How Israel’s war on Hezbollah is pushing Lebanon’s health system to the brink of collapse

Analysis How Israel’s war on Hezbollah is pushing Lebanon’s health system to the brink of collapse
Israeli strikes on Hezbollah targets across Lebanon have killed at least 1,250 people and injured more than 5,000, overwhelming the nation’s hospitals. (Getty Images)
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Updated 09 October 2024
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How Israel’s war on Hezbollah is pushing Lebanon’s health system to the brink of collapse

How Israel’s war on Hezbollah is pushing Lebanon’s health system to the brink of collapse
  • Hospitals already crippled by grinding economic crisis are now overwhelmed by wounded people
  • Israeli airstrikes on Syrian border and close to Beirut’s international airport have further disrupted aid deliveries

LONDON: Lebanon’s healthcare system, already crippled by years of economic crisis, has been brought to the brink of collapse since Israel’s unprecedented attack on Hezbollah’s communications network in mid-September and the wave of airstrikes targeting its leaders and weapons caches.

According to some reports, several health facilities have been damaged by Israeli airstrikes. Last month, the World Health Organization said the “escalation of violence” since Sept. 23 had forced at least 37 health centers to close their doors.

Lebanon’s Health Ministry also said dozens of medical workers have been killed, with the WHO reporting 28 deaths in a single 24-hour period last week.

Lebanon was rocked last month by two attacks on Hezbollah’s communications network, which saw pagers and walkie-talkies carried by militia members explode simultaneously.

The devices, reportedly booby-trapped by Israel, exploded in public areas, killing 20 people, including children, and injuring 450 others, according to the Health Ministry, overwhelming hospitals across Lebanon.




A truck and ambulance burn after Israeli airstrikes hit a group of paramedics outside a hospital in Marjayoun, south Lebanon, Friday, Oct. 4, 2024. (AP)

Soon afterward, Israel began pounding Lebanon in its pursuit of Hezbollah, its leadership, and its weapons. The relentless airstrikes have killed at least 1,250 people and injured more than 5,000, according to Lebanon’s Health Ministry.

Israel and Hezbollah began trading fire along the Lebanese border on Oct. 8, a day after the Hamas-led attack on southern Israel that killed 1,200 and saw 250 taken hostage, prompting Israel’s retaliatory operation in Gaza.

Hezbollah rocket fire has displaced nearly 60,000 people from Israel’s north. The Israeli government says its aim is to push Hezbollah back to the Litani River, about 18 km from the Israeli border, which would allow displaced Israeli civilians to return to their homes.

Over the past two weeks, there have been reports of damage to healthcare facilities in Lebanon. In one such incident earlier this month, an airstrike on Marjayoun Hospital in the south knocked the facility out of service and killed dozens of staff.




Flames and smoke rise from an Israeli airstrike on Lebanon’s Dahiyeh, Sunday, Oct. 6, 2024. (AP)

Mounes Kalakesh, Marjayoun’s director, told AP news agency that the Israeli military did not warn the government hospital before the strike. Emergency Director Shoshana Mazraani described the facility’s ensuing closure as a “tragedy for the region.”

Israel’s Arabic-language military spokesman, Avichay Adraee, accused Hezbollah of using ambulances to transport weapons and fighters, but he did not provide evidence to support the claim.

Lebanon’s Health Ministry said on Oct. 3 that 40 paramedics, firefighters and health workers had been killed in Israeli attacks over a period of three days.

Last week, the International Lebanese Medical Association appealed to the WHO to pressure Israel to halt what it called a “massacre” of Lebanon’s health workers.

IN NUMBERS

  • 37 Lebanese health facilities forced to close owing to Israeli strikes, according to WHO.
  • 97 Rescue workers killed since last October, according to Lebanon’s health minister.

Tania Baban, the Lebanon country director of the US-based charity MedGlobal, said the healthcare situation in Lebanon today is almost indescribable.

“The healthcare system is in a very difficult situation,” she told Arab News, stressing that if further hospitals are knocked out of action, the sector may not be able to respond to the mounting number of wounded.

“Even if they don’t get targeted, if there are still going to be attacks that are this intense on the south and in Dahieh (Beirut’s southern suburbs), that’s going to create a strain.”

Lebanon has suffered successive blows since the 2019 financial crisis, which severely impacted the provision of essential public services.




Ambulances carrying the bodies of civil defense workers killed in an Israeli strike drive amid the destruction in the southern Lebanese town of Tayr Dibba, on September 29, 2024. (AFP)

“The economic crisis caused the devaluation of the local currency and inflation, which caused some serious problems in the procurement of medical equipment and supplies as well as medications,” said Baban.

“When the government announced bankruptcy, it wasn’t able to purchase supplies for the hospitals, so the hospitals were not able to cater for the patients,” she added.

The economic situation also impacted livelihoods, leaving many people in Lebanon unable to afford private medical care.

Lebanon has been in the grips of a financial crisis since late 2019, brought on in part by the mountain of debt the government had built up since the end of the civil war in 1990. In April 2022, Deputy Prime Minister Saade Chami declared the state and its central bank bankrupt.




Ambulances are surrounded by people at the entrance of the American University of Beirut Medical Center, on September 17, 2024. (AFP)

The World Bank reclassified Lebanon as a lower-middle-income country, down from upper-middle-income status in July 2022, after the country’s gross domestic product per capita dropped by 36.5 percent between 2019 and 2021.

Aid agencies in Lebanon are also concerned about the welfare of the approximately 1.2 million people who have been displaced by Israeli strikes and incursions in the south, the Bekaa Valley, Beirut’s southern suburbs, and Baalbek.

MedGlobal’s Baban says the scale of displacement in Lebanon has further strained medical services. Inadequate shelter, overcrowding, and the onset of winter heighten the risk of disease outbreaks.

“We’re worried about infectious diseases,” she said. “Flu season is on the way, COVID, the possibility of hepatitis A if they don’t have access to clean drinking water, and the possibility of, God forbid, cholera.”




Displaced families take refuge on central Beirut's Ain Al-Mreisseh seaside promenade on October 7, 2024. (AFP)

Giacomo Baldini, the Lebanon country director of the non-profit Relief International, said that while his team is providing hygiene kits and medical outreach in Beirut, Tripoli, and the Bekaa Valley, “the need for clean water, hot food, and medical supplies is huge, and will only increase.”

He wrote in a first-hand account from Beirut shared with Arab News: “We are hoping to provide mental health support as soon as possible. There are simply not enough skilled professionals in Lebanon to provide the amount of support needed.”

Baban said: “The Ministry of Health is doing its best to reach out to stakeholders, including international NGOs such as MedGlobal, to bring in supplies from abroad.”

The ministry’s plan is to bring in additional resources while this is still possible, she said. “He (the health minister) doesn’t want people to procure and purchase supplies locally so as not to deplete the supplies we already have in the country.”




A child wounded during Israeli bombardment rests at a hospital in the southern Lebanese village of Saksaqiyeh on September 26, 2024. (AFP)

However, the intensifying Israeli strikes on southern Beirut, where part of the Beirut Rafic Hariri International Airport is situated, pose a significant risk to the delivery of supplies.

“The health system’s capacity in Lebanon is deteriorating,” WHO chief Tedros Adhanom Ghebreyesus said in a post on X on Oct. 3. “Medical supplies cannot be delivered due to the almost complete closure of Beirut’s airport.”

He called for the “urgent facilitation of flights to deliver health supplies to Lebanon” as “lives depend on it.”

Baban of MedGlobal said NGOs are struggling to raise sufficient funds to alleviate the pressure on Lebanon’s health system amid the escalating hostilities and worsening humanitarian crisis.

And while there are donors providing “shipments of medical supplies that can be shipped into the country,” the suspension of flights by many carriers has hindered the process.

Israeli airstrikes on the main border crossing between Syria and Lebanon have also obstructed the movement of supplies and medicines into Lebanon.

On Oct. 4, Israeli airstrikes targeted the Masnaa border crossing, impeding civilians trying to flee and disrupting humanitarian operations, the international monitor Human Rights Watch said in a statement.

One of the biggest challenges Lebanon’s hospitals could soon face is maintaining a consistent power supply. Most still have access to fuel for generators and many have installed solar panels. However, as the colder months approach, they may have more challenges.




A man rides his scooter as he drives on the debris of destroyed buildings that were hit by Israeli airstrikes in Dahiyeh, Beirut, Lebanon, Sunday, Oct. 6, 2024. (AP)

“So far, we’re okay with fuel, but if that changes or the prices go up, then it might create a problem because in winter, you can’t depend on solar panels,” said Baban. “If fuel prices go up, it will be expensive to purchase fuel to keep hospitals running.”

The people working tirelessly to keep hospitals operational are also at risk of exhaustion.

Baban warned that while many doctors remain in the country, “they’re obviously already on the brink of being overworked after these sharp and rapid escalations.”

 


Sudan’s doctors bear brunt of war as healthcare falls apart

Women with children wait for medical care at the Italian Paediatric Hospital in Port Sudan on October 8, 2024. (AFP)
Women with children wait for medical care at the Italian Paediatric Hospital in Port Sudan on October 8, 2024. (AFP)
Updated 18 December 2024
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Sudan’s doctors bear brunt of war as healthcare falls apart

Women with children wait for medical care at the Italian Paediatric Hospital in Port Sudan on October 8, 2024. (AFP)
  • The violence has turned the country's hospitals into battlegrounds, placing health workers like Moussa on the frontlines

CAIRO, Egypt: Sudanese doctor Mohamed Moussa has grown so accustomed to the constant sound of gunfire and shelling near his hospital that it no longer startles him. Instead, he simply continues attending to his patients.
"The bombing has numbed us," the 30-year-old general practitioner told AFP by phone from Al-Nao hospital, one of the last functioning medical facilities in Omdurman, part of greater Khartoum.
Gunfire rattles in the distance, warplanes roar overhead and nearby shelling makes the ground tremble, more than a year and a half into a grinding war between rival Sudanese generals.
Embattled health workers "have no choice but to continue", said Moussa.
Since April 2023, Sudan has been torn apart by a war between army chief Abdel Fattah al-Burhan and his former deputy Mohamed Hamdan Daglo, leader of the paramilitary Rapid Support Forces (RSF).
The war has killed tens of thousands and uprooted 12 million people, creating what the International Rescue Committee aid group has called the "biggest humanitarian crisis ever recorded".
The violence has turned the country's hospitals into battlegrounds, placing health workers like Moussa on the frontlines.
Inside Al-Nao's overwhelmed wards, the conflict's toll is staggering.
Doctors say they tend to a harrowing array of injuries: gunshot wounds to the head, chest and abdomen, severe burns, shattered bones and amputations -- even among children as young as four months.
The hospital itself has not been spared.
Deadly shelling has repeatedly hit its premises, according to medical charity Doctors Without Borders (MSF) which has supported the Al-Nao hospital.
Elsewhere, the situation is just as dire. In North Darfur, a recent drone attack killed nine at the state capital's main hospital, while shelling forced MSF to evacuate its field hospital in a famine-hit refugee camp.

Sudan's healthcare system, already struggling before the war, has now all but crumbled.
Of the 87 hospitals in Khartoum state, nearly half suffered visible damage between the start of the war and August 26 this year, according to satellite imagery provided and analysed by Yale University's Humanitarian Research Lab and the Sudanese American Physicians Association.
As of October, the World Health Organization had documented 119 confirmed attacks on healthcare facilities across Sudan.
"There is a complete disregard for civilian protection," said Kyle McNally, MSF's humanitarian affairs advisor.
He told AFP that an ongoing "broad-spectrum attack on healthcare" includes "widespread physical destruction, which then reduces services to the floor -- literally and figuratively".
The national doctors' union estimates that in conflict zones across Sudan, up to 90 percent of medical facilities have been forced shut, leaving millions without access to essential care.
Both sides of the conflict have been implicated in attacks on healthcare facilities.
The medical union said that 78 health workers have been killed since the war began, by gunfire or shelling at their workplaces or homes.
"Both sides believe that medical staff are cooperating with the opposing faction, which leads to their targeting," union spokesperson Sayed Mohamed Abdullah told AFP.
"There is no justification for targeting hospitals or medical personnel. Doctors... make no distinction between one patient and another."

According to the doctors' union, the RSF has raided hospitals to treat their wounded or search for enemies, while the army has conducted air strikes on medical facilities across the country.
On November 11, MSF suspended most activities at Bashair Hospital, one of South Khartoum's few functioning hospitals, after fighters stormed the facility and shot dead another fighter being treated there.
MSF officials say they believe the fighters to be RSF combatants.
In addition to the endless stream of war casualties, Sudan's doctors scramble to respond to another threat: mass starvation.
In a paediatric hospital in Omdurman, across the Nile from Khartoum, malnourished children arrive in droves.
Between mid-August and late October, the small hospital was receiving up to 40 children a day, many in critical condition, according to one doctor.
"Every day, three or four of them would die because their cases were very late stage and complicated, or due to a shortage of essential medicines," said the physician, requesting anonymity for safety concerns.
Sudan has for months teetered on the edge of famine, with nearly 26 million people -- more than half the population -- facing acute hunger, according to the UN.
Adnan Hezam, a spokesman for the International Committee of the Red Cross, said there must be "immediate support in terms of supplies and human resources to medical facilities".
Without it, "we fear a rapid deterioration" in already limited services, he told AFP.
To Moussa, the doctor, some days feel "unbearable".
"But we can't stop," he said.
"We owe it to the people who depend on us."
 


At first Security Council meeting since Assad’s fall, UN envoy calls for end to Syria sanctions

Geir Pederson, the United Nations’ special envoy to Syria, center, listens to a woman who was looking for her missing relative.
Geir Pederson, the United Nations’ special envoy to Syria, center, listens to a woman who was looking for her missing relative.
Updated 12 min 58 sec ago
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At first Security Council meeting since Assad’s fall, UN envoy calls for end to Syria sanctions

Geir Pederson, the United Nations’ special envoy to Syria, center, listens to a woman who was looking for her missing relative.
  • Geir Pedersen warns that though the regime of former president Bashar Assad has been toppled, the ‘conflict has not ended yet’
  • Council members denounce Israeli authorities for illegal seizure of parts of Syria, call on them to withdraw forces and respect nation’s sovereignty

NEW YORK CITY: The UN’s special envoy for Syria has called for “broad support” from the international community for Syria and an end to crippling economic sanctions, to aid the reconstruction of the country after almost 14 years of civil war.

Speaking from Damascus on Tuesday, Geir Pedersen briefed members of the UN Security Council on the current situation in Syria. It was the council’s first open meeting about the country since the fall of dictator Bashar Assad’s regime on Dec. 8.

The UN’s humanitarian chief, Tom Fletcher, also appealed to all states to ensure “sanctions and counterterrorism measures do not impede” aid operations in Syria, which continues to suffer the effects of a humanitarian crisis that is one of the most dire in the world.

US, UK, EU and other international authorities imposed severe sanctions on Syria after President Assad’s crackdown on pro-democracy protests in 2011 spiraled into civil war.

They also slapped sanctions on Hayat Tahrir Al-Sham — the militant group that spearheaded the takeover of Damascus this month that ousted Assad — more than a decade ago. At the time, HTS was Al-Qaeda’s official affiliate in Syria but it broke ties with the terrorist group in 2016. However, it remains on the UN Security Council’s sanctions list, subject to a global assets freeze and arms embargo.

Western countries are now grappling with the question of how best to respond to the evolving situation in Syria now that HTS is in power. Though the group has softened its rhetoric, it is still widely labeled a “terrorist” organization by authorities in the West.

Pedersen said: “Concrete movement on an inclusive political transition will be key in ensuring Syria receives the economic support it needs.”

He noted the steps that are being made to achieve a peaceful and orderly transition of power in the country, including efforts to ensure the former government’s ministers remain safe, and calls for state employees to continue their work.

“This provides a strong first basis but it is not, in itself, enough,” Pedersen told council members. The transition must also be “credible and inclusive, including the broadest spectrum of Syrian society and Syrian parties, so that it inspires public confidence,” he added. He also stressed the need to draft a new constitution, and for free and fair elections.

Although events this month have sparked hopes of a real opportunity for peace, economic stability, accountability and justice in Syria, Pedersen warned that many people remain apprehensive about the “enormous” challenges that lie ahead.

“I worry that if this is not handled right, by both the Syrians and the international community, a turn for the worse again is possible,” he said.

Even though Assad is no longer in power, the “conflict has not ended yet,” Pedersen continued, highlighting as a particular concern the clashes between Turkish-backed and Kurdish groups in the north of the country.

“Although there is stability in many parts, and law and order improved, such stability can be fragile, with many front lines and open hostilities still ongoing in northeast, where civilians are being killed, injured and displaced. Such an escalation could be catastrophic,” he said.

Meanwhile, Israeli forces have carried out more than 350 strikes against military facilities, equipment and supplies across Syria since the fall of the Assad regime and the attacks continue, including a major assault on Tartus.

“Such attacks place a battered civilian population at further risk and undermine the prospects of an orderly political transition,” Pedersen said as he called on Israeli authorities to halt all “illegal” settlement activity in the occupied Syrian Golan.

“Attacks on Syria’s sovereignty and territorial integrity must stop,” he added.

Pedersen said he has held talks with Syria’s new de facto leadership. He also visited the “dungeons” and “torture and execution chambers” of Sednaya prison, which he described as “a testament to the barbarity of the fallen regime towards its own people.”

He said that seeing this firsthand served as a stark reminder of the importance of transitional justice, of clarification of the fates and whereabouts of all those still missing or who were disappeared, and of ensuring due process is followed in criminal prosecutions as a necessary safeguard against acts of revenge.

“Without this, Syria and Syrians will not be able to heal,” Pedersen added.

As an urgent first step, he called for the preservation and protection of all evidence and materials related to alleged crimes, and of the sites of mass graves.

Fletcher, the UN humanitarian chief, told the Security Council that the humanitarian crisis in Syria remains one of the worst in the world, with 17 million people in need of support, more than 7 million displaced across the country, and millions more living as refugees.

Nearly 13 million people already face acute food insecurity, he added, and recent events have “only added to these needs.” More than a million people were displaced in less than two weeks during the events that culminated in the fall of the Assad regime, he said, and hundreds of civilians were killed or injured, at least 80 of them children.

Health services and water supplies have been interrupted and more than 12,000 schools temporarily closed, affecting millions of students. As borders and commercial routes remain closed, there are shortages of bread and fuel, Fletcher added.

“The flow of humanitarian support was severely disrupted, with most organizations temporarily suspending operations. Several warehouses have been looted. Multiple aid workers lost their lives,” he said.

He lamented the fact that the effort to fund aid for Syria, “the largest country appeal in the world,” is one of the most poorly supported.

“With just two weeks left in 2024, it is less than a third funded, the largest-ever funding gap for the Syria response,” Fletcher said. “Now is the time to invest in the Syrian people.”

Russia’s ambassador to the UN, Vassily Nebenzia, said Syria’s future is “currently quite uncertain given the internal lack of stability and the palpable threats to Syria’s sovereignty and territorial integrity.”

He warned that there is “a real risk of Syria becoming a number of cantons, broken down by ethnic and religious characteristics,” and called on the Syrian people to make every effort to ensure that an inclusive national dialogue takes place, without separating people into “losers and winners.”

Slovenia’s deputy permanent representative to the UN, Ondina Blokar Drobic, told the council that a prosperous future for Syria will depend on a credible and inclusive political transition, and an inclusive Syrian-led and Syrian-owned political process. She emphasized the necessity of participation by women in this process.

Drobic also underscored the obligation on all parties to take a stand against terrorism, as she stressed the importance of preventing Daesh and other terrorist groups from reestablishing their capabilities, and of denying them safe haven.

Syria’s caretaker authorities “must also respect Syria’s other international obligations, including the Chemical Weapons Convention,” she added.


Turkish rescuers end search of Syria’s Saydnaya prison

Turkish rescuers end search of Syria’s Saydnaya prison
Updated 18 December 2024
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Turkish rescuers end search of Syria’s Saydnaya prison

Turkish rescuers end search of Syria’s Saydnaya prison
  • The prison complex was thoroughly searched by Syria’s White Helmets emergency workers but they wrapped up their operations on Tuesday, saying they were unable to find any more prisoners

ISTANBUL: Turkish rescue workers have ended their search for survivors in Syria’s notorious Saydnaya prison, their leader said Tuesday, after finding no detainees languishing in any hidden cells.
Located just north of Damascus, the prison became a symbol of rights abuses under president Bashar Assad, who was ousted by Islamist-led rebels on December 8.
The search by a 120-member team was conducted at the request of Syria’s new authorities, according to Okay Memis, director of Turkiye’s AFAD disaster relief agency.
“The entire building was searched and analyzed with a scanner, and no living person was found,” Memis told journalists at the site.
Prisoners held inside the complex, which was the site of extrajudicial executions, torture and forced disappearances, were freed early last week by the Islamist-led rebels.
But the complex is thought to descend several levels underground, fueling suspicions that more prisoners could be held in undiscovered hidden cells.
The Association of Detainees and Missing Persons of Saydnaya Prison (ADMSP), however, believes the rumors about hidden cells are unfounded.
The prison complex was thoroughly searched by Syria’s White Helmets emergency workers but they wrapped up their operations on Tuesday, saying they were unable to find any more prisoners.
According to the Syrian Observatory for Human Rights, more than 100,000 people have died in Syria’s jails and detention centers since 2011, when Syria’s civil war erupted.
 

 


Palestinian families sue US government over military aid to Israel

Palestinian families sue US government over military aid to Israel
Updated 18 December 2024
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Palestinian families sue US government over military aid to Israel

Palestinian families sue US government over military aid to Israel
  • Complaint calls for the implementation of the so-called Leahy Law, which the plaintiffs and rights group say Israel has been illegally exempted from
  • Since the start of Israel’s war against Hamas, the United States has enacted legislation to provide more than $12.5 billion in direct military aid to its strategic ally

WASHINGTON: Five Palestinian families on Tuesday sued the State Department over Washington’s billions in military aid to Israel, demanding the enforcement of US rules to curb arms flows due to allegations of human rights abuses.
The complaint, filed on Tuesday and to which the State Department has 60 days to respond, calls for the implementation of the so-called Leahy Law, which the plaintiffs and rights group say Israel has been illegally exempted from.
The law prohibits the provision of security assistance to units facing credible allegations of human rights abuses.
Since the start of Israel’s war against Hamas in October 2023, the United States has enacted legislation to provide more than $12.5 billion in direct military aid to its strategic ally.
The war was sparked by an attack by Hamas on Israel that resulted in the deaths of at least 1,208 people, mostly civilians, according to an AFP tally based on official Israeli figures that includes hostages killed in captivity.
Israel’s retaliatory campaign has killed at least 45,059 people in Gaza, most of them civilians, according to figures from the Hamas-run territory’s health ministry which the United Nations considers reliable.
Much of the Palestinian enclave has been reduced to rubble in the process.
At a press conference in Washington on Tuesday, Palestinian-American plaintiff Said Assali said his aunt and her six children were killed in an Israeli airstrike on Gaza City, alleging US weapons were used to carry out the attack.
“Our families paid an unbearable price for the State Department’s refusal to enforce its own laws,” said Assali.
Two former State Department staffers told journalists US authorities apply an informal “Israel exception” when assessing the country’s military actions.
“The reality is that Israel operates under a different set of rules. The State Department has created this unique, burdensome, high-level process for determining (that) applies only to Israel,” said Charles Blaha, a former State Department official who worked on such determinations.
Josh Paul, who resigned from the State Department last year in protest of US policy on Gaza, offered a similar assessment.
The State Department declined to comment on the filing of the complaint.
Earlier this month, rights group Amnesty International accused Israel of “committing genocide” against Palestinians in Gaza since the start of the war.
In November, the International Criminal Court issued arrest warrants for Israeli Prime Minister Benjamin Netanyahu and former defense minister Yoav Gallant on suspicion of crimes against humanity and war crimes.
Israel’s government vehemently denies the allegations, and has appealed the warrants.
Ahmed Moor, a plaintiff in Tuesday’s lawsuit, said seven of his family members in Gaza were living “under a constant fear of bombardment,” and that one had been killed.
“My family members are people just like you and me, and their lives have been destroyed by American weapons in direct violation of American law,” he said.
“My family’s living a nightmare.”


Syrian mass graves expose Assad’s ‘machinery of death’

Syrian mass graves expose Assad’s ‘machinery of death’
Updated 18 December 2024
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Syrian mass graves expose Assad’s ‘machinery of death’

Syrian mass graves expose Assad’s ‘machinery of death’
  • Former US war crimes ambassador Stephen Rapp: "We haven't seen anything like this since the Nazis"
  • More than 157,000 people have been reported missing to Hague commission

QUTAYFAH, Syria: An international war crimes prosecutor said on Tuesday that evidence emerging from mass grave sites in Syria has exposed a state-run “machinery of death” under toppled leader Bashar Assad in which he estimated more than 100,000 people were tortured and murdered since 2013.
Speaking after visiting two mass grave sites in the towns of Qutayfah and Najha near Damascus, former US war crimes ambassador at large Stephen Rapp told Reuters: “We certainly have more than 100,000 people that were disappeared into and tortured to death in this machine.
“I don’t have much doubt about those kinds of numbers given what we’ve seen in these mass graves.”
“We really haven’t seen anything quite like this since the Nazis,” said Rapp, who led prosecutions at the Rwanda and Sierra Leone war crimes tribunals and is working with Syrian civil society to document war crimes evidence and is helping to prepare for any eventual trials.
“From the secret police who disappeared people from their streets and homes, to the jailers and interrogators who starved and tortured them to death, to the truck drivers and bulldozer drivers who hid their bodies, thousands of people were working in this system of killing,” Rapp said.
“We are talking about a system of state terror, which became a machinery of death.”
Hundreds of thousands of Syrians are estimated to have been killed since 2011, when Assad’s crackdown on protests against him spiralled into a full-scale war.
Both Assad and his father Hafez, who preceded him as president and died in 2000, have long been accused by rights groups and governments of widespread extrajudicial killings, including mass executions within the country’s prison system and using chemical weapons against the Syrian people.
Assad, who fled to Moscow, had repeatedly denied that his government committed human rights violations and painted his detractors as extremists.
The head of US-based Syrian advocacy organization the Syrian Emergency Task Force, Mouaz Moustafa, who also visited Qutayfah, 25 miles (40 km) north of Damascus, has estimated at least 100,000 bodies were buried there alone.
The International Commission on Missing Persons in The Hague separately said it had received data indicating there may be as many as 66, as yet unverified, mass grave sites in Syria. More than 157,000 people have been reported missing to the commission.
Commission head Kathryne Bomberger told Reuters its portal for reporting the missing was now “exploding” with new contacts from families.
By comparison, roughly 40,000 people went missing during the Balkan wars of the 1990s.
For the families, the search for the truth in Syria could be long and difficult. A DNA match will require at least three relatives providing DNA reference samples and taking a DNA sample from each one of these skeletal remains found in the graves, Bomberger said.
The commission called for sites to be protected so that evidence was preserved for potential trials, but the mass grave sites were easily accessible on Tuesday.
The United States is engaged with a number of UN bodies to ensure the Syrian people get answers and accountability, the State Department said on Tuesday.
Syrian residents living near Qutayfah, a former military base where one of the sites was located, and a cemetery in Najha used to hide bodies from detention sites described seeing a steady stream of refrigeration trucks delivering bodies which were dumped into long trenches dug with bulldozers.
“The graves were prepared in an organized manner — the truck would come, unload the cargo it had, and leave. There were security vehicles with them, and no one was allowed to approach, anyone who got close used to go down with them,” Abb Khalid, who works as a farmer next to Najha cemetery, said.
In Qutayfah, residents declined to speak on camera or use their names for fear of the retribution, saying they were not yet sure the area was safe after Assad’s fall.
“This is the place of horrors,” one said on Tuesday.
Inside a site enclosed with cement walls, three children played near a Russian-made military satellite vehicle. The soil was flat and levelled, with straight long marks where the bodies were believed buried.
Satellite imagery analyzed by Reuters showed large-scale digging began at the location between 2012 and 2014 and continued up until 2022. Multiple satellite images taken by Maxar during that time showed a digger and large trenches visible at the site, along with three or four large trucks.
Omar Hujeirati, a former anti-Assad protest leader who lives near the Najha cemetery, which was used until the larger Qutayfah site was created because it was full, said he suspected several of his missing family members may be in the grave.
He believes at least some of those taken, including two sons and four brothers, were detained for protesting against Assad’s government.
“That was my sin, what made them take my family,” he said, a long, exposed trench behind him where the bodies were apparently buried.
Details of Syria’s mass graves first emerged during German court hearings and US congressional testimony in 2021 and 2023. A man identified only as “the grave digger” testified repeatedly as a witness about his work at the Najha and Qutayfah sites during the German trial of Syrian government officials.
While working in cemeteries around Damascus at the end of 2011, two intelligence officers showed up at his office and ordered him and his colleagues to transport and bury corpses. He testified that he rode in a van adorned with pictures of Assad and drove to the sites several times a week between 2011 and 2018, followed by large refrigeration trucks filled with bodies.
The trucks carried several hundred corpses from Tishreen, Mezzeh and Harasta military hospitals to Najha and Qutayfah, he said in the trial. At the sites deep trenches were already dug and the grave digger and his colleagues would unload the corpses into the trenches, which would be covered with dirt by excavators as soon as a section of the trench was full, he said.
“Every week, twice a week, three trailer trucks arrived, packed with 300 to 600 bodies of victims of torture, starvation, and execution from military hospitals and intelligence branches around Damascus,” he told Congress in a written statement.
The grave digger escaped from Syria to Europe in 2018 and has repeatedly testified about the mass graves, but always with his identity shielded from the public and the media. (Reporting by Timour Azhari in Qutayfah and Anthony Deutsch in Amsterdam; Additional reporting by Reade Levinson and Stephanie van den Berg; Editing by Angus MacSwan and Alison Williams)