A HOSPITAL IN HOMS
Khalid Shibib has written a novel telling the story of a young Syrian doctor sent from Damascus to the city of Homs in late 2010. He witnessed how the city became the scene of a full-scale civil war in 2011. The conflict between the regime of President Bashar Al-Assad and a fragmented but widely-supported Islamic State of Iraq and the Levant (ISIL) has devastated the country causing the deaths of over 150,000 persons and the displacement of almost half of Syria`s 23 million population. Homs city was the first major city to be contested. The novel describes how, over three years, the conflict totally changed the city, the hospital and the person himself.
Dr Shibib was born in Jaffa in 1947, studied medicine and specialized as neurosurgeon in Germany. Since 1992 he worked as a crisis health professional at the World Health Organization in Geneva. He retired in 2009, while still undertaking missions in many crisis-affected countries, including Syria.
Q: Dr Shibib, you have had a long career in the international relief and humanitarian world. What prompted you write this novel?
You write if and when you feel the need to write profoundly. Comparing writing to reading is like comparing the manufacturing of goods to consuming them. Working on and in conflicts and crises is always combined with some measure of suffering and stress, while writing about them gives you a chance to take a second look and to re-assess them. Though emotionally tiring, writing increases your capacity to deal with stress and helps with coping mechanisms: a type of catharsis! Writing this novel was also an attempt to convey a message to the world of literature, in addition to the world of humanity and science, and to trigger public interest and discussions about the medical health aspects of this and other conflicts.
The geopolitical stage (the city, country, population and the ongoing war) of the novel is well known. The novel also describes tiny events and scenes from daily life (refugee stories, reports and documentaries on TV and in the social media) and establishes fictitious links and patterns between them. This information is available for all those who want to write, speak or do something to help other people.
Q: What did you learn from writing this book — about the subject and about yourself?
In order to write, you have to read –– and I read a lot. Behind the numbers of those killed, injured and displaced by conflict, there are human tragedies that will affect the country for long time. You observe how individuals and systems respond to the crisis; how values, beliefs and culture help people to cope with disasters. I also learned that facing the humanitarian dilemma in the country is as difficult as finding a political solution. Humanitarian suffering substantially fuels the political impasse.
While writing the novel, I felt parts of my soul scattered here and there among its characters, without being any one of them. I felt myself independent of both sides in the conflict, and also between them –– without being neutral. This has helped me to place, hopefully with success, the health and humanitarian suffering of this war at the centre of the story.
Q: You are a Palestinian, raised in Iraq, with relatives in Gaza. How do you manage to cope with all this?
That is a good question. I have lived in various cultures, phases and levels of orientation. My awareness trip as a refugee started with an Arab phase with a dominant Iraqi background, a European phase with strong German input and, finally, an international phase working out of Geneva in many countries on three continents. Writing this book forced me to go back and forth across these phases and to re-cross barriers between them. It was an experience with émotions sans frontières!
Part of my extended family is still living in crisis, experiencing suffering and fear. When I was finalizing the Arabic version of my book in 2014, it was Gaza that was in trouble. While calling or skypeing our relatives in the city (at moments when they had electricity), you can clearly hear the terrible thunder of the Israeli bombardment of Gaza’s crowded residential areas in the background. While writing parts of my novel about the hospital, I was thinking of my relatives, but also of the doctors and nurses in Gaza hospitals.
Q: Why did you choose to write about Homs?
Homs is central to Syria’s conflict. It is big city and has an ethno-confessional mix that mirrors Syria’s cultural spectrum. It is “central” in Syria´s geography and the epicentre of the conflict, since it was the first city to be contested and divided between the conflicting parties –– with government- and opposition-controlled areas. It was one of the few conflict-affected cities that I had visited where I witnessed the suffering in the early part of the conflict. Now, in 2015, many cities in Syria have shared the sad fate of Homs. I am sure there are many stories in these cities similar to the ones in this novel.
Q: The city of Homs, one of the most ancient historical sites, has been more or less destroyed. What does this mean to you?
Both conflicting parties continue fighting in and around historical sites in the city and across the country. This has actually caused a lot of destruction inside the historical part of Homs that should be evaluated sometime soon. However, targeting historical sites as such is only known in Iraq through ISIL who deliberately destroyed a 6,000-year-old Assyrian artefact south of Mosul. Destruction of historical sites is the culmination of a series of unbelievable brutalities committed by some extremist organizations. These organizations are persistently distorting the image of Arabs and Muslims across the world. For me, they destroy part of the historical identity of the region I am proud to come from. This makes me really sad, furious –– but, above all, ashamed.
Q: The main character in your book is the young Dr. Sami, who we follow through the transformation of this once exclusive clinic into a hospital where the staff work eighteen hour days without pay. You worked in Syria for few months during this conflict; was it really as bad as you portray in your book?
The novel imagines the situation during the years 2011–2013. Now, in 2015, the number of victims has jumped to over 200,000 dead and a much higher number of wounded. Half of Syria’s 23 million people have been displaced or have fled as refugees to neighbouring and remote countries. The suffering is now much greater than that portrayed in the novel and so is the burden on the health system and the health workers.
Conflicts inflict enormous suffering and pain on the population, resulting in large numbers of dead and injured in a short space of time. This dramatically affects the ability of the health system to cope with these situations. Dr Sami’s character probably reflects the situation of many health providers, doctors and nurses who shoulder the burden of this war and have continued working for four years under worsening conditions. In order to cope with the deteriorating security situation and living conditions around them, these health providers have to change themselves. The dramatic shrinkage and metamorphosis of the health system implies a changing manpower situation within a very short time. In this context, Dr Sami is everyone and Homs is everywhere!
Q: Through your writing, we read about the disintegration of the Syrian society. Where there were once just Syrians, today there are Christians, Alawites, Shias, etc.
Syrian society is one of the most tolerant societies in the Arab world. However, its sectarian and ethno-confessional unity has been affected by events taking place inside and outside Syria, going back to before the conflict. The so-called “Sunni/Shia (Alawite)” conflict in Syria did not involve other religions and ethnicities, but marginalized them. For a time, the conflicting parties were using Christian-, Druze- and Kurdish-populated areas for their grassroots dialogue. These “peaceful” islands were seen as the guarantee of the continued existence of Syria as a country, and potential platforms for future local and national “peace talks”. Whoever is targeting these minorities (especially the Christian one) has removed the last buffer between Sunnis and Alawites, fuelling the conflict and reducing peace opportunities and the potential of post-war healing. Targeting minorities in Syria should also be seen in this light and not just as horrible war crimes.
The key message in this novel is to stop this war and start the political dialogue. All parties will discover sooner or later that there are only losers –– the war can only bring further destruction and suffering. I am afraid, however, that the key regional and global powers are still far from reaching this sad conclusion.
Q: The conflict in Syria has now entered its fourth year. Do you think there will be a solution, and do you think that the wounds of war will ever be healed?
Talking about peace from far away is much easier than proposing any practical steps towards achieving it. However, everything begins with words!
To predict what could happen in Syria, have a look at Iraq! The Syrian conflict is a mirror of that in Iraq. Both countries share the same conflict elements: ruling Ba’ath parties, a sectarian Shia-Sunni conflict (with reversed majorities), a strong Kurdish factor, foreign intervention and the targeting of minorities. Iraq is now a failed state and Syria will follow the same route if the conflict continues. Any solution should incorporate the partition of political power, consensus, transitional structures, and regional and global pressure on the parties. It is very urgent is to stop the fighting!
Healing is possible once the fighting stops and an agreement is reached, but it will be extremely slow and will vary from one location to another. The macro-level peace will have to be established by the Government and major opposition parties, but NGOs and grassroots initiatives will play a major role in reconciliation and healing at the community level. Reconciliation in Syria is unthinkable without some form of regional reconciliation.
Q: What public do you target with the English version of your book?
The Arabic version published a year ago was directed at interested readers and humanitarians in the Arab world, and I hope it will be read simply because what is happening now in Syria could happen in many other Arab countries. The Arab world is in the middle of an identity crisis that will continue in the coming decades and we will experience more conflicts stemming from the escalating violent dialogue between diverging forces of modernity and tradition.
The English version targets the international community and the general English-speaking public. Although different in many aspects, humanitarian crises like the one in Homs occur everywhere. In many crises, the preventable war-related death of civilians surpassed by far that of war-related death and injuries. In the conflict in the Democratic Republic of the Congo, for example, only 5% of deaths resulted from war injuries, while the overwhelming majority were civilians –– mainly women and children –– who died of preventable and treatable diseases, such as malaria, measles and diarrhoea. In Syria, many civilians are dying from non-communicable diseases such as diabetes, heart and lung diseases, and cancer and kidney failure, as well as from child and mother diseases. Something should and could be done to protect the health of civilian populations in times of conflict and to save their lives.
Q: How can people obtain your book?
The book is available in electronic and paper forms. The electronic version is available at:
Google play at: https://play.google.com/store/books/details?id=euf8CAAAQBAJ
Google Books at: http://books.google.com/books/about?id=euf8CAAAQBAJ
Amazon Paper version at: http://www.amazon.com/Hospital-Homs-Khalid-Shibib/dp/1780581548/ref=sr_1_1?ie=UTF8&qid=1430907937