Editor's Note: From a spark ignited during the Arab Spring, a violent conflict erupted in Syria in March 2011, resulting in more than 600,000 Syrians fleeing their country, the displacement within the country of nearly 2 million others, and an estimated 60,000 deaths. Dr. Fadi Al Khankan, a native of Homs, Syria and a pulmonologist now living and practicing medicine in the United States, is chairman of the Humanitarian Committee of the Syrian Expatriates Organization, a nonprofit organization of Syrian Americans and Syrian Canadians that provides humanitarian relief to residents of the war torn country. He spoke recently with Amber French, editor of the Migration Information Source, and the Migration Policy Institute’s Kathleen Newland about the conflict and a new report put out by the the International Rescue Committee titled, Syria: A Regional Crisis.
For the full text of their conversation, please visit the Migration Information Source Website.
Migration Information Source: When and how did the Syrian Expatriates Organization first become involved in the Syrian conflict on the ground? How has SEO's involvement evolved?
Fadi Al Khankan: At the SEO, we started from the beginning of [the] revolution. Initially, it was a Facebook movement, the same as the Syrian revolution or in Egypt or in Yemen. It was a FB movement and that [made us really organize ourselves] and to establish that organization to help to make democracy in Syria. Over the last two years, we have been working from day number one. We had applied for a nonprofit organization and we got approved. We —roughly more than 200 professionals in the United States and Canada — organized ourselves. Most of us are first generation here, so we know the Syrian people's language, we know the culture, we know what they need. Our group organized and covered most of the areas in Syria from North to South. Most of us have been activists in multiple ways and also most of us are members of other organizations ... Initially we started as a movement on Facebook, then we started mainly in revolutionary support. And then we moved forward as the need of the revolution has changed from the beginning when it was a revolution of freedom to now a revolution of medical and humanitarian aid, besides freedom.
MIS: The International Rescue Committee's report Syria: A Regional Crisis states: “Doctors described to the IRC a systematic campaign to restrict access to lifesaving health care through the strategic bombing and forced closure of hospitals and health-care facilities.” Had anyone anticipated the attacks targeting hospitals?
FAK: The [Syrian] regime has been targeting the key points in each city. As we said, we divide the areas inside Syria into two zones: [one] zone under the authority of the regime and the other is freed. In those zones, the regime has been trying to target their key points, the infrastructure of each city. [They went through] whole cities, targeting gas stations, bakeries, and hospitals. They left nothing. So the infrastructure of the cities has been destroyed ... For example, what we heard recently, [they send gas to] one of the gas stations. So people rush to get some diesel for heating and then they pound it to have the most casualties. So hospitals are really targeted largely. [That] moved us from using the hospitals — like in Homs, the national hospital in Homs has been bombed and it's [deserted] now — to make up secret field hospitals ... [there are] three classes of hospitals: field hospitals, on the front line; larger hospitals to perform a little bit more operations; to a larger hospital that is on the borders to perform more sophisticated surgeries.
MIS: Kathleen, is this typical of other crises? Have we heard in other recent violent conflicts of targeted attacks on hospitals and on other important centers for [everyday] living?
Kathleen Newland: I think that the Syrian crisis is unusual in the extent of the targeting of medical facilities and medical personnel also. We were told by some of [Dr. Al Khankan's] colleagues we talked to in Jordan that a colleague had recently been stopped as he was crossing the border back into Syria and was found to have medical equipment in his car. The Syrian authorities treated him exactly the same as if he had been importing weapons. They said if you were found carrying blood bags or things that are clearly palliative care, that it's just the same as if you had weapons in the eyes of the Syrian authorities. And I think that is unusual in the extremes to which the regime is going to undermine the support systems of the civilian population. As Dr. Al Khankan has said, it's not just the hospitals, but obviously in the time of war, hospitals and medical personnel are extremely critical, literally, to the survival of people. And also psychologically, I think.
I also have — and Dr. Al Khankan can correct me if I'm wrong — but I've also heard particularly in Syria that the medical profession had a special status, and that maybe it's because the dictator is himself a doctor, I don't know. Medicine is a very prestigious field. The regime had invested in medical schools and so on. And perhaps thinking that the medical profession is apolitical, that it's an area that was sort of safe to be developed within Syria because, you know, NGOs or civil society were deliberately kept down. That was obviously a miscalculation on the part of the regime because Syrian doctors have been among the most, sort of, activists and strongest supporters of the revolution.
FAK: In Syria, being a doctor was really implemented by families. Look at how many Syrian doctors are here in the United States. It's compared to other immigrants from other countries. Even [though] Syria is much, much smaller than India or Pakistan or China, you see a lot of [Syrian] doctors here. What's going on in Syria, the doctors/personnel are facing a huge burden. Even with the health-care professionals who are working for the regime ... [they are not] able to help the wounded people ... It's unfortunate to look at Syria now and you see a lot of shortage in doctors. All those doctors are outside Syria.
MIS: I was surprised to hear [that Syrian] medical students are having their certificates pulled. Have you encountered this in your work?
FAK: Yes, there have been a lot of medical students … [the authorities] pull their certificates ... Unfortunately, even the medical students who fled because they are wanted, because they protest against the regime, they can't get their certificates out. They cannot get what proved they had been students there. They had been targeted by the secret services, so it's very hard. Most of them are just working in field hospitals trying to help other people.
MIS: Are there any particular challenges that you face that the international community should be aware of in addressing health issues for refugees in both [rural and urban] settings?
FAK: The problem there is... Health is not a medicine [for which] you prescribe a prescription or a medical supply. Health is a whole socioeconomic status: shelters to sleep in, hot water to take a bath, clean food to eat, clean clothes, washing, electricity, gas, heat. So it's a big dilemma. Most of the work has been going on in field hospitals, taking care of the wounded. Not enough work has been done to help the chronic diseases: hypertension, diabetes, those sick people who have been really sick. They need medicine... There is also no preventive medicine. We met people who had not taken a bath for six to eight months. There is no hot water; they live in a tent. They eat ... with a small fire around. I look at, for example, Atma camp, you see people living in tents in that cold weather, between the olive trees. We saw children who have no milk to drink. Women are not able to breastfeed their children because they are not eating healthy food. So the disaster is not only medical. Just trying to provide medical aid is not enough. We need huge [humanitarian resources] to help the socioeconomic status of those people.
MIS: [Have] medical emergencies arising from the Syrian conflict given way to, or indicated the need for, any particular innovations or inventions in the medical or medical emergency industry?
FAK: We have worked very well in making a lot of field hospitals inside Syria. There have been a lot of volunteers who went inside Syria — organized. We have been working with a lot of programs, like the physician-sponsoring program, where we match each doctor who is working in Canada or America [with] a doctor inside Syria.
We are [also] working now in telemedicine. We are trying to open through the Internet — [setting up] conferences between a doctor outside [Syria] who is very well specialized here to another doctor inside for consultations, and making call schedules ... to cover all the basic needs for the people inside. We have been trying to collect a lot of supplies, medical supplies ... We are very organized in sending people [to get inside] Syria. We have a call, we know where to send the doctor; even sometimes we collect cases — for example, for neurologists — one of the neurologists will go there and see his own patients. Containers full of medical supplies [that] we have been trying to send [to Syria]. We [sent] one before and we are trying to send another one. But the need is so huge that not a single organization or one country can carry on. We need the whole world to stand up for Syrian people, to help in all aspects of this crisis.
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