She treated thousands of people in an underground hospital in a besieged rebel enclave in Syria. Now Amani Ballour, the doctor at the centre of the Oscar-nominated documentary "The Cave", is stepping out into the limelight.

But the 32-year-old paediatrician, who is still haunted by the dying and mutilated children she had to treat, hopes the attention the film has garnered will remind the world that the horror of the Syrian war is about to enter its ninth year.

"For me it is not a film, it's my life, my reality," Dr Ballour told AFP before she obtained a visa allowing her to attend the Oscars ceremony in Los Angeles on Sunday.

The harrowing 102-minute film shows the doctor not just struggling to keep wounded children alive in her operating theatre in the former rebel stronghold of Eastern Ghouta, but also having to deal with sexism as a woman in charge of a Syrian hospital.

"The Cave" is one of two shattering films about the conflict in the running for an Oscar alongside Waad al-Kateab's Aleppo-set "For Sama", which won best documentary at the Cannes film festival in May.

'Hell on Earth'

"The Oscar nomination will help throw more light onto the Syrian cause, and hopefully help push people to support us," said Ballour, who has been living in Turkey since Eastern Ghouta fell after a five-year siege in 2018.

The rebel enclave was described as "Hell on Earth" by UN Secretary General Antonio Guterres as it was being pummelled by President Bashar al-Assad's forces. With the war still raging in Syria, half a million people have been displaced in the last two months by an offensive by the Assad government and its Russian allies in the northwest of the country.

The exodus of refugees it has sparked is one of the biggest of the war.  Like millions of Syrians forced from their homes, Ballour said that she finds it difficult to be at peace with herself in exile. "When I was at home I could help people, I was calmer despite all the difficulties, the bombardments, the hunger and the tragedies we were witnessing every day," she said.

Instead, the young woman who has just won the Raoul Wallenberg Prize from the Council of Europe for her "exceptional humanitarian acts", is haunted by the suffering of her thousands of child patients. "The children did not understand anything... They always asked what was happening, why are they bombing us, why they were hungry. It was very difficult to explain to them," the doctor said.

She was particularly marked by one 11-year-old boy, Abdel Rahmane, who was in school when his class was hit by a shell, wounding most of his classmates.

'Where are my legs?'

"He lost his two legs. When he woke from the anaesthetic, he asked, 'Where are my legs? Why have you amputated them?'"

"You could not look the children in the eye when you are treating them, none of us could," she added.

The most difficult memory is of the day when the area was attacked with sarin poison gas in August 2013. At least 1,429 people, 426 of them children, were killed in the attack blamed on the Assad government, according to US statistics. "In 'The Cave' hospital there was no room left to put the corpses, we piled them up one on top of the other," she recalled.

Yet the documentary, made by the Syrian director Firas Fayyad, has moments of joy, like an improvised birthday party, when surgical gloves were blown up to serve as balloons. The medical staff became "one big family, we tried to find moments of joy... so we could feel human again," she said.

But as well as the daily horrors, Dr Ballour had to put up with the sexism in what is still a very conservative environment. "At the start, I heard them say things like (as a woman) I was not up to it. As well as all the pressures of the job, I had to prove that women were capable" of running a hospital, she said.