27Nov2022

SCM Medical Missions

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Humanitarian AidRefugeesSyria

A message from Rita Zawaideh, CEO of SCM

I went to sleep last night thinking this is the fifth year of the Syrian crisis and it is not getting any better. We seem to be going backwards every day. People ask why are people fleeing Syria and all I can do is show them the pictures and tell them some of the stories that the Syrian have told us to what happened to them when in Syria. They are all looking for a better existence for their children.

Most Syrians love their country and are proud of being Syrian. They cannot see an end to the fighting as we here in the West do not see an end.

Inside Syria, the situation has continued to worsen, with fighting intensifying in all regions and the economy and services in a state of general collapse. This is driving yet more people to leave, but is also having a profound impact on those who have already escaped to neighboring countries.

When people flee from war, they usually do so hoping to return soon. So they move nearby, perhaps to family or friends in a nearby town, or just across the border, where they can keep an eye on their homes and livelihoods. But after more than five years of conflict, many Syrians have now abandoned that hope. Their homes have been devastated, their families torn apart, and there is little prospect for peace. With nothing left, and their places of exile under increasing strain, hundreds of thousands of people are now ready to travel much further to find the security they so desperately need.

In most countries, refugees are not allowed to enter the labor market formally and face sanctions if caught. In Jordan, for example, they risk being returned to the camps; in Lebanon, they are forced to sign a pledge not to work if they wish to renew their residency status.

Without income, people are forced, first, to spend their savings, and then to take on debt. Even worse options may then lie in store. After years of grueling costs, many are simply no longer able to pay for rent, food or basic items.

SCM started the campaign to work in Jordan almost five years ago and we were organizing about 6 missions each year. After 4 years we were hearing about more people crossing the border to Turkey and then taking the boats to Lesbos, Greece. SCM moved its operations to Lesbos to help the refugees arriving there. After about 6 months on the island the situation changed and the different EU countries started to close their borders and people got stranded on the border of Greece and Macedonia. SCM moved our operation on Lesbos to northern Greece and the Idomeni area camps. We set up mobile clinics and the volunteers still kept coming and wanting to help. Last week the Greek government started to close those makeshift camps and moving the refugees to official military-run camps. We have been asked to work in those camps by the Greek government and SCM agreed. We set up our clinic and started working at the Sindos camp this past week.

Now what is next for the Syrians?

Before this move a lot of them wanted to stay in Idomeni near the border and be ready when it opened to cross to the Europe they had seen in the news- that was greeting them with open arms and flowers and welcome signs, but that has stopped and now they are stuck in this endless cycle of not sure where to go and what life has left for them.

When I go to the camps and talk to the refugees and try and give them hope I am also trying to give myself hope that we will be able to do more than just the medical id and the humanitarian. I want to reassure them that they will have a life and there will be schools for their kids to go to and they will have food, clothing and a roof over their head, but honestly I am not seeing anything like that.

What is the world doing but turning their backs on these people, they really want to go home. Like everyone else in any major crisis- is get out to protect yourself and your family and then as things get better go back home, but even that has been taken away from them.

I never thought I would still be doing this work for this long- this has taken over my life and I have been obsessed with trying to figure a way out to help, but I keep being hit with a wall. I am living in my house with heat, water, car and food can do what I want, but these people cant. There are so many that I know, the tour guide I used to use in Syria had to flee, friends of my daughter, family members that are spread all over the place and can’t ever see each other or attend a family funeral, or a wedding, or any other family event. People that are forced to get married in the camps and ant have the wedding that they had planned for. All they see is where are we going to be in a week or a month or a year from now. Where will my kids be- will they be alive. Some parents I talk to are so depressed that suicide is in their thoughts since they do not believe they are good parents not able to take care of their own. Women left to take care of 4 or 5 or more children not sure where to get the means to feed and clothe them, since the husband or the man of the house was killed tortured or in prison.

Please help us by making a donation of any size to help them live a decent life until we (the world) can find a solution to this crisis.

RefugeesUncategorized

New Camp for the Refugees

Most of us have seen the news headlines of the Greek government moving the refugees out of the makeshift camps at the Greece-Macedonia border at Idomeni. The refugees are being moved to official camps set up by the government and SCM is there to continue providing aid. Sindos is one of the new camps that is in a huge, old factory.

Here is a description from our volunteer Madi W. who has been on the ground since last month and plans to stay as long as we need her:

Sindos5-26-2016May 24, 2016: We’ve moved in to a new camp called Sindos. Although these camps are run by the military and have both military and police presence, the residents have free movement and the environment is very relaxed. The camp is located behind a Mercedes dealership outside of Thessolaniki in an old hangar. Tents are pitched inside and are numbered. Being inside is a huge upgrade from living in the mud and dirt in Idomeni. 350 people were moved in on Sunday morning before we came to set up that afternoon. We’ve been given a gray, garden shed-type building next to Block C with electricity and a private room to see patients. The view from our clinic window is a large green fence where people hang laundry to dry and the clinic door looks at the old building where the police and military are based. When we first moved in it had a very abandoned feeling to it and the empty blocks were echoed and eerie but today as new residents from Idomeni poured in they filled the place with life. The power of community is so strong! Women who had seen our OBGYN, Sam, earlier in the day brought friends back so they could all enjoy quality care and a wellness check. People come and tell us about their sick family members or friends, they accompany them and ask questions and advocate for them. That shows me that we’re a trustworthy service. They are confident in our ability to help as best we can.

Idomeni is being cleared so our team is present at the camps within walking distance of the hotel: Hara and Eko. We’ve been providing regular care at Eko since we arrived here back in March and are now working closely with a group called Katrinos out of a wonderful yellow ambulance for women’s care and the bright Swedish ambulance for general care. There have been weeks where we’ve had too many medical care providers- back in March I wouldn’t have even imagined that as a possibility! As the populations and needs change we try to adjust accordingly. The trust that we’ve earned here means so much to us. Hara and Eko will soon follow Idomeni as far as clearing out but we are standing by our community until the last patient is relocated to better conditions.

Sindos5-26-2016-iMay 26, 2016: The conditions in Sindos are not ideal but the basic framework is certainly loads better than in the pop-up camps or in Idomeni. The tents are large and sturdy and are inside where they’re protected from the wind and rain. The military and Swiss Cross are starting to hand out sleeping pads as well as blankets. There’s only porta-potties and there’s no hot water. 

The food isn’t ideal but we need to remember that lots of these peoples diets are supplemented by food from small NGOs or food they make themselves. We’re working on getting access to raw foods for them to cook and prepare for themselves.

We are now providing medical services at three camps – Sindos, Eko, and Hara. Eko and Hara will likely be closed down and cleared by the government. They currently operate on land near two gas stations. We will continue to provide medical and humanitarian aid for as long as we are needed. Please donate to help support our efforts in Greece. Your donations will go towards purchasing medications and supplies, and providing logistics support to our teams on the ground.

Humanitarian AidJordanRefugeesSyria

No Man’s Land

GREAT NEWS

The Jordanian military is going to let SCM get humanitarian supplies to the no mans land for the stranded Syrian refugees.

For right now we have a container that is arriving into Jordan on the 21st of May with 500 blankets plus other supplies that we will be donating to them to give at the border. We are still not allowed into the area. A raised barrier of sand, or “berm,” marks the Jordanian limit of a border zone between Syria and Jordan. The area where the Syrians are stranded is inside Jordanian territory.

Now Ramadan is approaching in a month and to get more things into that region we need to purchase supplies in Jordan since there is no time to get it to them immediately from USA. Food is already being brought in as well as mattresses and tents.

The vast majority of those in the berm are children, elderly, women and people who are sick. Hygiene remains a significant concern in the no mans land. Inside the berm, there is no water and no way to grow food, so the 60,000 inhabitants are completely dependent on international agencies for survival. There is nothing that people can do to help themselves there. If the water truck doesn’t get through, the consequences could be dire.

Please donate. Help us to help them.

GreeceRefugeesUncategorized

Something’s Gotta Change: But When? And How?

By Dr. Bill Dienst April 29, 2016, Idomeni and Polykastro, Greece

The 40 year old man who stumbled in front of a Greek police bus while fixing his tent suffered a devastating crush injury to his head. He received immediate medical attention by Dr. Omar Al Heeti who works as part of our joint team of medical professionals from Syrian American Medical Society (SAMS) and Salaam Cultural Museum (SCM), and with help from doctors from Medecins San Frontieres (MSF).

When the Greek Ambulance arrived, Dr. Omar traveled with the Ambulance crew all the way to the rural Kilkis Hospital, providing positive pressure ventilation and suctioning. The transport time was over an hour. At Kilkis, this man received intubation from a Greek anesthesiologist. Due to massive facial injuries, the intubation was extremely difficult. He was then transferred to the medical center in Thessaloniki. He remained comatose and died from his injuries two days later. He leaves behind a grieving wife and 4 small children who are still stranded in a tent in Idomeni camp.

On April 26, 2016, the Greek Ministry of Interior and Administrative Reconstruction issued the following notice in Arabic, Kurdish, Urdu and Farsi to refugees living in the camps around Idomeni:

Information to Refugees – Migrants

You are in Greece and you are guests in this country. It is your obligation to follow the rules and instructions of the Greek state.

The borders, and this is not a responsibility of the Greek government, are and will remain closed. This settlement does not cover any of your basic everyday needs. It will end its operations. You should move to the camps run by the Greek State, in a fast and coordinated way, under the responsibility of the Greek authorities.

The Greek State gives you the opportunity to stay in the temporary receptions facilities (camps, hotels, settlements and other facilities) in various areas in the country.

These facilities are open but are guarded and controlled so that you and your families are safe. There you will find food, medical care, clothes and personal hygiene items.

While in these reception facilities, you can move freely, going out and coming in, but you must return back at a specified time and you must observe the Operation Regulations. If you do not observe these rules, you will lose your right to Stay there.

You must also register. Soon after your enter the reception facility, the Greek Authorities will give you information on on your right to apply for asylum in Greece, and the option of relocation in another EU member state for those fulfilling the terms and conditions of the relocation programme. You will also receive information on the family reunification procedure so as to reunite with members of your family in EU member states.

You will also receive legal and financial aid so as to return to your country of origin in case your asylum application is rejected or in case you wish to return.

You are requested to follow the orders and instructions of the competent members of staff who will tell you how to leave this settlement in an orderly manner and how to be transported safely to the reception facilities.

Many of the refugees, and some of the international volunteers who have put so much time and effort developing the healthcare and humanitarian infrastructure at Idomeni camp, found this notice very upsetting. Some are angry with the Greek government for suggesting that Idomeni camp will soon be dismantled. MSF, Medicins du Monde, Praxis, ICRC, Safe the Children and hundreds of smaller NGO’s like us have invested tens of thousands of dollars trying to make life tolerable here. Infrastructure is still being developed: new showers, toilets, makeshift schools, etc.

Now we are finally catching up with the health care and humanitarian demands of this trapped population. For the first time, a dental clinic has started operations 5 days ago, fulfilling overwhelming dental needs. We hope to have similar dental services at the other gas station camps soon. Those of us who have been here awhile arrived to witness long queues of people shivering in the cold mud and torrential downpours of late winter rains. We had limited supplies and had to tell many people waiting in long lines “no, we don’t have the resources to help you right now with your problem.” Many of these limitations have been slowly but surely getting better.

The cold winter rains have subsided. Now, in spite of a few days of tear gas, sound grenades, rubber bullets and high winds which rip some of the tents to shreds, the overall weather and living conditions are improving.

It is no longer too cold, but soon, it will be too hot. I shudder to think what will happen in when the holy month of Ramadan starts in June and people are fasting from sunrise to sunset during the longest days of the year and summer swelter: heat stroke, dehydration, kidney stones etc. The treatment for heat stroke is to cool the patient down. But we have no air conditioned shelters, no ice, only tents, which can get hotter on the inside than on the outside during the daytime under these conditions. The nearest hospital in the town of Kilkis is over an hour away, and ambulances are limited.

No, the situations at Idomeni, EKO, BP and Hara gas stations are not tenable in the long run. We cannot blame the Greeks, for they did not ask for all this refugee crisis either. It was put upon them. The farmers in the tiny village of Idomeni (population 154) want their farmland back, and their way of life; and who can blame them? The railway station needs to reopen again soon someday.

This stalemate has to end sooner or later; maybe sooner would even be better than later, especially with the hot summer sun approaching. The problem that those of us serving the refugees face now has to do with timing: there is no way to accurately predict when the camps here will be dismantled. Meanwhile, we continue to develop further infrastructure to meet fundamental human needs for those who can’t wait.

DSCN2159Dr. Bill Dienst is a rural family and emergency room physician from North Central Washington. He has extensive experience in medical exchange programs in Veracruz, Mexico and in the West Bank and Gaza Strip. He is currently on assignment with Salaam Cultural Museum, a Seattle based nonprofit organization doing humanitarian and medical relief work with refugee populations in Lesbos and Idomeni, Greece.

Greece

The Ebb and Flow of Confrontation and Suppression

Monday-Wednesday April 11-13
Idomeni and Polykastro, Greece
By Dr. Bill Dienst

On Monday, we experienced the aftermath of processing our own emotions, those which we had no time to digest while it was all happening on Sunday: the tear gas, the sound bombs, the rubber bullets, the stampeding people full of panic, and the adrenaline rush of it all. The morning after brings with it a hangover of somber moods, as we reflect on what it all means: the growing loss of any hope among the lingering refugees.

I have been through all these emotions before in Gaza.* First, an oddly euphoric feeling of being alive during all the excitement of being under attack, then melancholy; and then feeling depressed with Post Traumatic Stress symptoms later.

But we have no time for all that now. We must get out of bed, have breakfast and head back to the front at Idomeni. With some trepidation, we proceed with our mobile health van, and set up in our usual spot.

Monday turns out to be fairly routine. We are back to our usual old practice pattern of “Urgent Care, Light.” A lot of self limiting conditions, for which we can only provide symptomatic relief. A lot of chronic complex medical and social problems which we can do little about. There are also the few cases where antibiotics are indicated. We provide a few wound dressings for second degree burns from hot water and campfires.

It’s the usual stuff: seemingly boring, but showing the people that we still care for them, while they are feeling that most of the world has forgotten them and their current predicament. We practice the art of primary care medicine: First do no harm! Try your best not over-medicate those with emotional distress presenting with physical complaints, but try not to miss those few serious conditions that require our medical intervention either.

Tuesday is much like Monday. Our mobile clinic at Idomeni runs smoothly, and I end my day there with the usual collaboration meeting with Medecins Sans Frontieres, Medecins Du Monde and the heads from all the other smaller NGO’s like us, who are providing health care in the camps. We review our response to Mass Casualty Incidents, like the one that occurred on Sunday, and how we can collaborate better. We are trying to start a vaccination program, but are still awaiting a green light from the Greek government. There is a clinical report of a case of measles without lab confirmation. We fear preventable epidemics might break out.

Then when we least expect it, Wednesday turns out to be a much different day. When we arrive, refugees are again amassing at the fence, and a standoff with Macedonian troops on the other side is already underway. There are fewer protesters this time than there were on Sunday. A few tear gas canisters and sound grenades fly. But then from the West, we see a column of Greek riot police moving forward to the east, fully equipped with riot shields and billy clubs, creating a wedge between the refugee protesters and the fence, with the FYROM soldiers watching from the other side.

Greece and Macedonia (or FYROM, as the Greeks prefer to call it) have had their share of hostilities in the recent and distant past. But neither side is looking for an armed conflict. The economies of both countries are suffering, even before this refugee crisis began; the last thing either country needs right now is a war, provoked by this refugee crisis. This escalation could easily have happened last Sunday, especially when the FYROM helicopter weaved menacingly along the border. I am sure it was equipped with attack weapons, which could have been unleashed into the crowd below.

On Monday, the media was full of reports from the Greek government which were critical of how the FYROM government handled the situation. But nobody in either government wants any further escalation: the Greek riot forces are now advancing their wedge, to cleave the refugee forces away from the fence. People are stricken with billy clubs, and we start taking casualties at our mobile health van.

We get fewer tear gas injuries than on Sunday, but more lacerations courtesy of the Greek riot police: about 5 cases within just a few minutes. Fortunately we are equipped with staple guns, which are much quicker than using conventional sutures. We have no time to dilly-dally. We must work fast, because we don’t know when the deluge of patients will stop. First iodine to disinfect, then wash the wound with saline, then lidocaine injection, then staples: pop, pop, pop! Antibiotic ointment, sterile dressing, then out the door. Next patient please. We can’t worry about tetanus, for we have no tetanus vaccine available.

Over the following days, it appears that the spirit of the refugee people is being gradually and persistently worn down. More people are getting on buses and going to the relocation centers, which some call internment camps. I doubt we will see riots of the magnitude we saw Sunday and Wednesday again, but who knows for sure?

Greece

There are Lots of Rumours; Some of them are True

Dr. Bill Dienst

Sunday April 10th, Idomeni, Greece

It’s 8 am. I arrive at breakfast in our Hotel Maison, located 40 minutes South of the Greek-Macedonian border. There at the border, thousands of Syrian and other refugees remain stranded.

David Stanton, the EMT working for Medics Bergen tells me about rumours he has heard the night before: Large numbers of refugees are planning to breach the border today. I hear similar rumours from time to time, but nothing much has happened so far on my watch.

Two weeks ago, also on Sunday, there was a big standoff between the refugees, encouraged by Spanish and Italian solidarity activists. They faced off with the Greek Police in full riot gear on the railroad tracks, 100 meters from the fence. We had our trauma bags deployed, fully ready, but the situation eased off several hours later. As far as I know, no one was hurt. The activists went back to Italy and Spain the next day, and the refugees went back to their squalor and their tents. We went back to treating colds and sore throats. Several hundred refugees boarded buses and left Idomeni for “relocation centers,” while thousands others still remain here. People are becoming more stir crazy and reckless: Children walk aimlessly right in front of my car, and I must drive defensively in order not to hit them by mistake.

I head North to Eko Gas Station refugee camp and attend the weekly medical logistics meeting for our coalition of small NGO’s. My medical and humanitarian team goes directly to the medical warehouse in Polykastro to restock our mobile health van. We stock every morning to prepare first for our mid day clinic at Idomeni, and then our evening clinic back at Eko. While at the morning Eko meeting, I hear more substantial rumours: several hundred refugees left Eko at 6 am this morning and are presently walking 20 km to the border at Idomeni: They are going to try and cross. Many left with their belongings in tow, just in case they get a chance.

We finish our meeting at about 11 am; then I head North to join my colleagues to start our clinic in our usual spot in Area C at Idomeni. When I arrive, I see thousands of people, not at the usual spot of protest at the railroad tracks, but to the West: right smack dab up against the fence topped with Concertina Wire, and some are trying to cut their way through.

DSCN2080On the immediate opposite side of the fence are riot police and soldiers from the Former Yugoslav Republic of Macedonia (FYROM). Tanks with mounted machine guns and Armoured Personnel Vehicles (APV’s) are there too. Things escalate; rocks are thrown across the fence at the soldiers, and FYROM forces respond with tear gas and sound grenades.

As I approach our Mobile Health Van located 250 meters South of the fence, I see David the EMT stumbling back, extremely sweaty, clammy and coughing uncontrollably. He has been gassed. We douse him with water, and he starts to recover. Moments later, we start receiving dozens more who have received more intense gas exposures. We start shifting into Mass Casualty Incident mode.

As we get over our initial astonishment and emotional shock, we start to get a handle on the situation. We start triaging people based on intensity of symptoms and associated trauma, related directly to the melee. Chaos and Pandemonium dominate, and now we need exert crowd control measures. We instruct our translators to start shouting loudly in Arabic: “Family members only! All others who are not hurt need to back away!”

Some people have been struck with billy clubs or rubber bullets, but 90% are simply suffering from different levels of tear gas inhalation. A few are splinted for possible fractures and we call the Greek Ambulance for one suspected low back/pelvic fracture. We send some of our volunteers forward wearing masks and equipped with 1 liter water bottles with a hole punched into the middle of the cap, so they can quickly douse those gassed and mitigate the severity of their symptoms, thus reducing their need to be carried by others to our van. Most of these cases are self limiting. One man gets IM epinephrine as we are concerned about his impending respiratory collapse, and several with asthmatic reactions receive bronchodilator therapy.

DSCN2138The wind suddenly shifts to the South, and all of us medical volunteers are now being gassed too. We become wounded healers. Our van pulls back 100 meters further South through trampled wheat fields to try and escape the gas.

This immediately feels familiar to me: instant recall. A feeling one never forgets if you have been tear gassed before. The burning on your face, the intense watering and stinging of your eyes; the uncontrollable sneezing and coughing. The feeling that you are going to suffocate, and then it passes, just as long as you don’t die right away: 2 minutes, 5 minutes, 10 minutes, depending on the concentration of gas you received and any premorbid conditions you might have.

It has been 10 years since my previous and only other gassing. This one occurred in 2006 at the hands of Israeli Occupation Forces in the West Bank village of Bil’in. Those weekly gas attacks there continue to this day. They involve concertina wire fences too: built to steal valuable olive groves from Palestinian villages and incorporate them into Jewish-only settlements. The tools used there and here are the same: concussion grenades, tear gas, rubber coated steel bullets and sometimes live ammunition. For me, that gas attack back then was much worse than this one; compounded by a concussion grenade that exploded right next to me, and left my ears ringing for hours.

The FYOM forces are now using rubber bullets and I am hoping it goes no further. We have previously seen a Greek helicopters, but now a FYROM military helicopter approaches, weaves in and out, then hovers menacingly over the border. I again start having quivering flashbacks, having seen American supplied Apache attack helicopters in Gaza before firing heavy shells over our heads from the sky and killing young men behind us. I am praying internally that it will not come to this.

I am sure leaders from both Greece and Macedonia do not want any further escalation either. The last thing either country needs right now is a war, given that the economies of both countries have been in the tank, even before this current refugee crisis.

We think the gas victims are waning; but they continue coming in waves. Gradually, the numbers keep getting smaller. It’s three o’clock: we pack up our van and head to Polykastro for lunch.

Dr. Bill Dienst is a rural family and emergency room physician from North Central Washington. He has extensive experience in medical exchange programs in Veracruz, Mexico and in the West Bank and Gaza Strip. He is currently on assignment with Salaam Cultural Museum, a Seattle based nonprofit organization doing humanitarian and medical relief work with refugee populations in Lesbos and Idomeni, Greece.