PHOTO: A casualty is taken into Dar el-Shifa hospital in Aleppo

The health care system in opposition-held areas of Syria’s largest city Aleppo “is being systematically destroyed” by years of conflict and regime attacks, according to a new report by Physicians for Human Rights.

PHR documents that only 10 of 33 of hospitals are still open and about 95% of doctors in the area have fled, been detained or killed. The ratio of physicians to residents is now 1 to 7,000, compared to 1 to 800 in 2010.

The Syrian military has launched 45 attacks on health facilities in eastern Aleppo, which has been occupied by rebels since July 2012. Even those hospitals which operate have been struck, one up to seven times.

There is no longer a single functioning MRI machine in eastern Aleppo. There is only one remaining thoracic surgeon, plastic surgeon, renal surgeon, neurologist, and cardiologist, and one or two urologists, ear, nose and throat specialists, and gynecologists. There are no psychiatrists or psychologists.

The report is based on interviews in late July in southeastern Turkey with 24 individuals who had provided health care, supported the health care system, or documented events in opposition-held Aleppo. Among the interviewees were staff who had worked at each of the 10 currently functioning hospitals, with the main aid and medical organizations supporting hospitals, and with the leading organizations documenting violations and providing health assessments in eastern Aleppo.

Between March 2011 and October 2015, 686 medical personnel have been killed in 329 attacks — almost 90% by regime forces — on facilities across Syria, according to PHR. Since September 30, PHR says there have been 16 attacks — 10 by Russian warplanes, five by either Russian or Syrian forces, and one by unknown forces.