Episode 436: Rising Above War in “The Underground Cave Hospital” in Syria with Dr. Amani Ballour

In today’s special episode, we are honored with the presence of Dr. Amani Ballour, a Pediatrician, Human Rights Activist, and someone who will be remembered as one of history’s great heroines. Throughout this episode, Dr. Amani talks about her journey from being a medicine student to managing “The Cave,” the underground hospital that saved thousands of lives during the Syrian revolution. You’ll also hear her passionate advocacy for human rights, her inspiring message of compassion and resilience, and much more.

Steve Shallenberger: Welcome to all of our “Becoming Your Best” podcast listeners, wherever you may be in the world today. This is Steve Shallenberger, your host, and we have a remarkable guest with us today. She is a renowned Syrian pediatrician and human rights activist. Her evolution from growing up under Assad’s regime to becoming a symbol of hope and determination is extraordinary. Her comparisons to figures like Malala are well deserved, as she has humanized the Syrian crisis and shed light on the pivotal role of women in conflict zones. So, welcome, Dr. Amani Ballour.

Dr. Amani Ballour: Thank you so much. Thank you for having me.

Steve Shallenberger: Before we get started, I’d like to tell you a little bit more about Amani. She is best known for her work during the Syrian Civil War, where she managed an underground hospital known as The Cave in Eastern Ghouta. Her leadership and dedication during this time were the subject of an Oscar-nominated documentary titled “The Cave,” released in 2019. Dr. Ballour was awarded the Council of Europe’s Human Rights Prize in 2020 for her humanitarian work. As we get going today, I’m so excited and looking forward to hearing her story. I know that every one of us, as listeners today, is honored to have you with us. We are going to gain some insights and appreciation for the blessings that we have. So, Dr. Ballour, tell us about your background, including the turning points in your life that have had a significant impact on you.

Dr. Amani Ballour: Thank you so much for this introduction. Well, I grew up in a conservative area in the countryside of Damascus, Syria. I didn’t get married like my older sisters; I continued my studies. It wasn’t very normal and allowed for girls to study at that time in my town. So, I had to always fight to get my rights since I was a child. I wanted to be an engineer, but I couldn’t, due to the thoughts and traditions in my town and the whole area and countryside. They said, “No, you can’t be an engineer; it’s not for girls.” I was very young at that time, so I couldn’t fight to make my dream come true. However, I was very good at school, and I got high marks that enabled me to study medicine. My family was very proud of me because I was able to study medicine and become a doctor. Doctors have a good position in Syria, and I think everywhere. People respect them. So, my family was very happy to have someone become a doctor in the family. I started to study medicine, and then I really liked it. I found it the best way to help people, to help others. I wanted to be a pediatrician because I like children and want to help them. But when I was in my fifth year of studying medicine, the Syrian revolution started. People began to peacefully protest, asking for human rights and democracy, which we don’t have in Syria. Just to give a little idea, in Syria, we have a dictator, and before him, we had his father. For now, more than 50 years, they have controlled everything in Syria. We have no human rights. We can’t say a word about politics, democracy, or freedom. 

Dr. Amani Ballour: People wanted to live like other people, in freedom and democracy, and started to protest. The Syrian regime, unfortunately, started to shoot them, to kill everyone who asked for their rights. Very quickly, they started to bomb the areas, the safe areas, using all types of weapons. The Syrian regime, with its allies, Russia and Iran, started to kill everyone, also in my town. So, I found myself amid this. I was able to graduate from the Faculty of Medicine in 2012. Then, I saw the innocent people in my town. They did nothing but ask for human rights and many other people who did really nothing and didn’t protest. But the Syrian regime didn’t differentiate between them; they just bombed everywhere—residential areas, hospitals, schools. So, I saw these people and said, “Okay, I’m a doctor now. I can help.” I had no experience at that time, but I could do something to help them. So, I decided to stay there to help these people. Immediately, the Syrian regime besieged us, preventing food, medicine, medical supplies—everything. They bombed the area very heavily and tried to kill everyone. The situation was very bad; it lasted for more than six years. I never expected that we would stay for more than six years in that area. We moved underground to work because hospitals were targets of bombing. Doctors were targets. I mean, everyone was a target of bombing. So, yeah, we worked underground for many years. We witnessed many, many massacres. It was horrible. There are no words to describe this. After this, we were forced to be displaced from our country, first to the north of Syria. Then, in 2018, I left the country.

Steve Shallenberger: Do you mind sharing? It’s certainly hard for me and maybe hard for some of our listeners to fully grasp what that must have been like. How did it feel to live in that kind of condition?

Dr. Amani Ballour: As I said, I didn’t expect that I would live in this area and witness a war. I didn’t expect this. I was just dreaming of having a good life, I mean, to be peaceful. Then, I found myself amid this and started to help the people. We said, “Okay, maybe this will end in a few months,” or every time we said, “Maybe tomorrow, something will happen. Maybe next month, something will happen.” But after this, and especially in 2013, a chemical attack happened. The Syrian regime targeted two safe cities during the night. People were sleeping, and the Syrian regime targeted them with sarin gas. More than 10,000 people inhaled poison gas. More than 1,500 were killed that night. Many, many children were killed. They were sleeping; they just were suffocating in front of us. We were just a few doctors and some volunteers. That was a turning point for me to see this. I was sure that something would change after this. I mean, using prohibited chemical weapons against safe civilians and killing them in this way—all these children. I was sure that something would happen. I mean, the international community, the big countries, would not allow this to happen. But in the morning after that night, and I can talk for hours about that night and about what happened in it. I started writing my book about that night because it was horrible. It was the worst thing I witnessed. 

Dr. Amani Ballour: In the morning, the Syrian regime targeted us again with other missiles—not chemical—and killed some people again. Nothing happened. We are in the 21st century; all the people see this. They saw the videos and photos, and nothing happened. Nothing changed. So, I realized that this is our life now. No one cares about us. The Syrian regime wants to kill everyone, and no one cares. It’s like they have a green light to kill everyone. It was really a turning point. I realized that we would last here, maybe forever; maybe all of us would die, maybe we would die tomorrow. But that changed a lot. So, we tried to deal with our new life this way. We decided, especially the health workers, to help everyone, to do our best to do our work. So, we moved underground, working in the hospital. We expanded and tried to smuggle the medical supplies, everything we needed. People in the area made tunnels underground to connect us with other areas to smuggle food and medicine. So, we tried to live every day. We didn’t think about the next day. We didn’t think about the future. I mean, we had no future. We had no hope after this. But still, there was a little hope that maybe something would change, maybe someone would think about us, maybe the big countries would stop this. But we were dreaming and dreaming day after day for more than six years.

Steve Shallenberger: Thank you for sharing that. We appreciate your insights, feelings, and thoughts and are grateful for being able to wake up and live in a place that’s safe and secure, where we have freedom and liberty. That’s a special blessing, isn’t it?

Dr. Amani Ballour: It is. I really appreciate the life I have now. I’m really thankful for the countries that allowed me to live peacefully in their countries. I was living in Turkey and Germany, and now I’m safe in the United States. I’m really grateful for this. When I feel like I’m safe with my kids around me, they are safe and warm, and they are not hungry. That makes me think a lot about the other children and other people who are still in Syria, suffering day by day for more than 13 years—since 2011 until now, and they are still suffering.

Steve Shallenberger: What motivated you, Amani, to share your experience in The Cave? And tell us, is that a book as well? There was a documentary made on that. So, tell us about it and give us some background on that, please.

Dr. Amani Ballour: There’s a documentary called The Cave. We called the hospital “The Cave” because it was underground. It’s unhealthy to be a hospital for the patients, but we had nothing else to do. We worked underground. It was dark, so it was like a cave. That was why we called it The Cave. We started working there for, as I said, nearly six years. When we thought that everyone would die and no one cared about us, we wanted to document our lives there, document what was happening, for the sake of history, to tell everyone the truth. Especially when the Syrian regime and its allies started to say that we were fighting terrorists, but we were not terrorists. There were a lot of innocent people and many children. They were dying without vaccines, without food, no baby formula. They didn’t allow baby formula to enter. I witnessed many babies die in front of us. So, we wanted to document this. I remember when three cinematographers came to me. They were also university students, and they carried cameras and started to film in the area. They asked me to film this to show the world what was happening. In the beginning, I was afraid and I said, “No, it’s dangerous. The Syrian regime, if they see these videos, they will bomb us or destroy the hospital, maybe, or find out about it.” But then I said, “Maybe everyone will die, and no one will know about us, so let’s do it.” They started filming, and they filmed for nearly two years. I didn’t expect this to last for two years. They made the documentary, The Cave, and it’s a little known, and many people saw it. I’m happy that many people saw this and know the truth about Syria. 

Dr. Amani Ballour: Then, I decided to write the book with my co-author, Rania. I’m thankful for her because, to me, I mean, the documentary is short. It’s more than 90 minutes, but it doesn’t show everything about what’s happening. It doesn’t tell every story. I wanted to tell the people about all the victims, about everyone, all the suffering of the people, everything happening, about how I feel and about how everyone feels. My story is a Syrian person’s story, but we have millions of stories like mine. So, through my story, and I started it from my childhood, writing this book, telling people that we are real people living in these circumstances. We are not only numbers. We are not machines. We have our feelings, and we have our dreams. I wanted to tell everything, to show everything through writing this book. So, yeah, I tried to write all the details, and it was very hard to write this book. I mean, to remember, again, there were many things I couldn’t forget about. But to remember everything in detail: the victims, the children. I was working as a pediatrician there. So, many stories about children. I started to remember their eyes, their pain, their voices. It’s really hard to write like this, but I really wanted people to know maybe to try to help because, as I said, people are still suffering in Syria. 

Steve Shallenberger: Did you write the book, Amani, while you were here in the United States? Or did you write it while you were in Syria? Where did you write it? 

Dr. Amani Ballour: I was out of Syria. I was in Germany when we started, and then when I moved here, I continued the book. 

Steve Shallenberger: Where did the idea of becoming a doctor come from for you? 

Dr. Amani Ballour: Well, honestly, I wanted to be an engineer. I didn’t want to be a doctor. But in Syria, everyone who gets high marks in high school has to become a doctor. They have to be doctors because this is the general idea in Syria that it’s the highest college. So, if you are smart, you have to be a doctor. This is wrong. Of course, it’s wrong. But I remember that my family put pressure on me to be a doctor. However, when I started studying medicine, I liked it and found it a good way to help others. 

Steve Shallenberger: How did you overcome the barriers in Syria to become a doctor? 

Dr. Amani Ballour: Well, as you know, it’s very hard in Syria. To become a pediatrician, it’s not hard. You can be a pediatrician in your clinic as a woman. But not everything is allowed for women to do. As I said, a woman can’t be an engineer. I’m talking about the ’90s or early 2000s. Now, it’s better. But to be, for example, a manager of the hospital—that got me into trouble because people said, “No, not a woman. We don’t want a woman as a manager,” especially with men working in the hospital. They didn’t want a woman to control other men. They didn’t accept this. Many people refused this and tried to criticize me and talk about me. I believed that women can do this. A woman can do everything maybe better than some men. I was a doctor like other doctors, so I decided to prove that women can do that. Because if I failed, everyone would say, “Okay, we tried a woman, and she failed.” So, I decided to prove to them that women have power. Women can lead. Women can change the world. So, I decided to do that, and it was like a side battle. Besides all the atrocities, I had to do this because I’m a woman. 

Steve Shallenberger: You mentioned that things are better in Syria today. So, have things improved, and what’s the climate there today? 

Dr. Amani Ballour: Not the situation for the people in Syria improved but this thought and customs have improved a little. You can see now young girls can study. When I was studying medicine, there were only three female doctors in my entire town who could study, but now you can find more girls going to university. But about the situation in Syria, it’s very bad now. In many parts of Syria, especially the areas controlled by the Syrian regime, the regime still oppresses everyone. They arrest a lot of people. There are many, many political detainees who did nothing but call for freedom, and we know nothing about them. My brother is a detainee. He just disappeared. They don’t tell us where he is. We know nothing since 2012, and many people like him. There’s another area in the northwest and another in the northeast; also they have many faction-controlled areas. The humanitarian situation is bad. Many people live in camps, not just small camps, but big families live in tents in winter and summer. It’s a very hard life. They have nothing. They have no home. Children can’t go to school, so there’s no education for many of them. The situation is also very bad. Also, in neighboring countries like Turkey, Lebanon, and Jordan, Syrians are living in camps and are still suffering. Millions of people are still suffering and need everything. They need the essentials of life. We always call for help for these people because they deserve to live a decent life. 

Steve Shallenberger: Amani, in what ways can individuals make a meaningful impact on global issues? Sometimes, we wake up and we say, “I just can’t impact this at all.” You read about it, you hear about it, but do you have any thoughts on that from your experience? 

Dr. Amani Ballour: I really strongly believe that one person can make a big change and a big impact on their communities and maybe in the world. There are many, many examples of one person making a big change. So we just have to believe that we can do everything we want. We just have to believe in the idea that we can do something. This is my advice for everyone: you can do something for Syria. If you live in the United States, if you are safe with your family, just try to research about other people who are suffering, not only in Syria but everywhere in the world. Just learn about these people and try to do a simple action to help them. You can advocate for them. You can talk about these people in your community. You can talk to your neighbors about them. Think together about what you can do. You can donate to these people. There’s a lot you can do. This is very important. 

Steve Shallenberger: What’s the best way to make a difference from your point of view? 

Dr. Amani Ballour: The best thing you can do is, as I said, to believe that you can change the situation. Just try to say to yourself, “This situation is horrible, and I don’t agree to see this.” We don’t have to see these children suffering. When you see this, especially those who live in safe countries, believe that as human beings, we are responsible for each other. It’s not something that we volunteer to do. No, it’s a responsibility, and we have to do this. This thought is very important. As I said, very simple actions. Imagine if everyone did a simple action to support this; you could see a huge impact, whether it’s to support Syria or other places. So we can see the change. Just think that you have this responsibility to help others. 

Steve Shallenberger: Well, you’ve certainly done it yourself. You’ve spoken out. You have your story in The Cave. What are some of the key takeaways you hope readers will gain from your story?

Dr. Amani Ballour: When I started working and helping the casualties in Syria, I had no experience. I was just a medical student and didn’t get enough training. I just started because I believed that I could do something. So, believe that you can do something, and also have this feeling for others. Think about others, think about other people, and think that it’s your responsibility to help them. This is very important. I wanted to highlight many important ideas in my book—the suffering of the refugees. I’m a very lucky refugee. I didn’t, for example, go through the sea like many Syrian people who are drowning in the sea, trying and hoping to go to another side to have a better life for children. Many Syrians were leaving with a little boat with their children, and they were drowning in front of their families. I mean, this is horrible, and still, many Syrian people and other people from the Middle East and from the East are trying to go to Europe or the United States through very dangerous areas. They still go through the sea. So you can imagine their situation. In the host countries, they still suffer. Starting a new life in a new country, with a new language, and a new community, is not easy. A lot of Syrians did this and were successful, but they need your help. Think about these refugees and try to help them. 

Dr. Amani Ballour: There are refugees all over the world—millions of refugees. Try to help these people. Think about them. They came here because they had suffered enough. They couldn’t live in their countries because it’s very hard to live there. So they find themselves forced to leave their countries. No one likes to leave their country. I love my country, and I wanted to be there. I wanted to be in my family house in my town. There are my memories and everything. We like our countries, but we are forced to be here. So try to help refugees, try to help people who are suffering. Think about the people who live in camps. Just close your eyes and imagine that you live in a tent. It’s a very hard life. We always see the wind take the tent away, and the children are sometimes sleeping on mud, with nothing. Imagine that your children can’t get an education and can’t go to school. It’s horrible. Many times, people ask children from Syria about their dreams, and they say, “We dream to go to school.” I mean, it wasn’t a dream for us to go to school. You see how the situation has changed. So think about the wars in the world. Unfortunately, we still see wars in the world and very bad situations in many places. This is horrible. I wrote this book because I wanted to make people aware of the horrors of war, so it never happens again, but it’s happening again. The political leaders did nothing, and they made the situation worse. But other people, the civilians, everyone who hears us, you can share this situation. We don’t want this to continue happening. 

Steve Shallenberger: Well, it’s been really very special having you on our show today, and we’re at the end of our interview. Any final tips you would like to leave with our listeners? 

Dr. Amani Ballour: Yeah, thank you so much for having this interview. I just want to call everyone to help other people, anywhere and in Syria especially. Read this book and know the truth about what’s happening in Syria because many people don’t know about what’s happening there, and they say that it’s just a civil war. It’s not a civil war. Read this book, watch the documentary if you can, and know more. After reading this, try to make a simple action to help these people who are suffering. 

Steve Shallenberger: How can people find out about what you’re doing? 

Dr. Amani Ballour: I’m on social media under my name, Amani Ballour, and you can read my book to know a lot about me. 

Steve Shallenberger: Excellent. Well, thank you, Dr. Amani Ballour, for being part of this show. What a great and productive visit this has been. To all of our listeners, we’re so grateful that you joined us. We wish you all the best, Amani, in the work that you’re doing. You’re making a difference. Thank you. 

Dr. Amani Ballour: Thank you so much for having me. 

Steve Shallenberger: To all of our listeners, we wish you the best as you’re working on becoming your best and making a difference in the world. You’re doing it, and we’re so grateful to have the privilege to associate with you. This is Steve Shallenberger, your host, wishing you a great day.