Mounir, a Syrian surgeon working in central England, avoids heart-wrenching TV reports about his native land if he can, worried they may affect his work.
Ever since the uprising against President Bashar al-Assad began in March 2011, Mounir has split his time between practicing orthopedic surgery in Manchester, one of England’s biggest cities, and mobilizing emergency relief for fellow Syrians struggling to survive amid war and destruction.
"I never thought there would be such a need in Syria for the profession I'm practicing. I never thought that one day there would be such demand for medical doctors and for basic life-saving procedures," said the 37-year-old, who declined to give his full name.
"As a doctor, I get phone calls from colleagues there -- 'please help us, we are running out of insulin, please help us, we are running out of blood bags, please help us, we need a CT scan' -- which one are you going to help?"
Nearly two years of civil war have left an estimated 60,000 Syrians dead, millions homeless, and a once enviable health system in tatters. More than half the 88 hospitals have been damaged and nearly one third are out of service, according to Syrian health ministry data released by the World Health Organisation.
As a trustee of Syria Relief, a UK-registered charity, Mounir has helped to raise more than 2 million pounds ($3.1 million), mainly from the Syrian diaspora, to send desperately needed supplies, from blood bags and vaccines to flour, clothing, and even ambulances.
Syria Relief's efforts are part of a much wider response to the crisis at home from the diaspora – in Canada, the United States, Europe, and the Gulf region – many of whom met in London in January to discuss their work and call for support before a UN donor pledging conference to secure $1.5 billion for Syria.
Not only have hospitals and clinics in Syria been attacked. Medical charity Medecins Sans Frontieres (MSF), one of the few foreign organizations working inside Syria, says the Syrian army has been waging war against health workers and services in rebel-held territory.
Doctors describe being targeted in bombing campaigns and risking death, detention, and torture to treat the wounded, whether civilians or fighters.
Many have left or been killed. One Syrian doctor, now a refugee in Turkey, told the International Rescue Committee he believed there were now only 36 doctors practicing in and around the city of Aleppo, compared with an estimated 5,000 before the uprising began.
Doing their best to fill the gap are expatriate doctors like Mounir, who have been able to work in Syria at a time when much of the country remains out of bounds to UN and international aid agencies.
"As a Syrian, it's quite painful to see my own people being hurt," he told AlertNet in an interview. "I lost a few friends who used to be my classmates and people I used to play with in my childhood. But that motivates me to help more, to put more effort into responding to all the requests we get from Syria."
Mounir’s Syria Relief has provided medical training and even paid hospital staff to stay in Syria rather than head for the safety of neighboring countries.
Like other expat doctors, Mounir has taken time off from his day job to sneak back into Syria to work in secret field hospitals – typically, makeshift clinics set up in private homes.
"…if you go to work in a field hospital and you put a sign up saying ‘this is a field hospital’, you will find it flattened the next day," he explained. "So it has to be in a secret place, even the families of casualties don’t know where the individual is being treated."
On a few occasions, Mounir heard army helicopters whirring overhead as he operated on a patient. "We knew that at any time, we might get hit, and we might lose our lives," he said. "But the priority for us was to finish our work. It is quite stressful because at the end of the day we are human beings as well."
At the meeting of the expatriate medical fraternity, Mounir met for the first time colleagues he had only spoken to via Skype.
As part of the 14-member Union of Syrian Medical Relief Organizations (UOSSM), they asked for international support while voicing concern that UN aid would only bankroll Assad's supporters.
Of the $1.5 billion sought by the United Nations – and pledged by donors in Kuwait – $1 billion is earmarked to help Syrian refugees in neighboring states and $500 million to help millions of Syrians displaced inside the country. It is the second sum that worries the doctors because the Syrian government has a high level of control over how the aid is delivered.
"We are Syrians. We are doctors. It's our country. We are taking the risk to go inside Syria to take the needed help to our people," said UOSSM spokesman Tawfik Chamaa. "We hope the international community will trust us. There is no other medical organization taking such risks or with so much involvement on the ground."
Chamaa, a general practitioner in Switzerland, told AlertNet that although the government considered anyone operating in opposition areas terrorists, "we are doctors, we don't have weapons," and the organization’s doctors were "ready to treat anybody anywhere, all over Syria."
Chamaa, a tall, elegant man who could easily pass as a banker or diplomat, fled Syria in 1979, aged 19, after taking part in student protests.
In the early months of the uprising, he found it hard to concentrate on his work, so he reduced his hours to devote more time to the Syria relief effort. When it became clear the conflict would be a long one, he returned full-time to his patients. He now holds a weekly meeting to inform them of the latest developments, "to stop them discussing the situation during my surgery” and distracting him from his work.