June Medical Mission Reflections

Hello, My name is Neil. I’m a family and emergency physician. Earlier this year I was visiting Turkey and became increasingly interested in the Syrian conflict, as border skirmishes and politics kept it in the news frequently. I’ve been aware of it, but something about proximity makes it more palpable. Due to widespread unrest in Turkey it seemed more viable to volunteer in another area such as Jordan. The area in Turkey where I was looking to assist was the site of a truck bombing, which solidified my decision to go elsewhere.

I spoke briefly over the phone with a very dynamic physician who happened to be practicing in my hometown in Ohio (Humam). I had been in communication with a medical resident from Damascus who had been in Jordan for several months (Bassell). Coordination was done primarily via email with an extremely helpful lady back in Seattle (Rita).

Not having any prior acquaintances, I flew to Amman, which was my first trip to the Middle East. The customs official was polite, but took his time examining my documents interspersed with some stern and questioning glances. I was greeted by one of our drivers, who proved to be incredibly helpful during the trip. I waited in Starbucks for the next flight from Chicago to land. I was nervous and spoke no Arabic, so I wandered into the airport Starbucks for something more familiar. Having traveled frequently, I took to expressions and hand gestures to communicate. In broken English the barista confirmed my order and I without thinking I gave the thumbs up…which as you may be aware, is not nearly as polite a gesture in the region as it is in the US. Soon a very kind and friendly physician arrived (Eiad) and we drove back to the hotel together.

We met in the lobby of the hotel that evening and I finally got to meet many of those I had heard about. I was relieved to discover that I was not the only one who did not speak Arabic. One physician was from southern Oregon and had no prior affiliation with our group. We retired early and awoke to get breakfast together at the hotel. Some of the group was staying at another hotel, as there was a SAMS medical conference coinciding with the mission.

While not unfamiliar with medical relief, I was continuously nervous and unbalanced by my lack of familiarity with the culture and language, and not having any friends in the group previously. Also I had somehow been missing the briefing emails that were sent out to the group.
Our first day was al Zataari camp in the north near the Syrian border. This is a city of tents and sheet metal structures whose population of close to 200,000 women men and children make it among the largest refugee camps on the planet. Entry took a long time, and we found out later that a Jordanian policeman working there had been killed the week before after some sort of disagreement.

Most of the problems were ambulatory issues but one young girl had to be sent to the hospital. There was a hepatitis outbreak in the camp, and for some logistical reason they were not implementing a vaccination protocol.

The next several days were spent at various hospitals and clinics in the greater Amman area. Some were established facilities, but others were people’s homes that we co-opted for several hours. One facility took care of spinal and peripheral nerve injuries.

The illnesses we saw were largely ambulatory, but many would be devastating if left continually unaddressed. The stories that were revealed after a basic medical history were heartbreaking. I’ve worked in downtown Detroit, and rural Appalachia, as well as areas affected by civil conflict in South America such as Ayacucho, Peru, where the Shining Path had heavily impacted the communities. Nothing prepared me for what we saw. Nothing that I could speak or write could convey the abyss of despair that has consumed these people. They were from all walks of life, teachers, bakers, mechanics, artisans, professors, and the like. They had lost their homes, their family members, their friends, and their country. Seeing small children missing limbs because an errant bomb dropped on their house is gut wrenching, then to discover the parents and siblings were killed in the attack adds an entire new level of suffering.

Part way through I took a break from the mission to attend the medical conference. While it was interesting, and I constantly seek new information to bring to my practice, I felt like I was wasting my time sitting in a room listening to lectures while the others were seeing patients.

The work was difficult, we woke early and often stayed up late sorting medication after dinner for a few hours to be ready in the morning with just a few hours sleep. I lost about 10 lbs. during the trip.

Returning to the US was a system shock. The idyllic life in the affluent and insulated communities of Seattle was a stark contrast to all we had just witnessed. So the question some may ask is why did I go? I’m not Muslim, or Syrian, or ethnically Arab. I’m a spiritual person, but not particularly religious. I don’t have any political affiliation that would dictate involvement. If we see suffering and choose to do nothing, are we complicit? What lengths should one go to if one determines assistance is needed? What is a reasonable approach to help? For me I don’t understand the politics, the cultural nuances, or the historical precepts. I only know what I can do. MK Gandhi said that the difference between what we do and what we could do is sufficient to solve all of the world’s problems.

Flying to Jordan and spending over a week there is not reasonable or possible for many people. I have a general policy that the highest form of charity is personal involvement, so I tend to spend money and resources on organizations that I deal with directly. Again, many people don’t have the time for this. For some, giving money or supplies is all they can do. Others are not well off enough for this. What I would ask is that if you can do nothing else just take the time to remember these people, say a prayer, give a kind word, tell a friend about what’s going on, and why it’s important to help. If nothing else just be aware that we live wonderful lives. Thankfully, many of us will never have to know pain like this.

Neil McFarland MD

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