I stand in owe of David Nott and feel ashamed when I compare my life to his life
The ability to give is a measure of your humanity
Radio4 broadcast ‘Aleppo doctors facing armageddon’
A Russian cluster bomb rolls into an Aleppo hospital… hours later 50 children are dead or maimed. This is not just war crime, says heroic British surgeon, it’s an abomination
The underground race to spread medical knowledge as the Syrian regime erases it.
By Ben Taub
For almost a year, Syrian government helicopters had been lobbing barrels filled with shrapnel and TNT onto markets, apartment blocks, schools, and hospitals. Welded tail fins guide the barrels to land on top of an impact fuse. The methods of targeting are so rudimentary and indiscriminate that, in Aleppo, many residents have moved closer to the front lines, risking sniper fire and shelling, because the helicopters don’t drop barrels near government troops.
When a large bomb explodes, it destroys bodies in consecutive waves. The first is the blast wave, which spreads air particles at supersonic speeds. This can inflict internal damage on the organs, because, Nott said, “the air-tissue interface will bleed. So your lungs start to bleed inside. You can’t breathe. You can’t hear anything, because your eardrums are all blown out.” A fraction of a second later comes the blast wind, a negative pressure that catapults people into the air and slams them into whatever walls or objects are around. “The blast wind is so strong that in the wrong place it will actually blow off your leg,” Nott said. He showed me a photograph of a man on the operating table, whose left leg was charred mush and mostly missing below the knee. “It’ll strip everything off your leg. And that’s why people have such terrible injuries. It’s the blast wind that does that, followed by fragmentation injuries,” from bits of metal shrapnel that rip through flesh and bone, and the flame front, which burns people to death.
In the aftermath of a barrel-bomb attack, Nott said, “as you walked down the stairs to the emergency department, you just heard screams.” Barrel bombs blow up entire buildings, filling the air with concrete dust; many people who survive the initial explosion die of suffocation minutes later. Every day, patients arrived at the hospital so mangled and coated in debris that “you wouldn’t know whether you were looking at the front or the back, whether they were alive or dead,” he said. “Every time you touched somebody, the dust would go into your face and down into your lungs, and you’d be coughing and spluttering away as you were trying to assess whether this patient was alive.”
The tiled floor of the underground emergency department at M1 was slick with blood and other fluids. Screaming men carried in headless children, as if they could somehow be saved. Hospital staffers wrapped corpses in white shrouds and stacked detached legs that still wore socks and shoes.
When barrel bombs fall on homes, they often send entire families to the ward. One day, five siblings arrived. Unable to treat any of them, Nott started filming the scene, so that he would have proof, he said, of “how terrible it was.” A baby with no feet let out a stifled cry, then died. An older brother lay silently nearby, his guts coming out. In the next room, a toddler with blood on his face shouted the name of his dying brother. Two medical workers carried in the fourth brother, who was about three years old. His pelvis was missing, and his face and chest were gray with concrete dust. He opened his eyes and looked around the room, blinking, without making a noise. There were wet, white blobs on his face, and Nott gently wiped them away. When the sister was brought into the room, he learned that a concrete block had fallen on her head, and the blobs were pieces of her brain.
The boy was dying. There was no treatment; he had lost too much blood, and his lungs had filled with concrete particles. Nott held his hand for four agonizing minutes. “All you can do is just comfort them,” he told me. I asked him what that entailed, since M1 had exhausted its supply of morphine. He began to cry, and said, “All you can hope is that they die quickly.”