(Eastern Ghutah, Rif Dimashq) 30-year-old Huda lost her little foot due to a tumor. She has always rejected the idea of marriage in fear that a healthy man might belittle her for being crippled. Today, married to Hatim who has lost his foot two years ago in a shelling on Eastern Ghutah, she tells Syria Untold: “After the revolution and the war I’ve finally found someone who is like me.”

In a report issued in June 2014, the Syrian Network for Human Rights (SN4HR) says that no less than 1.1 million people have been injured in Syria since March 2011. At least 45% of them are women and children, and 10 - 15% of these cases have turned into permanent disability or amputation.

Walking through the streets of rebel-held areas such as Eastern Ghoutah, one can realize the scale of such a catastrophe as you barely pass a road without seeing one or several injured. In the news, it is common to enumerate casualties and the number increases several folds for the injured, but the news ends there. There is no time or ability to mention how many of them have suffered the injury that will change their lives forever.

“Most injuries are a result of random shelling with various types of rockets and barrel bombs as a first cause, and with snipers bullets as the second most common cause. Most of the wounded are civilians; these cases are more than triple the injuries resulting from armed confrontations,” says the SN4HR report.

Many injuries result in permanent handicap due to the lack of specialized qualified medical staff, such as vascular and neurosurgeons. The lack of disinfectants and antibiotics causes infections that require the amputation of the injured limb. Then there is the type of weapons used, mostly explosive, as they often provoke compound injuries which lead to all sorts of disability, regardless of the quality of healthcare.

Death is easier

The loss of a limb or a sense could be almost as painful as a slow death; in Eastern Ghutah, many think those who died are in peace while they go on living in the same condition of their country, swallowing a slow death for every minute they survive.

Hatim folds his arms over his chest wondering: ”Those who are dead are martyrs, what do I benefit from staying alive?” He envies the martyrs for the comfort of death and the honor of martyrdom, whereas he has nothing left but the humiliation of begging for help to make a living for himself and his wife Huda. The couple share two pairs of walking canes that prevent them from holding hands down the street, reminding them of what life has taken away from them for good.

Nour, an employee at the center for artificial limbs, speaks of another agony. Amputation does not only affect the injured, it also causes much suffering to their family. They might lose their main breadwinner or caregiver and it might become their responsibility overnight, causing them traumatic shock. This alone is enough to turn the lives of entire families into a daily misery, reaffirming Hatim’s opinion. Death becomes a wish withheld by the curse of surviving. ”Yes, things are THAT bad,” confirms Nour.

There are too many examples related to the miserable reality of Syrians today, especially in besieged areas. In ʿAin Tarmah, Saʿid is a father to seven and a husband of two. This family was already not easy to provide for before his injury, but is today as remote as possible from a decent life. It is not only about war bombardments, poverty and starvation under siege, they also lack any source of income, as Saʿid’s injury has amputated his entire left leg. He has turned from the owner of two houses to a bread-seller knocking on people’s doors.

The women, who were previously chaperoned to avoid mingling, have turned to trading what little sugar, rice or gas is available. All in addition to the family having had to move to the neighborhood of Qabun to be closer to Damascus and under a more flexible siege.

Saʿid suffers from a sharp depression as do most of his family members. They kill time with sleep to avoid feeling the heavy demands of life that are now beyond their abilities.

Between suicide and challenge

ʿAla’, a drummer from Damascus who has lost his right hand, attempted suicide repeatedly. His life was dedicated to what he could do with his limb. Now that it is no longer there, he says: ”I can’t deal with others, I do not want to continue like this.”

The irony is that ʿAla’ has been jailed for participating in demonstrations against the government, but he was hit by a shell which his pro-regime parents believe came from rebel-held Ghutah. He has not been spared the mocking comments of his relatives.

12-year-old Wasim still plays football after losing his leg in a shelling on the neighborhood of Baba ʿAmro in Homs. He is now a refugee in Lebanon’s Tripoli and the goalkeeper for his school team. He awaits to replace the limb he buried in his city with another artificial limb, but this will not happen until he reaches full growth, so that the expensive alternative leg is not discarded a few months later when Wasim’s body overgrows it. He says: “I’m still one of the best defenders,” and he laughs, as he always does, according to his father.

The reaction of the impaired to the trauma of amputation differs according to many socio-economic variables. Some quickly accept it and persist with their previous goals in life, while others lose hope and self-esteem, and sometimes turn into dependent characters, asking others to take care of them. They give in to the role of the disabled, which spares them the agony of facing life’s demands with lesser abilities.

In a situation like that of Syria nowadays, where life has become an agony due to the lack of energy sources, communication and transports, it becomes common for everyone to ask for help and more so for those who wear the scars of war on their bodies. Too often they resort to begging.

Rehabilitation is very expensive due the cost of manufacturing artificial limbs. Many do not have any chance, because their injuries have amputated more of their bodies than what the simple abilities inside rebel-held Syria can repair. A great number of them are forced to emigrate looking for other countries with better medical facilities and aid.

Some make do with basic tools, similarly to the tea-vendor on the streets of Barzeh neighborhood in Damascus. ”I melted a thick plastic pipe and curved it, it now carries me and wears my shoe,” he told Syria Untold.

On the other hand, Hatim and Huda did not get an artificial limb despite the availability of a donor to cover their expenses, because they were too lazy to practice the exercises necessary to provide the muscle support to adapt to the new leg. Physiotherapist Nour complains at people refusing to help themselves, he believes they are wasting an opportunity many do not have. He doubts they do that to be able to continue depending on others.

What makes amputation in Syria today different from the past is that it can happen for reasons other than severe injury. You may be wanted by the regime and thus trapped in opposition areas where many surgeries cannot be performed.

What is still common in all of these areas is the psycho-physical pain related to the ghost limb, as if it was still there. After the amputation, people feel pain and itching and what they call “electricity” or “nerve pain”. Sometimes, therapists use a mirror to reflect the remaining limb and comfort their patients for a while, as if looking at what has remained might help them forget what is lost. All that is left is to carry on with what remains.