The Real Consequences of War: A Doctor’s Perspective from the Frontlines

As conflict once again dominates headlines in the Middle East, we are actively seeking first-hand accounts from those living through it today. While that search continues, we believe it is equally important to revisit the lived experiences of those who have eyewitnessed war up close.

This account, from Dr. Saiful Islam, a physician who worked during the Iran–Iraq war, offers a reminder of what conflict looks like beyond strategy and politics — at the level of human life.

I was in my thirties when I first went to Iran.

It was the early 1980s, during the Iran–Iraq war. I had joined the National Iranian Oil Company as a physician, part of a medical team supporting workers in one of Iran’s most critical oil regions. I was posted in Umidiyeh, in the southern province of Khuzestan. It was a place that mattered. Pipelines from across the region came together there before oil moved out for export.

Around us were hundreds of thousands of displaced civilians. Families had been pushed out from the frontline near southern Iraq. They were living close to us, uncertain, waiting.

There was a belief at the time that Umidiyeh would not be bombed. That the presence of so many civilians might offer some protection.

We held on to that belief.

The First Time I Heard War

My first encounter with war did not happen in the hospital.

It happened in Tehran.

I had stepped out one evening to find dinner. Within moments, everything went dark. Sirens began to sound. The streets, which had been full just minutes before, broke into panic.

I did not know where to go. I did not know where to hide.

Then the bombardment began.

I remember crouching under a staircase. I could hear the explosions, one after another. It went on for what felt like a long time. Thirty minutes, maybe more. Until then, I had never experienced anything like it. I was a doctor, but in that moment, I was simply afraid.

Even so, I continued south.

When the Casualties Started Coming

In Umidiyeh, the work began immediately.

The hospital was small, just 72 beds, but it carried everything. I worked in medicine, treating all kinds of illness. Very quickly, the workload became overwhelming. Many of us worked through the day and into the night, then again, the next day.

At first, we struggled to communicate. We spoke in fragments, with the help of nurses. But within a couple of months, we learned enough Farsi to speak directly with patients.

In the early days, the war did not always arrive in large numbers. There were nearby attacks, occasional casualties. We managed. But slowly, something changed. People began to live with the sound of war.

The Lives War Leaves Behind

The worst moments came after major attacks at the frontlines.

We would be warned in advance; the hospital would be cleared completely. Beds were moved into corridors. Even verandas were filled. Blood donation calls went out immediately.

Then we waited.

When they arrived, they came in numbers that are difficult to describe. Planes, trucks, pickups. Many had already died on the way. The injured were covered in blood. Bullet wounds. Shrapnel injuries. Severe loss of blood.

Inside, surgeons worked without stopping. Outside, we tried to bring people back. Those who had died were placed aside. There were too many.

No matter how much we prepared, it was never enough. Many died before we could reach them in time.

What stayed with me was how quickly it happens. One moment a person is alive, the next they are gone. The body loses color. The pulse fades.

For a doctor, that is something very hard to accept.

What War Looks Like to a Doctor

Outside the hospital, the war continued in quieter ways.

I remember seeing mostly women. They wore black. They were mourning. Sons, husbands, fathers, brothers. All gone.

Grief was everywhere.

People came to us with complaints that were not only physical. They could not sleep. They had no appetite. Their hearts raced. They spoke less. There was a heaviness in everything. A kind of silence that followed them.

Even with some support, families struggled. Without the men who earned for them, life became uncertain.

Over time, I understood something clearly.

Medicine has limits.

When destruction comes in such numbers, there is very little a doctor can do. We are trained to save lives, but in war, the scale is beyond us.

I still remember July 3, 1988. A passenger plane was shot down over the Persian Gulf. There were 290 people on board. Bodies were found in the water. Some were from our own area. There are moments when words are not enough. That was one of them.

Near the end of my time there, I experienced something that stayed with me.

Two fighter planes flew very low over our area. I could see the numbers on the aircraft. I could even make out the pilot.

Then they began bombing.

A fire broke out in the oil facilities. Flames rose high into the sky. Thick black smoke covered everything. The fire burned for days. The power and water systems were destroyed. For three days, we had neither. The temperature was unbearable; above 55 degrees celsius.

That was the first time I truly thought of my family. Of children. Of what it means to live, not just survive. I decided I would leave.

Soon after, the war ended. It had lasted nearly a decade.

Looking at War Today

When I look at conflicts in the Middle East today, I can’t imagine much difference.

The same patterns remain. People still try to dominate others. The reasons change, but the thinking does not.

The weapons today are of course more advanced now. The destruction is greater. But the suffering must feel the same. The people who suffer most have no control over what happens.

It feels like the world has never learned.

What We Still Don’t Understand About War

War is destruction. It takes away lives, homes, peace, and everything that gives meaning to life. There is no glory in it.

Only loss.

If there is one thing I would want people to understand is that compassion matters more than power. Kindness matters more than victory. We should treat others as we wish to be treated. We should care for others as we wish to be cared for.

Because once humanity is lost, nothing else remains.

Dr. Saiful Islam is a physician and public health consultant who served as a field physician with the National Iranian Oil Company during the Iran–Iraq war, working in a hospital in southern Iran where he treated civilians, oil workers, and war casualties. He holds an MBBS from the Medical Academy in Sofia, Bulgaria (1983), and a DTM&H from London (1985). Since 1999, he has worked as a private practitioner and public health consultant, contributing to research and development projects for the United Nations and other international organisations. He is now based in Dhaka, Bangladesh.