I’m a Syrian nurse and this is what it’s like to work inside my country’s worst refugee camp

There are no doctors in al Rukban camp, but people call me doctor because I try my best to treat increasing cases of disease among the 45,000 people. In reality, I am a nurse who spent 15 years as the head of intensive care nursing at Palmyra City Hospital before fleeing to al Rukban in southeast Syria where I have lived for three years.

My wife is a midwife, and in total there are six nurses and three midwives in the camp, as well as dozens of volunteers who took a one month nursing training course at a nearby US military base. Sometimes we know how to deal with a medical condition – but we also live in constant fear of doing something wrong.

For over a year, al Rukban was under siege by the Assad regime, which last month cut off the few remaining supplies of food into the camp. For months, the health situation has been appalling – we have been without basic medicine and unable to access qualified doctors. If we wanted medical supplies, we had to buy them through the black market and smugglers, often at four times the actual price. Since the regime’s siege intensified in October, seven people – three children, two women and two men – have died.

Earlier this month a UN aid convoy arrived, to the immense relief of everyone in the camp. The regime had repeatedly delayed the convoy’s arrival and we feared it would never come. Instead, it helped to bring joy and vital aid to a practically abandoned community through the provision of food supplies and vaccination points for the camp’s children.

But as helpful as it was, the food supplies can only last 10 to 15 days. On top of that, because Assad’s regime wouldn’t extend the UN’s time in the camp, nearly 3,000 children remain unvaccinated.

As we feared, the convoy supplied little in the way of medical equipment, bringing only anti-inflammatories and vitamins for the women and children. And there was no coordination and consultation with the medical staff in the camp who could have told the UN what was needed. As things currently stand, there are no promises of another convoy because, frankly, the UN doesn’t know whether the regime will allow them to send in more aid.

We gave the UN a list of around 150 people who are critically ill but they do not know whether they can help them by sending them to Syrian or Jordanian hospitals. When the delegation arrived at the camp, I asked them to visit 37-year-old Osama Al-Abdullah, who was dying of an infection he sustained while in Jordan for surgery. Their answer was that they only came to analyse and examine the situation; they couldn’t offer him anything. They then visited Osama and took several photos. He died the same evening.

Since al Rukban formed in 2015, it has yet to receive adequate medical aid. Before last week’s delivery, the last time any humanitarian aid entered the camp was 10 months ago. Another wait for aid will likely kill more of al Rukban’s residents, many of whom are suffering from health problems caused by hunger.

Because of the lack of food we have many cases of anaemia, especially among women. Complications in pregnancy are also common due to poor nutrition and lack of proper sanitation. My wife advises pregnant women and performs scans with the ultrasound scanner we have at our medical point, but she only has a few simple surgical tools for a natural birth. Many children are born in poor health and in need of an incubator, but like the scarcity of food and other medical equipment in the camp, there are none.

One of my darkest moments was when I realised I could not help a 10-month-old baby with severe diarrhea. He had been suffering for a week but his distraught mother could not afford the medicine he needed. I sat next to them both and couldn’t help but feel helpless and weak. We needed to calibrate his electrolytes using special drugs like potassium, but without a means of curing this woman’s baby all I could do was share her tears. Half an hour later, he passed away.

When we lose a child here, I feel like a father losing his child in front of his eyes, unable to save them. For the actual parents of these children, that pain is even more pronounced.

Heavy storms, in the meantime, have hit Syria, making the situation here worse than it already is. Mud houses covered in tarpaulins and fabric have been destroyed. And as winter draws in, the situation is only going to deteriorate.

We hear that Russia and Jordan are pushing to close al Rukban. They want us to return home but that would mean returning to regime-controlled areas where we could be subject to arrest and forced disappearance by the regime.

We have said it before, and we will say it again, we reject any settlement or return to areas under the regime’s control except under the following conditions: we will return if there is a political solution in Syria that guarantees we will live in peace; if it has been agreed by the UN Security Council; or if we will be protected by UN peacekeeping troops.

The residents of al Rukban camp are civilians, and we call upon the international community to protect us. Do not risk the lives of more than 45,000 people – 70 per cent of them women and children – by forcing us to return home without guaranteeing our safety.

Shukri Al Shihab is a nurse from Palmyra living in the al Rukban displacement camp