Having skirted around and met Syrians through lots of MSF work
around the Mediterranean, in Calais, in Jordan, in Lebanon,
actually I finally got into Syria last month,
where I was working in Raqqa, in north Syria.
You arrive, and of course it's not just a drive into town.
There are bunkers, there are blown-up vehicles, there are blown-up bridges,
there are 'Danger: Landmine' signs everywhere.
You get the feeling that you are far away from anywhere
behind lots of checkpoints, in a zone that has clearly seen
a lot of destruction recently
and it's a little bit eerie.
It reminded me of Haiti after the earthquake
where that level of destruction, that many buildings lying in rubble
across an entire expanse of the city...
...but it's just that much more sinister because it was much more complete,
the destruction of Raqqa,
just anecdotally looking as you drive through,
compared to what I saw in Port-au-Prince,
was much more complete,
and not a natural disaster.
So it's sinister.
Very soon after the end of the offensive,
by the 18th of November MSF was in there,
selected a house that hadn't been destroyed.
You can put three trolleys,
If you have expertise and materials, you can do quite a lot in a room.
Quite a lot.
There are landmines and improvised explosive devices
strewn across the city, the remnants of war,
other explosive devices intentionally placed there to cause injury,
others that are landmines that were originally part of defensive fortifications,
or just unexploded bombs that have fallen from an aircraft and if you touch it they go.
The staff that I joined were telling me, in those first two-three weeks,
you'd hear them go off constantly
and they'd think: 'Right, we're going to get some cases soon.'
They were getting seven, on average, seven, almost eight, cases a day.
And you're talking hand amputations, bilateral leg amputations. Blown off.
Civilians being trucked in through the rubble.
It's a level, I am told, a level of...
...of mining or improvised explosive devices,
that's not been seen ever before.
And it's in a civilian centre.
It's under beds, in kitchen shelves, on the streets...
It's everywhere.
Everywhere.
We were told one story
of how one of these mines was on such a delay that the
the family member, the man, had come home
checked everything was fine
the family had moved in,
he'd called them, got them to come, gone back to the camp, brought them
and then a mine went off.
So it must have been on a delayed timer long enough such that days had passed.
They're not packaged
we don't have X-rays
we don't have blood tests
it's a very different scenario.
That's a significant journey for someone who's just had both their legs blown off.
They won't survive that.
And if they've survived getting through the rubble to our little house in Raqqa,
they've already got quite a good chance of surviving,
but we need to ensure they will survive that two-and-a-half hours.
And someone who's got two legs blown off will not.
One such case arrived and he
was really very close - I couldn't feel his pulse, put it that way.
But he was still breathing.
He was quite literallly in that window where you can't...
there isn't quite enough blood left in your system
that you can feel their pulse
but he's just about got enough blood in his system
that's getting to the brain and he is breathing.
I mean, you're talking
probably three or five breaths left before you die.
I mean it's literally just that moment.
I think if any one of us wasn't there at that moment by chance
he wouldn't have survived. He was very, very, very lucky.
And we gave...
...four units of blood, three litres of fluid,
we applied the tourniquets, lots of painkillers, anaesthetics,
washed out everything, dressed it to minimise any excess bleeding
and shipped him out.
And he was so critical that normally we don't send
one of the doctors as an escort
because there's usually one doctor on shift and then there'd be me and one back up
but we actually sent a doctor on escort for him, just to make sure that he
arrived at his destination. And he did.