Doctors without borders: "We give them a second chance"
1st Jan 2015 Life
A lone hospital in Jordan is a refuge for the war-wounded across the region—and a place to repair both limbs and lives. The patients and doctors share their moving stories.
Who are the doctors without borders?
Jean-Paul Tohme, project coordinator for the MSF Hospital in Jordan
In the Marka district of Amman, sitting undisturbed on a hillside in the Hashemite Kingdom of Jordan, is Médecins Sans Frontières’ (Doctors Without Borders) Specialised Hospital for Reconstructive Surgery.
First established in 2006 as a surgical project within the Jordanian Red Crescent—caring for war victims from Iraq—it’s broadened its mandate to receive patients from the Gaza Strip, Yemen and now Syria. In September last year, it opened new premises at the Al Mowasah Hospital, a fully fledged medical facility devoted solely to reconstructive surgery, physiotherapy and psychological support for victims of war.
“At this hospital we start again. We give them a second chance”, says Jean-Paul Tohme, a Lebanese-born French national and project co-ordinator for the Médecins Sans Frontières (MSF) Hospital. It’s early morning and Jean-Paul is sipping cardamom-flavoured coffee while he outlines the distinctive character of the Al Mowasah: “Our patients aren’t hot cases [referring to immediate surgery to save lives], but what we call ‘cold cases’. They’re patients in need of the things we offer to allow them to live again."
“Most are Iraqi or Syrian,” he continues. “They’re traumatised already by what they’ve witnessed in their long journey to safety here in Jordan. At the initial point of contact with the wounded, no one has the means to do more than patch them up and hopefully save their lives. But here we’re all about rebuilding.”
Who are their patients?
Saha has undergone 19 operations to save her leg and hand, which were injured by shell explosion
Testament to this is Saha, a dignified and unassuming 35-year-old Syrian woman. While resting in one of MSF’s full-time accommodation rooms, Saha recounts the story that began in 2012, as her mother Amira sits patiently on an adjacent bed.
“Before the war, I was living a very simple life. I come from a comfortable middle-class family background and worked in a shopping mall. It was between seven and eight o’clock in the evening during Ramadan [observed by Muslims as a month of fasting from daybreak to sunset], and I was walking to my sister’s in the Kallaseh district of Aleppo when shells started to fall around me. I sought refuge in a house along the road with several other women and children.
“I have no plans for my future apart from being able to walk again without a limp. I want to live a life without pain.”
“Within two minutes of being inside, one of the shells hit the house. The woman standing next to me was killed instantly; I received shrapnel wounds to my hand and legs, and broke three of my ribs. I remember a flash of light and an explosion; I could see my arm flapping about in front of me when I tried to move it. I was screaming, ‘My legs, my arm!’ but I didn’t pass out.
“I was eventually wrapped up in a blanket by other survivors and carried to the nearest clinic. Later, I was moved to the Al-Razi Hospital where surgeons tried to save my leg.”
It’s been a long journey for Saha. She’s endured 19 operations trying to correct the damage done to her. She’s suffered infections that have complicated the healing process. The incorrect setting of her arm in Aleppo damaged the nerve endings in her fingers, inhibiting recovery. And, as if that wasn’t enough, her father was tragically killed by shellfire in Syria shortly after her own injury.
In the two months that she’s been with MSF, she’s slowly returning to health. Physiotherapy is restoring functionality to her hand. Her left leg is being gradually extended a millimetre per day to reach parity with her right leg to help restore normal walking. “I have no plans for my future apart from being able to walk again without a limp,” she says. “I want to live a life without pain.”
A hospital in need
13-year-old Mohammad from Baghdad pictured with his grandmother, was injured by a roadside bomb in 2012
The MSF hospital has received over 3,700 patients and undertaken 8,238 surgical procedures to date. It’s also conducted more than 134,000 physiotherapy appointments and more than 454,000 psychological sessions.
But with the numerous wars in the Middle East—all with no end in sight—the hospital has a four-to-five-month waiting list for new admittances. As the intensity of the violence increases in Syria, Iraq, Gaza and Yemen, so does the caseload. As Marc Schakal, head of MSF in Jordan, said in a recent interview, “One hospital isn’t enough.”
Set away from the hospital’s main entrance, down a side corridor, is the Learning Room. Here’s where 29-year-old paediatric counsellor Talha AlAli tries to restore the shattered emotional lives of children. On first impression, the room is a place of happiness. Brightly coloured drawings adorn the walls, and toys and games sit invitingly on tables. It’s not until you take a second look at the 15 or so children playing that you start to register the missing limbs, the abundance of wheelchairs and crutches, the small arms held in slings and the severe facial and body burns.
“Many of the children haven’t been to school for years, even before their injuries,” explains Talha. “So we try to focus mostly on reading, writing, and simple mathematics.”
“One hospital isn’t enough.”
Thirteen-year-old Mohammad Nagi Mashala from Iraq is grappling with the meaning of some Arabic letters written on the blackboard. As Talha talks to him, Mohammad sits with his crutches placed to the left of his chair.
The story of how Mohammad came by his injuries is, tragically, not exceptional. On July 8, 2012, a roadside bomb exploded as he walked from his home to the local mini-market in a suburb of Baghdad. Shrapnel tore through both his legs, causing extensive damage, particularly to his right leg. It’s Mohammad’s fourth admission to the MSF Hospital. In order to regain full use of his legs and return to normal walking, he’ll require ongoing surgery and physiotherapy until he stops growing at around 18.
Mohammad’s grandmother Rasmir has been in attendance during his long stay at the hospital: “What we’ve been given here, it’s more than very good—it’s like once we were dead but now we have the chance to rise again.”
Scars of the mind and body
Counsellor Talha AlAli admits to crying for the victims of war outside of work
In the basement of the hospital is the psychology department’s main office. Talha, writing up some notes from the day and out of earshot of the youngsters in the Learning Room, confides, “When I go home I can cry for the children as victims of war, but when I’m here my job is to focus on getting them well again, to enable them to trust the world once more.”
Telling the poignant story of a young Syrian boy in their care, who has extensive facial and body burns, Talha continues, “I asked Sayid if he would draw a picture of himself—he went away and came back with a picture of a monster. I told him he was a hero, not a monster.”
Talha explains the process of psychological acceptance and acknowledgement he and his colleagues foster in the kids. “When something goes wrong in your life, you usually have two options. You can either try to fix it or to live with it. We can’t fix the burns in these children’s faces or the loss of limbs, so we cultivate understanding and acceptance. Sayid needs to know that he’s a hero after all that he’s endured.”
Before going back to his little patients, Talha adds this thought: “If you raise a healthy child, you raise a healthy nation.”