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July 26, 2013
U.S. teaching field medicine
Aid groups share instruction, experience with Syrian physicians.
MICHEL STORS THE MEDIA LINE
Gaziantep, Turkey
Dr. Waja Muharram studied the tibia bone closely. The Syrian internist’s eyes darted back and forth as an American cardiovascular surgeon inserted and removed needles at a rapid pace, explaining how to provide trauma patients with intravenous fluids by tapping into the bone marrow. “We see so many victims who suffer from trauma,” noted the 41-year-old Muharram. “This technique will be of great use to us in the field.”
As Syria’s civil war, now in its third year, grows deadlier by the week, the country’s understaffed and inexperienced doctors are overwhelmed by the cases they see. To alleviate their shortfalls, aid organizations such as the Syrian American Medical Society (SAMS) have stepped up to provide training and equipment.
At a four-day SAMS conference in Gaziantep in eastern Turkey, five American physicians conducted a workshop for 42 Syrian doctors. The session combined classroom lectures using computerized medical equipment and hands-on techniques, such as the ones that amazed Muharram.
“There is a noticeable lack of experience with the Syrian doctors,” Dr. Muhammad al-Azzam, a radiologist from Ann Arbor, Mich., explained. “So this is a real professional course for them based on what they need with advanced trauma support.”
SAMS has made use of the latest battlefield techniques learned from the American army in Iraq. The tactical field care guidelines gleaned from the U.S. military’s experience there offer new methods to deal with trauma patients and limb loss. “The army invited us to seminars where we learned the valuable lessons we are teaching here,” said Dr. Ahmad Tarakji, a 39-year-old cardiovascular surgeon in Fresno, Calif.
Other techniques, such as the kink cavity, focus on new and easier methods to get air into the lungs. Rather than cutting into the trachea as is traditionally done but that requires a high degree of expertise, an incision is made into the esophagus. The procedure is much less complicated, allowing non-specialists the ability to provide in-field emergency care.
“Kink cavity is a much easier technique that can easily be learned,” noted Dr. Tamar Mullah Hassan, a 48-year-old internist who heads the SAMS office in Gaziantep. “The trachea procedure is difficult to master.”
Syrian doctors were impressed with their American counterparts. “There is so much we don’t know,” confessed Dr. Muhammad Taknari, a radiologist from Idlib. “The conference gave me a chance to learn some of them.”
In a revolution where most of the media emphasis has been on the rebels from the Free Syrian Army, humanitarian organizations, including SAMS, have been quietly working to provide care for the conflict’s victims. SAMS pays doctors’ salaries and evaluates their performance monthly. It has funded mobile clinics that visit approximately 12 villages a day. The staff, consisting of a physician, a nurse and lab technicians, dispenses medicines and coordinates prenatal care.
The dangers of working in a war zone have not deterred the doctors from carrying out their Hippocratic Oath. SAMS has sent a number of American doctors inside Syria to perform surgeries and establish field hospitals. Nevertheless, the risks are high. Last month, regime artillery attacked a convoy that included SAMS staff heading to the city of Qusair, where Lebanese-based Hezbollah proxy fighters reinforced Syrian army regulars. Several SAMS staffers died.
SAMS’s expertise and funding is desperately needed because Syrian hospitals are understaffed. In the city of Aleppo, which is divided between the regime and rebels, there are only five surgeons. Internists examine between 100 and 200 patients per day. “We are facing challenges that overwhelm us,” Muharram stressed.
Others complain of shortages in basic supplies and machines. “We don’t have enough equipment and drugs,” said Dr. Muhammad Jasim, a 46-year-old cardiologist from Rakka.
For now, however, physicians such as Muharram and Jasim are content to make use of their new expertise in the field. “We are struggling,” Jasim admitted, “but the struggle became a little easier today.”
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