Review: "Born at the Gates of Hell" by Maria Milland

Born at the Gates of Hell by Maria Milland
Published February 2026 via Steerforth
★★★★

I have been to other refugee camps before. But right away I can tell that this camp, with its residents, its army of aid workers, and the massive presence of guards, is like nothing else I have ever experienced. This is a detention camp storing people. (loc. 388*)

The al-Hol refugee camp in Syria was not Milland's first foray into humanitarian work, but it was unlike anything she'd seen before. There as an OB/GYN with the Red Cross, her work was constantly complicated by security concerns and cultural mores and just plain uncertainty. At al-Hol, again unlike anything Milland had seen before, oxytocin was routinely used to speed delivery—not for medical reasons but because both patients and staff had to be out of the hospital before dark, because it was too dangerous to leave later. Or: Milland learned early on that before she asked if a woman could be pregnant, she had to ascertain whether the woman was married, because it wasn't possible for an unmarried woman to be pregnant. (And if an unmarried woman were pregnant, she'd have to give birth in secret and quietly give the baby up.)

The statistics are striking. Milland describes a camp that had been open and closed, open and closed again; established for 15,000 people but holding around 57,000 when she worked there. That's roughly the population of Chapel Hill, NC, or Casper, Wyoming, but where Chapel Hill might see one or two murders per year, al-Hol saw 85 deaths to violent crime in 2021 (loc. 1459).

It's a thoughtful book. In addition to an overall view of what it was like working at the camp, Milland discusses individual patients she saw, the people she worked with (and learned from, since the context is so specific and unlike medicine performed in wealthier contexts), and just the sheer exhaustion of providing care in such a harsh environment. I appreciate the way she talks about the value her interpreter brought to the process—interpreting not just language but also cultural meanings and the like. This is a kind of memoir that I love (telling hard stories about things I am unlikely to experience firsthand but that are so important for more people to know more about), and does not disappoint.

One thing of note: Milland wrote the original in her native Danish, and then she did her own translation for this English edition. I can't speak to the exact translation, of course, because I speak precisely zero Danish, but I am so impressed with the outcome nonetheless; translation is an art rather than a science, and if it hadn't been noted in the book I would not have known that this was not a professional job.

*Quotes are from an ARC and may not be final.

Thanks to the author and publisher for providing a review copy through NetGalley.