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Emergency Physicians International was founded in 2010 as a way to tell the stories of the heroic men and women developing emergency medicine around the globe. This magazine is dedicated to their tireless efforts saving lives in the harshest conditions, 24/7/365.
Logan Plaster, Editor

Flying Doctors in Syria – Care Amidst Human Devastation

Flying Doctors in Syria – Care Amidst Human Devastation

A child is born in a refugee camp. Without access to any food besides breast milk, he grows slowly. He does not receive enough Vitamin D and develops rickets.

An eight-year old child watches his family die in an explosion. From that point on he is mute, too psychologically traumatized to speak.

A ten-year-old girl, trapped in a fire, suffers burns to more than 50% of her body. She survives but is horrifically scarred, both physically and mentally.

A pre-teen boy loses his father to bombing and becomes his family’s sole provider. He is then injured in a farming accident and, without medical care, is forced to heal on his own. The permanent deformity to his leg now affects his ability to work.

A teenager finds a dead body while playing with his friends. The image haunts him in his dreams – nightmares that mirror his reality.

A father raises his children alone after his wife dies from a preventable disease. He feels helpless when he can’t provide them with a home or an education.

A mother falls into a deep depression after her family has to leave everything behind overnight. She now lives without running water or electricity in the stifling heat of the Jordanian desert.
For those living in Syrian refugee camps, these situations are the norm. These and many other stories were passed on to me by those who lived them, and who are still living them. While the rest of the world has moved on, the effects of the Middle Eastern conflict continue to ripple.
My personal goals in international work have evolved through the years, impacted by my education and experiences. I currently work with a handful of small organizations, as well as a larger group, the Flying Doctors of America. The Flying Doctors were created in the 1990s as a non-profit, non-sectarian organization. Their mission statement aligns with my own, with the goal of providing “hope & healing” to marginalized populations around the world. While many medical missions provide a similar function, they are often religiously based. In certain locations, religion can have an impact on how medical care is received. The neutrality of Flying Doctors lends itself to trust and reliability. This is important not only to medical care, but also to volunteer safety in politically charged areas.

My prior experience in international settings touched the surface of humanitarian work, but I could not have predicted how my time with the Syrian refugees would change my perspective. In the midst of such devastation, how do we as outsiders make a difference and leave these lives better than we found them? As a physician, I am trained to look at a big picture and identify systemic problems within a community. With displaced populations, this becomes more complex. Limiting communicable diseases takes priority over diabetes education. Water sanitation trumps hypertension. The epidemiology within refugee camps completely shifts the typical goals of healthcare. Our organization works to make small changes that will be cumulative over time, but it often feels like bandaging a wound that will quickly bleed through.
In Syria, as in most settings of displaced persons, communicable diseases spread rapidly due to close proximity and unsanitary living conditions. Patients with skin infections and parasitic diseases were numerous in my small mobile clinic near the Syrian border. All of these illnesses are medically treatable. More concerning was the mental health of those who walked through my door. “How long have you been in the camps? Who lives with you? What are your living conditions like? Are you having nightmares?” I asked them, steeling myself. There was no way to prepare for their answers. Often, I had to take a moment in between patients to wipe tears from my eyes.

The extent of physical and emotional trauma witnessed in the chaos extends beyond post-traumatic stress disorder. The Syrian conflict has given birth to a new term: human devastation syndrome. It is not uncommon for entire families to be wiped out, leaving one or two survivors with an unimaginable burden to shoulder for the rest of their lives. The Adverse Childhood Events study on childhood stresses emphasizes that traumatic incidents early in life significantly impact mental and physical health into adulthood. Children who bear witness to tragedy and loss face an uphill battle, and healthcare is only a fragment of this. The power of the Syrian conflict to transform an entire generation is unthinkable.
Before they fled their home country, many refugee families were working middle-class, with an income, education, and lives they were proud of. They now live in tents in random camps¬, finding work from day to day. They struggle to raise children without access to healthcare, schools, and in many cases, food. Infants, born in the camps daily, often die because of harsh living conditions. With no birth certificate or documentation of their existence, it is as if they simply vanish. As the eyes of the media have turned away, many Syrians fear they will vanish as well. They asked me to return home and share their story – to help them overcome this feeling of invisibility to the rest of the world.

For the past five years, conflict in this area of the world has had a devastating impact on humanity. For a time, it was at the forefront of the news: photos of Aleppo before the war were contrasted with the vast expanses of rubble and heartbreak that exist today. The mainstream media exploited suffering for viewership. While ethically questionable, attention paid by the media influences the public’s desire to participate in ongoing relief efforts. However, the sheer availability of global media coverage today contributes to information overload. The scale of suffering in crises like the Syrian conflict can lead to compassion fatigue in viewers, influencing those who create the news to focus elsewhere. But the crisis is not over because the cameras are off. Social media allows us to swing the focus back to the refugees, honoring them by sharing their stories.

Social media also allows healthcare professionals to make connections and work together remotely. Perhaps more importantly, it can serve as a bridge from burnout back to functionality. While incredibly rewarding, working against the intractable problems of the Syrian refugees also led to feelings of despair and inadequacy. I was able to share their stories as well as my own experience on my blog. I could also connect with like-minded individuals via other forms of social media, which helped me to rekindle my passion for humanitarian work. Now that I have returned to the United States, I can stay connected with Jordanian medical students and organization leaders. Maintaining lines of communication lends itself to continued discussions, and planning of future projects.

Although my time working directly with the Syrian refugees was limited, it impacted my approach to humanitarian work drastically. I don’t have the answers when it comes to fixing these big problems. I do know, though, that the human spirit is resilient beyond measure. In times of conflict such as the Syrian crisis, this resilience keeps entire populations moving forward, while also motivating us as healthcare workers to continue our work for them.
When I returned to the US after working in Jordan, I continued to ask myself if I had truly made a difference. Successful international interventions depend on sustainability, but I found that with displaced populations, this is much more difficult. Healthcare is complex, and the most successful measures require a sustained, multi-disciplinary approach. It is difficult then, to imagine a powerful impact from a small team of healthcare workers in less than a month. But is a small difference better than no difference? When it comes to health, absolutely.

 

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