[Editor's note: Franklin Lamb emailed this updated version of his article from Syria]
How Two Sisters, Ten Year Old Ghina and 8 Year Old Nagham, Survived Three Sniper Bullets in Syria.
Written by Franklin Lamb, Children's Orthopedics Ward, Al-Mouwasat Hospital, Damascus, Syria, September 2, 2016.
It was about 11 in the morning on Tuesday August 2, 2016 when two sisters, ten year-old Ghina and her eight year-old younger sister Nagham were walking a short distance from their home in the town of Madaya to its "field hospital" in order to acquire serum for their anemic mother Sahar whose body was very deficient in calcium because of 18 months existence with very little food. Sahar explained to this observer a couple of days ago that she and her four babies, lived at times with nothing more than a watery soup made of grass, or sometimes black peppers, but most often made from the pink and white flowers of thistle plants she gathered from a nearby field.
For more than a year, after having fled from their own Sunni village of Zabadani due to fighting, the family has been living in surrounded Madaya, a mountain town of 40,000, now with four times its pre-war population, about 30 minutes northwest of Damascus. Military forces encircled Madaya in July of 2015 as part of a broader offensive to recapture the nearby Qalmoun Mountain villages and the town of Zabadani, held by rebels since 2012. Residents of Madaya have been trapped ever since.
Having made their medicine purchase, the girls started their short 60 yard walk home. A claimed eye-witness says that a sniper near al -Asali checkpoint took aim and fired at the youngsters. One explode-on-impact bullet entered Ghina's upper-left thigh, shattering her leg bone and thigh.
For an instant, not realizing what had happened, Ghina's younger sister 8 year old Nagham, noticing that Ghina had dropped the small plastic medicine bag to be given to their mother at home, instinctively picked it up and began to scold her big sister for dropping it. The little heroine, by now instantly covered in her sister's blood, tried to pull badly bleeding and screaming Ghina off the road to a secure location...the roadside ditch. The sniper took aim a second time. This time, shrapnel from the bullet struck Nagham's right arm and hand. The two young girls lay on the side of the road until minutes later passersby were able to pull them out of the line of fire and transport them to the towns nearby "field hospital".
Over the past year, snipers have killed seven people in Madaya, according to a report published on 7/13/2016 by Physicians for Human Rights, a US-based organization that has provided medical assistance to thousands in Syria since the civil war erupted in March of 2011. The PHR findings were confirmed in a separate Report from the Madaya Medical Commission published on 7/23/2016. The following week, snipers shot and wounded three more people, a Madaya resident reported last week by telephone to a relative of the girl's family.
The sniping of civilians continues until today in Madaya as some try to escape the siege imposed on their town. So also do deaths mount from the approximately 6,000 additional landmines recently placed around the southern and eastern sides of the town, by militia in order to further imprison residents inside.
Such indiscriminate use of landmines violates international humanitarian law and, as with sniping civilians, constitutes a punishable war crime once the conflict ends and hopefully the global community insists on full accountability under the law for all who have targeted the people of Syria.
Several dozen people have also died from starvation in Madaya, despite surrendering in exchange for relief from the siege. With almost nothing and no one allowed in or out, the town continues slowly dying from the inside.
At Malaya's "field hospital" whose medical staff consists of two heroic dental students and an animal veterinarian, Ghina was diagnosed with a displaced fracture, a badly shattered leg bone and a severed nerve in her upper left thigh.
Before long, Ghina's leg and thigh became badly infected and a tentative decision was taken to amputate it. As one of the MDs reported at the time via "What'sUP" to medical colleagues abroad, Madaya's health workers today are only able to perform emergency surgery, mainly amputations.
As Dr. Darwish, a dentistry student and one of three health professional still in Madaya insisted, they did not have the equipment or the training to repair the damage to Ghina's leg and thigh or most other serious injuries brought to the "Field Hospital." However, amputation of Ghina's leg was something they could perform.
Dr. Darwish further explained in a follow up email: "Franklin, if a situation requires major surgery, there's nothing that we can do about it. Recently a baby girl died after her delivery because we don't have neonatal incubators. That wasn't the first time, and it certainly won't be the last as long as we continue to lack the proper medical equipment. Too many children have died here in Madaya for this reason...we don't have the training, and we don't have the expertise. We're out of our depth. We can sort of perform C-sections, natural births and amputation operations, but that's it. We try to treat sick people that come our way, but with our limited training, many times it's just not possible. If a situation requires major surgery, there's nothing that we can do. One time, there were three children who were injured by a landmine. They were rushed to the hospital, but we just stood there staring. When it comes to these situations, we're normal people; we aren't trained doctors. The children died before our very eyes that day, and there was not a single thing that we could do except pray."
Madaya's severely wounded, like Ghina, have only one way to get out of the besieged town and thru the 65 checkpoints, countless landmines and snipers, and to receive the lifesaving treatment they need. It is through a painstakingly negotiated reciprocal agreement between rebel and regime forces, brokered by Iran and the United Nations last year. In theory it provides for the evacuation of some wounded people from Sunni Madaya in exchange for a parallel evacuation from two Idlib Shia towns of Foah, and Kafraya , besieged by rebel forces.