An Irishwoman's Diary

THE OSPEDALE Italiano stands foursquare on a city block on Jamal Abdel Nasser Avenue in central Damascus, across from an arcade…

THE OSPEDALE Italiano stands foursquare on a city block on Jamal Abdel Nasser Avenue in central Damascus, across from an arcade of shops near bustling Jisr al-Abyad Square. Since its founding as a dispensary in 1913, the hospital has survived the collapse of the Ottoman Empire, two world wars, the Arab revolt led by Lawrence of Arabia, French colonial rule, the Syrian independence struggle, Arab-Israeli warfare, numerous coups d'état and two US-led wars on neighbouring Iraq, writes MICHAEL JANSEN.

Sister Maria Kottaka greeted me at the information desk. She had donned the crisp white uniform worn by the 19 Salesian sisters in the hospital. When we met at a diplomatic reception three days earlier, she had worn the blue-edged white sari of Mother Teresa's Missionaries of Charity. Sister Maria, from Kerala in south India, pointed to a block of nameplates fixed to the wall: "We have more than 100 doctors working here. Most have specialised abroad in France, Italy, Russia, England, the US and Germany. All the staff are Syrians. We are volunteers and serve in every department."

She led the way through the spotless corridors of the renovated 1926 building, which belongs to a charitable foundation established in 1886 by Italian Egyptologist Ernesto Schiaparelli. His original purpose was to alleviate the suffering of Italian missionaries and traders working in the Middle East, but over the decades his colonial enterprise created indigenous institutions in Syria, Egypt, Jordan, Turkey and Israel. They are now operated by the Alliance of Italian Hospitals of the World.

"Ninety per cent of our patients are Muslims," said Sister Maria. "The UNRWA [ United Nations Relief and Works Agency] brings Palestinians, the Red Cross and Red Crescent bring Iraqis and Sudanese. The government refers patients who need specialist treatment and operations. Private people come. Embassies send foreigners." She led me through the departments, showing off the hospital's latest high-tech equipment, the small laboratory, the kidney dialysis room and the five-bed intensive care unit. We stepped into an observation room where a doctor stood at a panel monitoring a patient in the neighbouring operating theatre. Beds in the wards cost $12 a night while private and semi-private rooms begin at $43. "Nearly half our patients are poor," remarked Sister Maria.

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The sisters speak Italian among themselves, since the majority come from Italy, but Arabic to doctors, staff and patients.

Over tea and home-made biscuits in the sitting-room of the convent in the hospital compound, we were joined by Sister Lilly Kutty, also from Kerala, and Sister Bridget Doody from Co Limerick. Sister Bridget, 73, has given 28 years to this historic hospital, 15 of them on lonely night duty.

She leaves the handsome, white pollution-streaked hospital complex once a week to make calls on some of the 300 patients on her outreach list. "I visit each family five times a year, sometimes oftener." They include 100 to 110 refugees from south Sudan - "the poorest," she said; 65 to 70 lepers, "my friends"; and 150 Syrian families. She looks after orphans, the handicapped and elderly, and Iraqi refugees living in poverty after fleeing the war zone.

She provides each household with a bag of basic foodstuffs and supplies, some winter clothing and medical aids such as walking-sticks and wheelchairs. She offers small grants for roofing homes, fruit trees for planting in gardens, and chickens for meat and eggs. "We tried [ giving] a cow, but found that two cows are needed, one for milk, yoghurt and cheese for the family and the other for sale [ of produce]. But fodder is very expensive and it is difficult to raise a calf because people are tied to their homes. A widow living in a village can't go to town to visit her children, if she has a cow," she explained.

"The Lord sends the money when we need it." Her eyes twinkled. "I'm a bit cute and take people with me who make contacts." It was very difficult to get funds from governments, she said, because they often prefer grand schemes to small projects. When Brian Cowen visited the hospital on St Patrick's Day in 2003, she asked for help. Money was provided for refurbishing the quarters of live-in Syrian staff and the convent, which were in dire need of renovation and are now comfortably spartan.

Sister Maria and Sister Bridget, armed with a ring of keys, took me to the basement where we viewed store-rooms, the laundry, and the stainless steel fitted kitchen. We were hailed in Italian by two Egyptian nuns, one with a pharaonic face. Back in the convent we passed the sewing-room where the eldest nun, an Italian of 88, was bent over a sewing-machine. "She stitches all the bed sheets, robes for patients, and uniforms for the staff," said Sister Maria. "She was in Egypt for 40 years and has been here for 20."

Night was falling and the sisters were assembling in the chapel for a Mass conducted by the papal nuncio by the time we reached the courtyard. Sister Maria and I embraced. Our chance meeting had brought me to this remarkable place. Revelling in the fresh air and the fine drops of rain sparking in the light from the hospital windows, Sister Bridget walked me to the gate.

"It's sometimes difficult to be a lone person in a foreign sub-culture. Syria can also be difficult. But I'm happy here. This is the happiest time of my life."