Surrounded by sweeping, lush green hills in south-west England, Dr Thaier Al-Hussain is far from his home in Raqqa, Syria.

Located in the little town of Yeovil, an hour’s drive from Salisbury, his new home is nestled in the British countryside, tucked far away from cosmopolitan London. It is a much quieter environment than the city centre of Cardiff where he was based before. “It’s calmer here, the hospital is opposite where I live,” he says, smiling.

Fond of Game of Thrones and How I Met Your Mother, and with artwork sitting on his kitchen table, Thaier’s life, on the surface at least, seems tranquil enough. “This is my wife.” he jokes, pointing at a life-sized human skeleton model. I asked after his family, who have been living in Strasbourg, France, for nineteen months, fighting for asylum after leaving Turkey. “It’s difficult for them being stuck in their flat all day with no jobs and so much uncertainty, but hopefully their appeal for asylum will be successful,” he explains.

Before the war in Syria, Thaier had left Raqqa for Armenia to study medicine. There he enjoyed cooking and nightlife, learnt a new language, and completed his studies. His father, a cardiologist in Raqqa, and his mother, an elementary teacher, had convinced him to become a doctor at seventeen. With four brothers and a sister, and many relatives spread across Raqqa, he was in a competitive environment and had a family legacy to uphold. “Medicine was a family business, and my father passed on that mission to me,” Thaier remembers, “I was his candidate.”

In 2010, he returned to Raqqa and was preparing to specialise in plastic surgery. On his return, however, Syria had already begun its slide towards revolution and civil war. As the Arab revolutions produced a domino effect across the turbulent Middle East, protesters clad in the green and black colours of the Syrian revolution protested against President Bashar Assad’s government.

Thaier has mixed feeling about the president of Syria: “Bashar Assad is a criminal, a psychopath. The way he talks about things and the denial he is in is terrible. Initially, he tried to evolve the country in his first decade in power as president. He was getting rid of the old guard and trying to change the regime of his father. He was a dictator, yes, but he was building ties with Erdogan and King Abdullah, and we were close to almost getting visa-free access to Turkey.”

Thaier’s family were divided over whether Assad should stay in power or step aside: “My brother was very optimistic. He believed Assad would fall within six months because the Western powers and the Arab states would not allow the Syrian regime to kill protesters and act with impunity,” Thaier says. adding that his brother, like many young Syrians, admired the revolutionaries and activists taking to the streets against Assad’s security apparatus. “There was rage against the Syrian regime and the system of governance. People were getting tired of asking for favours for basic rights from state institutions.”

Thaier’s brother soon became deeply involved in activism, promoting, organising and leading protests against the Assad government. “He was brave and irresponsible, but if the world doesn’t have people like him, the world doesn’t move forward. People like my brother are the ones who usually get killed first.”

Thaier himself was more sceptical about how the revolution would implement its goals. These doubts were rooted in the long-term political and economic governance of the country, which had existed for decades prior to the revolution. Corruption was commonplace before the war, and livelihoods and families were dependent on the government’s good-will and complex networks of bribery to survive.

“It took the Assad regime over four decades to implant their system of corruption and bribery. It’s embedded in the blood of people in Syria. Nothing moves, no documents get signed, you can’t do anything in Syria, until you pay money to someone -  that is the norm,” he says. “You can’t change that system overnight. People are making a living from this status quo and have too much to lose from the regime falls.”

As the civil war consumed Syria, daily life became increasingly affected by the conflict and Thaier, rather than specialising in plastic surgery, found himself frequently performing trauma surgeries. Water and medical supplies began to dwindle in war-zones, as Thaier travelled to and from the hospital in darkness and worked under the sound of bombs and air raids. “It didn’t feel real. It doesn’t feel real until it starts happening to your own city.”

The Syrian regime’s intelligence apparatus (the Mukhābarāt), which has been incarcerating and torturing thousands of its own civilians for decades, was everywhere, and as the revolution tightened, it escalated its operations.

Thaier was less surprised by torture, than the number of disappearances. “Many of my friends were detained and vanished. I couldn’t believe, I couldn’t imagine, the sheer scale of the disappearances that occured.” At hospital, Thaier and other doctors were forced to fabricate diagnoses to protect protesters and activists injured by Assad’s war machine from the Mukhābarāt,  who regularly patrolled the wards.. “I treated them and usually asked ‘Why the hell did you come to the hospital when you have this type of injury? They will catch you, arrest you, and take you to prison where you’ll disappear.’

In 2013, the situation changed for the worse. A coalition of rebels including Jahbat Al-Nusra and the Free Syrian Army captured Raqqa. Within just a few hours, they emerged victorious and proceeded to rip down the golden statue of President Bashar Assad's father, Hafez Assad, in the city square.

 The military expertise of the jihadists and their firepower bolstered the Syrian revolutionaries and overwhelmed the 400 Assad loyalists garrisoning Raqqa. Islamic State seized control and soon absorbed other Syrian towns and cities such as Deir-ez-Zor, Palmyra and pockets of Aleppo, as well as Iraqi cities including Mosul, Ramadi, Fallujah, Tikrit, and Sinjar, into their growing ‘caliphate’. 

“I left a week after Islamic State arrived. The city wasn’t ‘liberated’, it was gifted to them by the Syrian government and military,” Thaier says, adding that the rise of Islamic State in Syria sounded the death knell of the Syrian revolution. “Assad wanted to let the rest of the Syrian population know exactly what would happen if a whole city fell under the control of the opposition.”

 Thaier’s family home was badly damaged by rocket fire within the first five days of the city being under rebel control. They left for the border town of Tal Abyad, and Thaier joined Doctors Without Borders.

Under Islamic State, life became increasingly perilous as the jihādists imposed control over every aspect of civilian lives. The fundamentalist police, Hisbah, executed people by public beheadings and crucifixion, whipped dissidents, tortured and mutilated smokers, and stoned women to death. Women were forced to wear the niqab and male doctors were forbidden to treat female patients. The sexual enslavement of women and young girls became a normalised feature of life in Raqqa post-2013. The fate of hundreds who disappeared into IS prisons remains unknown and rape, extortion and looting were common in Islamic State’s Syrian ‘capital’. On certain levels, there was little difference between the Islamic State’s hisbah and Assad’s Mukhābarāt.

“I started laughing when Islamic State declared Raqqa their capital,” Thaier says. “What was so sad was that people bought into their lies. It was due to a lack of education that the Islamic State was able to poison so many minds.”

Activists and doctors alike were targeted by both jihadists and the Assad regime. In June 2013 in the town of Tal Abyad on Syria’s Turkish border, the ethnic conflict intensified between Islamic State and Kurdish guerrillas. An agitated Islamic State leader, with a grenade on his belt and carrying a gun, confronted Thaier and his friend as they were on the way to work.

“My friend, who was a nurse, and I were walking towards the hospital when the man started punching him and broke his glasses. He was angry that we were not treating a fighter who had injured his foot. He shouted: “You doctors think you are so smart, once we’re done here, we’re coming after you.” He could have killed me, and that was when I made the decision to go.”

Following the death threat, Thaier left Syria in August 2013 and became a refugee in Turkey. He was later granted asylum in the United Kingdom and Raqqa quickly became the epicentre of the so-called ‘War on Terror’ as the United States and her allies began a campaign to drive Islamic State from the city, and destroy its ‘caliphate’.

Life under the occupation of Islamic State became even more violent and cost thousands their lives. Improvised explosive devices, drones, sniper fire, suicide bombers; child soldiers, and ideological trained units of hard-core soldiers were all part of the package facing SDF and YPG defence forces in rubble-strewn Raqqa.

Civilians became human shields as Islamic State foot soldiers occupied their homes, hospitals, mosques, and schools - a tactic replicated from defensive operations in Iraq during the sieges of Mosul and Fallujah. Attempts to flee Raqqa were made difficult, if not impossible, as those who attempted to flee faced execution or were cut down by coalition airstrikes and Islamic State sniper fire in no-man's land.

Civilians in Raqqa also faced frequent air raids by Syrian and Russian air forces, as well as U.S-led airstrikes and artillery that shelled families in their homes and critically damaged Raqqa's infrastructure. Thaier’s prediction that his city would be destroyed had sadly become a reality.

“When the opposition first captured Raqqa, I told my parents that we had to leave. I told them that the Syrian army would level the city.” However, it was to be the U.S, the United Kingdom and France who would inflict the most damage. According to Amnesty International’s report published in 2018, the US and its allies inflicted devastating loss of life on civilians in the ISIS-held Raqqa as the city centre was pulverised. “Seventy per cent of our five-storey building was levelled by airstrikes,” Thaier remarked.

With Islamic State now defeated and Raqqa now under the control of the SDF and YPG, the question of how countries should deal with their citizens who left to fight for the terrorist organisation has divided the international community.

Thaier has mixed feelings about the foreign fighters who had occupied his home city: “In Raqqa, there was a mixture of people. We had Christians, Kurds, Arabs and a secular and religious community.” When the foreign fighters began arriving, their ignorance and fanaticism scared people.

Indeed, the fact that foreign fighters and extremists from abroad often imposed Sharia law on civilians bred resentment amongst the local population and activists who opposed Assad’s government and the extremist ideology of militant Salafi-jihadists such as Baghdadi and Julani, leader of Jabhat Al-Nusra.

“Syrian communities were frightened by these people and their extremist views. They didn’t understand Syria or the basic tenants of Islam - some of them didn’t even speak Arabic,” Thaier explains. “They were clearly searching for a purpose in their lives and were troubled people. I don’t want to imagine what they must have been going through in their home countries. A question of faith may have motivated them and they may have wanted to do something profound to redeem themselves in the eyes of God. What better way to do it than die in Syria in jihad? It is escapism.”

Reflecting on swelling new refugee camps such as Al-Hol, where 15,000 members of Islamic State now languish after the fall of Baghuz, Thaier is less sympathetic to the plight of the adults than their children.

“I understand people’s sentiment, but these people chose to join the Islamic State. Children born under the ‘caliphate’ are a different story, but the adults made a conscious choice to join a genocidal organisation, groomed or not groomed. Shamima Begum, for example, was promoting the killing of other people and Islamic State’s hate and extremist ideology. People like her must pay the consequences for their actions.”

Back in the English countryside coping with post-traumatic stress (PTSD) and emotional exhaustion has been challenging for Thaier. “It was difficult to see so many innocent people pay the price. They didn’t support the opposition or the Assad regime. They lost limbs, lives, hopes and homes. After everything you have seen in war, things don’t surprise you anymore. You become desensitised to everyday problems in normal life,”  he says.

Thaier still wants to return to his home of Raqqa one day, despite the decimation of huge swathes of the city but is unable to do so until the country finds peace.

“For now I’m thinking of staying in the United Kingdom until the situation calms down in Syria until I am absolutely certain it’s safe to return. My brother can never return while the Assad government is in power.”

Despite being a refugee, Thaier remains determined to move on from the conflict. “I can’t keep thinking about the past or I’ll never move on,” he says smiling. “This year is the first time I feel like I have a life and a home.”

The journey that shaped me: dr. tHAIER AL-Hussain speaks at tedx talk at the courtald institute in march, 2018

Thaier Al-Hussain

Dr. Thaier Al-Hussain is a medical doctor who worked in Syria during the early years of the conflict and joined Doctors Without Borders in April 2013. He worked for Doctors Without Borders until August 2014 and moved to London to study for Masters in International Health at UCL. He founded 6abibak, an Online Arabc Medical Journal which is now one of the largest followed health journals in the Arab world with over 14 million followers on Facebook.