Canadian surgeon heading to Syria as country pleads for earthquake aid

Anas Al Kassem leans forward slightly toward his computer screen as the chime of the Skype call fills his home office in Ancaster, Ont.

The surgeon isn't sure he's going to be able to get through to his friend at an orthopedic hospital in Idlib province in earthquake-damaged northwestern Syria.

This time, he's lucky.

"Hello, how are you?" Al Kassem asks.

At the other end, Dr. Sameah Qaddour reveals he and his medical teams have been performing as many as 50 procedures a day and sleeping roughly four hours each night. Even so, they are forced to turn away hundreds of other patients because they don't have the capacity to assess them or provide continuing care.

The hospital where Qaddour is operating was damaged in the quake. Video he shared with CBC News shows visible cracks in the ceilings and places where stones have fallen from the walls.  The staff there doesn't know if the building is safe, but they have little choice but to continue using it.

WATCH | Cracks have appeared in the ceiling of this Syrian hospital:

"They have a significant lack of antibiotics and painkillers and anesthesia drugs," Al Kassem says, translating for Qaddour.

Other videos show patients of all ages in chaotic, crowded hospital wards, some even being treated on the floor. Children can be heard crying and screaming in the background as medical staff frantically move from case to case.

While aid has flowed into Turkey, doctors on the Syrian side of the border told CBC News they haven't seen any help or supplies come their way yet.

Al Kassem is part of a small group of Canadian and American medical personnel that plans to enter Syria later this week and bring relief and supplies though the Union of Medical Care and Relief Organizations-Canada (UOSSM). The group is also sending along a container of medical supplies from Ottawa, which it hopes to get across the border.

Rough situation even before the quake

More than 33,000 people died in the earthquake near the Turkey-Syria border on Feb. 6, with more than 5,700 reported dead on the Syrian side, according to Reuters.

Even before the quake, it was difficult to get aid into Syria through its tightly controlled borders.

The area of northwestern Syria hardest hit by the quake is largely rebel-controlled, after years of a brutal civil war with the forces of President Bashar al-Assad.

In 2020, Russia and China vetoed a United Nations Security Council resolution to continue to allow aid to flow into northwestern Syria from two crossings, reducing the viable crossings to just one, at Bab al-Hawa.

On Monday, one week after the earthquake struck, the United Nations announced that Assad had agreed to open two new crossing points from Turkey to the northwest to allow for improved delivery of the desperately needed aid, including equipment, for an initial period of three months.

A UN convoy carrying aid such as blankets and hygiene kits that was scheduled to come through Bab al-Hawa before the quake only made it through on Thursday. Those on the ground say it is inadequate given the scale of the disaster.

On Sunday, Raed Al Saleh, the head of the Syrian Civil Defence (also known as the White Helmets), had called for the immediate opening of more border routes into the disaster zone and criticized what he called the UN's slow response.

"Waiting for UN Security Council authorization to reopen more border crossings into the northwest is completely misguided, this unnecessary stalling will only cost more lives," Al Saleh said in a release.

"We urgently need the UN to open more border crossings into northwest Syria so that cross-border humanitarian aid can flow in unhindered. Failing to escalate medical aid deliveries rapidly will leave the UN with more blood on its hands."

'No medical equipment, no food'

Muhaid Kaddour, another surgeon working in an Idlib field hospital, confirmed that as of Friday, he hadn't received any help.

"When I say nothing at all, I mean nothing at all till now [has entered] across the border from Turkey or from people from another area," he said in a video he recorded and sent to CBC News. "No medical equipment, no food. Five days after the earthquake: nothing."

Kaddour added his voice to the chorus pleading for aid groups and other countries to help and for the border to open so supplies can flow in.

"The catastrophe is very big and is very hard. We need your support," he said.

WATCH | Syrian surgeon Dr. Muhaid Kaddour appeals for help:

Hospitals in the region were already in poor shape before the quake and largely reliant on help from aid organizations.

"The hospitals were built or constructed within the last 10 years of the war. So they're fragile hospitals. They're not very well equipped," Al Kassem explained. "Turkey is more developed than Syria, if you will."

He said the Assad regime and years of Russian airstrikes have greatly affected the situation in northwestern Syria.

WATCH | The view from inside a crumbling and overwhelmed hospital in Idlib province, Syria:

"They don't have a health-care system," said Al Kassem. "They don't have a government to support the hospitals and the clinics. Actually, it's the NGOs like ours that support these centres and clinics."

The amount of aid that has trickled across the border isn't enough, he said.

"I'm talking to the physicians every day, and nurses on the ground. They're doing hundreds of procedures." He cited one small hospital that received 500 cases on the first day of the earthquake, and could only admit 120.

"Imagine the amount of supplies you need for these surgeries. These are not simple surgeries. These are, you know, fractures, and there's spine and brain surgeries."

'They need advanced medical care'

Al Kassem has made numerous trips with the NGO during Syria's civil war, but expects the upcoming visit to be different.

"I think it's way more overwhelming because of the scale of the disaster and because of the short time [in which] it happened," he said. "Imagine the area of Idlib and northern Syria has four million people. Almost three million are internally displaced."

Al Kassem says that many people have suffered "crush injuries," which require complicated care. Some need subdural hematomas drained, while others may have abdominal bleeding.

"They need advanced health care in an ICU setting, and on top of that, a crush injury can lead to a syndrome of crushing the muscles and impacting the kidneys, causing some sort of kidney failure as well. So you may need dialysis units."

WATCH | Dr. Anas Al Kassem explains the extreme need for help in Syria:

For many, the risk of infection and disease like cholera combined with a lack of clean water and food will further threaten survival.

That immediate need will be replaced with different longer-term needs, Al Kassem says, like reconstructive surgeries, rehabilitation and prosthetics. All of that, doctors say, will require a steady flow of help and an open border.

As his Skype call with Quaddour draws to a close, the latter takes a moment to plead with Canada for more help.

"He's asking the Canadian government, the Canadian people, to send supplies immediately, as soon as possible," Al Kassem says.

"He's counting on Canada as a good country of peace, known for significant humanitarian impact in this kind of crisis, to send immediate supplies to them."