Dr. Jamil reflects on the week that he and his brother Dr. Idries spent in Jordan working as part of a medical mission providing care to displaced Syrian refugees.

Sometimes with adversity, inwardly, a person may gain so much; while outwardly, to many, it may look as though they have nothing left. Is this really so surprising though? After all consider, what can a person do when everything of material value has been taken away from them? Where can a person go when their home has been reduced to ash and to rubble? Who is a person, and who will they become when everything that once defined their very existence on this earthly plane has been laid bare? Who are they, and who will they become when they awaken to a reality that obscenely informs them that their former existence was nothing more than an illusion? A vivid dream perhaps, and one in which the specter of stability, normalcy, happiness and contentment looked and felt so real; but turned out to be no more real than the fairness, justice and repatriation is that they now so hopelessly long for? So take a moment to ask yourself the following. Does your nationality define who you are? Does your money define who you are? Are you your bank account? Do your friends define who you are? Do your family members define who you are? Does your job define who you are? Does your home define who you are? Do your borders define who you are? If these things do in fact define who you are, then who do you become when they’ve all been taken away from you? Who do you become when you’ve been stripped bare, rendered naked, and left with nothing more to hide behind? Who do you become when you are forced to face yourself and to define yourself simply by who you are and not by where you live, what you have, or who you have left? Spend some time in Jordan with Syrian refugees, and you will quickly come to know what it is that a person may gain inwardly when it looks outwardly as though they have nothing left.

When Idries and I decided to go on a medical mission to help care for Syrian refugees living in Jordan, I did not know what to expect from the experience. What would we see when we got there? Where would we be going? Who would we be caring for while there? And could we REALLY do anything to make their lives tangibly any better? How would our time there affect us? Would our time there change us? Should our time there changes us? And what if our time there didn’t change us, what would that ultimately say about us? Before leaving I wondered, were we really going to Jordan for the refugees, or were we going to Jordan for ourselves? Were we going to Jordan to serve others, or were we going to Jordan to serve our own need to feel that we were at least doing something when so many are doing so little? These were the questions that I left home asking myself, and with the mission now over; I still don’t know that I have satisfactory answers to these questions. I do know however that as I type these words, and as I really sit down and reflect upon my experience in Jordan, for the first time I find myself crying. I am crying for the refugees; I am crying for you; I am crying for me. I am crying for all of us, each and every one of us. Because what my time in Jordan with the Syrian refugees made so clear to me was that there really is no “you”. There really is no “me”. There really is no “them”. There is only an “US”. “You” are “me”, “I” am “you” and “we” are “them”. There are no Syrian refugees. There are only human refugees from Syria.

 There is a Bengali word “Praan” (প্রাণ). This word is frequently used to describe a concept best described as “The Stream of Life”. As I understand this concept, “The Stream of Life” refers to an essence, to an energy that flows through and that connects all people and all things on this planet. It refers to a believe that we are not individual people unto ourselves, living in separate places and leading separate lives. But instead, that we are all one people, living in one world, leading intertwined lives that are all connected by a force that cannot be seen, but that can be felt, if only we are willing to allow ourselves to feel it. According to the concept of Praan, when one of us cries, we all cry. When one of us bleeds, we all bleed. When one of us has been victimized, we’ve all been victimized. There is an old Bengali poem called “The Stream of Life” or “Praan”. It was written by an Indian author named Rabindranath Tagore, and it was part of a larger Nobel-prize winning collection of poetry that was published in 1910. Portions of this poem were used to create the lyrics of a song by the same name that was released by Garry Schyman in 2007. These lyrics sum up the concept of Praan better than I ever could. They sum up the belief that there is no “you”, no “me” and no “them”, only an “US”.

“The same stream of life that runs through my veins night and day runs through the world and dances in rhythmic measures.
It is the same life that shoots in joy through the dust of the earth in numberless blades of grass and breaks into tumultuous waves of leaves and flowers.
It is the same life that is rocked in the ocean-cradle of birth and of death, in ebb and in flow.
I feel my limbs are made glorious by the touch of this world of life. And my pride is from the life-throb of ages dancing in my blood this moment.”

When I first sat down to write my reflection on the time that my brother and I spent in Jordan working with the human refugees from Syria, I intended to give a day by day accounting of where we had gone, of what we had done and of who we had seen. But then, as I actually began to write this piece, it pretty quickly became clear to me that writing from the perspective of where we had gone, what we had done and who we had seen was the wrong approach. After all, this experience was never suppose to be about us. It was never suppose to be about where WE had gone, what WE had done or who WE had seen. Instead, this experience was, and always will be about the human refugees from Syria. This experience was about serving them and about telling the world their story; and I hope that I can tell their story in a way that motivates readers to help while simultaneously honoring the strength of those that I encountered and tried my best to serve.

Just to provide some context on how big the crisis involving human refugees from Syria now living in Jordan really is; during our one week in the country we visited a number of clinic locations scattered throughout the nation. We visited locations both in the Zaatari refugee camp and outside of the Zaatari refugee camp. We visited locations in the North and in the South of the country.  We visited locations in the East and in the West of the country. Now, because there is no official infrastructure in place in Jordan for human refugees from Syria living outside of the Zaatari refugee camp, the organization (SAMS) that we were traveling with often times simply would rent private clinical locations outside of the camp. These locations were located in both urban and rural areas that had large refugee populations. Once at these clinic locations, we would set up our equipment and get work; providing care to any and all human refugees from Syria that came to see us. In a day, it was nothing for us to see 300-400 patients per day at a clinic location. While the Zaatari refugee camp and the plight of the human refugees from Syria living within the Zataari camp has gained most of the world’s attention; the reality is that close to 80% of the human refugees from Syria currently living in Jordan live outside of the camp. Instead, many of these human refugees from Syria live in rural and urban areas among the Jordanian people. But while the refugees may live among the Jordanian people, they are not Jordanians. As a result, they frequently live in substandard housing and in conditions that smack of utter poverty. This is largely due to the fact that many of these human refugees from Syria frequently have few if any sources of steady legal income. Many also do not have the option of gaining legal employment and a source of steady legal income because again, they are not Jordanian citizens. So while these human refugees from Syria may live in communities where resources like adequate medical care exist, this care is largely unavailable to them because the Jordanian government only guarantees healthcare to its own citizens. In short, the human refugees from Syria living outside of the Zaatari refugee camp live among Jordanians, but they live among Jordanians as second class citizens. They live in areas where resources exist, but they also live in areas where these resources remain just out of reach. And this reality is not meant to reflect poorly on the Jordanian government. Jordan is itself a small country with limited resources. And in-spite of it’s limitations, Jordan has willing absorbed a massive influx of human refugees from Syria. Jordan has also done this while receiving inadequate help from the outside world. But, while Jordan has done it’s best to accommodate the human refugees from Syria, there are limitations to what one small nation can do.

Many of the clinic locations that I visited throughout the country were fairly austere. In fact, one “clinic” location that I worked at in Irbid was not a clinic at all. At least, it was not a clinic in the conventional sense of the word. Instead, this “clinic” was nothing more than a school that we were just using for the day to see patients. And our exam tables for the day at this “clinic”? Well, you guessed it. Our exam tables were nothing more than student’s desks that we lined up one next to the other. Putting these desks together, we were able to create a flat surface large enough for an adult to lie down on while being examined.

Now, even when actual exam tables were available, and even when we were able to care for patients at proper clinic locations, luxuries that we in the West all take for grant when seeing a Doctor were still either unavailable or were in critically short supply. For example, at every clinic location that I visited, including the clinic at the Zataari refugee camp; I was unable to change the linens on the exam tables. This was not because as one patient left the exam room the next patient would come in too quickly for me to properly prepare the room, though the pace of patients coming in and out did have an assembly line like quality to it that barely afforded me an opportunity to catch my breath. But no, instead, I was unable to change the exam table linens between patients because simply put, each exam table only had one set of linen. So there were no additional linens to change. This fact, while trivial in the grand scheme of things I suppose, really did bother me greatly. Something like not changing the bedding between patients would be absolutely unacceptable back home in the U.S., but in Jordan, when caring for the human refugees from Syria, it was not only acceptable, it was the norm. And while this norm bothered me, the human refugee patients from Syria that we served never seemed to take notice of it. Instead, they were just so happy to be receiving medical care from the group of “Western Doctors” that had made the long trek to visit them that, upon entering the exam rooms, they never even so much as batted an eye when they climbed onto the exam tables and encounter the wrinkled, balled up, frequently soiled linens. They just smiled, used the linens to cover their legs, and then climbed up on the tables. As they did so, each and everyone of them thanked me for seeing them. They thanked me because while we in the West like to believe that healthcare is a “right”, and while our politicians in the West love to validate our belief by telling us that healthcare is a “right”, the human refugees from Syria living in Jordan know better. They know that healthcare is not a right, but is instead a privilege available to the fortunate few. Funny how adversity can provide perspective.

During my time in Jordan I saw patients young and old, healthy and not-so-healthy. I saw pregnant patients who would be deemed “high risk” back at home, but who in Jordan were lucky to see a Doctor once a month. I saw women widowed who came in with complaints of “urinary tract infections”, but most of whom I am convinced just needed someone to talk to. Someone to listen to their stories. Someone to validate their humanity. I saw children who were wetting the bed nightly, not because it was a normal part of being a kid, but instead because they were suffering from Post Traumatic Stress Syndrome. I saw children who had been maimed and orphaned. Men who had been tortured and women who had been raped.

So many of the patients that I encountered  in Jordan touched me, but three in particular stand out. The first I saw in Irbid. She was a pregnant women who came to me wanting to see “the Doctor from America” just to make sure that her “baby was o.k.” Having had an old ultrasound machine at my disposal, I did a quick scan during her visit that I hoped would serve to reassure her that her baby was in fact doing o.k. Instead, what my ultrasound revealed was that not only was she well past her due date, but there also was very little amniotic fluid around her baby. Additionally, the ultrasound revealed that her baby was in the breech presentation and that the baby’s kidneys had a Polycystic appearance. In short, what my ultrasound revealed was that things were potentially not o.k. at all. Instead, she needed to be delivered by cesarean section ASAP. And after that cesarean section, her baby needed to be closely monitored to determine how well or how poorly his kidney’s were functioning. But as a human refugee from Syria living outside of the Zataari refugee camp, she did not have a “personal Jordanian Doctor” that was “assigned” to care for her. Instead she told me, her plan was simply to go to the hospital whenever labor began. She would then just rely on whatever Doctors was “on-call” at the time that she presented to the hospital to deliver her. However, in her state, with her baby being breech, having potentially compromised kidneys and very little amniotic fluid surrounding it, waiting for labor was a dangerous option. So I was presented with a dilemma that there was no obvious good solution for. Ultimately, what I did was to write an extensive letter for the patient that detailed all that I had found that day during her visit. I implored whoever it was that would ultimately read the letter to ensure that she was delivered by cesarean section immediately that evening. I included my name in the letter along with my qualifications back home. I also included the name of the medical mission that I was traveling with. I then gave the letter to the women. I told her to carry the letter immediately to the nearest hospital, and I advised her to insist after arriving at that hospital that appropriate care be given. With the letter in hand, and as she was leaving the exam room, she did what so many of the patients that I encountered while in Jordan had done at the conclusion of their visits. She turned to me, nodded her head slightly while holding her right hand towards her forehead, and then in Arabic she something to the effect of “may God bless you and always give you more”. When she, and when every other patient that I encountered said this to me, I felt a little bit ashamed. And each time I thought to myself “no, I am already blessed beyond my wildest dreams. By the grace of God, I have more than enough. So may God bless YOU, and may God give YOU more”. And as she exited the exam room, I wondered if I had given her and her unborn baby enough. I wondered if there was something more that I could have done to ensure that they would really be “o.k.”?

In Amman, while visiting a long term rehab center, I encountered 2 children that had been maimed. The first of them was a 10 year old boy who had lost most of his family in a bombing. During this same bombing, he also lost parts of both of his arms and one of his legs. And yet, in-spite of all of his losses, he was so friendly and so outgoing. With the help of an interpreter we talked for a while. I wanted to learn more about him and about his family. I wanted to show him that I cared about him. I wanted to show him that people cared about him. I wanted to show him that not all people were like the animals that had taken so much away from him at such a young age. But all he wanted to do was to talk about Sponge Bob Square Pants. Thankfully, all of the brutality that he had suffered had not robbed him of every last bit of his beautiful and innocent youth. And so………we talked about Sponge Bob, Squidward and Crabby Patties.

 

 

The second child that I met at the rehab facility was a 12 year old boy whose school in Syria had been bombed. That’s right, you read correctly. His SCHOOL had been bombed. During the attack on his school, he suffered a leg injury that resulted a chronically infected wound. His injury required extensive surgical intervention, and when I met him he was rehabbing that injury. Sadly, his Mother and his 3 siblings had been killed in a separate bombing months before his school bombing. Only he and his Father were left. When I asked him whether or not he was sad or angry, he simply looked at me, smiled, and then said “no”. Instead, he said that he was “grateful to be alive” and that he knew that there were “people who had it worse” than he did. That’s right, he said that he knew that there were people who had it worse than he did!!! He had a chronic leg injury, had lost his home, all of siblings and his Mother; and still he was concerned about those doing worse than he was. While his statement showed a great degree of selflessness and an insight well beyond the child’s 12 years, the sad thing about what this child said was also that he was right. There were those who had it worse than he did. Friends, I could share story after story after story with you. I could share more stories with you about who I saw, about what I saw and about where I went. But there’s no need, because these last two children’s stories tells you all that you need to know about the human refugees from Syria now stranded in Jordan. At the outset of this blog I asked the following questions. Does your nationality define who you are? Does your money define who you are? Are you your bank account? Do your friends define who you are? Do your family members define who you are? Does your job define who you are? Does your home define who you are? Do your borders define who you are? If these things do in fact define who you are, then who do you become when they’ve all been taken away from you? Who do you become when you’ve been stripped bare, rendered naked, and left with nothing more to hide behind? Who do you become when you are forced to face yourself and to define yourself simply by who you are and not by where you live, or what you have or by who you have left? Perhaps these two quotes from the legendary poet Khalil Gibran say it best. “Out of suffering have emerged the strongest souls; the most massive characters are seared with scars” and “Yesterday is but today’s memory, and tomorrow is today’s dream“. Human refugees from Syria are strong and resilient. The strength of their character is like nothing I’ve ever seen before. Their past is in many ways outwardly very tragic, but they do not feel sorry for themselves. They also do not want you to feel sorry for them. Their past represents a memory that they outwardly are struggling to cope with. But inwardly, they look with a deep seeded faith and an unwavering enthusiasm towards dreams of a better tomorrow.