“Tragedy and triumph” – Doctor recounts medical mission to treat Syrian refugees

May 11, 2017 | by Madhavi Ryali, M.D.
Categories: Healthy Driven Heroes

As expected, our mission was an awakening of sorts. I managed complex medical issues for refugees. I also managed my own feelings of guilt knowing that at the end of the mission I would get to return to my comfortable home. Ironically, the patients I treated were so much closer to their homeland than me, but they won't be able to go home for a much, much longer stretch.

As anticipated, I bore witness to both tragedy and triumph in the refugee camps.

Pediatric patients

While in the camps, I was asked to see a 6-month-old boy with fevers. My colleague, Dr. Elaine Spirakes, examined his brother who was only a year older. Both of us were anxious about our evaluations, relying more on our experiences as mothers than doctors — we last saw pediatric patients many years ago in medical school.

The babies' parents smiled reassuringly at us, as it seemed they trusted our medical opinions more than we did. My ever-patient translator, Kenan Alhayek, also helped alleviate my stress, given that his top-notch translation skills made it seem that I was speaking directly to the baby's parents without a language barrier.

I held the baby's tiny body, and my mind wandered off to my own experience as a mother of a sick 6-month-old. I remember sitting in Dr. Uzma Mohsin Muneer's office, frantically explaining details of my daughter’s fever to her.

I remember the urgency and fear of having a sick baby who couldn't communicate with me. I remember praying that her recovery would be quick so that she would feel better sooner.

It is a true injustice that any parent should have to experience these anxieties with the additional stress of having limited running water, plumbing, electricity and financial resources to get help. In that moment, my heart connected with these young parents who are trying their best to provide for their children when every possible obstacle has been put up to prevent them from doing so.

Patients on dialysis

A group of us was sent to Bekaa Valley, which is a farming region 20 miles outside of Beirut in the northeast corner of the country. It lies on the border of Syria, and as such, houses large populations of Syrian war refugees.

The Syrian American Medical Society (SAMS) Lebanese team gathered nephrology patients for me. Many of them were dialysis dependent. Dialysis dependence in any living condition is a tremendous weight to bear – the treatments are frequent, aggressive and life sustaining.

I sympathize with dialysis patients back home in Chicago who are required to make their appointments despite brutal winter weather conditions. Well, then imagine trying to sustain such a regimen in a besieged war zone.

Even if one could fortuitously make the journey to a dialysis clinic in such a situation, they very likely have no means to pay for dialysis when there is no Medicare, no commercial insurance, no Obamacare. The government barely supports food and water for refugees, let alone costly dialysis treatments.

SAMS steps in and graciously assists patients in finding non-governmental organizations (NGOs) to financially support their therapy. However, like everything else, dialysis must be rationed; patients get treatments twice a week instead of the recommended thrice-weekly therapy. Younger patients are prioritized over the older. Over time, the toxic metabolic renal milieu catches up with these young people.

In the U.S., I counsel patients to think of dialysis as a temporary period in their lives. Many American patients become eligible for kidney transplantation over time. However for a refugee, transplantation is impossible due to lack of funding for immunosuppressive medications and the overall medical support that is required to keep a graft alive. Beyond that, I was told that there is a bureaucratic law that actually makes the transplant surgery illegal.

The triumph

The triumph during that visit to the Bekaa Valley was meeting the children of the camps. I visited a preschool and met with 20 exuberant little faces who were learning their ABCs. Of course my mind went to my own two effervescent butterflies back home, my daughters. They would have easily fit in with this crowd of kiddos who were extraordinarily jovial with me despite being among the most vulnerable human populations in the world.

Please don't forget the Syrian refugees and other vulnerable populations around the world.

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