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Beirut • Cut off for three weeks by a regime siege, doctors in the Syrian town of Qusair are treating hundreds of wounded in battle-damaged homes and underground shop storerooms, short on antibiotics and anesthesia and using unsterilized cloth for bandages and hand pumps instead of oxygen canisters.
Amid relentless shelling, there are some 1,000 wounded, at least 300 of them seriously and in need of immediate evacuation, one doctor coordinating medical efforts in the town said Monday. But so far, the forces of President Bashar Assad's regime backed by fighters from Lebanon's Hezbollah militant group are barring any exit as they try to crush rebels and retake the town.
With the Syrian civil war well in its third year, Qusair, near the Lebanese border, has become the latest urban battleground in the grueling fight between Assad's military and the rebels trying to overthrow his regime. The heaviness of the battle reflects the strategic importance of the town, located on supply routes that are vital for both sides.
A doctor and an activist in the shattered town acknowledged Monday that regime forces have tightened their grip in recent days. But they said new reinforcements of hundreds of rebel fighters have managed to infiltrate the siege, in what is likely to prolong the fighting in this town once home to 40,000 people.
Qusair, an agricultural community once famous for its olive oil, is now a ghost town, said Rifaei Tammas, an activist reached through Skype.
The town's homes, most of them one or two stories, have mostly been damaged or leveled by the fighting. With electricity cut, those able to afford them rely on generators running on smuggled fuel. Old wells have been re-dug, feeding untreated water to the town's residents to substitute for the water plant now seized by regime forces and fighters from Lebanon's militant Hezbollah group who have openly joined the Syrian forces in the battle for this town.
"It is a stifling siege," Tammas said from inside Qusair, adding that most people now survive on one meal a day of grains, bread and olives.
Tammas' own father, a man in his fifties, died Friday from a mortar shell as he ventured out to search for bread. Tammas said he had to collect his corpse from the town's vegetable refrigerator, which now operates as the local morgue after the original one was destroyed in earlier fighting.
Qusair, about 9 miles from the Lebanese border, has been the target of a relentless government offensive since May 19, and the surrounding countryside has been engulfed in fighting as regime troops and Hezbollah fighters seized villages while closing in on Qusair itself, while thousands fled the town.
Both sides attach major importance to the area. In the regime's calculations, Qusair is strategically located between Damascus and the Mediterranean coastal heartland of the Alawite community, the sect to which Assad belongs and which forms the strongest pillar of his regime. For the rebels, overwhelmingly Sunni Qusair has served as a conduit for shipments of weapons and supplies smuggled from Lebanon to opposition fighters inside Syria.
The fight for Qusair has also brought to the open the direct involvement of Hezbollah, which has a vested interest in the survival of Assad's regime, its key ally along with Iran. Hezbollah's involvement threatens to drag Syria's neighbor Lebanon even deeper into the war and destabilize its already explosive sectarian mix.
In the Lebanese northern city of Tripoli, Sunnis and Alawites battled from Sunday into the early hours Monday, leaving five dead and 34 wounded, according to security officials, who spoke on condition of anonymity in line with regulations.
Despite claims by the Syrian regime forces of advances made in Qusair, activists from the town deny their rivals seized new territory, and say new reinforcement of rebel fighters have boosted morale in the town.
A video posted online Sunday showed Col. Abdul-Jabbar al-Akidi, head of Aleppo province's rebel military council, in Qusair. It was not clear how he made it into the town amid the siege.
"The road here was not easy, but when there's a will there's a way," he said, standing among fighters in the town. "The regime destroyed this town, Qusair is completely destroyed, the mosques, homes, everything."
Al-Akidi vowed his men will not allow the regime and Hezbollah fighters to enter the town "unless it's over our dead bodies."
Kasem Alzein, the doctor who oversees a team of 80 medical staffers including 13 doctors in several makeshift hospitals in Qusair, said the priority was to evacuate some 300 seriously wounded civilians from the town. He said as many as 20 of them died in the last five days because of lack of critical medical attention.
"The humanitarian and medical conditions are terrible," Alzein said, adding that no medical supplies have reached the town since the government launched its offensive. "We are treating people in homes in an unsterilized environment. We tried to evacuate the wounded and we can't. No one is helping us."
A desperate attempt by local medical teams to evacuate wounded last week turned disastrous when pro-regime forces attacked their convoy, he said. As a result, 13 of the wounded were killed and others were brought back into the town with new wounds on top of the old ones.
He said medical supplies are running out and doctors most urgently need oxygen to keep the most seriously wounded mainly women, children and elderly alive. Increasingly, the wounds are from sniper fire to the head and chest, requiring surgery and blood transfusions.
"There is little we can offer them," Alzein told AP from Qusair via Skype, the sounds of battle raging in the background. "We watch them suffer and sometimes wish they would die because we are unable to alleviate their pain," he said.
Alzein said 50 abandoned homes around Qusair, mostly damaged from the top floors by shells, have been turned into makeshift hospitals and wards.
Four homes have been converted into operating theatres, which include at least one underground. He said the doctors had stocked up on medical supplies, but they are running out of antibiotics, bandages and anesthetics. Oxygen supplies are already exhausted, he added. Many of the town's residents had to donate blood more than once because there no refrigerators to store it in, Alzein said.
Civilians and wounded are sharing basement storerooms of shops and ground floors of homes to avoid shelling by mortar and artillery rounds.
As Tammas spoke to the AP, a mortar shell hit the house he was visiting, where five injured were housed, but it only damaged the top floor. "We are safe. But it is only a matter of time," he said later.
Alzein, who was on the same visit, said he was unable to return to the operating room, located in another house, because of the shelling outside.
Appeals by the United Nations and other aid organizations to allow humanitarian workers into Qusair have gone unheeded by Damascus.
On Sunday, U.N. chief Ban Ki-moon called Syrian Foreign Minister Walid al-Moallem to express concern over the situation in Qusair, according to Syria's state news agency SANA. Al-Moallem replied that the Red Cross and other aid agencies will only be able to enter Qusair "after the end of military operations there," SANA said.
Russia over the weekend blocked a Security Council declaration that would have criticized the Qusair offensive. A U.N. diplomat said Russia did so because the council made no statement when rebels seized the town.
On Monday, Russian Foreign Ministry spokesman Alexander Lukashevich described the rebel fighters as "bandits" who had terrorized the town's residents, driven out its Christians, turned a local church into their headquarters, and raided neighboring Shiite villages.
"The proposal that the international community should raise its voice at a time when the Syrian army is finishing a counter-terrorist operation against insurgents who have been terrorizing the population of the border-lying Syrian town for several months can hardly be called timely," Lukashevich said.