ITV News' Global Security Editor Rohit Kachroo has this exclusive report which contains distressing details
A Damascus hospital has become a secret "slaughterhouse" for Syrians who oppose President Bashar al-Assad, where doctors and nurses use medical equipment to taunt, torture and kill activists during check-ups.
The Syrian regime has exploited special protection afforded to hospitals in conflict zones to turn the facility into a prison and a clearing house for murdered activists.
Many of the victims' bodies are then taken to one of a network of mass graves, including a quarry next door to the hospital.
Tishreen Hospital, which was named after the Arabic word for October to commemorate the Yom Kippur War of 1973, is on the northeastern outskirts of Damascus.
But the truth of what has happened there over more than a decade – and what is still happening – can be revealed by an ITV News investigation based on interviews and off-the-record conversations with former inmates, regime defectors, activists, and intelligence officials.
Analysis of years of satellite images shows how cemeteries have been built where bodies are discarded.
At one of the sites, an open pit could be seen as recently as Tuesday this week, ready for more corpses from the military hospital.
"We could say it’s not a hospital in the first place. It’s a slaughterhouse" said ‘Adam’, a political activist who was held at Tishreen for two weeks.
ITV News is not revealing the dates of his captivity to help protect his identity.
"It’s like a different world. The doctors and the nurses treating the prisoners there, you cannot imagine we are living on the same planet, we are sharing the same oxygen."
He described how he was kept in cells close to the main hospital building and was admitted for several hours at a time to be humiliated and beaten.
A second mass grave ten miles away in the Baghdad bridge area outside Damascus took many more of the victims
Even among some inmates at other prisons, Tishreen had developed a reputation.
Adam was transferred there after detention at another facility, where soldiers would threaten him with a trip to Tishreen, saying: "Is there anyone who would like to meet his Lord so we can send him to the hospital?"
Adam travelled to Frankfurt to speak to ITV News, close to where he has made a new home.
But he arrived with evidence of his torture during his previous life – an X-ray image he smuggled from Tishreen showing his badly injured foot, and pictures of the wounds he suffered during his captivity.
When he lifted his shirt, he revealed another scar caused by a doctor who lunged at him with a knife.
"A doctor looked at me and told me 'You will be dead in a few days,' he had a sharp knife, a medical knife, and he just stabbed me in my chest… He stabbed me in my chest on the left side."
It was part of a pattern of behaviour by medics, who wore medical coats, but spoke like regime propagandists.
"When one of the nurses came to me and she saw my feet bleeding at that time she said: 'OK we’re going to help you' and she brought medical forceps and she started to shove them inside my feet. I was just holding [back] my screams."
She had plunged the device into an open wound. "The bones were outside," Adam says.
"And they started to tell us: 'You look like a terrorist, you are a piece of sh*t, you are like a**holes' and at that time, I was just like a skeleton, I was nearly 40 kilos.
"I was totally shocked, I expected this from the soldiers, from the military, but these are nurses, and these are doctors."
Parts of Adam’s account are echoed by several other witnesses who have spoken to ITV News, former inmates arrested for political activism, who were amongst the few who managed to get out of detention.
Speaking in northern Syria, Mohammed Medlej, a political activist who was held there between 2017 and 2021, described how he thought he was going to be killed
Speaking in northern Syria, Mohammed Medlej, a political activist who was held there between 2017 and 2021, described how he thought he was going to be killed during a massacre inside the hospital.
"A soldier entered the dormitory, and he trapped us all in a corner and started dragging us out one by one.
"He would put a towel on one of us until they would choke, and foam or liquid would come out, or until they would have five minutes left and they would fall over and die."
"He started to execute us one by one, and I was one of the people tasked with removing the bodies and piling them up.
"The soldier killed six of the group and then it was my turn. He told me, 'Your turn is coming, get ready'.
"I was so frightened I didn’t know whether to laugh or cry. In the end, I thought 'thank God, the end is finally here,' I was going to die, and it will all be over."
Tishreen was first chosen by senior regime officials because it was home to one of the largest mortuary refrigerators in Syria, according to a former senior insider.
Its role has never been publicly acknowledged by the Damascus regime. But an internal order labelled 'extremely confidential' which was sent out in June 2012 and signed by Major General Ahmad Sulaiman Talas, president of the security council in Deraa, can be made public for the first time.
"With regards to the dead amongst the terrorists who have not been identified," it reads, "continue until the corpse has reached Tishreen military hospital where it will be assigned a number…"
In the years that followed, as Tishreen was overwhelmed by the number of victims, officials turned to a working quarry next door to bury some of the dead.
But a second mass grave ten miles away in the Baghdad bridge area outside Damascus took many more of the victims.
Construction work can be seen on satellite images assessed by ITV News as early as 2014 - but the digging of burial plots began to accelerate in 2016.
Several witnesses have said the site is currently in use and images taken in the last few days appear to show an open pit where more bodies will be buried.
For those who escaped Tishreen – a small minority of those who passed through the doors of its cells – it hurts to see President Assad edging back onto the world stage.
In August, ITV News spoke to former gravesite workers who helped to bury the corpses of activists detained by the Assad regime.
They described how the bodies of young children were left unburied and used as food for dogs.
The dictator was welcomed back into the Arab League at a summit in May and could appear at the forthcoming COP climate conference in November.
"Something should be done to stop these things, or at least to bring Assad to court, to make Assad go away," says Adam.
"It’s like a nightmare for the Syrians. It cannot be accepted in this world to live beside this radical dictator’s regime."
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