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Life in Syria: Going to the market on a sunny day


Dr Joanne Liu - MSF International President

Joanne's first field assignment with Médecins Sans Frontières/Doctors Without Borders (MSF) was in 1996. Since then, she has completed over 20  missions. Like many of her MSF colleagues, her humanitarian work has taken her to some of the most unstable regions and humanitarian crises of the world. These include Somali refugee camps in Kenya, the Democratic Republic of Congo, Honduras, Haiti, Ethiopia, Nigeria, Indonesia, Palestine, Uganda, Sudan, Sri Lanka. She is all too familiar with the sound of gunshots and artillery, and has had to live in conditions so dangerous that she slept with her boots on in case of a rebel attack. She took those risks along with her fellow MSF colleagues with the sole goal of delivering medical aid to those with the greatest need.

Dr. Joanne Liu was recently elected International President of MSF in June 2013, as just returned from Syria, where she worked as a doctor in a field hospital alongside Syrian colleagues.

Life in Syria: Going to the market on a sunny day

I traveled to Aleppo Governate and the most striking thing, once inside Syria, was the apparent calm. The landscape is mostly pastoral, and even peaceful if not for the presence of a couple of checkpoints. 

MSF has settled in a small village a few kilometres from a bigger urban site. Our medical activities here are organised around a field hospital of 25 beds, with an emergency room, operating theatre, in-patient department, out-patient department and maternity department. While I was there I mainly worked as an emergency room (ER) doctor but I also participated in ward rounds, saw patients for consultations and contributed to the maternity medical activities.

The personnel are highly dedicated, even though at times there is lack of medical staff and everybody is stretched. There has been a brain drain of medical specialists and of the remaining medical staff; many are physicians who were still in training when the conflict started. Now they have to cope with the gruesome consequences of the conflict.

"Collapse of a society"

It’s deeply disturbing to see, for instance, babies come in with serious malformations. During the ten days I was in our hospital, we received an unusually high number: three babies were brought in with severe birth defects, possibly resulting from a lack of folic acid. We cannot draw conclusions from these three cases, but even for myself, a trained paediatrician with 20 years experience, it was a shocking illustration of the collapse of a society that used to enjoy a sophisticated system of healthcare.

The story that stays with me most is that of the two pregnant ladies. It happened on a sunny, warm day. Towards the end of the morning we heard planes roaming above our heads. A few minutes later I heard the sirens; two women were rushed into the ER.

One was pale as a white-board, breathing with difficulty, with a shrapnel wound to the left thorax.  She was six months pregnant. Her O2 saturation was decreasing dramatically.  We quickly stabilised her in the ER and rushed to the operating theatre for a chest tube.  She was fighting to breathe for the rest of the day, while we gave her transfusions and oxygen.

We closely monitored her. The next day, she had won the battle for her life. Sadly, the baby had died.

Emergency surgery

The other woman was six months into her pregnancy as well. She was screaming with pain; she had an injury to her left ankle, a hole the size of a tennis ball, with major loss of tissue and bones. The surgical team took her into the operating theatre, reconnected blood vessels and put in place an external fixator. Her foot did not win the battle; it had to be amputated below the knee the next daybut her baby survived.

It was a sunny day and two pregnant ladies were going to the market. An everyday event, that brought home the horrors of this devastating conflict.