Blumenfeld: Medical care for Syrian refugees, a gentle jihad of hope

This young, Syria- refugee girl was among children who got medical treatment at a make-shift pediatric clinic in the Al-Zaatari refugee camp in norther Jordan, the biggest refugee camp in the world.
This young, Syria- refugee girl was among children who got medical treatment at a make-shift pediatric clinic in the Al-Zaatari refugee camp in norther Jordan, the biggest refugee camp in the world.Fairfield Citizen/Contributed

EDITOR'S NOTE: The writer is a retired pediatrician who recently returned to Fairfield from a medical mission to treat Syrian refugees.

The Hashemite Kingdom of Jordan is exactly that -- a kingdom. Unlike the vestigial European monarchies, in Jordan, the king retains considerable personal power within a nominally constitutional framework. Jordanians seem quite happy with this arrangement; King Abdullah is seen as a good king who works hard for his country. The notion of a future "bad" king is dismissed with a smile, as if I were suggesting that the sun may someday rise in the west.

So it was something of a royal decree that opened the Jordanian border to Syrians desperately fleeing the horrific violence in that country, often with just the clothes on their backs, and having witnessed the razing of their homes and the deaths of family members. In a demonstration of Arab hospitality on a grand scale, more than 600,000 Syrian refugees have entered Jordan since 2010. Another 2.5 million Syrians have escaped to other neighboring countries. The exodus into the unknown of whole communities escaping a war zone has never been experienced, or even imagined, by virtually any living American.

As much as I enjoyed my tour around Jordan, it was the Syrian refugee crisis that brought me there. Inspired by friends who preceded me in March, I joined a seven-day medical mission coordinated by the Salaam Cultural Museum, a Seattle-based nonprofit organization that promotes a better understanding of Middle Eastern and North African cultures. SCM also provides humanitarian aid to people affected by conflict and natural disaster. Since 2012, they have organized teams of medical, dental, pharmacy and mental health professionals to provide care to Syrian refugees in northern Jordan.

The reaction of most people before I left went something like, "You're going where?" Jordan is quite safe (believe me, I checked), so I easily shrugged off concerns for my personal safety. More intimidating, though, was the prospect of dusting off my long-dormant pediatric skills. The mission staff insisted they were happy to have me, but the best confidence-builder I could come up with was to repeat to myself that I was better than no doctor at all.

In Jordan, there are a few "official" refugee camps overseen by the U.N. and the Jordanian government. But about 80 percent of refugees find a place to live -- legally or illegally -- outside the camps in communities where they may have family or friends from their hometown in Syria. Each morning, we piled into our vans and drove to one of these communities to conduct clinics, but one day was spent at Al-Zaatari, quite possibly the largest refugee camp in the world.

It turns out that doctoring is like riding a bike. My stethoscope accurately located hearts and lungs, and eardrums still looked like eardrums. I floundered with non-American medication names and dosages, but the team pharmacist was there to bail me out. I had excellent interpreters. What I lacked, though, despite advance

expectation-setting, was any way to prepare for the conditions under which I would practice pediatrics.

The daily clinics were makeshift spaces not meant for health care, typically a school or community center. Word had already spread that we were coming, and by the time we pulled up along a hardscrabble, dusty side street, a crowd already had gathered in front. We picked our way through the crowd into the building, and then perhaps up or down a flight of stairs, to set up for the day.

A typical "exam room" was a small office or classroom. We made do with whatever furniture was there, and because of space limitations, two, or even three, practitioners often shared the space. If I had the luxury of an exam table at all, it might be two school desks pushed together with towels thrown over them. Forget lab tests or X-rays. We did brief visit write-ups, but never had a medical record to consult.

The mission teams combined for more than 2,000 encounters. The usual day was a six-hour nonstop session, amid a constant din. Most of the children I saw, amazingly, looked quite healthy, and presented with colds. I did not see an acutely ill child all week -- no raging infections, no dehydration -- which I took as a good thing.

A little probing, though, as precious time permitted, revealed other issues: scarcity of healthy food; iron deficiency; poor water quality; unavailable schools; few referral resources for chronic conditions; tooth decay; epidemic bed-wetting; palpable grief, anxiety, and depression in children.

Waiting hours so your child can see a physician for cold symptoms was, in my view, a way for these exhausted, homesick parents to get reassurance about their children. I took every opportunity to offer just that.

The Al-Zaatari camp was a very different experience, with all problems amplified. A few hundred thousand people, more or less, live in limbo in a teeming, semi-permanent city. Refugees without proper identification and sponsorship are essentially imprisoned in the tightly guarded camp. Families are housed in what can only be described as storage containers spreading far into the desert. There is not a stick of green anywhere.

I worked in the camp's spartan health center with a Syrian pediatrician who comes to Al-Zaatari regularly from Amman. At first I wondered what made this man tick, but as I watched him work, I understood. In his gentle, dogged way, he was on his own jihad -- in Arabic, and with no evil connotation, quite simply a struggle -- to save a generation of Syrian children. The greatest heroes often go unnoticed, but I met one that day.

You can make a donation to SCM through my fundraiser, Ron's Medical Mission, via this link: http://bit.ly/1xBUIds

Ron Blumenfeld is a Fairfield writer and retired pediatrician. His "Moving Forward, Looking Back" appears periodically. He can be reached at rblumen2@gmail.com.