The city of Aleppo, Syria, has been called the most dangerous place on Earth.
Since 2012, civilians living there have been caught in the middle of bloody battles between the army of Syrian President Bashar al-Assad and rebel forces opposing them.
Last summer, three Chicago-area doctors, Dr. Zaher Sahloul, Dr. John Kahler and Dr. Samer Attar, traveled to the city to offer much-needed medical aid.
A few months after their trip, the hospital where they treated patients, called M10, was destroyed by bunker-buster bombs, which target underground facilities like M10.
Chicago magazine has named the doctors Chicagoans of the Year for their humanitarian work.
Sahloul and Kahler join host Phil Ponce to discuss their medical mission to Aleppo.
Below, a Q&A with Kahler.
Chicago Tonight: What compelled you to travel to arguably one of the most dangerous places in the world – Aleppo, Syria?
Dr. John Kahler: Two reasons come to mind. There was a “60 Minutes” piece on the 2013 gassings that the Assad regime carried out in the suburb of Ghouta. Anywhere between 1,200 and 1,700 people were killed. “60 Minutes” did a very detailed visual. The last scene was no less than 500 bodies lined up in a warehouse, row by row, most of them being kids. It got me and touched me. I’ve never been able to get it out of my mind. I’ll still wake up thinking about it. That’s what pushed me to start reading more and paying more attention to the Syrian issue and getting involved with the refugees in general.
But then when I was in Greece, right after the big mass of Syrians started leaving, with all of the boats – and that little boy had died in Turkey. The picture of the little kid face-down on the beach. During that episode, I went to Greece to help there. I was in Idomeni, which is on the Greece-Macedonia border, which used to be the pastures, so they would come across and they’d walk north and attempt to begin to walk into Europe, essentially. When they got to the Macedonian border, they’d stay overnight and get cleared to go in. With the crisis going on, they shut that border down. I was there when they closed it.
A camp of 18,000 people grew up almost overnight. And you can imagine all of the violence that was there and the terrible stories that were being told there. I was there. When my medical directors came over for a meeting, Dr. Sahloul was among them. I know him from Chicagoland, of course, but we had never talked too much. In April, there was a bombing of the al-Quds Hospital in Aleppo. What was reported during that bombing, was that the last of the pediatricians in Aleppo had been killed.
I’m a pediatrician. I’ve got six kids and 12 grandkids. So, the memories of those kids being killed and those pediatricians being killed kind of moved me to a place that I had never been. I thought that I needed to go and stand in solidarity with my Syrian colleagues, both to bear witness to the heinous crimes that are going on and the evil that’s there, but also to stand hand-in-hand in the place where the last pediatrician, Dr. Muhammad Mo’az was his name, where he was killed. I wanted to stand there and actually physically be there. There was something spiritual that was moving me to that. I pulled Dr. Sahloul aside and said, “I want to go to Aleppo.” He said, “John, you know how dangerous it is.” And I said, “Well, you know, I’m a big guy. I do know how dangerous it is. I can take care of myself. Get me in.” So I bugged him for a couple of weeks and then there was a plan to go in. He and Dr. Attar, who had been there before, decided to go and I got to go with them. That was the genesis of that trip.
CT: Did your family have any reservations about you leaving on the medical mission?
JK: My family certainly did. I don’t think they were as informed about what was going on. Let’s just say, Dr. Sahloul and I were giving an interview to NPR from Aleppo. While we were talking to the interviewer, there were bombs going off – you could hear them. As soon as my family heard the interview, I quickly got a number of very, very worried emails and text messages. They were much more worried after they realized what was going on. This was right as the violence was escalating.
CT: You’ve embarked on medical missions around the world, but never in Syria before last summer. What were your first impressions of Aleppo once you arrived?
JK: I had been in Haiti right after the earthquake and I think, in my mind, that’s what I was taking with me. I mean, I figured things would be bad, but I figured that’s sort of what it would look like – that type of destruction. But this was much worse.
In Haiti, you could see where you could be rebuilt. This was collapsed here, but this wasn’t collapsed here. A little bit of this and a little bit of that. Where we were – and this was five months ago, before the latest intensity of bombing – it was still rubble. Whole blocks were bombed out. One of the hospitals we worked at was underground simply because it had been hit three or four times.
The superstructure was blown up. But what happened after we left, the nature of the ordnance had increased. They started using things called bunker-buster bombs that are made to blow up underground facilities in a warzone. So they escalated that and they put all four of the hospitals we had worked at out of operation for about two to three months, then later using targeted bunker-buster bombs. It was absolutely devastating.
CT: From your experience, was most of the destruction from the Assad regime or rebel fighters?
JK: In my opinion, yes, it seemed like most of the destruction was from the Assad regime. Now, some of the destruction was from fighting. There’s no question that if I shoot at you from this building and you shoot back me, I can’t blame you for destroying the building because you’re shooting at me. Where we were, from a humanitarian standpoint, basic civilian infrastructure was being targeted.
There are two types of ordnance: directed ordnance from the sky, from missiles fired by jets and then there’s these things called cluster bombs, which are non-targeted. So these are pushed out of helicopters. The helicopters know exactly where they’re going to be and they get pushed out of the helicopters and fall on markets. From a nefarious standpoint, the first responders would come to try to help out and the helicopter would circle around and throw another one off, killing first responders. That’s a terrorist’s modus operandi.
For the Assad regime to use that, it lumps them under the same standpoint as using the same techniques as terrorists. They also use the technique of a full siege. It was a revolutionary position. They put together what they thought would be a six-month siege, figuring the West would help. Well, obviously it didn’t work that way.
CT: How were you received by the Syrian people?
JK: Wonderfully. Here are people that are trying to put stuff away in order to be understanding that their city is about to be under siege. And yet we were treated like perfect guests. And this was the beginning of Ramadan, so we only ate twice a day. Except they knew I was a Western Christian – even though I told them that I’m here to work with you, not here as your guest to be treated like an uncle – I’m here as a colleague. They’d be smiling and nodding. And yet, every time I got back from a morning assignment, they’d pull me to another apartment and there’d be a meal prepared for me. They’re the most wonderful people that I’ve ever met.
CT: Unlike Dr. Sahloul, who was born and raised in Syria, you don’t know Arabic. How difficult was overcoming the language barrier while you were there?
JK: English is one of the languages taught in the country, so it wasn’t unusual for me to have a nurse that spoke enough English to help me. And I needed help because I was doing pediatrics. I wasn’t a surgeon. Cutting is the same in whatever language you’re working in.
I did need help and got it from both the nurses and the pediatrician that I worked with, whom I still talk to every day.
One of the reasons why I left is because I didn’t want to be a burden. I would’ve gone back the next week if my language skills were up for it.
CT: What kind of security precautions did you have to take to ensure your safety?
JK: We had guards in the car going in. We had to make a decision going in: whether we’d go in with an ambulance with a ‘Red Cross’ symbol or just normal vans. The simple issue with traveling is going in with an ambulance with a ‘Red Cross’ logo makes you a target.
In most situations, the way the international law is written, you’re supposed to be exempt if you’re a member of a humanitarian mission. That’s what was being violated. And it wasn’t being violated by accident – it was being violated on purpose, of course.
We took two unmarked vans in and out of Aleppo. We had armed guards in each van.
There was no kidnapping. ISIS wasn’t there. There wasn’t a need to worry about kidnappings. That’s why we had guards on [Castello Road], though. Because on the road there was always a concern of the van being pulled over, particularly if they knew there were Western physicians in the van. We’d be a target.
I posted something on Facebook the first night I was there. I posted something just to raise awareness. I got an immediate call from Zaher to take it down because if the regime knows that we’re in Aleppo, we’ll become immediate targets. He said the regime watches that and directly targets. Going back out in the van, if ISIS would’ve known there were two physicians – one American and one Syrian – we would’ve been a direct target.
CT: Did you ever fear for your life?
JK: Leaving Aleppo, I did. Coming in, I didn’t. I stayed one night in the underground hospital and three in the aboveground hospital. You’d hear the bombs and stuff like that, so that was a little bit scary.
At one point, we got into a traffic jam under a bridge. Think about a “Mad Max” movie, where there were burned-out cars all over the place. Sometimes you could smell the burning flesh.
Once we stopped, we became sitting ducks. There are buildings on either side of you and the buildings have snipers in them. You’re not just getting shot at by the sky. Some of these snipers are rebels and some are Assad militia. I got scared to death. But the driver did an amazing three-point turn, went off the road, up and around something.
At the beginning of the trip, as we were pulling onto the road, some guy was coming the other way and stopped and was talking to our driver. And our driver laughed then floored it.
When we got to the end of the trip, out of danger and out of the van, Zaher said to me, ‘What were you doing during the ride?’ And I said, ‘I was just holding on.’ And I asked him, “What were you doing?” He said, “I was praying.” I asked him, “Why were you praying?” And he said, “You didn’t understand what the guy was saying, did you?”
And this is one of the good reasons to not have language skills: the guy said to our driver, ‘Pray to your God because you’re about to be killed on this trip.’ The driver just laughed it off and floored it. But I was glad I didn’t understand it! There are perks to not knowing Arabic well.
CT: There have been several moving images of children caught in the middle of the crises in Syria. As a pediatrician, did any moments from the medical mission especially affect you?
JK: There were two. One was right when we got there, to the M10 hospital. There were two kids in the intensive care unit, which had six beds. Both two had been hit by shrapnel from a barrel bomb. One was a little older than the other. One was about seven or eight years old and had his spinal cord severed, had a head injury and a lung injury. When we saw him, we had to put him under anesthesia and incubate him, stuff like that. He died the day after we left. That was the first of that type of injury I’d saw.
There’s another one that really haunts me. We had our clinics late at night so that people weren’t out during the day. So, we saw patients between 8 p.m. and midnight at the pediatric hospital I was working at. One of the families I saw, was a seven or eight-year-old girl that was brought in by the father and mother. She was starting to wet the bed, wasn’t eating, was crying a lot and was clingy – all the cardinal signs of an anxiety disorder.
Now, that’s certainly not hard to think about, right? But when we were done talking through the translator, I could see there was something else on the father’s mind. I could tell that. So I said, “Do you want to step outside the room and talk for a couple of minutes?” He was hesitant about it and I said, “Come on,” you know, you’ve got an old grandfather figure like me, let’s talk.
So we went out there. And he started to cry. He put his head on my shoulder and I put my arm around him. What he was crying about – when he finally calmed down enough to talk through the translator – he was crying because he felt completely impotent.
He felt like he wasn’t taking care of his family. He wasn’t able to protect his family. He was terrified of what was going to happen to them if he were killed, but also was afraid of them being killed while he’s out.
You hear these stories about people going out to find fuel or food and their house being bombed. So people are afraid to go away to find the stuff because their family may be killed before they come back and they can’t stay because they need to go out to find stuff. So it’s this level of impotence that really affected me.
I certainly identify with what it’s like to not be able to protect your family. That type of story sat with me because in the camps in Lebanon and Jordan, I’d hear versions of those stories, but those are people that got away.
I wasn’t sure whether this guy didn’t leave when he had an opportunity because he didn’t have enough money or he was making a political stand to stay in his country. I didn’t get into that. I didn’t have the time or ability to do that. But whatever it was, he felt completely impotent and it killed me to see him like that.
CT: Would you ever return to Syria for another medical mission?
JK: Oh, I’d go tomorrow afternoon if I could. I’m retiring at the end of the month, partially to work with the Syrian diaspora where they exist. Part of what I want to do is help in any way possible for the creation of a free Syria. I would go back as soon as things are calm enough from a humanitarian perspective.
I would’ve stayed if my language skills would’ve been better. But now my goal is to work in whatever capacity I can to help these people. These are wonderful people and they don’t deserve what’s happening to them.
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