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After five years of war, the doctor working in a Syrian border clinic thought he had seen everything. But with last week’s Russian bombing raids, there was still worse to come.
The latest surge in Moscow’s air campaign was causing wounds so extreme that traumatised staff were working 24 hour shifts to cope with the severity and volume of the injuries, Dr Adel said.
“We’re not even treating wounds anymore - the bodies are just blown to pieces,” the doctor, director of a rehabilitation clinic near Turkey’s Oncupinar border crossing, said.
His staff said that most of the injured were civilians, due to indiscriminate bombing of built up residential areas, including those in which residents were seeking shelter from bombing elsewhere.
The casualties of Syria’s war are scattered among hospitals and backstreet clinics throughout southern Turkey.
For more than three years, when rebels swept into the east of Aleppo many of the casualties have ended up in Kilis, nestled against the Turkish side of the border 40 miles to the north. Since Russian jets and pro-regime forces launched their latest attempt to encircle the city, the injuries have come in a flood.
The director of an unofficial shelter, who like Dr Adel and other doctors, all Syrian, asked not to give a full name, said his staff were witnessing “extreme” injuries” and that the rate of amputation had soared.
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“Sometimes our nerves fall apart,” he said. “Sometimes we cry. These men are our people, and our families are the ones fleeing.”
One of the shelter’s usual patients, a 75 year old man from Aleppo, was absent on the day of The Telegraph’s visit. Staff said he was at a condolences ceremony for the sixth of his sons to have died in the conflict.
In interviews from their hospital beds, rebel fighters said that Russian air power had transformed the battle for Aleppo’s north, grinding down its array of opposition groups before sending in ground troops for the final push.
“When it was just the regime that bombed us, one or two low-flying planes would set out to bomb our villages, and that was it. But the Russians, they strike us continuously,” said one man, pulling back his blanket to reveal a gaping hole in his femur. He said it had been caused by a bomb he didn’t even hear coming.
Moscow waded into the Syrian war at the end of September, launching an air campaign that has tipped the balance in favour of President Bashar al-Assad’s regime.
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In Aleppo, it allowed Iranian-backed Shia fighters from the Lebanese militia Hizbollah, Afghanistan and Iraq to achieve in three days what government forces had failed to do in two years - encircle the rebels and break a longstanding sieges on two nearby Shia towns.
That offensive forced more than 35,000 Syrians to flee, with most now camped in squalid conditions along Turkey’s closed border, waiting for it to open.
Turkey’s deputy prime minister, Numan Kurtulmus, said last night that the country, which is already hosting more than 2.5 million Syrians, had “reached the limit of its capacity to absorb refugees”.
But he added: "We are not in a position to tell them not to come. If we do, we would be abandoning them to their deaths."
Mr Kurtulmus estimated that as many as one million more refugees could flee Aleppo and surrounding areas, putting huge pressure not only on his own country’s asylum policy but, down the line, that of Europe.
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In a refugee camp at the Oncupinar crossing, Syrians said their trailers were shaking each night with the force of bombs across the border. Some said their relatives on the other side of the closed crossing were preparing to return to the villages they had fled from, accepting that they would die.
“My sons knew they wouldn’t get through, so they have gone back to their homes,” said a man who gave his name as Abu Mohamed. “I only wish that I could go with them. I am no better than them. They deserve death no more than me.”
On the battlefield itself, pro-government forces pressed ahead with their offensive. Opposition activists said Shia fighters were engaged in heavy clashes with insurgents around the village of Ratyan, north of Aleppo.
An official with one of the province's main rebel coalitions, the Levant Front, said the regime and Russia had also launched more than 150 strikes on three villages between the two regime enclaves it had linked up in last week’s lightening offensive.
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“Assad’s regime and army have been finished for more than two years - now we are fighting sectarian militias and Russia,” said Mohamed Yasser, a member of the Levant Front’s political bureau.
The battle for north Aleppo may prove to be a turning point in the war. As well as threatening rebel positions across the province, it could put large parts of the Syrian-Turkish border under the control of pro-Assad forces within a matter of months.
Although the war has claimed more than a quarter of a million lives, doctors in the Kilis rehabilitation shelter said no one could yet appreciate the toll it had taken on their country.
“It’s only when we return to Syria one day that we’ll see how many amputees, how many widows, how many orphans there really are,” said one medic. “That’s when we‘ll learn what this war has done to us.”
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