Her Dream of Becoming a Doctor Turned into a Nightmare, and a Movie

— Dr. Amani Ballour, the first and only woman to manage a hospital in rebel-held Syria

Dr. Amani Ballour’s first ever patient was a 12-year-old boy who had been shot in the head.

She was 24 at the time, studying medicine at Damascus University in Syria, just as protests against President Bashar al-Assad were reaching a boiling point in early 2012. The boy had been near one of the demonstrations when government forces swooped in to quash the rally, shooting at random and turning the young bystander into a victim.

His parents, worried that the authorities would arrest them, decided not to take him to a hospital and instead turned to Ballour, who was their neighbor at the time.

But by the time they got to her, he was dead, Ballour recalled in an interview at The Times. “I could do nothing for him.”

From that moment, her life became inextricably linked with the fate of Syria, a country that for nine years would be leveled by a brutal war, leaving an estimated 500,000 men, women and children dead, as of 2018, and displacing more than five million more.

“I just wanted to study and be a doctor and have a clinic. That was my dream,” Ballour said. “But lots of things changed in my life.”

Almost immediately after she graduated from the university, Ballour started volunteering at a hospital in eastern Ghouta — a rebel stronghold near Damascus — as one of the few doctors in the area. The hospital, which was under construction, was intended to be a large, six-story medical hub, but the work was abandoned as government forces ramped up attacks and seized the area, forcing the team of 13 doctors to move operations into the winding, subterranean space that made up the foundation of the unfinished building. Soon enough, the new, underground clinic came to be known as the cave.

In 2016, after four years on the job, Ballour was promoted to manager, making her the first and only woman in charge of a hospital in rebel-occupied Syria. Her work in that role formed the gravitational center of a new, aptly-named documentary, “The Cave,” from National Geographic Documentary Films that was nominated for an Oscar this year.

As the conflict dragged on, the patients, some as young as a few days old, continued to pour in by the thousands, injured from the battles, weakened from the war, some with shrapnel wounds, others with missing limbs, and many coughing and suffocating from chemical attacks that had been repeatedly condemned by the rest of the world.

Ballour, as manager, would supervise their treatments, jumping in to perform emergency surgeries herself and making house calls for patients too sick to come to her, all the while remaining composed and human. It was also on her to find ways to keep the hospital a safe haven, ordering fortifications above ground when needed and scrounging for resources. With Ghouta under siege by government forces, the hospital survived on financial aid from medical nonprofits, while supplies of medicine, food and milk for children were all cut off and had to be smuggled in, Ballour said.

Every day, Ballour and her largely-female team of doctors and nurses grappled with the kinds of challenges that medical professionals in other parts of the world rarely face: What to prescribe a sick, malnourished baby when there’s no food? How do you perform a surgery without anesthetics? How do you keep a hospital running smoothly to the deafening soundtrack of bombings above ground and wailing parents below?

The most difficult thing, Ballour recalled, was choosing which ones to help with the few resources they had. “All of them have the same symptoms; all of them are suffocating,” she said. “But I had to choose: I will work with this child and the other will die.”

“I always think about that. I feel I am guilty.”

Ballour, the second youngest of two brothers and three sisters, was always “stubborn.” Her eldest sister was married off at the age of 13, but when Ballour entered her teenage years, she insisted on finishing her education and going to college.

“I wanted to do something different,” she said. “Before I started studying medicine, I wanted to be an engineer.”

Her family refused to support her because in their eyes engineering was a man’s job. So she switched plans, focusing instead on becoming a pediatrician, which seemed more palatable for her family, she explained.

Later in her career, despite having proved herself as both a skilled doctor and a strong leader, she nevertheless constantly bumped up against the deep-rooted limitations of being a woman in a religiously conservative society.

In one scene in the documentary, which was directed by Feras Fayyad and offers a fly-on-the-wall glimpse of the hospital’s daily operations, a man looking for medicine for his sick wife asks Ballour if he can speak to the manager.

“I am the manager,” she responds.

When she informs him that the hospital has no more medicine, he pushes back. “Find me someone who can help. A male manager who can do a better job,” he says.

“Are hospitals with male managers able to get you the medicine?” Ballour responds, calmly, quietly.

“Yes,” he insists, “women should stay home, not work.”

It is only after one of her male colleagues steps in to defend her that the man relents and leaves.

But Ballour said she had noticed a slight shift in perception. “Some men said, ‘the hospital was very good, you were right, you did a great job.’”

“That’s why I believe we can change the community,” she added.

In 2018, Assad’s Russian-backed forces intensified their attacks on Ghouta and, according to Ballour, offered the remaining residents a choice: Leave in buses or stay back and be killed. So she and her team made the difficult decision to close down the cave and leave, moving first to Idlib in northern Syria and then crossing into Turkey, where Ballour has been for the last two years.

Since she fled, her circumstances have improved and she has found fleeting moments of levity. In the summer of 2018, she fell in love with a man named Hamza whom she had been in touch with digitally while she was in Syria but met in person only when she arrived in Turkey. Within a month, they got married. “I liked him,” said Ballour, blushing and cracking a rare giggle as she spoke of their love story. “We have the same things we care about. I felt comfortable when I met him, as if I knew him for a long time.”

In January, she was awarded the Council of Europe’s Raoul Wallenberg Prize for her humanitarian efforts. Last weekend, she attended the Academy Awards in Los Angeles, Calif. And, today, she and her husband are applying for asylum in Canada, hoping to start afresh and move forward.

But the memories of the war continue to haunt her and make it difficult for her to work with children again. “When I see sick children, they remind me of my children in Ghouta,” she said referring to all the children who came through the cave and she considered her own.

“I can’t forget them.”

Here are three articles from The Times you may have missed.

  • “I just wanted to travel with women who enjoyed motor-biking and not shopping.” More than 3,500 women from 79 countries have spent a year circumnavigating the globe on two wheels, logging some 63,000 miles. [Read the story.]

  • “I would never put myself in that position.” One of The Times reporters who broke the story of Harvey Weinstein’s alleged abuse more than two years ago spoke with Donna Rotunno, the lawyer behind Mr. Weinstein’s legal strategy. [Listen to the podcast.]

  • “Leftover women.” The Chinese government, in an attempt to pressure single women above the age of 27 to get married, labels them sheng nu or “leftover women.” We follow one woman as she navigates the social pressure to find a husband. [Watch the Op-Doc.]

Many stars chose to walk the red carpet at last weekend’s Academy Awards in the safe, glamorous looks of Old Hollywood. But the handful who chose to, as our chief fashion critic Vanessa Friedman put it, “throw down the gauntlet and change things up,” stood out.

Natalie Portman (above) wore a Dior gown and a black cape with the names of the female directors who had been snubbed by the Academy embroidered in gold, including Lorene Scafaria (“Hustlers), Lulu Wang (“The Farewell”) and Greta Gerwig (“Little Women”).

In Her Words is written by Alisha Haridasani Gupta and edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Sandra Stevenson.

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