The Japan Times - Syrian girl rescued after quake battles 'crush syndrome'

Trapped under the rubble for 40 hours, she was rescued alive but now faces the risk of having both her legs amputated because of tissue damage from the crush injuries, say her doctors.

Sham was celebrated for her courage after humming a tune along with her White Helmets rescuers, who worked for six hours to free her from the concrete -- scenes captured in footage that has gone viral online.

"She gave us strength when we heard her," one of the group's volunteer rescuers, Mohammed Nasreddine, told AFP, recalling how they would hum the tune called "Damascus" together.

"Our joy was indescribable when she got out," said Nasreddine, whose White Helmets group has been famed for freeing people from bombed buildings in the country's rebel-held regions throughout Syria's civil war.

Sham, like many survivors of the 7.8-magnitude quake that killed over 44,000 people across Turkey and Syria on February 6, is now suffering from what doctors call crush syndrome.

It occurs in limbs that were starved of blood circulation for too long and starts with a severe pain in the affected extremity, which can still look healthy in the early stages.

In the condition known by the medical term rhabdomyolysis, muscle fibre dies and is released into the bloodstream, sometimes causing kidney failure.

Patients at first seem to be in good condition before they start to deteriorate.

"This is what we call 'the smile of death'," said orthopaedic surgeon Tarek Mustafa, who explained that it can cause cardiac and other potentially fatal complications.

- Amputation risk -

"Sham is one of several patients suffering from the syndrome who have been admitted to the region's hospitals," Dr Mustafa said, with health services in the rebel-held Idlib region reporting at least 100 such cases.

Many of these casualties are traumatised children, some already reeling from losing one or both parents in the tragedy.

Sham's mother and sister were killed when the family's building collapsed in the town of Armanaz, in the northwestern province of Idlib, while her father and two brothers also survived.

The family had moved there in 2019 after fleeing a military offensive by the Russian-backed Syrian regime, which has regained control of most of the country's territory since the war started in 2011.

Sham's possible leg amputations have been postponed for now, but she is not yet safe, said Dr Mustafa, who works in one of the hospitals run by the Syrian American Medical Society in the northwest.

When the White Helmets heard that Sham's legs may be amputated, they posted a tweet asking followers to pray for her and for other survivors battling crush syndrome.

Another of the group's rescuers, Ziad Hamdi, recalled how "I was working to free her legs, and tears came to my eyes. She reminded me of my five-year-old daughter."

In the clip, he is heard promising to take Sham to an amusement park if she can just hold on a little longer.

"I want to wear beautiful clothes," the little girl responded cheerfully. "I want to be a princess."

"She's witty, I did not expect such an answer" from a child fighting for her life, said Hamdi. "We made a promise. I will take her to the amusement park and buy her whatever she wants."

H.Hayashi--JT