The medical professionals of Medecins Sans Frontieres are increasingly coming under fire from militants, despite their valiant efforts to provide much-needed care in areas where the health system has often collapsed.
A group working diligently, quietly and courageously behind the scenes in war-torn Syria made headlines when they, against all international laws, became targets.
Last month, Dr Muhammad Maaz, one of the last paediatricians in Aleppo, was killed in air strikes along with dozens of other medical staff at Al Quds hospital. Six other medical centres were targeted, including a maternity clinic, in only weeks.
Al Quds was one of more than 150 hospitals supported by Medecins Sans Frontieres (MSF) in the war-torn country. The organisation directly runs six facilities in the country, while providing funds and medical supplies to the others.
The death of Maaz, who worked overtime under bombing to save lives, hit a chord internationally. It highlighted the dangers medical staff face when working in the war-torn country.
According to MSF, 23 medical staff were killed and 58 injured in Syria last year, while 82 centres supported by the group were bombed – 12 of them destroyed. There were also regular attacks on ambulances.
When not targeted by bombs and air strikes, group members are also in the sights of terrorists. In January 2014, ISIL abducted 13 MSF staff members. Among them were eight Syrian colleagues who were released after a few hours. The five other staffers were held for up to five months before bring released.
“It is unacceptable and a breach of international humanitarian law to target those trying to save lives,” says Dr Amber Alayyan , who has worked with Syrian refugees since 2013 and with MSF since 2011.
The paediatrician, who works as a medical coordinator for MSF, was on a brief visit for meetings in Dubai before returning to Turkey.
“Medical providers and facilities are under constant threat in Syria,” she says. “The doctors and medical personnel continuing to work there are true heroes.”
Before focusing on the Syrian crisis, Dr Alayyan worked for a decade in Africa, Pakistan and other parts of the Middle East, including Palestine.
She is one of the many MSF personnel who regularly pass through Dubai, which is a centre for the organisation’s work throughout the region. MSF has been in the UAE since 1992 under the patronage of Sheikh Nahyan bin Mubarak, Minister of Culture, Youth, and Community Development.
Last year, 266 people on assignments for the organisation, or working for them full-time in operations, medicine, logistics, human resources or communications, passed through the emirate.
MSF medical staff stop in Dubai for briefing and debriefing, applying for visas, in transit, meetings and training before they head back to their home countries or to projects.
The body has two offices in the UAE, a branch office in Tecom and a logistics office, which is in the Jafza One building. It also has a warehouse in Jebel Ali where non-food items such as blankets and tents are stocked.
In total, 26 local staff work in executive functions, finance, human resources and administration, communications, fund raising and logistics.
Internationally, MSF won the Nobel peace prize in 1999 for delivering emergency medical aid to those affected by conflict, epidemics or disasters. Traditionally, it moves into areas to pick up after health systems collapse.
“One of the things often forgotten in humanitarian crises is that besides the immediate effects of war injuries, wounds and even amputations, there are the chronic illnesses that take a heavy toll on the refugees,” says Dr Alayyan.
“When the health system collapses, people with cancer, with kidney failure, those who are diabetic or asthmatic and so on, they can’t survive without medical care. They die, often slowly and painfully.
“Imagine over five years now, children and infants haven’t had their vaccinations. Diseases like measles and polio are resurfacing in a country that had high rates of vaccination in the past.
“These un-immunised children are now vulnerable and susceptible to completely preventable diseases. The Syrian population is very health conscious and respect medical care, and so it has been a real struggle for them as they can’t safely access clinics or medicine.”
With the country’s ongoing civil war, there are fewer inpatient units operating, and Syrians often do not feel safe staying in those that are. Childbirth is also a problem.
“Rather than giving birth unpredictably, and possibly while fighting or shelling is going on, women often prefer to schedule a Caesarean,” says Dr Alayyan, who has many stories of pain and suffering from the field.
“Yet those who have lost everything, from loved ones to their homes to even their dignity, they are still giving and hopeful,” she says. “They offer tea and whatever food they have to you.”
Despite such experiences, Dr Alayyan is haunted by the memory of a family she came to know while helping on one of the Greek islands last year where MSF has rescue boats and first-aid buses. A boat built to carry 15 people, which had been overloaded with 50, capsized.
While some of the occupants were drowning and others were struggling to stay afloat, toxic fuel was leaking around them.
“Some ended up swallowing the fuel and getting seriously ill. That is what happened with one family where the mother and a child had swallowed fuel, while the father and other children struggled against the tide. Despite great efforts, one daughter, six-years-old, drowned.”
What was left of the family’s money after paying US$1,000 (Dh3,670) a head to the smugglers was lost at sea.
“They continued on to Europe. But one thing the mother said that haunts me to this day, she asked me to visit her daughter’s grave and pray for her. She knew that most likely she would never be able to visit it herself again.”
Whatever the circumstances, the doctors push on, helping wherever they can – and celebrating wins when they come.
One of the most dangerous places in the world to give birth is Afghanistan with its high fatality rate for women in pregnancy or labour.
Kara Blackburn, a midwife and women’s health adviser with MSF, recently completed an assessment of the organisation’s fastest growing emergency obstetrics and neonatal care project in Dasht-e-Barchi hospital in Kabul.
“The number of deliveries has doubled each month since our project opened just over a year ago,” she says.
“The predominantly Hazara community that we are looking after in the west of Kabul is a historically marginalised and still poor population, displaced from their original, mountainous homes in the provinces of Afghanistan due to decades of ongoing conflict.”
Over the past decade, in particular, they have slowly moved into what was originally a smaller Hazara community in the capital. The population there has grown from 200,000 in 2001 to about 1.2 million people today.
“The increase in deliveries in Dasht-e-Barchi hospital is related to a number of factors, including the hospital offering free, quality care, and that there simply aren’t enough maternity beds in Kabul,” Ms Blackburn says.
With hundreds of life-saving projects, and new ones being set up as need arises, the work of MSF would be impossible without the public.
“We depend on donations and so the great success and work we do is a reflection of the public’s trust and generosity,” says Dr Alayyan. “Our work is never done and, even if the crisis ends today, there is so much work to be done to help the people heal and live with their losses and wounds.”
To donate, go to msf.org/en/donate and then click on the URL of the closest MSF office
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MSF in the Middle East:
• Palestine
Operating since 1989. MSF provides medical and psychological assistance to people affected by the ongoing conflict in Palestine, covering Gaza City and Khan Younis, Hebron, Nablus, Qalqilya and East Jerusalem.
• Iraq
Operating since 2003. The conflict in Iraq continues to cause massive displacement and hardship, yet funding shortfalls have resulted in a reduced international response. Last year, MSF expanded its activities to provide basic health care and relief to displaced families, returnees, impoverished host communities and Syrian refugees. It runs operations in Dohuk, Erbil, Sulaymaniyah, Ninewa, Kirkuk, Salaheddin, Diyala, Baghdad, Najaf, Karbala and Babil.
• Lebanon
Operating since 1976. An estimated 1.2 million Syrian refugees, Palestinian refugees from Syria, and Lebanese returnees have sought refuge in the country since the Syrian conflict began in 2011. Lebanon, a tiny country with a population of only four million, is struggling to cope. MSF operates in Bekaa, Beirut, Tripoli, Southern Lebanon, Sidon and Shatila.
• Syria
Operating since 2012. More than 150 medical facilities in Syria. MSF provided regular or ad hoc support last year. MSF’s support includes providing medical supplies, a basic salary to hospital staff, fuel for hospital generators, contributing to the cost of reconstruction when a facility is damaged or destroyed, as well as providing technical medical advice. It is working in besieged areas around Damascus and in northern and western Syria.
• Jordan
Since the conflict began in Syria in 2011, Jordan has become host to about 629,000 registered refugees. A roughly equal number are estimated to be living in the country unregistered. To support the health burden created by these large numbers, MSF has established several health projects that undertake surgery and work on non-communicable diseases, as well as maternal and child health and mental health. Operating in Amman, Al Ramtha, Zaatari and Irbid.
• Yemen
Operating since 1986. High levels of poverty and unemployment combined with continuous insecurity make it difficult for Yemenis to access health care. MSF provides a variety of services, including surgery and emergency and psychological help in Aden, Al Dhale, Taiz, Saada, Amran, Hajjah, Ibb and Sanaa governorates.
• Egypt
A key transit and destination country for African and Middle Eastern refugees and migrants, Egypt has recorded a massive increase in arrivals and departures since 2011. MSF provides psychological support and specialised medical assistance in Cairo and Alexandria, including treatments after sexual violence.
rghazal@thenational.ae
