“I flew to Syria and Turkey to help save lives after the earthquake. The destruction was beyond imagination”

Since the beginning of the Syrian Civil War, Hamilton-based bariatric and trauma surgeon Anas Al Kassem has returned to his birth country on medical missions 13 times. This February, after the region’s biggest earthquake in modern history, he flew to Syria and Turkey to provide emergency aid. With limited resources, hundreds of thousands of people injured and more than 50,000 dead, doctors like Al Kassem faced a herculean task.

—As told to Sanam Islam

I was born and raised in Damascus. My dad was a pharmacist, and he was hard-working. The was no war at the time, and we had good lives, but even back then, I remember seeing people struggle under an oppressive regime. As a result, Syrians often left the country after university to work internationally.

I graduated from Damascus University in 1997, and in 2001, I left to pursue my dream of a medical education in Canada. I married my lovely wife in Montreal and completed my residency and fellowships in Ottawa and Texas. I was hoping to go home to Syria to practise after I finished medical school in 2011. But the war started that same year, and my family advised me not to come back. It was a difficult decision; I wanted to be close to them, but I also wanted to live somewhere where I was free to care for people regardless of their ethnicity or background. Unfortunately, that was no longer the case in Syria.

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I moved to Hamilton in 2014 to work as a bariatric and general surgeon. I also joined Doctors Without Borders and co-founded the Union for Medical Care Relief Organizations, which supports international medical teams by providing them with training and equipment. We assist five major hospitals in northern Syria and run 12 mobile clinics that offer basic medical care and mental health services for patients who can’t travel to hospitals. We also run six centres in Turkey, close to the border, that provide psychological care to displaced people.

When I heard about the 7.8- and 7.5-magnitude earthquakes on February 6, I knew that the suffering would be huge. That part of the world is extremely vulnerable. More than 1.2 million people live in refugee camps near the Syria–Turkey border after losing their homes in the war. They don’t even have bathrooms or kitchens, and they’re still at risk from airstrikes. Even a small earthquake—let alone these massive ones—would hit the area hard. I felt a responsibility to help, so I flew to Syria with four other physicians, arriving on February 18.

My family members weren’t living in the area, but I had many friends affected by the disaster. One of them lost 27 members of his family. An eye surgeon I used to work with lost his wife and three children. I heard countless stories like this during my nine days in the two countries. I’d seen many bad scenes during my trips to Aleppo and Idlib in the past, because of the routine airstrikes in the country, but the scale of the destruction in small towns on this trip was beyond imagination. Many neighbourhoods had completely collapsed. I couldn’t even recognize some of the beautiful cities and towns that my dad used to take me to. It’s heartbreaking to see your country torn apart.

Due to international sanctions, the UN had access to only one damaged border crossing, which meant that its first convoy of shelter supplies and hygiene kits didn’t arrive until four days after the earthquake. Later, they received permission to use additional crossings, but that took several additional days. The UN’s response to the crisis was slow, which I believe contributed to the number of injuries and deaths. The crucial heavy machinery needed to dig people out of the rubble and the medical supplies required to save lives was also not sent in a timely manner.

Related: As a Syrian refugee, I lived in a hotel shelter for my first few months in Toronto. Now I work there

I was working alongside eight other physicians—half of them local, half of them members of our Canadian team. When more than 50,000 people have died, you can assume that the number of people injured is likely three or four times that amount. Since some victims were trapped for three, four, five days under rubble, many complex cases came into the hospitals, and we often had to perform multiple procedures on a single patient.

In one hospital in northern Syria, we were receiving about 500 injured patients a day. Even a trauma centre at a major Toronto hospital like St. Michael’s, where I’ve worked, has the capacity to treat only about 100 injured patients per day. And we were working in a field hospital with limited resources, equipment and surgical staff. Since we didn’t have the necessary tools, we had to get creative and improvise, but we knew we couldn’t provide the best level of care.

Many cases broke my heart, including a three-year-old patient named Arslan. He lost his dad, mom and siblings after a building collapse. The White Helmets were able to evacuate him, and they were so relieved that he made it out of the rubble. We treated him for a week; he needed multiple sessions of wound care and nearly had to have his legs amputated. Then, a few days after I left the country, I learned that he had died. I was devastated. If there had only been a proper children’s hospital with an ICU and the necessary equipment, he likely would have survived.

As emergency responders, we rely on one another for emotional support to get through. We also turn to spiritual practices; in the Quran, it says, “If you save one life, it’s as if you saved the whole of humanity.” That reminds me not to get overwhelmed—we knew we couldn’t save every victim of this disaster. Instead, I focus on helping one person at a time. When there are low points, I think about the children I’ve managed to rescue. Getting to send a single child home to their family makes everything else worth it.

And yet, far too many of the victims we treat—particularly children—have lost either their family members or their homes. It’s my hope that the Canadian government will not only help rebuild the areas affected by the earthquake but also bring these families out of camps and into proper housing. I feel that we have a responsibility, as human beings living comfortably in the West, to lend a hand to those who are suffering. Whenever I go on medical missions, I come back to Canada more motivated than ever to raise funds. I’ll keep working until the day we can rebuild a country—and a future—for these children.