What I Saw From the Frontline of Syria's Humanitarian Crisis

As diplomats continue to make their strategic moves on what to do in Syria, the tally of dead and displaced Syrian civilians only continues to grow, and their voices remain largely absent from the public discussion. As a North Carolina born, Syrian-American medical student with much of my extended family still in the country, I recently had the opportunity to meet some of these families and hear their stories firsthand. 

I was on my first bus ride down to Kilis, Turkey, a small town bordering Syria filled with tens of thousands of refugees when I attempted to make small talk with the first of hundreds of Syrian refugees I would see over the following five weeks.

"So are you staying in Gaziantep or Kilis?” I asked. “We don’t live anywhere,” he said, pointing out his wife and five children in the minibus. “We left Syria two weeks ago, and have been going to different camps in Turkey but haven’t  been granted access anywhere. In the meantime, we’ve been sleeping in bus terminals.”

He went on to tell me that his family was the last to leave his neighborhood in Syria, where missile strikes had blown past his home on a daily basis. His five-year old son fell into depression in Syria as the streets gradually emptied, and would often tell his father, “I just want to play.”

“For my family’s safety and the children’s happiness, we had to leave,” he said.

Hearing their tragedy provoked the urge to help then and there. I had some bread left over and was debating whether giving it to them would be received with offense or appreciation. I gave it to the mother, and instead of distributing it then, she pocketed it for later.

Returning to the father, I asked what, were he given the opportunity, he would want to say to the outside world.

“A word to the world,” he began, “that you use your conscience when considering the Syrian people, that you regard Syrians as human beings, who, at the very least, have a right to life. We are not asking for anything but to live in dignity. The international community, especially America, speaks daily about “red lines.”

Assad has raced past all red lines. He has created rivers, not lines, flowing in blood. Missiles, air strikes, bombs, bullets, and chemical weapons are being used on us daily, and the world continues to watch.”

He paused for a moment, then pointed to my water bottle. “That water has become more expensive than Syrian blood.”

I didn’t know how to respond. I was trembling from the gravity, pain, strength, perseverance, and fortitude in what he had just said.

Arriving in Kilis, the man and his family left the bus station with a handful of black trash bags filled with their belongings, on their way to a public park where thousands of refugees squatted, waiting for access to a new camp that was set to open soon. After a 15-minute cab ride, I arrived at the makeshift polyclinic where I would be working, only to find out that the park, dense with homemade tents of blue plastic tarp hoisted onto laundry rope, the only shelter from the piercing sun and 100-degree heat, was right in front of me. If I had known, I would have given them a ride at the very least.

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In a room filled with handsome youth who were recovering from shrapnel and bullet injuries --- many of whom were amputees, bowel-incontinent, or paralyzed, never to walk again --- I met Kareem, a nine-month old boy with a cleft palate whose father had come to Turkey in search of treatment.

Kareem’s mother had been wounded by shelling in Aleppo and her fate and location were unknown. Kareem’s cleft palate had made feeding difficult, and he was so malnourished that he was unable to sit on his own. When I asked to hold him in order to listen to his heart and lungs, I was momentarily struck by how badly he smelled from poor care.

I rocked him for a few moments, and as our eyes met, his weak mouth yielded into a smile. I was suddenly seized by sadness. Here was a boy who, at his age, should have been standing, whose mother was unaccounted for, whose father didn’t know how to care for him, and who had been abandoned by the world. I couldn’t bear the thought of at least not trying to help him.

Kareem needed a nasogastric feeding tube immediately, but no pharmacy or NGO nearby had one. I was able to find two pediatric tubes an hour away. I asked the father to bring him to the clinic the next day, where I gathered a history, measured his weight, took pictures, and after watching video tutorials online on proper tube insertion, proceeded to help the pediatrician at the refugee clinic in inserting and securing it.

At the same time, I reached out to Dr. John van Aalst, director of pediatric and craniofacial plastic surgery at UNC, who travels to the region to perform cleft palate repairs. After hearing Kareem’s story, Dr. van Aalst connected me with the Palestinian Cleft Society, which has provided Kareem’s father with proper supplies including bottles, nipples, and formula, from Jordan.

A month later, his father informed us that Kareem had gained significant weight and is standing with help from his family. His cleft palate repair is pending sufficient weight gain.

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She came into the clinic with her husband, panicked and in pain, as the clinic was closing for the day, with only me and a male internist left on site.

“Help me,” she said. “I’m seven months pregnant, my water broke four days ago, and I don’t feel the baby moving.”

Having to think on my feet, I told her to come in, fumbled with an ultrasound, and was able to determine the presence of a fetal heartbeat.

“Baby’s alive,” I said, smiling as mom and dad squeezed hands tightly sighing in relief. What next? I performed a pelvic exam and determined she was likely in active labor and needed to go to a hospital. She had already visited a couple of hospitals in Turkey, but had been told she was fine and rather than admitting her, gave her medicines to prolong the pregnancy.

Even after the medications, she had continued to contract. Like so many of the refugees I met, uprooted from their homes and bereft of even the ability to communicate their needs due to the language barrier, she had grown frustrated and spoke of re-entering Syria. If she delivered there, her baby would likely die --- a fate she had nearly resigned to. I convinced her to go to the Turkish hospital, where they had a NICU for premature babies, and joined them in the ambulance, interpreting my assessment. Surely enough, she delivered a baby boy seven hours later.

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António Guterres, UN High Commissioner for Refugees, has described the Syrian refugee crisis as “the great tragedy of this century, a disgraceful humanitarian calamity with suffering and displacement unparalleled in recent history.”

I don’t know how the international community should work to end the upheaval in Syria. But I do know that each of us can work to alleviate the suffering by getting involved, getting educated, and mobilizing within our communities to provide refugee mothers, fathers, and children with the humanitarian aid they so desperately need.