Daniel Etter for The New York Times
Dr. Housam Moustafa, a surgeon in training, treated a Syrian rebel at a clinic in Reyhanli, Turkey.
GAZIANTEP, Turkey — Six months after Syrian secret police officers led Dr. M. Nour Maktabi away from his Aleppo clinic, the morgue at the university hospital summoned his family to collect his corpse.
At first glance, his three brothers thought it was a mistake. When they had last seen Dr. Maktabi, in May 2012, the 47-year-old chest specialist weighed a doughy 200 pounds. The dead man was covered in wounds and emaciated, weighing less than 100 pounds — "a bag of bones covered in flesh," as his younger brother Wadah put it.
But on closer inspection, the brothers found Dr. Maktabi's name inked in small letters on the bottom of one foot.
It was a grim but not uncommon fate for Syrian doctors and other medical personnel whom the government suspects of treating wounded rebels. More than 100 physicians have been killed and hundreds more have disappeared into Syrian jails in the last two years, according to doctors and opposition organizations. The government reviles treating wounded rebels as "akin to carrying weapons," said Wadah Maktabi, a pharmacist.
Embattled cities like Aleppo and vast swaths of the countryside suffer from an acute shortage of doctors and medical supplies, with the government's deadly campaign an important factor in prompting doctors to flee. Because of the shortage, all kinds of people with little previous surgical experience — dentists, medical students and nurses, not to mention car mechanics and bakers — are now performing minor surgery.
Numerous untrained volunteers have been talked through operations to the point where they can now extract a bullet from an arm or a leg, but not from more complicated spots like the chest or the throat.
In a report in March to the United Nations Human Rights Council, the Independent International Commission of Inquiry on the Syrian Arab Republic accused both sides of targeting medical care as part of their military strategy. "Medical personnel and hospitals have been deliberately targeted and are treated by parties to the conflict as military objectives," the report said.
The 10-page report documented a litany of abuses by government forces and rebels: Treatment has been denied on sectarian grounds. Hospitals and clinics have been attacked. The government and rebels have limited care in medical facilities to their own supporters. Doctors and nurses have been forced to accept the bodies of executed opposition fighters and to register them as deceased patients.
"Doctors and field hospitals are being systematically targeted like all revolutionary activists," Razan Zaitouneh, a founder of the Violations Documentation Center, a Syrian human rights organization, said via Skype from Damascus. "Targeting doctors, bakeries and aid workers is all a way to strangle rebels and their families."
Doctors Without Borders has also documented how both sides have devastated health care across the battered nation. "Providing medical care was transformed into an act of resistance, a crime, and medical structures became military targets," it said in a report this month.
Some medical centers established for rebels by the Free Syrian Army barred civilians, which increased the chances of the government bombing them, the doctors' report said. Both sides also looted hospitals, it said.
Dr. Mohamed Wajih Joumah, a surgeon and the former head of the Aleppo medical association, said that of the 12 large government hospitals in Aleppo, six had closed. Only about 35 doctors are working at or near the front lines, Dr. Joumah estimated, but others put the number at closer to 100. There were once at least 2,000 physicians in the city, doctors said.
Many specialists are missing, including trauma surgeons, vascular surgeons and anesthesiologists. Important diagnostic machines like CT scanners no longer work.
Battle injuries can usually be treated in some form at the 72 field hospitals in northern Syria, Dr. Joumah and other doctors said. But people with chronic illnesses like cancer or new outbreaks of contagious diseases like tuberculosis fare worse.
They rarely find the drugs they need, or if they do, they often face prohibitive costs like $30 per vial of insulin. Aleppo had been the center of Syria's extensive pharmaceutical industry, but the factories have ceased production.
Barring increased aid, the overall outlook remains grim.
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