Jamal is not yet a teenager. His school closed in 2011, soon after the Syrian revolution turned into an armed conflict, and his father found him a factory job. One day in 2012 as he returned from work there was a battle going on in the main street near his home. Jamal immediately started carrying wounded children smaller than he is to shelter in a mosque. Then Syrian army reinforcements arrived, clearing the streets with gunfire and hitting Jamal in the spine. The youngsters who took him to the hospital advised him to say that “terrorists” had caused his injury. But Jamal did not want to lie -- he told the doctors that a soldier had fired the bullet. The doctors told him to shut up and say it was the terrorists. But they treated him anyway.
Syrian hospitals are at the front line of the conflict. Bullet wounds in children’s bodies are regarded as signs of sedition. Security men prowl wards disguised as medical staff; there are checkpoints outside hospitals and snipers on the roofs. Arrest and torture await doctors who treat opposition fighters or demonstrators, instead of handing them over to the security services.  Doctors loyal to their jobs or salaries are sometimes targeted for kidnapping by criminal gangs or armed opposition groups.  Health workers in conflict zones cannot get to work and vaccination systems are disintegrating -- the government reported in March that 36 percent of its hospitals are out of service.  Many pharmaceutical factories have been destroyed, leading the World Health Organization to express worry about shortages of life-saving medicines. In opposition-controlled areas, makeshift field hospitals slopping with infections offer crude, agonizing surgical procedures.
Things are worse in areas contested between the government and its revolutionary adversaries. Up to half of Syria’s population -- including Jamal’s family -- lives in informal urban settlements, relatively poor districts that provided the vanguard for the revolution and now are often battlegrounds.  These settlements mostly populated by rural in-migrants are also places where over the past four decades the Baathist state created a new Syria of textile and service industries, with free education, health and social services, and electricity and running water in nearly every home. Syria largely avoided foreign debt on its path to development. Instead, the country amassed “strategic rent” -- aid from Iran, and before that from the Soviet Union and Saudi Arabia. Syria traded with these donors its resistance to US hegemony; alternative possible futures for the Palestinians; and a version of the Arab state that was not dependent on Israeli or US guarantees.
Jamal is seeking treatment in a neighboring country. Syria’s health care system, which before the conflict delivered better health outcomes than Saudi Arabia’s, is now too politicized to cope with a child hit by indiscriminate fire.  Nonetheless, many of the government’s supporters today have kept their faith that the Syrian state has provided for the people. “Didn’t we give you houses? Didn’t we give you schools? Are you tired of them?” are rhetorical questions sometimes brandished by security men in house-to-house raids or torture centers.No Longer Free
But the Syrian success story was in trouble before the conflict began. The government was not able to supply productive opportunities for many rural youngsters, many of whom were shipped off to Lebanon’s harsh labor market. Conflicts between factions of the country’s inscrutable elite -- rent-seeking bureaucrats and businessmen -- generated periodic economic crises that pushed Syria to seek external resources and policy inspiration.  The crisis of the past decade prompted a reconsideration of the country’s social welfare system. In 2005, a new “social market” policy encouraged foreign investment and simultaneously cut social welfare provision. The new approach brought in billions of dollars of Arab and Asian investment in construction, banking and tourism, and opened Syria’s producers to competition from countries with less generous welfare systems. As the policy came into effect, Syria’s oil prod