She is hope for humanity5
By Simi Jan
Photo: Stine Heilmann
She risked her own life to save thousands of others in a secret underground hospital during the Syrian war. A year and a half later, she is still haunted by that season in hell. But Amani Ballour is determined to help other women overcome the trauma of war because she knows firsthand the importance of keeping hope alive.
The light that streams through the thin curtains of the apartment in Turkey illuminates a face that looks far younger than its 32 years. Her figure is slight, her voice soft and calm. If you didn’t know her story, you would never guess that, for years during Syria’s bloody war, she ran a secret, underground hospital. You would never guess that she saved thousands of women and children. You would never guess that she is what hope looks like.
The Cave, they called it, the secret hospital tunneled beneath the earth, where pediatrician Amani Ballour risked her own life to save the injured. The Cave is also the title of an Oscar-nominated documentary that traces the heroic work she and her colleagues performed, cut off from supplies of food and medicine, in a city under siege. For her humanitarian efforts, Amani was recently awarded the Raoul Wallenberg prize. She is grateful for the recognition because she believes it will help her in her new life, as she launches a project designed to help women struggling to overcome the lingering effects of trauma, which is to say women like herself. For although Amani faced unbearable horror in the Cave, she somehow managed to turn it into a place of hope. And now, she wants to bring that hope to others.
“I was always very determined, always wanting to challenge the norm and change things”
The Girl Who Climbed Trees
“I was always very determined, always wanting to challenge the norm and change things,” Amani admits. “I was a little rebellious.” As a child, she would climb trees with the boys, despite her mother’s and neighbors’ constant admonitions about what girls were not allowed to do. Unlike her sisters, who married while still in their teens, she decided to continue her education. She had offers, and her mother insisted she take them, but she convinced her father to let her study.
She grew up in Eastern Ghouta, a village on the outskirts of Damascus, in a large house with a beautiful garden with a big olive tree. By and large, it was a happy childhood, with playmates and birthday parties, daily trips to the bakery for fresh bread, hens and goats to tend. But she was afraid of her father, who frequently yelled at her, her siblings, and especially at her mother. “She didn't defend herself,” Amani says. “I saw our weak mother and decided not to be like her.”
That seed of strength continued to grow. As a child Amani dreamed of becoming a doctor, because it was a prestigious profession that required the highest scores. But in high school, she changed her mind. “I wanted to become an engineer, because everyone said a girl cannot become an engineer,” Amani recalls with a soft laugh. “I always wondered why there were restrictions for girls and not the boys. I wanted to change something, challenge them.”
But pressure from her parents and society at large forced her to give up her engineering ambitions. She reverted to her earlier goal, and, in 2007 began studying medicine at Damascus University. There, she took classes with men, and met other strong women— students and lecturers—who inspired her. She told herself once again that she would never become like her mother.
The Cave, the documentary
The Cave premiered at the Toronto International Filmfestival in the autumn of 2019, and has gone on to win several international awards.
Directed by Feras Fayyad, the film was produced by Kirstine Barfod and Sigrid Dyekjær from Danish Documentary Production, and was funded by National Geographic, TV2 Danmark and International Media Support.
National Geographic is broadcasting The Cave on TV and streaming it in 171 countries. The film is also being screened in cinemas around the world and at a number of festivals.
War and Plastic Surgery
If she had known what the war would become, she would never have gotten the nose job. For all her confidence, Amani’s nose had always bothered her, making her feel ugly and unwanted. In 2013, with her studies well underway, she decided to have it fixed. The surgery made her happy, and her self-confidence grew. It was only later, when the instruments and medicines—even the bandages— used in the operation were in critically short supply, that the guilt would come.
The war crept in like a crafty snake. At first, in 2011, there were just protests, a few police control posts, a few bombings. Amani wasn’t alarmed; she continued her studies. Like everyone around her, she was certain the international community would intervene to stop president Assad as he cracked down on protestors. But there was so much she didn’t know then. She didn’t know that, in her village, the trees she loved so much would disappear, hacked down for heat and cooking. She did not know that death would sweep in like a cyclone, and leave nothing but a dark, devastating shadow.
The international community did not stop Assad. In 2013, soon after Amani had cosmetic surgery, Eastern Ghouta was besieged. At the time, she had earned her basic medical degree, and was pursuing advanced studies, but it soon became too dangerous for her to travel into the city. She quit school as well, and devoted herself instead to working in a place she had recently learned of: an underground hospital where they treated the injured in secret.
When Amani started, the hospital was comprised of just three rooms tunneled beneath the earth, but it—like the war—would expand. No daylight got through, and the doctors and other staff were plagued by shortages of equipment and medicine. Amani quickly became accustomed to the smell of blood, and to the sound of airplanes overhead. They meant another bombardment, and more victims to treat. On occasions she would slip out to her brother’s apartment, but mostly she grabbed whatever sleep she could at the hospital.
In the midst of all the misery there were small islands of hope. The people they saved, of course, gave the staff the strength to keep working around the clock. But Amani remembers other fleeting moments of humanity too, like Dr. Salim listening to classical music on his smartphone while he conducted surgery, or the nights when she and the other staff would sit around fantasizing about pizza and pasta. There were the high-heeled, black and cream-colored sandals she bought during the siege, on the street where she used to shop for clothes before the war. She wore them to work at the Cave because they made her feel tall and feminine and normal. Those sandals were the only thing apart from her black coat that she would take with her when she left the hospital for Idlib.
“This film is my testimony. All the dead had a story. It is my obligation to tell their stories.”
After four years in the hospital, Amani, then 29, nominated herself for promotion to the job of manager. She quickly ran up against sexism, even there. An ambulance driver started a petition to make her step down as a manager. “He used to shout at me, sometimes I shouted back,” she recalls. “But he didn't get signatures, so he gave up.” And it wasn’t just men; women too accused her of being unqualified just because of her gender. “It’s an important job, are there no men here?’ people would ask.”
But some of the men, like senior surgeon Dr. Salim, defended her when others began questioning her title, and their support helped swing the tide. But even after she won the majority of the staff’s votes, Amani knew she hadn’t convinced everyone. “I wanted to change their mind, but it was a heavy load on my shoulders. If I failed as a manager, they would judge all women. So, I didn't have a choice, I couldn’t fail.”
Yet however difficult the battle to prove herself was, there was a much worse fight happening every day: the fight to save lives. And then came the worst fight of all, the night she will never forget.
Children died because I didn't help them
The square in front of the hospital was packed with the bodies of women, men, and children. Some were dead, some were unconscious. But the worst were those who were suffocating, the ones who screamed helplessly as they fought to breathe, their eyes begging, their bodies trembling.
Amani’s heart galloped. Her mouth was dry, her eyes glazed with shock. She had been awakened in the middle of the night and told to rush to the hospital. Now, she wondered if she was still asleep. Was this a nightmare? Or was it a reality worse than all the death she had already witnessed in the past year? She ran through the sprawled bodies to enter the hospital. It was there she learned that Assad had attacked his own citizens with the toxic chemical sarin.
Her colleagues were furiously helping patients. She quickly grabbed medicine and an oxygen tank from the supply room, and sprinted back to the square. By the time she got there, some of those who had been alive just a few minutes earlier were now dead. She saw a man she knew, someone who had been so happy when he became a father a few years before, now sobbing as he carried the lifeless body of his child. She put the oxygen mask on one child, and watched another, lying nearby, die. Mothers screamed for her help. Desperate relatives, who knew she was a pediatrician, yelled at her. She was their only hope.
Every second counted as she tried to save as many lives of those lying around her as possible. Another child was blessed with her oxygen mask, but for every lucky one, several paid the ultimate price. “I had to choose,” she says now, her brown eyes wet, her voice thin. “I had to decide: I will help this child next to me and see the other child die in front of my eyes. I only had one oxygen mask. I saw children die because I decided not to help them.”
“I had to decide: I will help this child next to me and see the other child die in front of my eyes.”
One woman, a mother that Amani knew, screamed desperately for help. Her children used to come to the hospital for asthma treatment. They were always smiling despite the bombs falling around them, and Amani would try to make them laugh. But that night there was nothing she could do. “I will never forget that look,” she says. “I wanted to support her, but I couldn't. Her kids were dead, I had to save other kids. I wish I could explain to her that I had no choice.”
As she recounts this, Amani pauses, lost in a no-man’s land of pain, guilt and sorrow, before reaching for her phone. “We didn't have a fridge for the dead bodies, so we buried them in a mass grave after two days. The smell was…we couldn't wait. After one or two weeks, relatives kept coming in search for their loved ones, and we showed them pictures we had taken of all the dead bodies.”Now, she flips through a few: children, lying on the ground, some with their eyes closed, as if relaxing after an active day. “They don't have any blood, no injuries, you see. They look like they are sleeping.”
They weren’t sleeping. The chemical attack, which UN secretary general Ban Ki-Moon would label a war crime and describe as “the worse use of chemical weapons on civilians in the 21st century,” killed over 1400 people. “We couldn't even close their eyes,” Amani recounts. “It was so scary to see them.”
The film is my testimony
Amani prepares coffee in a small silver mug on the stove in the small kitchen in the living room. She loves the smell of Syrian coffee, though it makes her long for her home. Her new apartment is quiet and clean, but its white walls are bare, and the furniture is not her own. It is obviously a temporary place, a stopover before she finds something more permanent – maybe in Canada or somewhere else that’s safe. She doesn’t feel safe here, for she knows the Assad regime has eyes everywhere. “I heard that the Assad regime is watching me, that they want to kill me,” she says. “They deny the chemical attack and want to get rid of the witnesses. We were very few doctors who saw it.”
Still, she doesn’t regret participating in the documentary that bears the name of the hospital. “This film is my testimony. All the dead had a story. It is my obligation to tell their stories.”
She often wishes she were still there, still helping, still making a difference. Reluctantly, she left the hospital in 2018, evacuated by bus, and heartbroken to leave. But there was no alternative: it was too dangerous to stay. Among her colleagues who stayed behind, one doctor is in jail, another was killed while imprisoned.
Amani fled first to Idlib, the opposition-held territory in northern Syria. There, she received a call from a man named Hamza. He had seen the interviews she gave to foreign media while she was in The Cave, had seen her efforts to persuade the international community to intervene and halt the massacres and the brutality. Hamza admired her courage, and when he called, he confessed his love for her.
At the time, Amani was tormented by feelings of uselessness and guilt. “I stayed at home, alone with just my memories,” she says. “I had many nightmares. I remembered the children. I felt guilty, I felt like I had lost my life. Like there was no future.”
“Every month I was afraid of becoming pregnant. I was scared my child would remind me of the children in the Cave.”
She had been offered a job at a children's hospital, but as soon as she arrived and saw the patients, a feeling of dread descended on her, and she couldn’t breathe. “Every child reminded me of my children in the Cave. I couldn't look at them,” she says. “There were so many that last month that I saw lose an arm or a leg. Or die.” She left the hospital in tears.
It was in the middle of this hellish time that Hamza made his miraculous phone call. They met in person a few weeks later, after Amani had relocated to Turkey. Instantly, she felt a connection with him, as if they had known each other for years. He proposed on the spot, and she said yes, even before talking to her parents, who were still in Syria. Unusually in a society where parents normally choose their daughters’ husbands, Amani’s didn´t know Hamza – they had only spoken to him by phone when he called to ask for their daughter’s hand. But when Amani rang too, in order to get her father’s consent, he told her, “You make your own decision, you are grown up. I trust you.” It moved Amani to tears when she heard it—and still does. “That was something extraordinary, very unusual for my father.”
Yet her newfound happiness couldn’t erase the trauma of the past. “After I got married I didn't want children,” she recalls now. “Every month I was afraid of becoming pregnant. I was scared my child would remind me of the children in the Cave.”
These days, that fear is still with her, but it has diminished, and she can’t say for sure how she would react now if she found out she was pregnant. But her father sends regular messages asking when she will have a baby, and telling her to take care of Hamza, whom he says he likes, though they still have never met. She laughs as she relays this, for a moment forgetting the bad memories .
From the Cave to the Hope
In all of this, Amani has found a new cause, or maybe it has found her. She is working to establish a foundation that will help women move on from the trauma of conflict. “So many women lost their husbands in the war,” she says. “I want to teach them skills, so they can get jobs, support their children, and become independent.”
The foundation will also help educate both sexes about women’s rights. Some of the men who opposed her presence in the Cave ended up thanking her in the end, so firsthand experience has also taught Amani that it is possible to change men’s ideas about women’s roles. “We have to teach them, for example what the Quran says about women's rights, for the holy words are wrongly interpreted by some men in order to suppress women.”
Amani Ballour’s foundation, Al Amal
The foundation helps women in conflict zones by recruiting and funding female medical workers who can provide healthcare and assist affected populations. It also trains future generations of female leaders in conflict zones to break down gender barriers.
You can donate money to and learn more about Amani Ballour’s Al Amal Foundation via this website here
And finally, she hopes to create role models for young women—people like Malala Yousafzai or Angelina Jolie or…herself. “While I was in the Cave, a lot of girls told me, ‘I want to be a doctor and manager like you.’ It made me so happy. I always told them: yes, you can and don't let anyone prevent you from it.” Her eyes light up when she talks about the foundation, and it’s obvious to see that the project has become her life’s work. The foundation’s name is Al Amal, which means ‘the hope’ in Arabic.
Deep in her soul, Amani still struggles with her memories of the war. She still freezes at loud noises, still flinches every time she hears an airplane overhead. She sometimes wakes up in the middle of the night screaming. In her beloved country, the war grinds on, and people are killed every day. Many of her friends and neighbors are dead or vanished, including her older brother and brother-in-law, both of whom were arrested by the security forces nine years ago and have not been heard from since. She has not seen her parents since she left, or the old olive tree where she would drink lemonade as a child, but they tell her it still stands. She hopes to introduce Hamza to them all one day.
When she was still in the Cave, her father used to leave messages of love and encouragement on her voicemail. They were like oxygen to her. ”My daughter,” he would say. “At some point, people will forget the war. But they will never forget you. I'm proud of you. Remember that your plants are waiting for you to come back home.”
5’s team in Turkey
Stine Heilmann is a renowned Danish photographer. With over three decades of professional experience, she specializes in distinguished, unique portraits of women around the world.
Simi Jan is an award-winning foreign correspondent at TV2 Denmark who covers the Middle East, Afghanistan, and Pakistan. Based in the region for the past several years, she is a best-selling author, and a well-respected speaker on conflict and women’s rights.