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Going Global

The Going Global blog is an opportunity for emergency physicians to share their experiences practicing and teaching outside the United States. Submit an article about your experience to EMN at emn@lww.com. Be sure to include a brief biography and photographs of the authors. Photos taken during time spent abroad are also welcome, and should be 300 dpi and in jpg, tif, or gif format.

This blog was started by the emergency medicine residents of Palmetto Health Richland in Columbia, SC, who travel the globe on medical missions. The program is under the direction of Thomas Cook, MD, who oversees one of more than 40 academic departments of emergency medicine that sponsors Global International Emergency Medicine Fellowships.

Wednesday, April 24, 2019

Medicine, Hopscotch, and Hope for Syrian Refugees

​BY MECCA MADHUN, DO, & SHAZA AOUTHMANY, MD

We pulled up to the northern Lebanese-Syrian border after a two-and-a-half-hour ride from Beirut across bumpy dirt roads, and heard little voices singing, “Ahlan bil, dakatra!” (Welcome, doctors!)

We were dressed in our Syrian American Medical Society (SAMS) vests with stethoscopes around our necks, and made our way to the clinic, long alleys of white tarps covering tin walls and ceilings. It was barren and dark; we left the door open and set up our clinic space near the light from the door. We had six plastic chairs, a small plastic side table, an otoscope, alcohol pads, a thermometer, and a stack of blank paper to act as prescription pads.

Children started streaming in. Each family had anywhere from two to 10 kids. Some said there was something wrong just so they could visit us for the day. Other kids needed some ibuprofen to get them through the upper respiratory infection season.

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Between the URIs and coughs, we saw a 12-year-old girl who complained of hand dryness. Her fingertips were peeling extensively, and she had blisters on her palms. She said her hands bled most of the time. She said she worked to help provide for her family. Every day she would move wood from one place to another. She sometimes wore gloves, though at times there weren't enough for all of the workers. We applied bacitracin, wrapped open wounds, and prescribed lotion for long-term use. She was so thankful that she gave us hugs.

We saw more than 135 children, and at the end of the day they invited us to play with them. We played hopscotch, and one of the boys allowed the group to use his soccer ball. Most of the other kids wanted to play with our equipment. After letting one child try a stethoscope, a mob of children surrounded us, screaming, “Ana, ana!” (Me, me!) One by one, we let them hear their own heartbeats.

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The two of us and another resident, Suha Al-Shambari, MD, were enlightened by our experience in Lebanon. Our program under the University of Toledo Medical Center has always encouraged residents and faculty to travel on missions throughout the world. Our program mostly ventures to South America and Central America, and going to the Middle East required much research and planning. We all grew tremendously from the experience.

By being emergency physicians, we were able to provide care for many different types of presentations and chief complaints. These included pregnancy, women's health, geriatrics, diabetes, hypertension, infectious disease, and most importantly, pediatrics. More than half of the Syrian refugees are children. Our visit helped reassure them that there are people trying to bring them health care, an education, and a future.

Dr. Madhun is a second-year emergency medicine resident at the University of Toledo Medical Center in Ohio. Dr. Aouthmany is an assistant professor of emergency medicine and the associate emergency medicine residency program director at the University of Toledo Medical Center. She is also the global medical director at the University of Toledo.