Dr. Jay Dahman normally works in a hospital where the windows haven't been shot out during a gunfight.
But the pediatrician from Toronto quickly settles down to work in the main medical centre in Anadan, a town just north of Syria’s largest city, Aleppo.
"This is where it happens, this is where the action is," Dahman says, surveying several rooms in the basement of the hospital where most of the treatment is given. The doctors who run this centre had to move most of the primary care facilities underground a few months ago after the Syrian regime tried to bomb the building.
Dahman has just completed his third visit to Syria, along with Mark Cameron, an advanced care paramedic from Peterborough, Ont. Both men care for those wounded by war and train doctors and medical staff at various clinics throughout the countryside of Aleppo province.
"This crowd is going to start saving patients that have previously been dying here, with the 15 or 20 minutes of training we can give them," said Cameron.
Cameron and Dahman came with a computer and a slideshow to show doctors and nurses new ways of stabilizing patients so they can be moved to larger medical facilities over the border in Turkey.
They are thought to be the first medical staff to bring tranexamic acid into Syria. Also known as TXA, it's administered by injection to reduce blood loss by closing trauma wounds internally. That makes it especially useful in situations where doctors would otherwise have to use blood transfusions in war zones.
"They have a shortage of blood here and whatever they have, much of the blood they have is tainted with infections," said Dahman, who usually works at Toronto’s Humber River Regional Hospital.
Dahman volunteers with the Syrian American Medical Society, a non-profit humanitarian group that organizes medical care in Syria by North American health professionals.
Dahman, 43, was born in Toronto but is of Syrian origin. Coming back to perform medicine where his parents were born has a special significance.
"I’m not an activist, I’m not a politician. I’m here as a physician, as a humanitarian. Leaders of the world need to step up and prevent what’s happening here," from getting even worse, Dahman said.
As a pediatrician, he is used to working with children back in Canada with critical injuries. But he admits that he finds the cases he faces inside Syria even more upsetting.
Last week, Dahman visited a hospital in Al Bab, outside Aleppo. There, he treated a 15-year-old boy who was shot while driving away from a Syrian military checkpoint. The boy suffered severe wounds to his digestive system and kidney.
Dahman said the boy’s prognosis is improving. But he's worried about what the future holds for the young man.
"You know, you’re fixing him and he’s going to walk out of this hospital and may sustain another injury or a bomb or a blast or a sniper. He may end up either in the hospital again or dead.
"It’s really, really heartbreaking."