His uncle was waiting for us in a side street of a border town in southern Turkey. Up winding alleyways, through a cluttered courtyard, past children’s peering eyes, a mutual acquaintance and I were guided onto the barren cement roof of a building.
A 14-year-old boy sat roasting small pieces of skewered meat over a flame with his left hand, his missing right hand conspicuous despite his attempts to tuck it away.
A member of the so-called Islamic State sawed his hand off a few months ago, along with his left foot. A cloth bandage covered the stump of his arm, while the bare end of his severed lower limb jutted out.
With his uncle’s help, Ahmed – not his real name – hopped to a plastic stool that one of the children moved towards him.
“They told me that if I had been 15 or 16 I would have been killed,” Ahmed said, implying he had been relatively fortunate compared to those older than him.
Visibly shaking at times, defiant at others, he spoke to Refugees Deeply about the events that led to his “punishment.”
Ahmed claimed some of his relatives had been involved in the uprising against the Syrian regime from the beginning and had later also fought against ISIS. When ISIS took over the area in eastern Syria in summer 2014, he continued living with his grandmother but had failed to “ask for forgiveness” from ISIS, he said, noting that this was a requirement for all those whose family members had opposed the extremist group. He had also resisted attending mandatory Sharia law courses.
“Schools in the area stopped running four years ago due to government bombing,” he said. “I started working as a mechanic’s assistant from age 10.”
It was during the holy month of Ramadan last year that ISIS fighters came to his home and broke down the door at 3 a.m.
Ahmed said he was kept in a Syrian prison for 10 days and then moved to an Iraqi jail, along with about 50 others.
“Three younger and all the others older but under age 21,” he said.
Only upon arriving in Iraq did his captors speak to him.
“They tried to convince us to join the group. Some did, some didn’t,” he said, explaining that the two recruiters were a Tunisian and a Saudi named Abu Muslim Al-Saudi. “They treated us well until we refused [to serve]. Then they tortured us.”
Ahmed claimed about half of his group had agreed to join ISIS, but that the Saudi interrogator had specifically said that those who did not want to join would not be punished.
“They promised,” he repeated a few times, with a lingering twinge of disbelief at the betrayal of trust that nearly cost him his life.
“Then they killed many from the group and they cut my hand,” he said abruptly, momentarily changing the subject.
Later, he added that he subsequently found out that all of those who had refused had been killed except for him, and that the Saudi ISIS member had purportedly decided Ahmed should also be killed. Ahmed was then taken back to the Syrian city of al-Mayadeen.
“They took me into a room with only a chair and table. Four men came in to ask questions and the last one to enter said if I was 15 or 16 I would be executed, but that I was too young,” he said.
Ten days later they cut his hand and foot off in a hospital, “to serve as a message” for others resisting ISIS, and brought him back to his family’s home at 3 a.m. – the exact same time as when they had abducted him.
Soon afterward, family members managed to take him across the border to Turkey.
When Refugees Deeply met Ahmed, he said that he and his family had already spoken to many organizations from several different countries but that no one had yet assisted them and that his family had to find money for a wheelchair themselves.
Dr. Wael al-Raas, who founded the first center providing mental healthcare to refugees in the town of Reyhanli, in southern Turkey along the Syrian border, said that he has seen many cases of children and adolescents who lost limbs due to the conflict and many who were detained by regime forces, but he had met few who had been mutilated by ISIS.
He added that “children and adolescents tend to have a more stable, secure life in ISIS areas” than in opposition-held ones, which are subject to more frequent regime bombing.
Another reason for not encountering as many wounded children from ISIS areas in Turkey is partly due to the group’s close surveillance and clampdown on civilian movement. To evade ISIS patrols, Ahmed’s family had to use smugglers who knew clandestine routes.
Al-Raas, who was imprisoned by regime forces in March 2012 when he was the head of a department at Aleppo’s Ibn Khaldun hospital, has been running the Reyhanli center for the past two and a half years.
The Union of Medical Care and Relief Organizations (UOSSM), with which his initiative is associated, has greatly expanded its activities over the past few years, including mobile clinics, child protection and mental healthcare services in northern Syria.
He noted that it was generally easier to treat Syrian refugees suffering from trauma in Turkey than in Syria where stigmas related to seeking psychological help remain prevalent.
“They’re more willing to ask for medicine, but less so psychotherapy,” he said, despite such therapy being severely needed in many of these cases.
He added that “you need a stable, secure environment for full case management,” which is extremely difficult to create in opposition-held areas under constant fire and nearly impossible in ISIS controlled territory.
On hearing of Ahmed’s case, al-Raas noted that it would be a particularly complex one to treat, given the multiple traumas due to imprisonment, the double amputation and the permanent mutilation.
He added that typically, in teenagers, depression resulting from such high levels of trauma often manifests itself in the form of aggressiveness.
The doctor has seen many teenagers who had been recently “discharged” from service by rebel groups with which they had been fighting, “mostly in order to provide for their families’ needs since they got paid, or to avenge the killing of a father, brother, etc.” Almost all of them were suffering from mental health problems.
“And you usually need three or four sessions just to get the patient to start trusting you,” he noted.
On the issue of mental health support for Syrian refugees in southern Turkey, al-Raas said the Turkish government had granted authorization for new facilities to operate in the southern city of Gaziantep but that they were still awaiting final approval.
In Ahmed’s case, expedited resettlement in a third country that is able to offer the needed support and safety is obviously crucial.
When the U.N. Refugee Agency (UNHCR) comes across such pressing cases, they process the applications based on their assessed “priority of need, and the availability of resettlement places and resources,” the Iraq branch told Refugees Deeply. The cases are processed on the basis of a three-tiered system – emergency cases (requiring resettlement within days), urgent cases (refugees who “have serious medical risks or other vulnerabilities requiring expedited resettlement within six weeks of submission”) and normal cases.
In Iraq, cases related to 1,028 such people (both Iraqis and Syrian refugees in the country) were submitted in 2015, and 327 people were accepted for resettlement by third-party countries.
“The majority of cases,” UNHCR said, “were submitted under the Survivors of Violence and/or Torture category (58 percent), followed by Women at Risk (19 percent) and Refugees with Medical Needs (17 percent).”
“The final decision on whether a refugee will be resettled is determined by the resettlement country, not UNHCR,” the office pointed out.
At the time of the visit, Ahmed’s family said that an embassy in Western Europe was looking into providing him asylum. Refugees Deeply received a message recently that he is now in Europe.
* Given the sensitive nature of his case and the safety of family members who are still in areas under ISIS control, no details about Ahmed’s current location or real name can be disclosed.
This article was originally published on Refugees Deeply