Amin and Imran* are two paramedics from the besieged East Ghouta, Syria suburban area near Damascus who work with hospitals that Doctors Without Borders (MSF) supports.
They describe their struggle to respond after a public square was bombed on 23 January 2015. Seven makeshift hospitals supported by MSF treated 147 people wounded in this incident, more than half of whom required surgery.
Amin: Around half an hour after we left the mosque, fighter-jets started bombing the town square. We received a call from the emergency unit and we were instructed to head to the raid area to evacuate the victims.
The town square is at a crossroads and hosts a popular market where street vendors sell their products.
I was shocked when I arrived. The place was hardly recognizable, due to the extent of destruction. Dozens of people, dead and wounded, were scattered all over the place, children, men, women, old people.
Imran: A thick cloud of dust covered the place. You could only see a few metres ahead, making it very difficult to locate the victims.
The bombs brought entire buildings to the ground, with residents inside. There was indescribable, horrifying destruction. Immediately, we started evacuating as many victims as we could, driving them to hospitals in the region.
Amin: Immediately after the first trip, we rushed back to the raid area to evacuate more victims. There was a second raid. Bombs fell from everywhere. An ambulance was hit and I was wounded in the head, but my injury was superficial.
Imran: I was also hit in the arm. Thankfully, my injury was superficial too. It is not uncommon for there to be a second wave of bombing after a bombing raid.
We paramedics, every time we are dispatched to evacuate victims, we never discount the possibility that we could become one of the statistics.
We had already been bombed before while evacuating wounded people. One of my colleagues was seriously injured in that bombing. He lost an arm. He is still alive, but he can’t work anymore.
Amin: We were feeling fear and anxiety, but we started rescuing victims and evacuating the wounded towards hospitals. The rescue operations are made harder by technical obstacles and lack of resources.
Fuel is scarce and we have no personal protection gear, such as helmets. Our work is almost a mission impossible. Our attempts to respond to these needs fail most of the time.
Imran: Exactly. Our ambulances are just regular vehicles which have been transformed to fit two wounded people in the rear part of the cabin.
On that Friday, we had to evacuate eight or nine people every time. And there were other difficulties too – the vehicles are not equipped to be driven in devastated areas and the tires frequently get punctured by the debris, making the operation harder and forcing crews to stop and change tires.
We are somehow getting used to regular bombings, but sometimes you are confronted with a scene that you just cannot cope with.
I can never forget those tiny body parts that probably belonged to a little boy, full of life. This is the sort of thing we see almost every day. We forget some images, but others refuse to fade away.
What we see here and what is happening here is a tragedy. The risks we take are scary. We knew from day one that anything was possible as far as our destiny was concerned.
We made up our mind and accepted the job, as a humanitarian mission and being aware that if we stopped doing what we are doing, the humanitarian situation will worsen.
We try to be cautious as much as possible, but in reality, we share the same general danger as everyone living here under the bombs.
In the besieged parts of East Ghouta, intense bombing has been continuing for weeks, on an almost daily basis, and is still ongoing. Hundreds of wounded have been treated in MSF-supported medical facilities in the area.
Alongside the four medical structures that MSF runs inside Syria, the organisation also supports Syrian medics working in more than 100 facilities throughout the country, providing both material support and training.
* Names have been changed