Our dedication to our calling and our sense of collegiality with other doctors cuts across culture, ethnicity, religion, and politics. We teach each other, we consult with one another, and we innovate together.
We imagine that the elements present in our own work circumstances are similar to those of most physicians across the world: autonomy, respect, financial security, and personal safety, as well as intellectual and professional challenges. However, at a recent Physicians for Human Rights (PHR) training for Syrian doctors on the documentation of torture, my eyes were opened to levels of courage and commitment I have never experienced in my 30 years of practice and international work. I had to come to grips with my own ignorance and shame as I saw the challenges faced by our brother and sister physicians in Syria and by those who are refugees in neighboring countries.
Their daily efforts to care for their patients far exceeded my wildest imagination. Many of us have worked in other countries for weeks at a time in less than optimal settings: without electricity or water, without PowerPoint or books, without MRIs or cotton swabs, dealing with patients who lack insurance or any money to pay for care. I have worked in a number of locations with limited public health resources and challenging settings for health professionals, including Sierra Leone, Haiti, and the Democratic Republic of the Congo. Yet, rarely have we seen physicians directly targeted for providing medical care, as we now witness in Syria. Doctors and other health professionals in Syria are regularly targeted and harassed, and hospitals and other medical facilities are shelled. Denying medical access has become a dangerous tactic of war, with brutal public health consequences for entire communities.
Only the bravest among us risk imprisonment in order to care for our people. Only the bravest of us put our own lives and those of our families at risk on a daily basis because we are committed to serving all patients, regardless of religious or political affiliation. Only the bravest travel daily across borders and through checkpoints to provide care, receive training, or reunite with families after weeks of working 24/7 in dangerous environments.
Syrian doctors are building and staffing field hospitals, which are regularly the only option for providing care. Health professionals are miraculously performing amputations, complicated abdominal surgeries, and removing shrapnel with limited supplies. They have been forced to work through the sights and sounds of barrel bombs and rockets directed at their clinics and hospitals, never knowing if they will live through the day.
They refuse to leave their posts, despite the personal costs: insomnia, nightmares, flashbacks about legs and arms in operating room buckets, children with abdomens torn open from gunfire, family distress, and intense sadness. They admit to feeling numbness, anger, irritability, rage, hopelessness, pain, and grief. The physicians working in Syria describe terror and darkness in their hearts, as they receive constant streams of injured and tortured patients daily. The physicians living as refugees in neighboring countries describe feelings of guilt and regret that they cannot go back to serve their people directly. They cannot practice legally in their country of refuge, leaving them unable to generate income or support their families. Several of these amazing doctors, pharmacists, and lawyers are returning to Syria because this is the only way of being with their families and assuring themselves that they are doing all they can to support their people.
When the doctors arrived at the recent PHR training, we saw vacant faces and hearts full of grief, but this wariness began to fade as the training week progressed. Laughter crept into conversations, stories and photographs of death were brought up less, and breathing became slower and deeper. One memorable night even included singing and dancing. Our training allowed these physicians to not only build on their medical skills, but also provided them with a forum to meet with colleagues who have endured similar hardships. And while divided in many ways by tragedy, we all came together as one, committed to supporting one another as we look towards a post-conflict Syria.