Mobile hospital a first step in bringing normalcy

KILIS, TURKEY - Ali Ahmad was walking with his young son one evening after dark. It was after they had fled Aleppo, Syria, and begun their lives as refugees in southern Turkey. It was a clear, starry night.

“He looks up at the stars and he says, ‘Dada, are they coming to bomb us?’ I, I….” Ahmad can’t really finish the sentence. Even if his English was better, how could a father explain that his son is afraid of the stars?

“All of us Syrians, we need psychologists. All of us. We have seen our houses destroyed, all kinds of things,” said Ahmad over lunch with the staff at Malteser International’s new joint project with the International Blue Crescent Relief and Development Foundation in Kilis. The two international aid organizations — one Turkish Muslim, the other German Catholic — have come together to launch a 28-bed mobile hospital in this border town in which the population has doubled to 88,000 in the last two years due to the influx of Syrian refugees.

Ahmad is head nurse at the mobile hospital, which officially launched Sept. 13. The doctors, nurses and support staff at the new hospital are all Syrian. They all left Syria reluctantly. They saw the hospitals where they worked bombed, homes where they lived destroyed and sniper fire in Aleppo picking off one or two random civilians per day.

The trauma of seeing their country torn apart by a war they see as neither necessary nor resolvable has hit their children hardest.

“We adults, we can cope 80 per cent,” said Syrian English teacher and translator Ole Nasser.

The grownups can fall back on their roles as teachers, doctors, husbands, wives, mothers and fathers. But the children have no mask to hide behind, she said. Few of them can imagine a future when images of destruction, randomness and death make up so much of their childhood experience, Nasser said.

Nasser’s former high school students from Aleppo have written Syrian exams administered here in Kilis and many are hoping to gain admission to universities in Turkey and other countries. She is proud of their achievements and their courage in pushing forward into the future. She knows that for the younger children there’s no easy path to anything like a normal life.

The mobile hospital is a first step — a first, small contribution to a new Syria for the doctors and nurses. Like refugees everywhere, being shut out of their own country, pushed out of their hopes and dreams — including their dreams for Syria — is an injustice they find hard to bear, hard to understand.

The Malteser-IBC hospital in Kilis will take some of the pressure off an overburdened local public hospital. Under the crush of patients, which includes people suffering extreme stress, hypertension, complications from untreated chronic conditions such as diabetes, as well as war wounded, the Kilis hospital is forced to discharge patients sooner than it would like. The mobile unit will follow up with those patients, begin processes of rehabilitation, longer-term treatment and care.

A joint project of a German and Turkish NGO, the agencies have co-ordinated every aspect of planning with the Turkish ministry of health and the municipal government. Turkey has ensured that there will be no free-for-all of international NGOs dreaming up individual responses to the 600,000 Syrian refugees now in Turkey, and that’s a good thing, said Anja Simic, the Malteser program co-ordinator in Kilis.

Simic is a Bosnian humanitarian professional with experience working for the United Nations High Commission for Refugees. The days of random, amateur, short-term efforts fuelled by emotion, media coverage and instant fundraising are passing into history. Simic believes refugees deserve professional, planned and co-ordinated services. And governments such as Turkey’s deserve respect to allow them to set priorities.

Malteser and IBC’s other goal is what the development experts call capacity building. One day this hospital will be loaded onto trucks and moved south. With it will go a team of medical professionals who know the refugee population and have worked together on the health effects of war and displacement.

While deference to local authorities and dedication to capacity building are guiding principles for the development professionals, the doctors have other priorities. As the medical staff spent the day together at their new but empty hospital, they were thinking about the suffering they know is happening in Syria.

While conversation over lunch worked its way around one more time to Syria’s future, the doctors turned to Simic and asked whether they could treat sarin gas victims from the Ghouta suburb of Damascus. It had been two weeks since the attack, the United States and Russia were working out a procedure for tracking down chemical weapons and Damascus is more than four hours drive away in peacetime. It’s not even close to a realistic proposal.

Simic tells them, “Of course.” But first they would have to be admitted to the Kilis hospital and then, after initial assessment and treatment, be transferred to the mobile clinic. That’s the agreement with Turkish authorities. The doctors shake their heads over the bureaucracy.

The hospital is equipped and designed to travel. It can run off a generator or any source of electricity it finds. The high-tech container-treatment room includes a system for filtering the air. The four ambulances are well enough equipped that doctors could perform surgery in them if necessary.

But it all sits in a landscaped courtyard, hooked up to city electricity and water. As far as Kilis is concerned the city now has a new annex to its hospital.

The Syrian doctors want to be in Syria now. They want to treat Syria’s wounds.

“If I were a general surgeon I never would have left,” said Dr. Mahmoud Mustafa, who gets a laugh out of the idea that as an ophthamalogist he is one of Bashar al-Assad’s colleagues.

For International Blue Crescent, partnership with Malteser International was quite natural.

The German and Turk agencies first worked together to help Turkish earthquake victims in 1999. The International Blue Crescent sees the Knights of Malta’s NGO as a natural partner because interfaith dialogue is written into the IBC’s basic statutes, said IBC vice president Muzaffer Baca.

“It’s not just a humanitarian issue,” Baca said. “They made it a solidarity issue very early.”

Baca believes Germans and Turks make good partners. The two nations fought on the same side at Gallipoli in the First World War. Turks don’t associate Germans with the colonial powers, such as France and Britain, or with the kind of influence the United States and Russia have exercised both before and after the Cold War, Baca said.

The IBC sponsors regular interfaith conferences — “Abraham meetings” — for religiously based NGOs. At their most recent conference in Edessa, Turkey (Abraham’s home before God sent him wandering), they brought together Iranians and Israelis to discuss the humanitarian needs of the region.

The work IBC has taken on with Syrians is particularly important for the Turkish agency, and not just because a broken, dysfunctional Syria is a threat to Turkey. A large part of the Syrian population is ethnically Turk. Turks can be found from Uzbekistan to the Balkans. Baca claims he’s not interested in a kind of political pan-Turkism, but the connections among Turks are something that should help the region.

The Malteser-IBC hospital is in a neighbourhood not far from downtown Kilis, flanked by a couple of feeding stations that also offer social services to refugees living in town. The 40,000 refugees renting rooms in the city are the majority. There are 20,000 in the first Kilis camp, another 13,000 in a newer camp. A separate reception centre has a capacity for 5,000. A very large site is being prepared for a third camp just north of Kilis.

A recent influx overwhelmed the official camps and resulted in people sleeping in city parks. Turkish authorities and NGOs worked quickly to find places for the refugees, but locals claim they still find refugees sleeping all over the city.

The Malteser effort in Kilis goes beyond the hospital. The agency supports psycho-social work — counselling for traumatized refugees — and a school, again staffed by Syrians.

Everything they do is designed to be “part of any new Syria,” said Simic.

“We’re not saving anybody. We’re helping Syrians to save themselves,” she said.