From the frantic, chaotic corridors of the hospital where he works in the heart of eastern Aleppo, Hikmat Shihan has had a frontline view as his city has been progressively encircled and destroyed. Now he can see it being choked. Food for patients is growing scarce, the water supply is dwindling and the baby formula is all but gone. Without a single ventilator, the intensive care unit is close to shutdown and, in a city where just 30 doctors remain, the orthopaedic surgeons are performing heart operations.
“It’s a terrible feeling, especially when you see the children and you don’t have any food to give them,” says Shihan, a 26-year-old radiographer. “Or when you see an injured person and you can’t do anything to help because there is no equipment and there are no doctors.”
Airstrikes on hospitals in rebel-held eastern Aleppo by Russian and Syrian government forces are so frequent that medics have adopted a coding system to obscure their locations. Shihan’s hospital, one of just six that remain operational in an area with a population of 250,000, is known as M2. But that offers little protection. Just last week, shells slammed into the building at about 3.30am, killing two patients and injuring three staff. An ambulance was also destroyed.
On his phone, Shihan carries pictures that show him and his colleagues pulling charred bodies from the smoky wreckage of a flattened building. Another image shows what he says is his flat with a gaping hole in the wall - the result of a bomb that fell nearby last month.
Across eastern Aleppo, residents describe a city being hollowed out. Some areas have electricity for just two hours, and an airstrike on a water plant last month has staunched the flow to large population areas. With winter approaching, food and fuel shortages are causing acute alarm.
At an orphanage where he volunteers, Shihan says that staff, having seen how the regime besieged other one-time rebel strongholds such as Darayya and Homs, had been stockpiling food for months. "It will be enough to get us to mid-December. But we used to give the children three meals a day - now it's down to two," he tells The Irish Times. He says the 46 children - 40 of whom have been orphaned by the war - live in constant fear of the sound of ground-shaking bombs falling from the sky.
On Thursday, the UN special envoy for Syria, Staffan de Mistura, urged the world to avert "another Srebrenica, another Rwanda" occurring in Aleppo. He warned that the east of the city could be destroyed by Christmas if the "cruel, constant" Russian-backed bombing continued. To some on the ground, Christmas is an optimistic estimate.
“We are witnessing the slow death of 250,000 people,” says Zedoun al Zoubi, who has 12 doctors at hospitals in the eastern sector under the auspices of the Union of Medical Relief and Care Organisations. “If it goes on like this, you will see people dying due to hunger within a couple of weeks.”
Al Zoubi says he struggles to muster much anger, or even sadness, any more. “It’s blank. Just blank. No anger. No sadness. No happiness. Nothing. We’re zombies,” he says, his speech weary and slow.
“This is a city that will die. The entire world is watching a city dying. Aleppo is the third oldest city in the world. It’s 9000 years old... It has seen earthquakes and disasters, but now, in the 21st century, the city is being slaughtered and the entire world is watching.”
Amidst the horrors of the siege, people do what they can to impose some semblance of ordinary life on their days. In their flat in the eastern neighbourhood of Mashhad, Wissam Zarqa and his pregnant wife Aisha go about some of their usual routines. They pick up what they can find at the local market, and Wissam has continued to teach classes at an English-language school and at Aleppo University.
As the air assault has intensified and the noose has tightened around the eastern zone in recent weeks, however, the space for normal life has contracted along with it.
“People go out, even though it’s dangerous. But when it comes to food, there’s nothing in the market that you can buy - [ONLY]a few vegetables that are planted here in small green areas,” Zarqa says. An airstrike on a local water plant two weeks ago cut the supply to Mashhad, and already the water containers Wissam and Aisha had stockpiled are empty.
“I see people around me getting thinner and thinner, especially women, especially those who take care of their children,” he says. “People are using whatever they have stored... There is no milk in the market at all. Charities would usually give milk, but all of it ran out it seems.” And whereas once residents of Mashhad could count on six to eight hours of electricity a day, now they’re lucky to get two.
These daily struggles play out against a background of extraordinary and brutal violence. Last month, Zarqa says, he himself had a close call. He was at home with Aisha when the building next door was targeted by an airstrike, causing a loud explosion and leaving a fire in its wake. He ran to the scene to see if he could help. When the ambulance arrived, a rocket was fired at the same spot.
“It hit exactly the building I was under... I was okay, but someone was injured next to me. I didn’t have enough time to take care of him, because I wanted to go back home because I knew my wife would be very worried about me. I ran home and she was crying...
“We checked the flat. Glass was broken. The windows were broken in my flat. Luckily both of us were okay. That was the most difficult day. We stayed for three hours. All the people in the building came down, the women stayed in my apartment and I stayed with the men in the entrance. We spent about three hours there. During that time a neighbour came [WITH]his son who was injured, and he died. So we had to carry him upstairs. It was really sad.”
Eastern Aleppo has endured two weeks of the heaviest bombardment of the five-and-a-half-year Syrian civil war. Since the start of the offensive, which followed the collapse of a short ceasefire, hundreds have been killed and a US-backed peace initaitive has been left in tatters. Air strikes on the eastern sector of the city by the Syrian military and Russian jets were lighter on Thursday and Friday than during the previous two weeks following a Syrian army announcement on Wednesday that it would ease its shelling and air strikes to allow people to leave. Some trapped residents reported receiving text messages telling them to repudiate the fighters in their midst, but said there was no way in or out of the city. For their part, the rebels said they had no plan to leave Aleppo and denounced an amnesty offer from President Bashar al-Assad as a deception.
Although services across the city are near breaking point, local officials continue to work. Zarqa describes how council staff spend their days clearing rubble from blocked streets in the aftermath of overnight bombings. Despite the fuel shortages, ambulances collect the injured and bring them to the six hospitals that remain partly operational. According to al Zoubi, those hospitals receive 100 injured people per day for every doctor they have, which means only a small proportion can receive adequate medical attention. “So they decide whether this person has more chance to live than the other person,” al-Zoubi adds.
Another constant presence is the Syria Civil Defence, also known as the White Helmets, a civilian search-and-rescue group that had been considered a favourite this week for the Nobel Peace Prize. Their motto has been “to save one life is to save all of humanity”, and for many they have been one of the few signs of hope through Syria’s grinding conflict.
"Tomorrow is not guaranteed in Aleppo city," says Ismail Abdullah, a volunteer with the White Helmets in the besieged eastern zone. "If you go to your work, you don't know if you'll get back. And if you get back, you imagine maybe your house will be destroyed and your family will be killed."
Abdullah sounds shattered. It’s almost 1am, and he is staggering towards the end of a long day. The weeks since the collapse of the ceasefire have been “hell”, he remarks simply. Throughout these weeks, like many of his fellow volunteers, he has been working around the clock. “You need to do everything you can to help people - distribute food, get water for the neighbours, for your family. If there is bombing you must helps people from under the rubble,” he says.
When the conversation turns to the international response to the crisis, Abdullah has only contempt. “People in Aleppo city are really desperate. They’re scared and they’re frustrated, because the international community didn’t do anything for them. Since the uprising they have said, ‘we will help you, we will help you’, but they didn’t do anything. They’re just saying things. They didn’t protect civilians. They didn’t do a no-fly zone. They didn’t provide medical supplies or anything for civilians or kids.”
In interviews with The Irish Times, some residents reported detecting shifts in the pattern of the assault in the past two weeks, with a new focus on targeting electricity and water. Zarqa has a sense that the bombings are "more accurate" than they once were. This tallies with claims by the United States and conflict monitors, who have reported systematic attacks on infrastructure in the east of the city.
“In the past, with the barrel bombs, it was just random,” says Zarqa. “No specific target at all. But now with the bunker buster bombs, there is something specific they are targeting... [IT FEELS]they’re getting nearer. The siege is getting tighter and more difficult.” On his phone he has a video of the aftermath of what he says was a “bunker buster” bombing: it shows two huge craters, one of them at least four metres deep, with children playing in the rubble.
Storming Aleppo’s rebel-held zone, which includes big parts of the densely populated Old City, could take months and cause a bloodbath, de Mistura, the UN Syria envoy, warned on Thursday. “The bottom line is in a maximum of two months, two and a half months, the city of eastern Aleppo at this rate may be totally destroyed,” he said.
But even if civilians could leave, many of them would choose to stay. Shihan, the radiographer, stayed on in Aleppo out of a sense of duty, he says, when his wife fled the city a year-and-a-half ago. She now finds herself in Islamic-State-controlled territory to the east, and they get to speak by phone only occasionally.
Wissam and Aisha also chose to remain - partly out of a determination not to give up on their city. "If teachers and engineers left this place, what would be left? Only war," says Wissam. "There is a revolution. Do we leave the country with nothing? No future? No education? Just a pointless war?" Zarqa's parents, who are now in Turkey, have often asked him to flee Aleppo and join them there. But he couldn't bring himself to leave. "It's exhausting. It's not easy to live in such circumstances. But we are trying to cope with the situation. We have hope that things will get better. I teach in a school. I see a lot of hope in the coming generation, that it will be different. Maybe they will have a better chance."