AMMAN: Somewhere in the rebel-held Idlib countryside, a hospital hides in plain sight.

Located in a long-abandoned office building, the hospital blends seamlessly into the modest urban environment, inconspicuously tucked in between the apartment buildings and outdoor markets that line the street.

The Violet Maternity Hospital, which opened last month, treats women—mostly pregnant mothers—and children, and it is the only such hospital for dozens of kilometers in any direction.

Violet intentionally opened to little fanfare, as both local residents and the hospital administration fear that, like so many critical medical centers across Syria, it will be destroyed by a warplane at any time.

“The regime is absolutely deliberate in their bombing,” Noor Awad, the hospital’s communications director, told Syria Direct, under the explicit condition that the hospital’s location not be disclosed.

The regime and Russia “will destroy our critical infrastructure wherever and whenever possible,” he added. “That means office buildings, that means schools, and that especially means hospitals.”

Through May of this year, the Syrian government and allied forces carried out 336 attacks on 265 medical facilities across Syria, Physicians for Human Rights reported. Idlib was one of the hardest-hit provinces.

Since June, “seven out of Idlib’s 10 major hospitals have been targeted,” Salim al-Khadr, a member of the Idlib Provincial Council, told Syria Direct on Monday.

Inside the Violet Maternity Hospital. Photo courtesy of Noor Awad.

“There is nothing you can do, no precautions you can take. Nothing at all can ensure your safety,” said hospital spokesman Awad.

In June, Syrian and Russian forces began an intense air campaign across Idlib, destroying non-military targets including schools, mosques and Civil Defense centers, prompting tens of thousands of civilian residents to flee.

The warplanes have taken special aim at Idlib’s medical infrastructure, as in Aleppo province, destroying emergency rooms and field clinics. An airstrike on a Save the Children-supported maternity hospital last month in rural northwest Idlib killed two people and left a six-month pregnant woman without her legs, the London-based, international NGO said in a statement following the attack.

In a province in desperate need of medical care, residents say that a hospital has now become synonymous with a bombing target.

“There’s a huge demand for the hospital—and it’s certainly well-appreciated—but some people are definitely afraid that it’s located in a residential area,” Abu Omar a-Shimali, a freelance nurse in Idlib, told Syria Direct.

“There’s no denying that Russian and Syrian warplanes have systematically targeted hospitals,” he added. “Some people are asking that medical centers and hospitals only be located in safe areas along the Turkish border.”

Two months of unrelenting bombing has changed Idlib, not just in terms of its public infrastructure or demographic landscape, but also psychologically. Under the constant threat of bombardment, residents are giving hospitals the “not-in-my-backyard” treatment previously reserved for rebel headquarters located in densely populated city centers.

Save the Children-supported maternity hospital in Idlib bombed last month. Photo courtesy of Save the Children.

It’s not that people don’t want or desperately need medical care. Before Violet opened, women had to travel dozens of kilometers across dangerous terrain to receive costly, and oftentimes inadequate, maternal medical care.

“There is no understating the demand for medical centers across Idlib,” Abu Omar a-Shimali told Syria Direct. “Everything is in short supply, namely doctors and essential medical equipment.”

In Idlib city, now a ghost town once home to 350,000 people, “there are no formal hospitals left operating,” the nurse said. “The savage wave of bombing over the course of recent weeks destroyed virtually every single one of them.”

‘Nothing can ensure your safety’

The Violet Organization for Aid and Development—a Turkey-based humanitarian non-profit—funded the maternity hospital, which serves around 90,000 Idlib residents and displaced Syrians.

“As we studied Idlib, we realized the urgent need for women’s and children’s medical services, and we endeavored to fill that void,” Noor Awad, the hospital’s spokesman, told Syria Direct.

It is women such as Umm Ahmed who hospital administrators had in mind when designing the facility.

Just weeks before the hospital’s opening, Umm Ahmed was shuttling across the Idlib countryside—hungry, displaced and eight months pregnant—with her two children in tow.

“There were bombs falling on a daily basis,” she told Syria Direct. “And all the while I was carrying a life inside me.”

Umm Ahmed was not only fleeing from the bombs, she was trying to find adequate medical care.

“The psychological toll of being pregnant under the constant fear of bombing was devastating,” she added. “We were on the run every single day.”

At moments when the skies cleared of the warplanes overhead, Umm Ahmed would try to navigate the thick summer heat to reach the nearest maternity hospital, 30km away, through a complex network of cars, taxis and buses. However, when the transportation costs in the war-torn environment ran at least SP20,000 (approx. $92.98), such a journey became unmanageable.

If she were to have given birth at that far-off hospital, it would have cost another SP50,000 (approx. $232.45), which, for many, amounted to a prohibitively expensive sum.

“I was absolutely exhausted,” she said. “It was more than I could handle.”

Days later, the Violet Maternity Hospital opened, just before the delivery date of her third child, allowing her the personal attention of trained medical professionals just minutes from her home.

“This hospital made a tremendous difference,” Umm Ahmed told Syria Direct. “In terms of transportation, the free treatment and the quality of medical care…everything about this hospital was far better than my previous two deliveries.”

The hospital—which features a 25-person medical staff including three OB/GYNs, two pediatricians, an anesthesiologist and a team of nurses and midwives—includes both an operations division, for intensive care, natural births, and Caesarian sections, as well as an outpatient clinic for women and children.

The hospital treats between 50-60 patients daily, including around two childbirths, while providing free medical services.

“Of course there’s the fear that we could be bombed at any moment,” Ahmed, a local resident, told Syria Direct, “but this hospital is a huge accomplishment for the medical community in our town.”

“The regime targets everything, hospitals included,” Awad told Syria Direct.

“But at the end of the day, this is just a building, and what concerns us is providing much-needed medical services for 90,000 people at this exact moment, not in spite of, but rather in light of, the daily bombings,” he added.

“I’ll continue to have faith in God, but life must go on.”