Sunday, January 12, 2020

Tetanus

Yesterday as I was getting report (update of all the patients) from the off-going nurse I commented on how much I've learned and seen already. Things I would never see "back home". Diseases so horrifying and cruel that faces, images and families are burned in my mind forever. Diseases that have been all but eradicated through vaccination in more developed countries. Things, that sadly, due to willful ignorance I may actually have to see break hearts, families and bodies again"back home".
I mentioned that the only thing I feel like I haven't seen, and that I hope to never see (as it is one of the most gruesome and torturous diseases imaginable) was TETANUS.

That day I saw tetanus. I wish I never had. Torturous is the right word for it. It's easily contracted through the soil. Yes, even in the U.S. soil and that of other developed countries. Just a small cut, sometimes so small it goes unnoticed or thought of as insignificant is enough to the let the tetanus bacteria in where it releases toxins. Within days these neurotoxins cause a systemic infection causing every muscle in the body to wrench, tighten, twist, and contort. A person has the tell-tale "lock jaw" sign in which the muscles in their face and neck (and everywhere) are so stretched, and strained, and tight that one cannot open his mouth, the jaw is locked shut. The back muscles constrict so extremely the skeleton is bent painfully, unnaturally into an awkward, arching, twisted backbend that lifts the patient off the bed as they whimper and cry in torment. But even crying is hard because the face is so taught. I watched it happen.

Aside, from vaccinate immediately (playing catchup), treat with antibiotics (often for several weeks/months) and try to relax the muscles with drugs and give pain meds for the unearthly contortions (all of which help...some...but not enough to make it un-excruciating).

I will try to portray to you, very briefly, the image I keep seeing over and over. As we went to move the patient from the emergency stretcher to a hospital bed, his father slid his arms under his shoulders and under his knees as you would to normally carry a child who had fallen asleep up to bed. However, the patient was rigid, and not a little. There was no bend in his knees, no flopping of his head or falling of his arms to his sides as he was lifted. Rather he lifted as one straight-backed stone, arms bent harshly at 90 degrees, muscles so tight it kept his whole body as if it were only one very solid piece. All I could think of was that it looked like someone trying to carry a surfboard. Because of the awkward stiffness of the patients body, it took two other people to carry this frozen body to the bed.

DON'T write/speak/tell me anything about anti-vaxx anything. Just don't. 

No shortage of need in this world

While at the hospital families provide all the cares for the patients. Many come from very far away and have almost no resources. A caregiver is required to be with the patient at all times except in extreme circumstances where there is no family or family is also hospitalized-or if they are an orphan. With the infants, many parents actually climb inside the crib and sleep with the baby in the crib. Others, sleep in the hospital bed with their child...and sometimes a spouse...and other children they had to bring along. These are not large hospital beds and sometimes an entire family sleeps in the bed with the patient (technically not allowed, but when there is no space, what are you going to do? Others sleep outside on the ground or in the outdoor concrete corridors of the hospital. A few have tents, many use whatever they have on hand to build a makeshift shelter for the night, days, weeks, months they are here.

The hospital doesn't feed the patients or families. The families either make or buy food and bring it in. This a problem for many who either come emergently or have no means to buy or make food once they do arrive. They also do many of the cares, like counting how much the patient eats and drinks, weighing and counting diapers and ensuring physical therapy exercises get done after they have been taught how to do them. It is all up to them. (This is common in many hospitals throughout the world, particularly in developing countries.)

As I mentioned before, many people come from far away and risk a lot by coming, particularly at this time of year. (Some villages don't even have roads that lead to or from them.) It’s harvest season and bringing their child to the hospital means they may lose an entire years worth of crops and salary and work. For those who come from very far this might mean walking, a scooter with several family members crammed on, or a long bus and tuktuk ride. Laos has very few “cities”. The majority of Laos is incredibly rural with very basic housing housing many generations together. There is no clean water. It all must be boiled or bottled. Much of Laos doesn't have electricity. Some parts of Laos that do have electricity often have shoddy, jerry-rigged set-ups and fires are common because the makeshift addition of electricity with crazy wires, etc hanging to/through a house not intended built for it. The villages (which are counted by how many families live there, not the number of people) are small and often only work as subsistence farmers, meaning they only grow enough to feed their own families and trade within their small communities without much, if any, excess. So again, missing the harvest can be devastating. I can only imagine the strain and stress this puts on them, not to mention the whole ordeal of having to figure out how to get here, often not knowing how they will get home. Mad respect for all of the people in Laos. There is some help the hospital can give for these families to ensure they have food while they are here, and in extenuating circumstances will sometimes help them get back home. As with most places, those who live closer to the city have more access to care, and are often more educated regarding medical care and disease prevention. 

One especially great thing about this hospital that I’m sure makes a huge impact is the “Outreach” program. The outreach team will, I think twice a week, go out to visit previous or chronic patients that have missed their appointments or ensure the family is doing the home care correctly. The outreach team will also ask if there are any sick in the village and bring them back to the hospital if care is needed. Some times they go out for several days if they are going some where that is difficult to get to are far away. They kind of work as a home health, social work, patient and family advocate, solve every problem team.  We have one child here right now that lives several hours away that outreach brought in. They patient has a serious chronic condition reliant on frequent blood transfusions but the family has no way of getting here. Outreach went out and found this child 5 months after he was due for an appointment. He, of course, is very, very sick. I would say we probably have about 10 kids with this exact story every week. Outreach does amazing work, and they do what they can but there are simply too many, too far away and sometimes family does not want, or cannot come in and the children pass away. There is no shortage of need in this world which is difficult for me to completely fathom, even in the midst of it, having come a from a land of so much excess. 

Monday, December 30, 2019

Volunteering in Laos, the beginning- Initation by fire




The staff here is pretty fantastic. Not only are they knowledgable, they have the tolerance and humility of saints. I can’t imagine having new volunteers come every month or few months and having different ideas of what is important or how things should be done. I, of course, have things that I wish I could emphasize and change but the truth is they are doing a pretty great job and I have to understand the relativity of the situation along with my own personal biases about what is most important and what should be done or improved upon next. The longer I am here the more I realize that I am actually not “doing” much. The staff know what they are doing far more than I do. The deal with things like preventable disease like meningitis, Japanese encephalitis, polio, tuberculosis, among others things like burns and tropical diseases like malaria, dengue, weird fungal stuff, far more than I do. In these, and many other situations, they are the experts, and I learn a lot from them. 

Yes, the longer I am here the more I feel like my job is not necessarily medical as much as solidarity and to stand as a witness. I don’t know how that translates or comes across but that is the best way that I can think to say it. I am experiencing a lot. I am seeing a life that I knew was remote and less fortunate than my own, but I am seeing a ruggedness I hardly believed existed anymore…and I am in the city. And seeing now that my job is more of a witness, and hopefully, a help I will attempt to share some of the things I see and experience. I understand that my view is colored very much by my own life and as I am seeing on the regular, with much humor involved, many things are misconstrued or lost in translation. So, forgive me if things are not quite right or “lost in translation,” either from my misunderstanding or because they are passing through the filter of my mind. 

In regards to a lack of frequent updates, I have learned sometimes you just have to wait for these things to come out in their own time. They can’t be forced just because I have the time or desire to write. Sometimes my mind and spirit-and the story-need a little time, a little distance and a few breaths before being able to “speak them out loud”. All that being said, here goes. 

Ended my second shift ever at the hospital coding an infant. I’d made friends with mom, even though we don’t speak the same language, throughout the day. Her baby was sick and we moved him from the main area (where he had been for a few days) to the Emergency Area where we could give him more attention (when I say we, I mean the Lao staff, I technically am not allowed to provide patient care, only support to the staff). I had put my arm around mom when he first took a turn for the worse. A few hours later things got really bad. As soon as chest compression started on his little body, mom ran straight at me from across the room and collapsed crying into my chest. I held her for several minutes while they performed CPR on her new little baby. In the end, he did not survive. When he was gone and lying still, I helped mom into a chair next to a bed and placed him in her arms. He was very sick and we have limited resource. Too tired to cry right now. 

Two shifts in and we coded and lost another baby. 

I’ve witnessed many deaths since I’ve been here. More than we would at home. The hospital does a great job and saves a great number of lives but there is still a lot we can’t do. 


Taking this act behind the scenes

I'm going private. Very few people even know this blog exists but since I plan on sharing it a bit more, I want it to be a little more secure. Let me know if you still want access to it as I'll be changing it to private in the next few days. 

Sunday, June 3, 2018

More from Bangladesh


I always have to be in the right mood to write about my travels and it’s difficult to get there sometimes, I guess because it’s hard to face and because I wish I were still there. Plus there is always a certain amount of perspective that comes with any travel especially to a country very different from one’s own. That perspective can fade quickly and you can be a little ashamed of yourself for how quickly it fades. I also almost feel a little bit that real life is happening in places like the camps and in developing countries and that my own is life is very much a facade or a shadow of what real life is. And that is certainly true considering more people live without adequate basic resources let alone feel oddly “poor” because we can’t have everything we instantly want despite having an excess amount of food and access to any amount of clean water we could hope for. I don’t quite feel like I’m accomplishing anything in my little life here in the states sometimes despite being incredibly busy and worried about who knows what. 

And so I begin, trying to convey complex feelings even I don’t understand and to tell the stories of another world so very different from our own that I don’t know where to begin. And the world in the Rohingya refugee camps is definitely that. These people deserve, more than most, to have their stories told-for the sake of all humankind their stories need to be told. Now, I know that whatever I write someone will find a way to criticize or be offended by. I ask those people to keep their mouths shut or go help in the camps and then tell their own stories, not to judge me by mine-seen and experienced through my admittedly imperfect eyes. I can only write from my own experience, using my own thoughts through the eyes I have, at the present time of experiencing it. 

I put this disclaimer here because I am not what most people think of when they think of a “humanitarian”. Those who know me, know that I can come off a little cold, abrupt, rigid…sometimes ice-queen-y even. I’ve been told this about myself. I don’t know why I come across that way but I know that I do. I also know I am not overly sweet nor do I see the world through rose-colored glasses. I’m incredibly sarcastic with the dry, morbid sense of humor shared by many a nurse and most accurately once described as an optimistic cynic. I do love kittens though. My only reason for telling you this is to point out this…you do not have to be a perfect person to do something good. Even with our dark or imperfect sides, or even if we do not “look” like what others want us to look like while doing a certain activity, we can still do and be some good. Even if we are not “good” in a way that other people want to us be. Now to the camps. 

It’s difficult for me to convey individual stories this time because we really only had one translator.  I signed up go with SAM’s (Syrian American Medical Society)-the same group I went to the Syrian refugee camps in Jordan a couple of years ago. It turned out that only 3 of us ended up going. It was two pediatricians, Promise, a long-time private-practice pediatrician from Washington D.C., Samantha, a newly trained Brit from London who has done extensive volunteer work for long stints in developing countries with various NGO’s, and me. This was our team going Into the camps. Just the three of us. They each saw anywhere from 70-80 patients a day each and used the local Bengali doctors in training as translators. (There were two newly graduated Bengali doctors but who haven’t taken their exams yet. SAMs was paying them salaries to help out in the camps but mostly they were doing it because they were amazing, exhausted but tireless people.) I tried to help triage but since I had no translator our little triage information was basically limited to vital signs and and physical appearance. And mostly, the three of us, were there trying to give some respite to the doctors and “medics” taking vitals who’d been doing so for who-knows-how-many months, generally 6-7 long days a week. God bless each one of them. 

There were a few friends that generously sent me money to help me balance the cost of this trip and buy medical supplies for the clinics. Most of what I bought was basic stuffs like blood pressure cuffs, thermometers, stethoscope, etc. Although my job was incredibly easy it was complicated by not being able to communicate with the medics who were there before me who I think appreciated the respite but didn’t want to dump on me and I didn’t want to come in and step on toes but we did all in all get along and felt each other’s good intentions even if we couldn’t communicate in words. One of the medics even used my sharpies to make me a beautiful drawing and presented it to me with a shy smile. 

There was one little girl, about 9 years old, who came to the clinic several days in a row for something that the doctors were following. She would have to wait for hours to be seen and would shyly watch me (well stare at my eyes really and try not to get caught) So I brought her over to my little triage table. I taught her how to use the equipment and take vital signs. Her whole demeanor and smile changed throughout the week. She became my little nurse’s assistant. It also made a lot of the people who came to the clinic to be seen crack a slight smile to see working there along side of me. :)

I need to talk a minute about the children there. The Rohingya in general seem to be a very mild, somewhat shy people. But even in other places, like the rest of southeast Asia where, culturally, the people are very calm and mild, the children are still curious and still smile and play. The children within the camps were abnormally stand off-ish and mistrusting. (Understandably so.)  They did not try to interact at all. In fact, it took quite a bit of coaxing to get them to interact. It makes sense given what they’ve been through and are still going through but it was so drastically different that it stood out immediately. Eventually…I did get them to open up :).  If I had any kind of impression or thoughts while preparing for this particular trip it was, “focus on the kids”. I think playing with the children helped the adults to relax and trust us a little bit more too. It softened all us a bit to have the kids start to smile, including the staff members working with us and the neighborhoods surrounding our little clinics. 

There were two clinics that we went to in different areas of the camps. Mostly we saw primary care type stuff. But really next level primary care. People came with colds and body aches but much more severe colds and body aches than what we might go to the doctor and complaining about. People had really, really bad colds that had gone on for weeks/months. They had respiratory infections that were extreme. And the body aches, I can only imagine were exponentially worse than any body ache I’ve ever experienced. The amount of work and walking they do in a day on almost no calories (if any), not to mention the referred pain from the traumas and emotional stress that they experience probably puts my worst stress headache to shame. We saw 60lb women carrying 30lb bags of rice and double buckets full of water (I think a gallon weighs like 17 lbs or something). The heaviest patient I recall seeing, including men, weighed 119lbs. It is not a stretch to compare their physical appearance to that of what you may have seen in holocaust videos. Everyone was malnourished and some of the babies were terribly, terribly thin. 

I do have to mention that there are supplemental feeding clinics for babies and breastfeeding mothers. There are a few “hospitals,” one particularly that has and “ER” with inpatient capacity set up by Doctors Without Borders. There are women support groups and even some education going on. In the space we were using as our clinic, another group was training some of the women as mid-wives. There are people helping and doing some very good things. However, the amount of help available in comparison to the amount of need is heart-breaking. If our help was a drop in the ocean, it wouldn’t even be big enough to make a perceptible ripple. It goes back to something I’ve come to realize and shared with people in the past. I cannot change the world, I’m not going to solve world hunger, what I do is not enough. But it is what I can do. I have very, very small circle of influence but I will do what I can within the tiny speck of my world.

We saw several cases of the mumps, a few cases of the measles, lots of chicken pox (completely preventable diseases with vaccination) and there was an entire clinic set up to the treatment and containment of diphtheria (also preventable with a vaccine) by Samaritan’s Purse. I have to admit the clinic was impressive. From my standpoint and impression based on that clinic and what I’ve seen elsewhere, they do phenomenal work. Unfortunately, we saw very young children already developing cataracts and losing their vision. I don’t know if this is from the sun, dust, or disease but we saw it more than we should have. I don’t know if anyone is there doing or screening for this but I sure hope so. To see people have permanent damage, go blind or even die from easily preventable circumstances in our day and age is so frustrating. 


The need for basic life necessities was incredibly scarce, despite the amount of aide attempting to be provided by the host country of Bangladesh and from various groups and NGO’s throughout the world. I saw unimaginable-and even as I witnessed them- unfathomable problems of pure survival. 

Again, we mostly saw primary care issues: colds, asthma, muscle aches, a few wounds…only of course they were all a much higher degree of “sick” than what we in western cultures might consider going to the doctor for. The colds had gone on longer and were more severe. The muscle likely much more extreme due to sleeping on the ground in addition to having all the extreme physical stress they put on their bodies from the amount of physical labor it requires to survive on nothing. I’m sure we can all agree they likely have much stronger emotional stressors that contribute to the pains, hurts, and exhaustion that can lead to physical, emotional and mental illness. 

Throughout my time in the camps as I went about trying to do what little I could while there I kept finding myself grateful for the little things. Seeing all the dirty, swollen, busted up feet I suddenly found myself very grateful for shoes. I was more appreciative of each bite I took while there. And, oh, how thankful I was for a hot shower at the end of the day to rest, relax, and be very clean after being so hot, dusty and sweaty. And I’d think, as I indulged in what felt like a much “needed” shower and washing away of a long day, that most of these people had likely never had a long hot, shower like that. Even before they escaped across from their home country of Myanmar/Burma, they likely did not live in such a way that afforded for much rest, let alone hot running water with the turn of a knob. And I grew more and more thankful for little things. And as I grew more thankful I grew more charitable and wanted to give more. As I watched this happen within in myself there was a thought that kept surfacing: Giving out of guilt doesn’t do anyone any good. Giving out of gratitude will change both the amount that is given and the feeling with which is received. 

There is always a temptation to feel guilty for what we have. Especially when we see such extreme, dire circumstances. I do’t believe that guilt does anyone any good. Wouldn’t we all rather receive a gift from a friend who is happy to give than a hand out from stranger who feels guilty? Even with the language barrier, maybe because of it, these were my friends and I was made happier for what I do have and simultaneously happier to give what I could to my new friends. 


Thank you again to all those who helped. It makes a huge difference in what I am able to do when in the camps and for my faith in humanity. God bless you all. 

Thursday, April 19, 2018

Bangladesh-Rohingya Refugee Crisis

I’ve had a difficult time writing about Bangladesh. Even as I write out all that I can remember I feel a little hesitant about posting it. I don’t want human suffering to become a spectator sport. Not that any one of my friends reading this-and especially not those who personally sacrificed to support me-would view it that way. I have just been stuck. And I want to make sure it doesn’t come across as me taking exotic trips and coming back to tell the tail. 
That isn’t what it is like. These are serious problems and real people living them. And very real evil causing painfully real suffering to more of our fellow man than we can understand. Even being in the camps I don’t think my brain, heart or soul was able to fathom the magnitude or severity of the situation. And I don’t want to exploit or romanticize it in any way.

It’s difficult for me to get the stories of those I met this time out there because of the language barrier. I did not have a translator to help me. All the work I did was done through non-verbal communication. Whereas I do think it is beneficial to share individual stories-I feel that each person deserves to be seen and heard-I can’t do that for anyone this time. (I also think it helps those of us who’s worlds feel so far removed from the situation that it renders us unable to comprehend the Rohingya (and other) refugee crisis or other deprivations and horrors going on throughout the world.)

I will tell you that I think the heaviest person we saw, including men, weighed 119 lbs. I saw 60 lb women carrying 30 lb bags of rice. I saw too-skinny people walking up and down steep hills to carry water and rations they’d waited in line for back to their makeshift tent-homes. 

We saw several cases of the mumps, a few cases of the measles, lots of chicken pox, (completely preventable diseases with vaccination) and there was an entire clinic set up for the treatment and containment of diphtheria (also preventable by vaccine) by Samaritan’s Purse. Unfortunately, we saw several cases of very young children who have already developed cataracts and are losing their vision. I don’t know if this is from the sun, dust, or disease but we saw it more than we should have. I don’t know if anyone is there doing anything or screening for this but I sure hope so. To see people have permanent damage, to go blind or even die from preventable circumstances is so frustrating. 

The need for basic life necessities was incredibly scarce, despite the amount of aide attempting to be provided by the host country of Bangladesh and from various groups and NGO’s from around the world. I saw unimaginable-and even as I witnessed them- imaginative feats of pure survival. Despite the incredible lack of resources the camps are always bustling with industry and invention. The people are not lazy. They are industrious and fighting to survive and have done an impressive job of making a homes, a city really, out of nothing. 

Throughout my time in the camps as I went about trying to do what little I could while there, I kept finding myself grateful for the little things. Seeing all the dirty, swollen, busted up feet I suddenly found myself very grateful for shoes. I was more appreciative of each bite I took while there. And, oh, how thankful I was for a hot shower at the end of the day. To rest, relax, and be very clean after being so hot, dusty and sweaty. And I’d think as I indulged in what felt like a much “needed” shower and washing away of a long day:  most of these people had likely never had a long hot, shower like that. Even before they escaped across the border after being chased from their home country of Myanmar/Burma, they likely did not live in such a way that afforded for much rest, let alone a long, hot shower with running water with the turn of a knob. And I grew more and more thankful for little things.

This trip for me personally, turned out to be a lesson in gratitude. I know that is a feeble a weak thing, a true luxury really, to take away, but it made a difference in me. And as I grew more thankful, I wanted to give more. Another thought I had briefly was that I really should fell guilty for all that I do have but then I quickly realized that giving out guilt doesn’t do anyone any good. Me not taking a hot shower is not going to save the world any more than me not taking it is going to vicariously allow someone else to have it. But an increase in gratitude made the shower fantastically better and made me both able and willing to give much more. I think it magnified both how much I gave and the attitude with which I was able to give. Giving out of guilt I think takes some of the dignity away from the receiver as well. They can feel the intent with which it is given I believe. When given from a positive place, such as gratitude, I believe it can be received a little better as well. I know I would having an easier time accepting something from a friend who is happy to share than one who feels obligated by guilt. You become a little more sensitive to stuff like this I think when there is a language barrier and you have to go more off of “vibes” than verbal communication.


Thank you again, to those who helped make this trip possible. The work we did there was good but it was minimal in comparison to what is needed. Nevertheless, I am glad we were able to do something, even if it was something small. Because doing something is always better than doing nothing.

Tuesday, October 4, 2016

Syrian Refugees in Jordan

Thank you for your donation.
    It went directly to the refugee camps in Jordan. These camps are full of God’s children who need to be reminded that they are loved and that there are those out there, like you, who remember them and love them and are willing to make sacrifices in your own lives to improve theirs.  Generally when people ask if they can give me money I try to use it on a specific person and hand deliver it.  Such as the set up of the camps and the extensive amount of travel time and limited resources in the area I was not able to hand things out personally as I usually do.  I am happy to let you know that if you donated goods (like underwear, scarves, or baby carriers) then I was able to distribute these to people either through social workers, or by sliding them into the pockets, scarves or secret handshakes with those that seemed in most need of them.  We often took two to three people into our little closet triage room where they were separated from the masses.  This is where I did most of the subtle distribution of goods ;).
    If you donated cash, whereas there were a million things I could have tried to procure and distribute, there was very little time and very little resources available to me due to travel time and work in the camps. The biggest need we found was medications for those with chronic conditions like high blood pressure, diabetes, and even those who had received transplants (kidney and heart) prior to having to flee. As a group, we pooled our money with SAMS and these connections to supply these medications to the people.  There were pharmacists in our group originally from Jordan and Syria who had family member who worked in distribution. I know this is likely slightly different than how you thought your money might be spent but through these connections we able to get medications at a very good price and supply these people with 3 months worth of medications. If you are unhappy about how your money was spent, I am happy to reimburse you out of my own pocket.
    The Lord is performing miracles and granting kindnesses to people all over the world and He allows us to be a part of it, if we want to be. And let me tell you, we will be witnesses to immense miracles if we look for them, even in the worst of circumstances.

It is difficult to write something like simply because of the magnitude of it. I wish I could tell each person’s story because surely each person’s story deserves to be told. Because of the language barrier and massive amount of people that needed to be seen I know very few details of each person’s story but I can also tell you that there are miracles taking place and that there are incomprehensibly good people working hard to alleviate suffering. Meeting, getting to know, and working along side these people reminds me that despite how much evil and consequent suffering there is in this world, that there is still light. That there is still good. It is quieter than the evil, but it is stronger, and it is changing lives.

One such miracle occurred in the last minute arrival of two unexpected donors. A company entitled, Medtronics that makes medical supplies and LDS charities. Somehow these donors quietly got connected to SAMS (Syrian American Medical Society-the group I went with). I do not know the details of how Medtronics became involved but I do know that of LDS charities. It seems quite happenstance but the results of their last minute involvement changed everything.

I happen to belong to the LDS church (Church of Jesus Christ of Latter-Day Saints) but I did not have any affiliation with the church for this particular project, but recognized another “Mormon” when I saw one.  On night one of our arrival in Jordan (where we would be visiting the Al Za’atari Syrian refugee camp) I walked in to our first official meeting and saw two people who I had a suspicion were also LDS. As the meeting went on they were introduced and spoke a few words. They told of how just a week (or two??) before they had seen the local Jordanian office for SAMS and had decided to stop in. The organizer and chair of our group, Majd Isreb, was in Jordan for just one day and was in the office that day. It turns out these two LDS persons were service missionaries. Their primary responsibility is to seek out those in need and to evaluate what needs to be done and determine if the church can help. The missionaries recognized the amount of good SAMS was doing and asked how they could help. With the donation of heart stents supplied by Medtronics and miraculous assembling of an instant cardiac team of physicians the only thing left was lots of money. The LDS missionaries asked SAMS to draft a proposal, which was submitted and approved in a matter of days.

You guys, paperwork doesn’t go through that fast. It did. The money came through and while my  team was in Jordan, over 100 life-saving heart surgeries were performed for refugees. Over 100!

Generally, if people ask if they can send money to me I think of it as me being an on ground proxy for them.  Basically, it is them doing the good, I am just the messenger. I use it kind of in a nickel and dime sort of way to provide for needs I see along the way on a very small, individual scale basis. This time, because of the last minute miracle of heart surgeries and overload of work we were doing within the camp itself, as well as the difficulty of obtaining and more extreme difficulty of distributing goods, I wasn’t able to do that exactly.

As the group would meet and discuss what was going on and what was needed we found ourselves with more needs created by the miracle of being able to perform so many heart surgeries. You may or may not know that basically any heart surgery requires one to be on life long medications. SAMS, not wanting to be irresponsible or short-sighted in their care (a major thing I respect about this organization) knew that these people would need follow up care and medications. One of the volunteers-and a great force for good-was a physician who had come to volunteer with SAMS. She is originally from Jordan and has family there. One family member in particular who was a pharmacist and could get medications at a wholesale price. I took all of the money I received and donated it to SAMS in order to provide these medications and other long term medications needed to keep people safe and insure they got real, proper care. I hope that you feel as ecstatic about how long-reaching and real the affects of your charity will go with how I used it. Given the circumstances, I knew that in this case, SAMS and its volunteers and connections, in this particular case could do more with it than I could on my lonesome this time. Although I plan to continue to do as much as I can within my small sphere of influence, I feel that God took my small sphere and combined with just the right people at the right time and magnified both mine and your contributions to make it have much more far-reaching effects than I could have on my own in this instance. And I am grateful to Him for it.

If for any reason you are unsatisfied with how this money was spent, please let me know and I will pay you out of my own pocket to reimburse your gift.

Other places where you money/donations went

Because of the conditions and number of patients we were seeing this wasn’t possible. I had no time to discuss much of anything other than main medical complaints and their vital signs.  Unfortunately, the camp life culture and scarcity of supplies has made it difficult to help.

Two places where items were given away.

We quickly learned that we couldn’t give anything out to children, particularly young children because they would flaunt what they had been given and get hurt (sometimes badly) and have it taken from them.  We would be overwhelmingly swarmed by children wanting something too, (which also often resulted in children being hurt).  It came down to either having to hand things out to people who happened to be carrying a bag or large pockets that day that had extra room we could slip things into and that we felt off intuition could be discreet. I would estimate that approximately 2/3 of the items donated were distributed through the psych-social program set up by SAMs.
After spending my first day with this program I felt very comfortable allowing this.  The program is set up very much like a referral visiting teaching program. (For those of you unfamiliar with this idea it is a program implemented by the LDS church. Members of the church go and visit each other to offer support, friendship and resources when needed.)  Because 80% of Syrian refugees living in Jordan actually live outside the camps along side of the Jordanians, there are massive needs there that also go unnoticed. Those volunteering for, or employed by, the SAMs outreach clinic will visit Syrians they know about and ask them if they know of any refugees.  They will also ask Jordanians on the streets if they know of any Syrians living in the area.  It felt quite a bit like “tracting” or knocking doors, as missionaries often do. I was impressed with the great amount of effort put into finding and helping refugees.  Because they do house visits and professional needs assessments and because of the difficulty of distributing in the camps, I felt more than comfortable sending a lot of your physical items donated with those doing the outreach within cities. They could distribute to those most in need. The other 1/3 were handed out by myself and other people I worked with within the small clinic inside the camp.

I spent my time at camp Al Zaatari, which is the biggest camp.  In fact, it has now become the fourth largest populated “city” in all of Jordan-even though it is not even technically a city-or a permanent residence. But other volunteers found the items useful and also took some items to various camps they were working in to hand out when needed.

Scarves.  They scarves were beautiful.  Thank you Saratoga stake. I am not a scarf connoisseur, but one of the muslim women volunteering along side of me mentioned that they were all very high quality, exceptionally beautiful scarves.  I commend you on your taste and generosity ;). I gave these out mostly to young women that I felt likely had a desire to feel more beautiful and fashionable in such gloomy circumstances.  I also found one girl, who was clearly new to wearing a hijab. (Hijab: the scarves worn over their heads for modesty.  The hair is covered because it is thought to be one of a woman’s most beautiful features.  Girls begin wearing the hijab once their menstrual cycle begins-many choose to start wearing it around age 10-12 at the beginning of the new year so as not to be embarrassed by the obvious announcing of receiving a first period with the sudden appearance of the hijab right after.) I thought it was unlikely this 12-ish old girl had a wide variety and I hope it made her feel special and beautiful.  I have to tell you, she was sweetly humble and very excited to receive it.  Both because she was chosen out of everyone to receive a gift, but most especially because I could tell she actually loved the gift itself. I gave her two :).

Underwear/hygiene products:  These items were handed out through the psych/social program set up by the group I went with and by myself and fellow volunteers in the camps themselves.  We were limited to being able to give them out to those we were felt could be discreet and were lucky enough to be carrying bags that had extra space that we could slip things into. 

Soccer Balls/Frisbees.
I somehow ended up with two hidden away in my luggage. (Guess that means I’ll have to go back.)

I also really like to provide pictures, but partly due to religious reasons, and partly because I am sure people want to maintain their dignity and do not want to look helpless and thirdly for security reasons.  If their picture were to surface they may be located and targeted, or more painfully, their families who have either not been able to escape or who have chosen to stay in Syria could be punished.

the kids. oh the kids.
Hug line.

As I mentioned before it was difficult to give anything to the children. It was also difficult to really play any games with them that included an item. From soccer balls being stolen so that no one can play with them, to frisbees being thrown on roofs to ruin the game. Even handing out stickers turned to chaos and resulted in injuries. The smallest gesture of drawing funny faces on hands with a pen even became troublesome. It hurt me so much to see all of this.  I know they all want these things-along with attention, but I could not reconcile doing something the resulted in children getting hurt or abused. Lines didn’t work. In fact, they seemed to make things worse.  The bullies would just off to the side and beat up (not slightly) and take from the kids who had waited in line to receive whatever it was we were trying to gift.  All the kids new and understood the idea of a line but with the bullies and the pushing and the fights breaking out in the lines, it wasn’t working. I thought (even prayed) about what I could do and give to these kids that would not cause them to get hurt or have a game ruined seconds into it.  Hugs. They need hugs. They can’t be stolen, taken, or ruined. I swear to you, the strangest thing happened.  I know it sounds almost too cheesy to be true, but after the very first hug or two that was given out the best line you have seen formed.  There was minimal pushing and shoving, and the bit that was done did not have the same violence that seemed to occur in the other lines we had tried to establish. I gave the absolute best hugs I could give. Nice and tight and long and full of laughter. The kids would get their hug and then immediately jump right back in line for another one over and over again. One boy in particular, determined to keep a scowl on his face came back more than anyone else. He would get to the front of the line and stare me down, a bit like a dare. I would stare right back and squeeze him till the edges of his mouth cracked. After several hugs or this little guy (probably about seven years old) the stare down lasted longer than usual and his smile was trying to break through even before I hugged him. I waited. He tried to fight the creeping smile. When I waited before hugging him he started nudging me. His arms were folded. Always. He couldn't bring himself to unfold them so he would basically do a little body slam/nudge with his arms all wrapped up. He bumped into me repeated, the anticipation pulling at the corners of his mouth until the best hug I could muster wrapped around him and he'd stay there, glowing, trying to not to smile, arms folded. Then, to the back of the line again to wait his turn for another hug. It might been the most productive hour of my life to date. Remember, over half of people living in refugee camps are children. Many of them are unaccompanied, meaning they have no parents.  Some of them are known to have been killed, some are separated from them still living in Syrian or other places, and for some, we just don’t know. The other thing to remember that even the children who have parents, may not have parents who are able to fully devote themselves to their children.  These people have seen terrible things, witnessed horrific offenses and experienced crushing loss.  As a result, many have PTSD, are depressed, and have a myriad of other issues they are dealing with.  Unfortunately, what sometimes happens is that they are not able to function as they would like as parents. At best the children are left to fend for themselves because of the depression of the parent.  There are other extremes you can  imagine that include violence, abuse and impatience with the children.

Perhaps one of the most difficult things for me to see was the desire so many had to contribute, to help, to be productive. Syrians in general tend to be very well educated. The camps are full of people who are used to living very meaningful, productive lives, and in order to stay alive, they are now sitting in boxes in the middle of the desert with nothing to do. They want to move on, they want to cope and survive and overcome but with nothing to do but literally sit. and wait. and sit some more. they are fighting hard to hold on to sense of self and dignity. Seeing people come through the clinic who were once very self-sufficient and who are longing to help themselves and their people and now being forced to live like beggars is hard to watch.
After seeing so much of this, one man in particular that came through the clinic broke me. He came into our little triage area (a 4 foot by foot room that we were shove 6 people into at a time to take histories on before sending them to the doctors). I don’t even remember what his medical complaint was, for some reason I don’t think he had anything serious.  As I was taking his vital signs he said in perfect English, “Let me help you.”

“I am a literature professor. I can help. I can translate, I speak perfect English. I can speak to the people. I can help you understand each other.” He tried so hard to keep himself poised so as not to sound like he was begging. It took everything he had to present himself clearly and professionally. I can’t quite accurately describe what it is like to see a man, who truly does and wants to have so much to give, do all he can to hold on to his dignity and identity, grasping at any situation to find a purpose and something to take his mind off of the horrors he’s seen and experience. (I am sobbing as I write this-as I have done so many times before while trying to write this. This story alone is what perhaps has taken me so long to be able get this out to you-it’s difficult to relive...and to see through tears enough to get this out.)

The truth of it is. He could have been very useful to us. We needed translators, perhaps more than anything. But because of the organization and the difficulty of keeping order in an impromptu, what was supposed to be temporary housing for a few, that has turned into 100,000+ people the camp is very strict about who helps in the clinics (they came by and checked out credentials from time to time).  They have their own local staff that we have to work with on their terms, by their rules.  We weren’t allowed to let this man help. Watching hope for a purpose drain from his eyes as we told him he couldn’t help broke me. Broke me in places so deep I feel the broken pieces every day. Now I sounded like I was begging as I told this man that we do need him. He would be useful and I wish we could use him. I frantically searched and asked those around me what could be done, how can this man with so much to give not be allowed to help us in our (and his) time of need. I tried to convey to him...everything: that I saw him. that I understood him. That I had so much respect for him and his fight to persevere.  I don’t know that I conveyed anything other than a helpless girl that was of less use in the camp than he could have been. The only difference being that I didn’t live there, I’m not trapped. And I happen to have a passport from a different country. As he walked out, with a little more of the light he’d been fighting to hold on to draining from his eyes, I broke down and sobbed-much like I’m doing now. The only other nurse on the trip, Barbara-who had been many times, simply closed the door to the triage room and let me cry.  When I finally managed to put myself back together, we opened the door to the triage room and went back to work. The man was already lost in the crowd. It’s not right. It’s not fair. And I will do anything I can to make sure that these people are seen and fought for.