On March 28, 2015, Jabhat al-Nusra and allied opposition groups wrested Idlib city from government control in Syria. The following day, the Syrian air force attacked the city’s Red Crescent-run hospital with rockets, causing significant damage and forcing the hospital to close. Two days later, on March 31, the air force bombed and severely damaged the city’s national hospital – the last functioning hospital in the city. Activists reported that opposition groups intercepted radio correspondence in which government military officials ordered air force pilots to destroy the hospital.
The attacks on hospitals in Idlib city are just two examples out of dozens in which Bashar al-Assad’s forces have targeted health care facilities and personnel in opposition-controlled areas in order to counter military advances made by opposition groups. In the past few months, opposition groups have been making considerable gains across the country to the detriment of the Syrian government. The opposition’s April takeover of the Nasib border crossing between Syria and Jordan and nearby military posts in Daraa, the seizures of Idlib city and Jisr al-Shaghour in Idlib governorate between March and May, and recent reports of dissatisfaction among Assad’s core Alawite constituency have all been serious blows to the Syrian government.
Faced with these setbacks, Assad has carpet bombed civilian populations and targeted medical facilities in opposition-controlled areas. Physicians for Human Rights (PHR), which is documenting attacks on medical personnel and facilities in Syria through an interactive map, has recorded an uptick in such attacks when Assad loses ground to the opposition. Syrian government forces launched eight and 14 attacks on medical facilities in March and April, respectively. These numbers represent the greatest number of attacks documented since August and September 2012, when Assad’s government developed and executed what would become one of its signature tactics – attacking medical facilities in opposition-controlled areas in retaliation for military losses.
In response to assaults by opposition groups on Aleppo city, Damascus city and suburbs, and towns across Idlib governorate in August and September 2012, the Syrian government bombed opposition-controlled areas with increasingly heavy weaponry. During approximately the same time frame, from mid-July through the end of September 2012, government forces launched 36 attacks on medical facilities – the greatest number documented in any 10-week period during the war. The vast majority of these attacks (78%) occurred in Aleppo, Idlib, Damascus, and Rif Dimashq governorates, where the Syrian government was facing the most military setbacks.
In recent months, analysts have been predicting Assad’s downfall. They say he’s on his back foot and that his days are numbered, but I’m doubtful. We heard the same predictions in article after article in the summer of 2012 – yet, he remains in power using the same horrific tactics he developed years ago. President Assad, who is a doctor himself, is well-aware that killing a doctor leaves dozens of others without care, fighters and civilians alike. Bombing a hospital causes even greater devastation. It kills doctors and patients, destroys medical infrastructure, and instills fear in communities, which often prevents them from seeking medical care. Activists believe that Assad bombs hospitals not only to prevent fighters from receiving treatment, but also to punish civilians in opposition-controlled areas and ensure that life cannot exist outside of his regime’s control. Syrians have a term for this: drying out the sea to kill the fish.
While there is growing dissatisfaction among Assad’s core constituency, and the self-declared Islamic State now controls half the country, little else has changed in the past three years. The Russian government ensures that Assad has warplanes, helicopters, missiles, and barrel bombs. Iran makes sure that he has additional troops. With their assistance, Assad continues to devastate cities and towns and provoke opposition fighters to join the Islamic State. The United States, lacking the political will to get too involved in another war in the Middle East, is focusing on atrocities committed by the Islamic State, rather than Assad’s government. Until the international community wakes up and collectively forces a diplomatic solution, analysts will continue to muse over Assad’s potential downfall while thousands more civilian lives are lost, families displaced, and hospitals destroyed.