or very poorly, be managed, there is a large number of indirect deaths that are difficult to count, which you estimate between 1.5 and 2 million. You remind us that there are 13.4 million people in Syria who need humanitarian assistance, 75% of the Syrian population depends on humanitarian aid for their daily survival, 60% of health structures have been destroyed, more than 90% of the Syrian population is below the poverty line and 80% of economic structures have been destroyed. What can we say beyond the numbers ?

Ziad Alissa : It is true that the number of deaths that we quote is higher than the figure that we hear, either from the official Syrian authorities or from people who simply take into account the direct deaths announced. But there are many deaths that have not been announced. We must not forget that when we see the direct victims of bombings or military operations, there are also tens of thousands of people who were arrested in prisons, tortured and died. All this is not taken into account. We must not forget also, as you have just said and as UOSSM France has noted, that the health system in the areas not controlled by Damascus in Syria has completely collapsed. This system does not meet the daily needs of the population. In addition to the direct victims, there are indirect victims, the chronically ill who cannot find their treatments, problems such as heart attacks without a radiology service to perform an emergency coronary angiography, we see this every day. Cancer patients who can’t find their treatments and centers to treat cancers, chronic kidney patients who can’t find centers to get dialysis. So many victims are not in the statistics. When we noticed this, we indicated that the numbers were higher in reality than those announced. And all of Syria is experiencing this lack of access to health services, not just in the north of the country. I think that the figures quoted by UOSSM France and other NGOs on the ground are closer to the truth and show an even more dramatic reality than what is portrayed in the media.

©UOSSM

Pierre Brunet : Professeur Pitti, do you have anything to add?

Raphaël Pitti : There is a collapse of the health system. Look at the impact of Covid for example. We are intervening in the Idleb area in particular, where you have 4.2 million people, 2.8 million of whom are refugees from the Aleppo area, Ghouta or elsewhere, and who are mostly living in tents in very precarious conditions, totally dependent on international humanitarian aid, and then all of a sudden Covid appears. How, at that point, can we consider isolation for these people when they are confined to living in tents, having to look for food every day, fetch water, go to the toilet, etc? Today, more than 90% of the identified cases in the area come from the Delta variant, the mortality rate is very high. And when we talk about sorting people in France, saying “In the resuscitation services we have sorted the patients, taking into account the situation as it was” as if it was a disaster situation, what about the situation in this area of Syria? when there are only 200 intensive care beds that are 100% occupied, when there is a lack of medical oxygen, when there are only 95 respirators, when there is no device to monitor the levels of oxygen and carbon dioxide in the blood, when there are no antibiotics, when there are not enough corticoids? What about the situation of this population, which also has a very high rate of malnutrition, which makes it very vulnerable in terms of immune defenses? We asked Médecins du Monde, which also works in these areas, to come with us to meet the European Union Commissioner for Humanitarian Action in Brussels, about three months ago. We went to tell them how serious the situation was in Syria. And not only in the northern areas of Syria, but in the whole of Syria. In addition to the economic crisis in Lebanon, which impacts the already extremely difficult situation in Syria. We have explained that there is a risk of famine in Syria, especially in this winter period when we arrive at the break period, that is to say this period when the crops have been consumed and we must wait for the next harvest, and there is no money to buy the most urgent foodstuffs that people need. So this is a terrible situation for Syria, not only for the areas still controlled by rebel groups, but for the entire Syrian territory.

©UOSSM

Pierre Brunet : Let’s talk about malnutrition. I would remind you that one child in three is malnourished in Syria. In addition to your medical and health aid, are you developing aid in response to this situation, to the risk of famine that Professor Pitti just explained?

Ziad Alissa : At UOSSM France, we have primary care centers inside Syria. Through these centers, which receive mothers, children and sick people for daily examinations, our teams on the spot have noticed many cases of malnourished children. We wanted to go further and conduct a study among the children in the IDP camps, examine them and determine the causes of malnutrition. We especially went to meet the populations living in the IDP camps inside Syria, and their situation is much more serious and dramatic. Displaced inside Syria, they do not have the status of refugees, therefore no humanitarian aid like those in the refugee camps in Turkey, Lebanon, Jordan. The status of refugees in the neighboring countries allows them to have access to a minimum of humanitarian aid to live. While inside Syria, they are completely dependent on associations like UOSSM France to work. Malnutrition begins with mothers who are unable to breastfeed their children properly because they themselves are malnourished. Their situation is miserable. The Syrian pound has lost much of its value. People cannot feed themselves properly because they cannot afford to buy food. As young mothers are malnourished and cannot breastfeed their children, they need infant milk, which is difficult to find locally. We know that a malnourished child is a child who will easily catch diseases. The families live in poor hygienic conditions, often in tents, there are no appropriate sanitary facilities. All these elements generate a galaxy of problems around malnutrition, and our teams on the ground have noted this. We have set up programs to fight against malnutrition, but despite all the good will of our teams, despite all the means of UOSSM France, this scourge of malnutrition persists among children. We have seen families who eat only two meals a day, or even just one meal at times, to leave the food for the children, and despite this, we have not yet succeeded in fighting malnutrition among children in the IDP camps as we should.

©UOSSM

Pierre Brunet : I was struck by a term in one of your latest newsletters, where you explain that out of nearly three million people living in the Idleb region, 40% are displaced by war, and a large proportion of them are experiencing what you call “psychological chaos.” I would remind you, by the way, that there has been a resumption of bombing in the Idleb region since last October, with the trauma of these war situations. Can you elaborate on this notion of psychological chaos?

Raphaël Pitti : You have to try to imagine what the situation might be for these people, who have been displaced, who are no longer living at home, who are essentially dependent on international humanitarian aid, with Russian pressure, particularly at the level of the Security Council, which is trying to close all humanitarian corridors. There is only one humanitarian corridor left open, and it should end in December. Will it be renewed? What will be the situation of this population if international humanitarian aid can no longer transit through Turkey to be distributed to them? The future is totally uncertain, with the constant bombings and the health situation as we have described it. What hope can we give to these people in this situation, who at the same time live in camps? There is no education, there are no opportunities for young people to pursue higher education. What do you think the psychological impact is if you can’t project yourself into the future at all, when you know that at any moment a plane could fly by, bomb and kill you? There is a deep stress, very important, generating a situation of constant psychological trauma. All the experiments done in animal laboratories show this: you only have to put mice in a situation of constant, daily, continuous stress, with no hope of getting out of it, to see the state of depression in which these animals find themselves. This is the reality of the population living in Idleb. They do not know what tomorrow will bring, and today is extremely difficult. We cannot expect this population to be happy with the way they live. So the term used by Dr. Ziad Alissa is “chaos” in the psychological sense of the word that this population is living.

Professeur Raphaël Pitti of UOSSM in Syria ©UOSSM

Pierre Brunet : You mentioned the issue of humanitarian aid crossing points in Syria, which I wanted to ask you about. I would like to remind you that after ten years of conflict, international humanitarian aid remains the essential means of survival for a large part of the Syrian population. And yet, as you reminded us, Professor Pitti, it is hampered by the questioning of Resolution 2165 adopted unanimously in 2014, which has only been extended until the end of December 2021. Recall that 50,000 trucks of humanitarian aid had been able to benefit from these crossings since 2014, and that 1,000 UN trucks transit, each month, through the humanitarian corridor of Bab Al-Hawa, which is the only one still open, in the northwest of Syria, on the Turkish border. There are three other crossing points that are currently closed: Bab Al-Salam, also in the north-northwest at the Turkish border, Al Yarubiyah in the northeast at the Iraqi border, and Al Ramtha in the south-southwest at the Jordanian border. In your opinion, of these four crossings that were originally approved by the UN resolution, which ones should be reopened as a priority, in addition to maintaining the one at Bab Al-Hawa, which is the last vital cordon?

Ziad Alissa : You have located the four corridors correctly. Currently, only the Bab Al-Hawa corridor is open. The humanitarian corridors are used by all those working on the ground to bring humanitarian aid inside Syria to areas not controlled by Damascus. As a medical NGO, this humanitarian aid mainly translates for us into medicines, consumables and everything that hospitals need. Other humanitarian associations are transporting food, basic necessities. All these humanitarian corridors are essential to bring humanitarian aid inside Syria in these areas. But what we see, with the Russian and Chinese vets at the UN, is that every six months we have to mobilize to renew these openings. Now December is approaching again, and we are going to experience this anxiety again: will the opening be renewed or not? We know that Russia is pushing for “crossline” aid inside Syria. But crossline means that all humanitarian aid goes through Damascus, across the battle lines. And the observation of all the people who work inside Syria is that when this aid passes through Damascus, it does not reach the people who need it. Unfortunately, humanitarian aid has been used as a weapon of war in recent years, this is a reality. All the people who work in the field know this. They choose who they want to give this humanitarian aid to. This is unacceptable. They are using the technique of siege to suffocate the people and a whole city. We have seen this in Al Boutan, in Deraa, and elsewhere: a city is surrounded, under siege, and they forbid the passage of humanitarian aid. We have seen it in Ghouta and East Aleppo for example, children dying because they have not found medicine or food. So if this last humanitarian corridor is closed, if we go in the direction proposed by Russia, there will be an additional humanitarian disaster because entire areas will be completely cut off from the world without being able to bring humanitarian aid. We have seen the examples of Aleppo during this war, where in order to empty an area and push people to leave it, humanitarian aid is blocked. What we are looking for is to stabilize these areas. And in order to stabilize these areas, we must continue to bring people what they need, their daily needs. They need to eat, they need to be treated, they need a roof over their heads, they need to take care of their children and above all they need the bombings and the deaths to stop. And the essential humanitarian corridor of Bab Al-Hawa is not enough for all of northern Syria. It is imperative to reopen all the humanitarian corridors. What we are asking for is the unconditional opening of the four humanitarian corridors that were originally decided upon.

NOTE to readers: The second part of this interview will be published in the next issue of Humanitarian Challenges No. 60 on Tuesday, January 11, 2022.

 

Dr. Ziad Alissa, co-founder and President of UOSSM France

As an anaesthetist and resuscitator, Dr. Ziad Alissa has been involved since the beginning of the conflict in Syria in the implementation of medical and humanitarian aid to the health care workers in Syria by co-founding the French and international medical NGO UOSSM, the Union of Organizations for Medical Relief and Care. He has carried out some forty humanitarian missions in Syria and in the neighboring countries of Turkey, Lebanon and Jordan. Trained in war medicine by Prof. Raphaël Pitti, he coordinates the implementation of training programs for health care workers in Syria, which have enabled 31,000 health care workers to be trained since 2012.

Professor Raphaël Pitti, Head of training at UOSSM France

Raphaël Pitti is an associate professor of emergency medicine, anaesthesiologist-resuscitator, and army general physician. A specialist in war medicine, he joined UOSSM France in 2012 as head of training and has enabled the training of tens of thousands of caregivers. On March 1, 2021, he carried out thirty-one humanitarian missions with Syrian caregivers in the north of the country. In June 2021, he and Dr. Ziad Alissa conducted the first training in Raqqa to fight against COVID-19.

Pierre Brunet, writer and humanitarian :

Born in 1961 in Paris to a French father and a Spanish mother, Pierre Brunet found his first vocation as a freelance journalist. In 1994, he crossed paths with humanitarian aid and volunteered in Rwanda, which had been devastated by genocide. In early 1995, he left on a humanitarian mission in Bosnia-Herzegovina, then torn by civil war. There he took on the responsibilities of program coordinator in Sarajevo, then head of mission.

Upon his return to France at the end of 1996, he joined the headquarters of the French NGO SOLIDARITES INTERNATIONAL, for which he had gone on mission. He will be in charge of communication and fundraising, while returning to the field, as in Afghanistan in 2003, and starting to write… In 2011, while remaining involved in humanitarian work, he commits himself totally to writing, and devotes an essential part of his time to his vocation of writer.

Pierre Brunet is Vice-President of the association SOLIDARITES INTERNATIONAL. He has been in the field in the North-East of Syria, in the “jungle” of Calais in November 2015, and in Greece and Macedonia with migrants in April 2016.

Pierre Brunet’s novels are published by Calmann-Lévy:

  • January 2006: publication of his first novel “Barnum” by Calmann-Lévy, a story born from his humanitarian experience.
  • September 2008 : publication of his second novel ” JAB “, the story of a little Spanish orphan girl who grew up in Morocco and who will become a professional boxer as an adult.
  • March 2014: release of his third novel “Fenicia”, inspired by the life of his mother, a little Spanish orphan during the civil war, refugee in France, later an anarchist activist, seductress, who died in a psychiatric institute at 31 years old.
  • End of August 2017: release of his fourth novel “The Triangle of Uncertainty”, in which the author “returns” again, as in “Barnum” to Rwanda in 1994, to evoke the trauma of a French officer during Operation Turquoise.

In parallel to his work as a writer, Pierre Brunet works as a co-writer of synopses for television series or feature films, in partnership with various production companies. He also collaborates with various magazines by publishing columns or articles, notably on international news.

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