The siege around Eastern Ghouta near Damascus has tightened, Medecins sans Frontieres has reported, after a month that witnessed the greatest regime brutality in the war thus far on the area. Aug. 16 witnessed what has widely been described as a massacre, as "double-tap" airstrikes by the Syrian government killed well over 100 people in one afternoon, and came amid 20 concurrent days of heavy regime attacks in which at least 150 people were treated for war wounds every day. "August was the worst month we've seen medically," said a hospital director at one of the facilities supported by MSF in Eastern Ghouta. "Anyone who isn't injured or dead can count themselves lucky. Enough death and siege. Enough blood and misery. Enough." Over recent days, he added, there has been a "moment's respite" from the airstrikes due to the sandstorm which covered much of the region. Of the 13 makeshift hospitals MSF assists in the area, the death toll from just six of them was 377, including 105 children, during the worst 20-day period. The Unified Relief Office in Eastern Ghouta reported that 556 people were killed during August, with 372 new orphans created during that time. Virtually no medicines are entering the besieged area, exacerbating an already dire situation, and any remaining makeshift hospitals are severely overstretched. "Hundreds of injured are coming in. Sometimes we have to go two or three days without sleeping. This month is incomparable to before. It is the worst I've seen," the doctor, who asked to remain anonymous, told MSF. MSF supports 13 makeshift hospitals across Eastern Ghouta, but they are overstretched and close to breaking point. "This is one of the bloodiest months since the horrific chemical weapons attack in August 2013," said Dr. Bart Janssens, MSF's director of operations. In that month, almost exactly two years before this latest massacre, over 1,000 people were killed in Eastern Ghouta in a sarin gas attack attributed to the Syrian government by much of the international community. The regime denies responsibility. "It is clear that there were at least 150 war-wounded treated per day in East Ghouta during these 20 days of bombing. The hospitals we support are makeshift structures, where getting medicine is a dangerous and challenging endeavor, and it is unthinkable that they would have been able to cope with this intensity of emergency trauma response with such constraints," he added. "The Syrian doctors' continued unswerving effort to save lives in these circumstances is deeply inspiring, but the situation that has led to this is totally outrageous." On top of that, the conditions of the siege are intensifying, meaning even medical evacuations are no longer possible, and the area under siege has expanded, the MSF statement adds. "Three new areas to the north of Damascus – Al-Tall, Hameh and Qudsaya – where at least 600,000 people live have been newly put under siege since 22 July," the MSF reports. "This means that people are stopped and searched and no medical supplies, food, fuel or other basic essentials are allowed in." Due to the lack of basic medical supplies, and impossibility of evacuation, many extreme procedures have to be carried out. Janssens said that MSF is aware of 400 amputations which occurred in Eastern Ghouta in August. "Many of these people's limbs could have probably been saved if the medical care in besieged areas were not so desperately constrained," he added.
