German prosecutors accused a Syrian doctor Wednesday of torturing detainees and killing one of them while working in military hospitals in his war-torn homeland, on the first day of a landmark crimes against humanity trial in Frankfurt.

The accused, identified as Alaa M under German privacy laws, arrived in Germany in 2015 where he continued to practise medicine until his arrest.

The trial at Frankfurt’s higher regional court is the second of its kind in Germany, and adds to other European efforts to hold loyalists of President Bashar al-Assad’s government to account for alleged war-era atrocities.

Alaa M faces 18 counts of torturing detainees at military hospitals in Homs and Damascus in 2011-12, including setting fire to a teenage boy’s genitals.

He also faces one count of murder, for having allegedly administered a lethal injection to a prisoner who resisted being beaten.

The accused helped to perpetrate “a systematic attack on the civilian population,” said federal prosecutor Anna Zabeck as she read out the charge sheet.

He “tortured detainees by inflicting substantial bodily harm on them”, she told the court.

He has denied the allegations.

Prior history

Al Jazeera’s Dominic Kane speaking from Berlin said Alaa M did not directly enter a plea in Wednesday’s deliberations.

“Instead, he spoke to the judges and to those gathered in court about the course of his life while he was in Syria, and what he has been doing here in Germany since coming here in 2015,” Kane said.

Alaa M became one of some 5,000 Syrian doctors in Germany who have helped ease acute staff shortages in the health sector.

The father of two children, who has worked in several German hospitals, did not address the charges in his initial remarks but acknowledged he had worked at a military hospital in Syria.

He said he had no problems living as a Christian in mainly Muslim Syria before the war and that he made a payment of $8,000 to be exempted from compulsory military service there.

His trial came after another German court last week sentenced a former Syrian colonel to life in jail for overseeing the murder of 27 people and the torture of 4,000 others at a Damascus detention centre a decade ago.

Universal jurisdiction

The proceedings in Germany are made possible by the legal principle of “universal jurisdiction”, which allows countries to try people for crimes of exceptional gravity, including war crimes and genocide, even if they were committed in a different country.