Syrian doctor Fadi Dalati in his office at the Saint-Pierre University Hospital in Brussels. April 15, 2020. Photo: Wilson Fache for Asia Times

BRUSSELS — Mask, glasses, and surgical cap: Fadi Dalati’s face is almost unrecognizable, but one can guess the dark circles under his eyes.

“This hospital is the reference center in Belgium for infectious diseases. We are on the front line against this pandemic,” said the doctor, who works at the Saint-Pierre University Hospital, in Brussels.

He does not use such expressions lightly: where he comes from, war is not a matter of rhetoric.

Like thousands of other Syrian physicians, this thirty-year-old from Homs has found refuge in Europe to escape the conflict that has ravaged Syria for almost a decade. Many of them are now at the forefront of the battle against the novel coronavirus in their host country.

“Belgium was there for me when I arrived in 2013 and needed help. Now, the country needs me, so I’m doing my best,” he told Asia Times.

Outside, rows of green tents have been set up in the hospital parking lot to sort out virus-free patients from those likely to be affected with Covid-19. A few steps away, a black hearse patiently awaits in front of the morgue: from reception to passing, nothing is left to chance.

With 11.4 million inhabitants and more than 8,000 victims, Belgium has the highest per-capita death rate in the world.

“The empty streets, the people locked inside their homes… It reminds me of Syria in times of war,” said Abod, 27, who works in the sterile storage area in another Brussels hospital.

Originally from Raqqa, the former stronghold of the Islamic state group, he chose exile in September 2015, passing through Turkey, Greece and the Balkan route before reaching Belgium. From one front line to the other.

“Syrians and so many other refugees working in the medical sector in Europe are putting their lives at risk at the moment. If I were a far-right activist, this crisis would probably make me re-evaluate my political beliefs,” he smiled.

‘Not my first war’

Some have already paid the ultimate price: in Italy, a destination of choice for Syrian doctors for several generations, four have already died since the beginning of the pandemic. Among them is Abdel Sattar Airoud, an oncologist born in Aleppo in 1945.

“Even after officially retiring five years ago, he continued to work as the director of a retirement home. It was there that he was infected by one of his patients, who was actually a neighbor. He was happy to serve during this crisis,” said Kinda Airoud, his eldest daughter.

Airoud eventually passed away on March 16. Due to complications related to the burial of those who die from Covid-19, and because of the lack of a plot in the local cemetery dedicated to Muslims, the doctor was buried more than 100 kilometers from his home — where his widow now lives alone.

“Since I left Syria, I have been worried about my parents, who are still there. Ironically, now they are the ones who are scared for me,” said Bashar Farahat, who is originally from the Idlib region.

He fled his work as a pediatrician in government-held Syria in 2013, after being arrested over links with the opposition. He obtained asylum via the UNHCR in York, England after two years in Lebanon.

In the midst of an unprecedented health crisis, he just started a contract in the emergency room of the local hospital. “I’m not particularly anxious. This is not my first war,” he joked.

“Syrian practitioners, because of their experience, have learned to work under pressure,” he added, emphasizing that he is more worried about his homeland.

Syria’s brain drain

Officially, Syria is said to have less than 50 cases and three deaths related to Covid-19. That figure, however, is suspected to be well below the actual number of infected people.

In a country ravaged by a decade-long conflict, a spread of the epidemic could have catastrophic consequences, particularly in the Idlib region, the last remaining opposition stronghold and home to three million people — many of them displaced in camps or substandard housing.

“Even before the coronavirus, the health system there was on the verge of collapse. It’s a real frustration to have been forced to flee: my place is in Syria. I wish I could help my people,” Farahat sighed.

What was once touted as one of the best health-care systems in the Arab world has been hollowed out by the war, brain drain, as well as sanctions.

“Having to flee my country when I know there is a huge need was the worst experience of my life,” said 28-year-old Damascene Yamama Bdaiwi, who now works with coronavirus patients at Airedale Hospital in the UK city of Bradford.

“When things settle in Syria, I can maybe go back and work as a doctor there. I have this dream,” she added. In the meantime, Bdaiwi helps by giving online courses once a week to medical students living in opposition-held areas.

The World Health Organization reported in March that only two-thirds of Syria’s hospitals continue to function, while 70% of the healthcare workforce has left the country.

“Much of this situation is a result of pro-government forces systematically targeting medical facilities. Nurses, doctors and medical volunteers have been attacked, detained and disappeared by parties to the conflict,” said the UN Commission of Inquiry on Syria.

Physicians for Human Rights, a US-based organization which has long taken an activist role on behalf of medics in Syria’s opposition-held territories, says nearly 1,000 of these healthcare workers have been killed in the conflict to date. The NGO found that 91% of medical personnel killings were committed by the Syrian government and its Russian ally.

“Every time a doctor leaves the country or is killed, it creates a catastrophic vacuum; a shortage that is difficult to fill and that will have very significant consequences in the short, medium and long term,” said Rayan Koteiche, Physicians for Human Rights’ Middle East researcher.

Unthinkable return

For those who served in the once-sprawling opposition territories, almost all of which have been clawed back by Syrian leader Bashar al-Assad’s forces, return is nearly unthinkable.

“As part of a study last year, we asked dozens of medical professionals under which conditions they would agree to return to Syria to practice. They all told us they would need to see a change in regime,” said Koteiche.

Even if that unlikely condition were met, it is hard to imagine that the thousands of Syrian doctors who have found refuge abroad will return home once the war is over. It often took them years to rebuild their lives and, finally, exercise their passion again after navigating the Kafkaesque bureaucracy of their host countries.

For some, like Fadi Dalati, Europe has become more than just a shelter. “I cherish this new identity,” he said. “Now, I am Belgian.”