Doctors in Aleppo confirm that the unilateral ceasefire in Aleppo between Thursday September 20 and Sunday September 23 ended without any medical evacuations by the UN nor aid deliveries after their conditions for clarity in the procedure and civilian protection for the population of eastern Aleppo were unmet.

After weeks of government bombardment and a three-month siege, the Syrian and Russian governments proposed a controversial plan to encourage civilians and fighters to leave the besieged city through 8 corridors in replication of their policy of evacuations across the country. It was in this context that the topic of medical evacuations were also raised between the Syrian and Russian governments on one side and local authorities in eastern Aleppo on the other side, facilitated by OCHA, WHO and Syrian NGOs in Gaziantep.

The hospitals in Aleppo were asked to provide lists of evacuees and describe their medical needs. Meanwhile, they received none of the clarity they asked for about the timeframe of the plan, guarantees for the evacuees to not face arrest and to be able to return to Aleppo. Dr. Hamza, a general doctor in Al Quds Hospital and one of the newly appointed spokesmen for nine leading doctors in eastern Aleppo, told medias that “we need guarantees that there will be no arrests or attacks on the sick, wounded, and their companions. There was no clarity on the meeting points, on which cars would transport them, or on whether they would be searched.” 

Meanwhile, in violation of the 3-day cessation of hostilities, Russian airstrikes continued to pound the city’s frontlines and civilians who approached one of the corridors were reportedly sniped at by government forces. Leaflets pressuring the city’s residents to leave with messages such as “This is your last chance. If you do not abandon this city, you will be eliminated’’ were dropped by the Syrian government. The Syrian government also failed to let medical and other aid supplies in. Finally, on the Sunday of the plan itself, Russia withdrew its approval for medical evacuations entirely.

The UN said on the following Monday that the plan was aborted for several reasons, “including delays in receiving the necessary approvals from local authorities in eastern Aleppo’’ and Under-Secretary-General for Humanitarian Affairs Stephen O’Brien accused both the Syrian regime and the local authorities’ in eastern Aleppo of obstructing the process out of ‘’narrow political and military interests.’’

In a statement from October 12 included below, hospitals in eastern Aleppo had set out protection as the first step to enabling evacuations, and ending the aerial bombardment and the systematic attacks on the hospitals as a first mechanism to protect civilians in their own home city. They also outlined the necessity of bringing in supplies to the besieged city. No UN aid has entered Aleppo since July 7, and UN chief Ban Ki-moon has warned food rations will run out by the end of the month.

With safety as the priority, doctors inside Aleppo maintain that without explicit guarantees and monitoring from the international community, medical evacuations could exact to a process of demographic change in eastern Aleppo as experienced in Homs and Derayya. According to Dr. Hatem, one of the last remaining pediatricians and the Director of IDA’s Children’s Hospital in eastern Aleppo, “the UN contacted me as a pediatrician to ask me for children’s names. I told them there’s no problem as long as you give us the conditions we asked for. To each of these conditions, they told us, ‘We’ll see in the future.’’

The doctors stand ready to work together to save lives and to take seriously any proposals that do not pose of the risk of inadvertently supporting demographic change. The doctors recognize that the UN is making difficult decisions about what will save lives in the complete absence of action from the Member States, and share in its disappointment that the international community has once again failed us. We have repeatedly brought to the world’s attention that ‘humanitarian pauses’ and medical evacuations are insufficient when the root problem of aerial bombardment is exterminating the civilians of Aleppo and the round-the-clock targeting of hospitals prevents the medical community from treating them.

Medical evacuations would not have prevented the deaths of the more than 500 victims killed in Aleppo from airstrikes since September, whose window for reaching life-saving treatment is medically less than 2 hours. They did not have the choice of waiting for cessations of hostilities to survive.

We particularly support O’Brien’s recent push for Member States to execute concrete military power to ensure civilian protection over Syria, as mandated by international law and duty. We appeal to the United States and Europe to heed the UN’s calls and take urgent action to see this materialize into a nationwide no-bomb zone, so that the annihilation promised in the leaflets do not come true, and we can continue our medical mission in peace.

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The Statement Issued by Medical Heads in Aleppo City

Aleppo, October 12, 2016

We, the persons in charge of the medical matters in the besieged city of Aleppo undersign and clarify the following:

The eastern neighbourhoods of Aleppo city have been subjected to an unprecedented aggression since September 2016 by the aerial forces of the Russian and the Syrian regimes which target the city by different types of weapons, topped by bunker missiles, barrel bombs as well as vacuum bombs. We have documented at least one chlorine gas attack during this campaign on al-Zibdiyyah neighbourhood in Aleppo. At the same time, the siege was complete on these neighbourhoods and all the roads were cut off.

Due to this fierce campaign, no less than 400 civilians were martyred and more than 1000 others were injured. In addition to this, most of the hospitals in the city were targeted, notably al-Sakhour hospital which went completely out of service.

Within these inhumane conditions, we have been offered initiatives to evacuate the injured and patients out of the city so they can receive treatment and be referred to Turkey if necessary. Based on this, we would like to clarify the following:

  • Starting from our humanitarian duty towards our people in Aleppo, we will take seriously any humanitarian initiative that aims to rescue the people.
  • Our basic request is to stop the aerial bombardment and the systematic attacks on the hospitals and provide the best mechanisms to protect the civilians in their homes.
  • We call for entering the necessary medical supplies and we are ready to provide the UN or whichever representative with the list of the necessary materials.
  • We also ask for entering food items and baby formula to prevent malnutrition and starvation.
  • We call for a secure humanitarian corridor to evacuate the patients and the injured.
  • If it is not possible to send these materials through land, we ask for them to be dropped by air.
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