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MELISSA BLOCK, HOST:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

AUDIE CORNISH, HOST:

I'm Audie Cornish. And we begin this hour in Syria, the scene of heavy fighting today. In several areas, government troops are on the offensive against rebels, and Western officials fear another massacre in the rebel-held town that's been under siege for more than a week. We've reported extensively on the many videos posted by Syrian activists showing civilians killed and wounded in the 15-month-old conflict.

But there have also been many casualties on the government side, as NPR's Deborah Amos discovered on a visit to a military hospital in Damascus.

DEBORAH AMOS, BYLINE: For Abdul Kareem Mustapha, a 51-year-old colonel in the Syrian Army, the war came to him at 8:15 a.m. on his way to a military post.

ABDUL KAREEM MUSTAPHA: (Speaking foreign language)

AMOS: The civil war is still unofficial, as analysts and pundits argue over definitions. But at this military hospital in Damascus, the casualties are mounting.

MUSTAPHA: (Speaking foreign language)

AMOS: I was going to my job when two taxis cut us off. Armed men started shooting, says Colonel Mustapha. They killed one of the four officers in the military car and they wounded all the others. Mustapha's fresh bandages are on his stomach and on his hands. He's sure his attackers were rebels from the Free Syrian Army, but he doesn't call them that.

He says they are terrorists financed from outside Syria.

(SOUNDBITE OF PHONE RINGING)

UNIDENTIFIED MAN #1: (Speaking foreign language)

AMOS: An Army general runs this hospital. His office has two life-size photographs of Syria's President Bashar al-Assad on the walls. The general doesn't want his own picture or his name published.

UNIDENTIFIED MAN #1: No photo, no photo.

AMOS: Assassinations of military personnel have been rising in Damascus. The general is willing to reveal some alarming statistics. He says the casualty rate for soldiers has doubled since the U.N. monitors arrived. He says on average, 15 dead and 15 injured every day in the capital. At night, he says, he can hear shooting from his office. This is where he works and sleeps.

It's too dangerous to go back home, he says. Back on the ward, these wounded soldiers are struggling with severe injuries, often inflicted by army deserters, men who once served on the same side. Twenty-four-year-old Lieutenant Heithem al-Bukai says he was shot by a sniper in the northern province of Idlib a few days ago. A government escort translates and helps him with his remarks.

The rebels there are young in Idlib, he says.

HYTHAM EL-BUKAI: (Through translator) Sixteen, about 17, yeah.

AMOS: Are they well armed?

EL-BUKAI: (Through translator) Yes, they have - they have snipers, they have rockets, RPGs.

AMOS: He says the rebels even have anti-tank weapons. It's impossible to confirm the Free Syrian Army's armory. Syrian activists say they've knocked out nearly 30 tanks. The burned remains of one tank was parked on the highway in central Syria, one place where the army has been on the offensive. The shelling has been relentless against the rebels based in residential neighborhoods in Homs.

Civilians have been trapped in that fighting. The U.N. has called the violence unacceptable. Today, outside the northwestern town of al-Haffa, in the foothills above Syria's Mediterranean coast, monitors say they were confronted by angry pro-government mobs. They threw stones and metal bars to stop the convoy from entering the rebel-held town surrounded by the army.

This heavy fighting is still far from the capital, says Bshir Said, an opposition activist. He explains that Syria has many revolutions. Every neighborhood in every town has a different story.

BISHAR SYED: So you can see demonstrations in a place and you can see, like, fighting and war in another place. And in some places, very quiet and very easy and - we have 500 revolutions in Syria.

AMOS: The Syrian capital was one of those calm places today, but the rising number of casualties at the military hospital in Damascus shows that the different revolutions are now coming together. Another activist, who wouldn't give his name for fear of arrest, says that Damascus is watching and waiting.

UNIDENTIFIED MAN #2: For us, it's not a civil war yet. It's a very serious, dangerous problem and we hope not to reach this point.

AMOS: U.N. officials raised the alarm again today, but no one can agree on how to end the fighting. The head of U.N. peacekeeping declared that Syria is now in a full-scale civil war and said the government has lost parts of some cities to the rebels and is fighting to regain control. Deborah Amos, NPR News, Damascus.

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