By Dr. Anwar Hussain, April 2019
I am an ER physician from Chicago. I was in Lebanon as part of a medical team with #MedGlobal in April 2019. We worked in partnership with MAPs (Multi Aid Programs), founded by Dr. Fadi, a Syrian neurosurgeon.
The team included multi-specialty medical and surgical teams. We worked in different camps and locations depending on need/specialty and also due to OR/Cath availabilities. Here, I share my experiences as an ER physician at an acute care facility.
I was at one of the #MAPs medical centers which had three-bed acute care facility. I worked with a Syrian Internist, several nurses, and techs – who are all refugees. At the acute care center, I saw a significant number of pediatric orthopedic injuries, abdominal, chest complaints, asthma/COPD exacerbations, diabetes, and hypertension related issues, viral syndromes, lacerations, wound infections, and burn injuries.
The nursing staff, comprising of all Syrian refugees, were very skilled. They were able to provide wound care, incision and drainage, casting, IVs, nebulizer treatments, and laceration repairs. Their skill set was quite impressive.
For any labs or imaging, patients had to go to the labs and x-ray center, which is a 10-minute walk to a different facility, and then they bring back their images and lab results with them. There is also a physical therapy center, which helps with crutches and physical therapy needs, which was also a 10-minute walk from the center. The EKG machine was quite archaic but it did the job. Patients with chest pain would get an EKG, but if they needed a troponin, they would have to go to a lab at a different center, and the results will be available after 24 hours or they’ll have to go to the hospital. Fortunately, I didn’t see any STEMI (acute heart attack) patients during my stay there.
The other clinical challenge was language and cultural norms. Fortunately, we had interpreters most of the time. The women are dressed from head to toe, and it becomes challenging to evaluate these patients for abdominal or low back complaints. I had a female interpreter in the room who was able to explain the indication for the exam and allowed me to examine them appropriately.
The lack of medications was also a challenge. With any refugee crisis, there is very limited availability of medications. We had to choose from a few antibiotics, diabetic and antihypertensive meds, to treat a vast array of acute and chronic conditions. Fortunately, we didn’t have many patients with allergies to these medications.
The pain medications were basic, primarily acetaminophen or ibuprofen or their equivalent. I bought bottles of acetaminophen and ibuprofen from Costco, and they were a hot commodity. Patients with acute fractures, cancer patients and victims all received pain control with these basic analgesic options.
We didn’t have any monitors or ability to do CT scans at this site either. If anyone needed a CT, they would have to travel to a different hospital which is far and not easily affordable.
Overall, I was impressed by the MAPS facility, refugee medical staff, and the patients. We were all welcome with open arms, hugs, mint tea, and smiles. As people found out the American doctors are here, they even got their family members to come for a medical opinion. They are an amazing group of people, very resilient, proud and talented. Even though they all have gone through traumatic experiences of war, they are not giving up. They hid their sadness behind their smiles.
One common story I heard from many Syrian refugees was that their family is scattered all around the world. Their siblings, parents, spouse or kids are somewhere in Europe or other parts of the Middle East and they haven’t seen them in years.
While the world is engaged in all kinds of political battle, the refugees and the MAPs leaders with all kinds of challenges and uphill battle, are not looking back. They are determined to succeed.
One day our MedGlobal medical staff was invited to a school and we saw these amazing, beautiful children who gave speeches in Arabic and English, and they are all determined to become doctors, engineers, musicians, and soccer players.
This was my first visit to this region, and I was humbled by their condition and their resilience. I will not be surprised to see these children become future leaders. I hope we all do our best to help the refugees and especially find a way to help educate the kids, who otherwise will become victims of crime or human trafficking. I wrote this column because I was impressed by their approach of making education a priority, otherwise, a generation could be lost. It will be unfair if I do not plead for help on their behalf.
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