In refugee camps, Lifespan dermatologist provides care for people who don’t have a choice

What motivated you to become a doctor?

My parents were doctors. It was part of the fabric of home life. Back then, Mom and Dad would make calls at people’s homes. Patients would call us and I would take messages for them. Being a doctor wasn’t a job for them, it was part of everyday life. My dad knew his patients without having to look at a paper record. He would know the patient as a person, not as a patient. He knew all about their family life, the stresses in their lives, their children. I like to know something special about my patients as well, beyond their medical history.

What is unique about providing care for displaced people?

When patients come in to see a physician, they’re coming in because they need help. They identified a problem and they need help with it. They’re coming voluntarily, but displaced persons are not. They’re caught in this almost unpredictable cycle of events be it war or natural disaster. We talk about vulnerable populations in the U.S., but displaced people are stuck. When we see patients in the clinic here, they’re coming in because there’s a need. When we go in to take care of a displaced population, they’re there because they don’t have a choice. 

What was working in a refugee camp like?

The United Nations High Commissioner for Refugees is huge. They set up the camps, but they only provide shelter, water, and food. Health care they outsource to the International Medical Corps. We worked with Arabic-speaking physicians and nurses and were embedded with the International Medical Corps. We had to get screened to go into the camp. Most camps are well-organized, but you work in a clinic and you basically see patients in the clinic all day. My first experience was freezing cold all day. We were working out of metal containers so you really saw it. We saw so many children. This March, I was in Turkey and the Red Crescent was doing its work. But this time, it was less medical care and more about mass feeding campaigns. If they don’t have food and water, they get sick, and they’ll need more care. 

Besides the cold, what were some other challenges you faced?

There was no scale in the clinic. So the nurse and I had to improvise. I picked up a baby, weighed them, and wrote down my guess on a piece of paper. Then the nurse did the same. And then, we averaged it out. We had no choice but to think on our feet. We gave out so many topical medicines that we ran out. We saw so many patients. We’d get back to our hotel room in Amman and we’d be so emotionally and physically exhausted, we’d go to sleep right away.

What is something that left an impact on you?

The saddest things we saw were people coming in with burn injuries. They were living in close quarters and in tents, so they’d have a propane heater. Children would crash into the pots so there were lots of contact injuries. You can’t contain a child in a tent. There were a lot of bacterial and parasitic infections. Stuff you don’t see in the U.S. 

What were the specific needs of the children you treated?

There’s very little obesity in the camp, as you can guess. Children become malnourished and look younger. You’d look at the age and look at the child and it’s completely different. They look so much smaller. Yet the children are so resilient. I’ll never forget this one child, he was in a wheelchair and had spina bifida. He was paralyzed from the waist down. I saw an ulcer in the butt area and it turned out that it happened because he was sitting in a chair all day. We created a specialized cushion with materials available, and he did very well. 

What do people not realize about caring for displaced persons?

We are so fortunate here, and it’s a very fine balance. If we couldn’t get groceries for two weeks, we’d be in a lot of trouble. The experience makes you very grateful because you quit complaining. It’s such an incredible blessing to just go into the kitchen and get some water or fruit. It makes us much more grateful and tougher. That might sound like a very small thing but  the ability to recognize the difference between what’s a want and what’s a need is huge.