Born at the Gates of Hell: A Doctor's Frontline Story of Delivering Babies in al-Hol Camp in Syria

by Maria Milland

Overview

An OB-GYN at the center of the Syrian refugee crisis recounts 9 grueling months at the al-Hol refugee camp—a place of violence and murder, love and survival

Imagine what it’s like to be pregnant and give birth—or to try to care for and protect a family in the middle of hopelessness?

This book is not about politics. It is about individual human beings in a dry, barren landscape. Up to 75,000 people at a time—mostly women, babies, and children—live for years in tents and have no prospect of leaving because no country will have them.

Maria Milland takes readers on a powerful, documentary journey to meet the pregnant and laboring women facing the difficult, harsh, and violent living conditions of al-Hol camp in northeast Syria. Her firsthand account provides vivid, unique, and honest insight into life inside the camp, which has never before been described to the outside world.

Amidst the brutal everyday realities of the camp, the maternity ward is a safe space, where health problems, as well as existential challenges, are displayed and embraced—and children are born. Behind towering fences, sprawling in the desert’s nothingness, they spend their childhood deprived of fundamental human rights, and with the looming risk of growing into a new generation of Islamic fundamentalists.

Beautifully written and carefully observed, this is not only a story of resilience and hope in the face of hopelessness, but also serves as a powerful reminder of our shared humanity.

Product Details

ISBN-13:	9781586424268
Publisher:	Steerforth Press
Publication date:	04/07/2026
Pages:	192
Product dimensions:	5.50(w) x 8.50(h) x (d)

About the Author

Maria Milland is a Danish obstetrician and gynecologist who has been deployed 11 times for international organizations to various countries throughout Africa, the Middle- and Far-East, and teh Caribbean. In 2022, she was dispatched to Syria where she worked at one of the al-Hol-camp's hospitals for 9 months. Born at the Gates of Hell is her first book.

Read an Excerpt

This is how I imagine it was:
She wakes up to the loud flapping of the tent canvas. Still half asleep, she tucks herself under the blanket, trying to block out all sounds, but can’t help wondering if the wind is picking up again. There have been so many sandstorms lately that it is almost unbearable. Sheltered by the comfy heavy blanket, she feels the warmth radiating from the tiny delicate body next to her. She carefully turns halfway around, and tries to find a snug position on the pad on the ground, without shifting about too much. Oh no, her movements have disturbed anyway. Her daughter stirs, begins to make sounds. Hopefully, she won’t wake up fully and awaken the rest of the tent.
Even though she is extremely tired, she can feel an unease growing in her mind — the unease that haunts her waking hours and that, over time, has become her constant companion. Well, at least today, all mouths were filled, she tries to reassure herself. She has noticed that the food portions being offered to them have improved. Both in terms of quality and quantity. Maybe her talk with the neighbors, who have the same concerns she has, somehow made its way through the right channels to reach the ears of those in charge. It seems as though the camp’s administration has stepped up and made an effort to ensure a more stable supply of food. The last three of her children were born here; she remembers that she was heavily pregnant when she arrived at the camp such a ruthlessly long time ago. She has been so worried for the three-year-old boy and the four-year-old girl. For a long time, it seemed like they were not gaining weight and thriving properly.
She listens to her father’s gentle snoring from the other end of the tent, just to the right of the entrance. As her eyes slowly adjust to the darkness, she can just make out the inside of the tent canvas. She watches the dust move in the air beneath the ceiling as it makes its way through that ever-growing stubborn hole in the canvas in the corner. Time and time again, she has asked her husband to deal with the tear in the, by now, worn-out fabric, but each time his reply has been that he hasn’t been able to find the right materials. Tomorrow, she will remind him once more.
She really should get some rest now. The wind seems to have died down a bit too. Just as she is finally about to cock out, the girl begins to whimper under the blanket. She hurries to place a soothing hand on her daughter’s belly, and then, in one practiced move, lifts up the comfortably loose-fitting dress — she has breastfed 12 children — and puts the girl to her breast. Lying half on her side, she smiles sleepily down at the little greedy mouth sucking eagerly. Uhhhhhnnn — Whoa, is she right when she thinks she hears something moving outside? Is that the sound of footsteps in the sand close by?
Instantly, she is wide awake. Like a watchdog, she pricks up her ears. Yes, definitely, it is the sound of feet — now more feet — how many feet are there? The feet move cautiously, as if trying to go unnoticed, but her attention is now fully focused on the other side of the tent canvas. She is sure somebody is out there. What are they up to at this hour? Very few people in the camp dare to venture outside their tents at nighttime.
Her entire system is on alert, all her senses are sharpened. She is thinking very fast, yet at the same time it feels as though she is paralyzed and unable to do anything. Isn’t that someone moving stealthily at the tent entrance? Her body stiffens completely as the tent flap is flung aside and a tall, dark figure enters silently, but without hesitation. With a swift agile glance, he sweeps the tent, as if trying to get an overview of the positioning of the many bodies in the room.
Instinctively, she holds her breath, as if to make herself invisible. Despite her fear, she draws her youngest child closer. Even in the darkness, she can make out that the man is fully masked, only his eyes are visible through a narrow slit. Under the blanket, the baby begins to moan a little. The eyes in the slit meet hers. From his hip, he pulls out his firearm and points the barrel directly at her as he takes a couple of confident steps forward. Through the half-open entrance, another four men step inside. At a rapid pace, they disperse to the different corners of the tent, except for the last man, who stands guard at the tent opening which is then closed again.
The initial intruder switches on a flashlight and sweeps the interior of the tent with its beam. Peering from under the blanket, she notices that all five men are armed, black tight-fitting masks are wrapped around their faces and necks. Faster than she can keep up, almost as if in a coordinated move, the children, by now wide-awake, are herded into the farthest corner of the tent. From behind the black hoods, loud whispers shush her offspring into silence. She is rigid with fear. The scenario feels unreal, like one of those movies she once watched back home in Iraq. Time freezes. The seconds stretch out, long as years. Her husband is grabbed by the hair and captured with the muzzle of a weapon just beneath his chin. Her old father has a gleaming firearm pointed directly at his temple. Her mother lies on the ground, curled into a crumpled ball. A black-masked beast has viciously placed his right heel on her bad shoulder while aiming his weapon at the side of her neck.
With trembling hands, she hugs her whimpering daughter tightly to her.
The leader walks toward the group of children at the rear of the tent.
“Haamid,” he commands, “come here”.
Her eldest son rises from the ground and moves forward with heavy steps.
The leader orders Haamid toward the center of the tent. With the weapon aimed at him, her beloved boy is forced down onto his knees. The black-clad figure points the muzzle of the barrel at Haamid’s forehead, right between his eyes, and hisses icily through the thick fabric of the mask: “that’s what you get.”
Pow-pow-pow-pow
She hears the sound of four shots exploding in rapid succession, as the bullets leave the barrel of the weapon, strike Haamid’s skull and plunge through his brain.

Table of Contents

1.PROLOGUE
2.DEPARTURE TIME
3.ARRIVAL AT THE END OF THE WORLD
4.AL-HOL HOSPITAL
5.BEGINNING LIFE IN AL-HOL
6.CESAREAN SECTION
7.YOUNG MOM
8.SANDSTORMS AND SICKNESS
9.CONSUMPTION
10.AT THE GATES OF HELL
11.PHASE 2 OF THE HUMANITY AND SECURITY OPERATION
12.HEADLESS
13.SHIPS OF THE DESERT
14.MISSION COMPLETED
15.AFTERWORD
16.WORDS OF GRATITUDE
17.BIBLIOGRAPHY