Aleppo, which has been beset by constant violence since 2012, and the site of unspeakable suffering from air strikes, ground fighting, and even chemical weapons attacks, has become a humanitarian nightmare.
A shortage of well-supplied hospitals has resulted in countless deaths that might have been prevented had the mortally wounded been able to seek medical treatment — a shortage of doctors, many of whom have either been killed or fled Aleppo since the fighting erupted, has made the situation even more dire.
"We are 15 of the last doctors serving the remaining 300,000 citizens of eastern Aleppo," a group of doctors claiming to be among the last in the city wrote in a letter to US president Barack Obama on Thursday.
"Whether we live or die seems to be dependent on the ebbs and flows of the battlefield," they added. "Despite the horror, we choose to be here. We took a pledge to help those in need."
Allegations of war crimes by pro-government forces have been flying around for over a year, but the situation on the ground precludes a thorough investigation of human rights violations. The situation has rapidly deteriorated over the past month, as a government-imposed siege prevented food and medical supplies from entering the rebel-held east.
"We do not need tears or sympathy or even prayers," the letter read. "We need action."
The nearly monthlong government siege of Syria's largest city is now on the verge of collapse, after a week of heavy fighting in northern and eastern Aleppo led to the defeat of pro-regime forces by a coalition of Syrian opposition groups.
The siege has not been completely broken, and the situation remains unstable, said Syrian journalist Hadi Alabdallah, who was in Aleppo while the battle unfolded.
Fights are still erupting sporadically across the city, he said, and airstrikes continue to puncture any aura of calm.
Both the regime of Syrian president Bashar Assad — and its close ally, Russia — have offered to impose a temporary ceasefire on the city long enough to evacuate civilians. But the doctors, in their letter, characterized the proposals as "thinly-veiled threats" to essentially "flee now or face annihilation."
The note contains horrific details about doctors with limited resources who must regularly decide who is worth saving, based on the extent of their injuries.
Its harshest rebukes, however, are pointed towards the Obama administration's perceived inaction in attempting to end the violence.
"We have seen no effort on behalf of the United States to lift the siege or even use its influence to push the parties to protect civilians," the letter read.
"The burden of responsibility for the crimes of the Syrian government and its Russian ally must...be shared by those, including the United States, who allow them to continue."
The White House told CNN that they had seen the letter, and condemned the "indiscriminate bombing of medical facilities by the Assad regime in Aleppo and elsewhere in Syria." The statement made no mention of Russia, whom they hope to pressure, along with the UN, into allowing humanitarian aid to flow into Aleppo.
"These attacks are appalling and must cease," the White House official said. "We commend the bravery of medical professionals across Syria who are working every day in perilous circumstances with minimal supplies to save lives."
Read the full letter here.
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