Raqqa’s besieged war-wounded struggling to reach life-saving care: MSF

"Patients tell us large numbers of sick and wounded people are trapped inside Raqqa city with little or no access to medical care and scant chance of escaping the city," said Vanessa Cramond, MSF medical coordinator for Turkey and north Syria.

"On 29 July, in the space of a few hours, our team treated four people, including a five-year-old, who sustained gunshot wounds as they were fleeing Raqqa city. We are extremely concerned for the lives of those who can't get out."

The US-backed Syrian Democratic Forces (SDF), a coalition of Kurdish and Arab fighters, have been battling since November 2016 to oust the Islamic State group from its self-declared caliphate capital.

Dangerous delays

The limited number of patients treated by MSF who managed to flee Raqqa city said that the only way to leave is by being smuggled out, causing dangerous delays in accessing urgent medical treatment.

"Some of our patients have been trapped behind frontlines for days or even weeks," said Cramond.

By the time they reach our hospitals, their wounds have often become seriously infected and saving their limbs is seldom possible.

"If they are lucky, they will have received some basic medical care inside the city, but by the time they reach our hospitals, their wounds have often become seriously infected and saving their limbs is seldom possible.

"By contrast, the patients who arrive from villages around Raqqa city with acute medical emergencies or trauma injuries have crossed the frontlines relatively quickly."

Following an airstrike, the patient's mother was trapped beneath the rubble of a collapsed building for 15 hours. After being dug out, she was able to receive some basic medical care and leave the city.

Since June, MSF medical teams in northeast Syria have treated 415 patients from Raqqa city and surrounding villages. Most patients are civilians with conflict-related injuries caused by improvised explosive devices (IEDs), landmines, unexploded ordnance, shrapnel and gunshot wounds.

Remnants of war

Beyond the city, in Raqqa governorate, many people are returning to their villages, but the conflict's effects are widespread. Towns and villages are littered with explosive remnants of war including IEDs, booby traps and unexploded bombs.

MSF also called for international de-mining organisations to be allowed access to carry out their activities so that residents can return to their homes safely and aid workers can provide urgently needed humanitarian assistance.

"There are large numbers of residual explosive devices in these towns that are preventing people from returning to their normal lives," says Cramond.

"For example in Hazima, to the north of Raqqa city, our teams resumed some medical services this week in a local school, but were forced to put this on hold after the building was found to be contaminated with mines and booby traps."

MSF, also known as Doctors Without Borders, is one of a handful of medical organisations responding to people's acute needs in Raqqa governorate and northeast Syria, with eight ambulances close to the frontlines, a medical post outside Raqqa city and a clinic in Ain Issa camp.

The Islamic State first seized Raqqa in early 2014, with the city becoming synonymous with the group's most gruesome atrocities, such as public beheadings.

Tens of thousands of civilians have fled the escalating violence in recent months but up to 50,000 people remain trapped inside the city.