DAVID GREENE, HOST:
You know, it used to be that hospitals and medical facilities, even in times of war, were neutral and protected safe zones. But in Syria these days, hospitals and the medical workers who've insisted on staying in that country have become casualties of war. Since the beginning of the conflict there, hundreds of physicians and nurses have been killed, injured or have fled the country. And that has forced some of those who stayed to take their work underground.
ZAHER SAHLOUL: There are some hospitals that are in caves in different parts of Syria, dug in the heart of mountains. I visit some of them before. But in Aleppo, hospitals mostly are built underground because of the barrel bombing. I mean, you can call Aleppo the capital of barrel bombs.
GREENE: That is the voice of a Syrian-American, Dr. Zaher Sahloul, who spoke via Skype from the besieged city of Aleppo. He was on one of his many missions into Syria since the war began more than five years ago. Sahloul was meeting with critically injured patients and the few medical workers left in the city who are struggling to treat them.
SAHLOUL: The city has a shortage of many subspecialists - neurosurgeons, vascular surgeons and pediatricians. Just a couple of weeks ago, we had - one of the doctors remaining, a pediatrician, in the city was killed. And just in the last day or so, I saw two children who are victims of barrel bombing. One of them had spinal cord injury - 5 years old. The other one, 12 years old, had a brain injury because of barrel bomb. I saw a woman whose two sons were killed. And she was third month pregnant, and also her fetus is dead. And she's in the intensive care unit. But this is the story of every family here I've witnessed. Every family has lost either a son or a father or a sister.
GREENE: Well, I don't even know where to start when I hear details like this. But let me just ask you - I mean, the little boy with the spinal cord injury you mentioned, I mean, is - did he - did he make it?
SAHLOUL: When I saw him, he was - had respiratory distress because he had shrapnels that cut high in his spinal cord, so we had to tube him. We had to put him on the respirator. He's in a stable condition, but he will be paralyzed for the rest of his life. A young woman whose sons were killed, most likely she will not make it. It's devastating. And with the limited resources, with the shortage of specialists, you cannot do sophisticated procedures for these patients. So you have to manage with what you have.
GREENE: Managing with what they have - in recent months, that has meant Syrian medical workers turning to doctors who are thousands of miles away for help.
Dr. Sahloul, you go back and forth between Chicago and Syria. And I've been reading, in the New Yorker magazine, stories about physicians when they are back in the United States or back in Europe actually getting text messages from medical workers in Syria.
SAHLOUL: Yes, I mean, we created virtual wards. Doctors inside Syria send us pictures of their patients - chest X-rays, CAT scans, labs. And then specialists in the United States, including myself, provide them with advice on what to do. Some of the doctors over here are telling me that this EICU, we call it - electronic ICU...
GREENE: Wow.
SAHLOUL: ...Is the best thing that happened to the city. And we will continue to expand on that.
GREENE: Is there - is there a story that stands out - I mean, a message you got when you were back in United States and using this new system to help a medical worker in Syria, sort of virtually guide them through - through a surgery or something like that?
SAHLOUL: You know, we had a patient, a young boy who had severe respiratory distress, and I was on the other side in United States. And we have, actually, what we call a smart camera, where we can zoom on the patient from United States to our iPhone. And I saw the patient was in severe respiratory distress, and the physician was struggling. And, you know, I advised him to intubate the patient, place him on the respirator. The patient's life was saved, you know, because of that, you know, minor intervention. I'm not saying that doctors in the United States are better than doctors here, but many times you don't have physicians ever here in the hospitals. You have technicians or nurses, and it's very important that we have this level of coverage, where you have specialists who can provide care for these critically ill patients.
GREENE: You know, just hearing - hearing you describe all the desperate conditions and hearing you describe the city that is under siege and, as you say, has sort of accepted its fate, I think many of our listeners might be very surprised to learn that you have a personal connection to Syria's leader, Bashar al-Assad.
SAHLOUL: Well, I mean, he was my classmate in medical school. We met with him in some of the conferences that we had after he became a president. We talked about politics, about his views of reforms in Syria. And no one expected that he will turn to be that brutal, that he will destroy half of his country, that he will be responsible for the killing of about 470,000 people. This is not, you know, work of what is supposed to be a physician. I - I have no words to describe my feeling towards him.
GREENE: I mean, if you were to have a chance to be face-to-face again with him, your medical school classmate, what would you want him to know?
SAHLOUL: I want him to know the faces of children that I've seen and the stories that I've witnessed. One time, he told me that he wished that he could have been a physician, not a president. I think if he come and he talk the physicians that we are seeing here and meeting here in Aleppo, who are the real heroes who continue to save lives in spite of the risk on their lives, I think he may have changed his mind. But he's very disconnected from reality, based on what I hear. I want him to look in the eye of Ahmed (ph), who will be paralyzed for the rest of his life, and tell them why did he do what he did. Why is he throwing barrel bombs on a major city? Why is he starving people to death? Why is he using chemical weapons? I have many questions to him. And many of the Syrians that I'm meeting here have many questions to him. But unfortunately, I think this will continue for some time. I doubt that you can reason with him at this stage.
GREENE: That was Dr. Zaher Sahloul of the Syrian American Medical Society. He was speaking to us from the besieged city of Aleppo in Syria. Transcript provided by NPR, Copyright NPR.