As Donald Trump announced that US troops were leaving Syria, international medical volunteers headed in to northeastern Syria. Their purpose was to support the local autonomous administration in the predominantly Kurdish area known as Rojava, which was threatened by invasion from Turkey.

Dr. George Hagglnud, an anesthesiologist and ICU doctor based in Germany, was a part of an eight-person International Medical Delegation of doctors from around Europe who came to support local doctors as the rural hospitals that are overwhelmed with military and civilian casualties as Turkey continues to bomb indiscriminately. The trip is part of what is now a regular influx of medical volunteers, returning for a week at a time to provide aid to areas completely abandoned by most international NGOs and military aid.

“It’s basically to show solidarity, take care of some of the overflow patients, and do some training at the same time,” says Hagglnud.

“I come from the libertarian socialist end of the spectrum and it’s just a revolution that has an extraordinarily lot in common with the way I envision a future society. Also just the horrifying attacks [the Kurds] are always under,” explains Dr. Hagglund.

The decision to offer medical support comes as Turkey initiates an invasion of the region, including massive airstrikes against Kurdish areas, in what President Erdoğan says is an attempt to create a 32 kilometer buffer zone. What many in Rojava believe, however, is that this is going to result in ethnic cleansing and the forceful destruction of the autonomous self-administration they have created since the Syrian regime receded from the Kurdish region in 2013.

While Turkey continues this barrage of attacks, and the area becomes a proxy battlefield for Russia and the US, the people trying to maintain medical support for the region are facing brutal acts of violence.

International Medical Delegation

Dr. Hagglnud’s medical convoy started in the town of Derik and then went to the region’s de facto capital Qamishli to meet with medical leaders to determine the needs.

“It’s impressive what they have done with no outside help,” says Hagglnud. The convoy reported that the hospitals were in good shape, run according to the principles of the Rojava revolution, including a horizontal leadership structure where no one was “pulling rank.”

“Everyone just does that which they can do. And they are all highly motivated to advance the Rojava revolution. Everybody I spoke to had a very revolutionary sentiment,” said Hagglnud.

The doctors needed certain types of skilled doctors to come to the region, particularly surgeons who could deal with battlefield injuries and perform skin grafting. Neurosurgeons, maxillofacial surgeons, ophthalmologists and orthopedic surgeons are all in high demand as the hospitals braced for increasing injuries from Turkish bombing raids.

Rojava has created an in-depth long-term care system for combat veterans who need rehabilitation, keeping them in “physiotherapy homes” where they are in their community rather than in chronic care, separated from their communities. “It’s so veterans realize they are an important part of society…so they know they are not alone,” says Hagglnud. “That’s a huge difference to what happens in the United States to veterans once they have been used and abused.”

Now those community homes are combat zones, and so the Rojavan doctors are hoping to create a system to send patients in need of long-term rehabilitative care to Europe.

From Qamishli, the delegation of doctors then traveled to Tal Tamir, a small town near the frontlines, where many locals are fighting to defend their homes.

“The people resisting them at this point are people from each village, they are just defending their village. It isn’t the big columns of YPG you used to see when they were fighting the Daesh [ISIS],” says Hagglnud.

The hospital, which was so tiny that the emergency room was made up of six bed carousels, was a stabilization point for the injured who could not be carried by ambulance to a hospital in bigger centers like Qamishli. Their facilities began to be overwhelmed by casualties.

“When we arrived, the ceasefire was declared … and as a result of the ceasefire the scope sort of changed. There was a 50/50 mix of bullet wounds [and other injuries]; each town has a resistance unit that is supposed to defend the town, and they were coming in with bullet wounds [in their] extremities and what not. Air strike injuries, blast injuries, bricks falling on them when houses crumble from air strikes. We also had a large number of civilians who were … dead when they got there,killed by airstrikes,” says Hagglnud.

The American-based Free Burmese Rangers were also in the region, providing direct combat medical services to those injured in the fighting.

“We are giving impartial medical support at the frontline to civilians and soldiers. We provide an ambulance service, we rescue wounded trapped by the Turks and the FSA [Free Syrian Army], we document the situation and human rights abuses, and we also provide food, water and blankets to displaced people near the frontlines,” says Dave Eubank, the team leader of the Free Burmese Rangers on the ground near Tal Tamir.

Many mainstream media outlets have neglected to report that the ceasefire was observed unevenly. Many of the Turkish airstrikes continued despite the ceasefire being in effect. This is a standard that the Turkish military has been setting in their treatment of the region, and many people in Rojava are reporting war crimes in the last few weeks as Turkey sends in the militias of the Syrian National Army to fight the Syrian Democratic Forces (SDF), a confederation of local defense units including the YPG/YPJ.

Many of the Syrian militias armed by Turkey, and presumably backed with the passive support of NATO given Turkey’s membership, are jihadi insurgents who are engaging in much of the same torture and brutal executions of non-combatants that ISIS was famous for. Few on the Kurdish side believe Ibrahim Kalin, the spokesperson for Erdoğan’s office, who says that war crimes will be investigated.

Danger for Medical Support

Among the accusations of human rights violations leveled against Turkey are those alleging targeting of medical facilities and personnel. A few weeks ago, Zau Seng, a Burmese volunteer from Free Burmese Rangers, was killed by a Turkish drone strike, and two other volunteers were injured. While Turkish Defense Minister Hulusi Akar says that they will avoid targeting civilians, activists in Rojava say that Turkey’s track record shows otherwise.

“Everyone in the zone of the invasion is targeted and already five Kurdish Red Crescent ambulances have been hit by Turk drone strikes and medics killed and two of our ambulances have been hit by drone [and] mortar [strikes] and machinegun [fire],” says Eubank.

Many activists from the region report that targeting medical facilities is standard operating procedure for Turkey. An ambulance rescuing people injured from a Turkish airstrike was hit in Tal Tamir on November 10, despite being clearly marked as a medical transport vehicle.

“There have been a lot of confirmed instances of the Turkish military targeting medical facilities. Bombing very close to hospitals, bombing medical points out in the field. Bombing ambulances. Several medical workers have already lost their lives in this conflict,” says Berivan Qerecox, a northeastern Syria-based member of Kongra Star, which focuses on women’s issues in the region. “And it is one of the many documented…war crimes that have taken place so far…that have gone unchecked and unchallenged — the international bodies are not taking steps to make reparations.”

Activists around the world who are drawing attention to the Syrian conflict — and the Turkish treatment of the Kurdish autonomous region in particular — are now raising the issue of Turkey’s intentional targeting of medical workers as a way of destabilizing the region and its people.

Deellan Shayda, an activist of Kurdish descent who works with the organization Bay Area Mesopotamia Solidarity and the California Kurdish Community Center, explains that Turkey is targeting medical facilities “because they are the ones who would be healing soldiers. There is no nice way to say this: the Turkish state and, really, any state that has nationalist tendencies and wants to wipe out an ethnic group, is not going to have any type of mercy.”

This was certainly true during the battle against the PKK and Kurdish insurgencies during the “Dirty War” of the 1990s, when Turkey actively targeted civilians, hospitals and schools. “This is not new to the Turkish state or their policy, but now it is happening not on their own soil,” says Shayda.

This perspective was shared by Dr. Hagglnud, who says that it was clear from his vantage point that medical workers were vulnerable to targeting. “They shot the two female paramedics and threw their bodies in the sewer…since then there have been two more attacks on ambulances,” he recalled.

Medic Jiyan Bengî has been coming to Rojava since 2014, when she came with a medical delegation. She returned again in 2015 to lend a hand with work like battlefield support and treating sick kids around the area.

“[ISIS] always [tried] to kill everybody, so at least it wasn’t surprising. In this case, it’s a NATO member trying the same,” said Bengî, who says that Turkish forces are attacking both civilians and medical teams. In her treatments, she is seeing deep burns that are uncommon to regular bombings, which could indicate weapons banned by the United Nations, such as white phosphorus.

For her, the killing of the medical worker from the Free Burmese Rangers appeared to be no accident. “Several times when we went to evacuate injured, [Turkish-backed forces] shoot on us or mortared us. … Everybody is clearly [recognizable] as medical workers, through clothes and the ambulances.”

Preparing for Violence Ahead

Much of the violence to civilians took place during what was supposed to be the ceasefire. While reports show Turkey observed the US demand for the ceasefire, and therefore should be allowed to continue military operations because they have acted in good faith, the ceasefire was selectively observed by Turkish forces and bombings continued in many areas of the country.

“Medics that come out and talk about their experience of being specifically targeted by Turkish airstrikes complicate the narrative of Turkey listening to the US, which they’re not,” says Shayda.

The project of Democratic Confederalism is now under immediate threat; the region has seen an influx of regime forces, Russian troops, Turkish-backed militias and the Turkish army, who occasionally cross paths with the few American troops left in the region. People around the world are supporting the people in Rojava by creating effective solidarity campaigns and raising the profile of human rights abuses and war crimes perpetrated against medical workers and civilians of the area.

As the Turkish bombing campaigns continue, the medical support is only going to become even more important, which is why many people are asking for donations to be made to the Syrian-German organization the Kurdish Red Crescent, a Red Cross organization providing relief to the area. Medical volunteers, through projects like the International Medical Delegation, will continue to enter the region and strengthen the medical care that the surviving hospitals are able to provide.

“It is a catastrophe waiting to happen,” says Dr. Hagglnud. “The people said they expect dark times ahead, but they are not prepared to give up their self-governance.”