SCM Medical Missions


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Vincent’s Story

Dr. Bill Dienst April 12, 2016, Eko Gas Station near Polykastro, Greece

Vincent (not his real name) is a friend of mine: A 28 year old man from Syria with a warped sense of humor. He acts like a child because he never had a childhood. He volunteers every day with our mobile healthcare van serving as one of our Arabic-English translators.

He greets me every day, shouting and laughing “Kill Bill!” I must admit, I find this unnerving. He goes on and on about these Quentin Tarantino movies, which I have yet to see. He thinks they are fabulous! “Just like a cartoon!” he exclaims.

I am trying to use him to help me do patient interviews; the line of patients keeps getting longer and longer. I am trying to focus on patient care. Vincent keeps trying to tell jokes; many I find foul mouthed and disgusting. I won’t even try to repeat them here. The line keeps getting longer and I find myself getting frustrated. Frankly, I him obnoxious at this point. I am starting to resent that I am stuck with him.

Then something happens, which changes my initial impressions. Late at night as the clinic is winding down, a sick 9 month old dehydrated child presents, who has had continuous diarrhea for 8 days. This child needs to be hospitalized, and the closest hospital is in the Greek town of Kilkis, over 40 km away across farm fields in the dark.

The main problem facing us now is lack of transportation. This child is not sick enough to warrant an ambulance, which are hard to come by anyway. I also need an Arabic-English translator to help the Greek doctor at the hospital.

So I go with this child, his mother and Vincent in my small Hertz rental car all they way to Kilkis (population about 60 thousand); three Syrians and one American. None of us have ever been to Kilkis before. I am glad I have studied the Greek alphabet, so I can read road signs and not get too lost trying to get to the hospital.

I wince at the idea of having to listen to Vincent’s warped sense of humor all the way to Kilkis. I start by asking him what he thinks should be done to resolve the crisis in Syria. “Drop a huge nuclear bomb on the whole country!!” I ask him why? “Then all the people who are suffering and dying slowly will finally be put out of their misery!!”

Then a funny thing happens. A tormented soul emerges from his internal angst, stops all the sick jokes, and starts telling me his personal story.

Vincent was not born not in Syria, but in Iraq. This is because his grandfather was a political opponent of former Syrian President Hafez Al-Assad, the current President Bashar’s father. Vincent’s family fled to Iraq to avoid persecution. His father divorced his mother when he was about 3 years old, so he never really knew his father. His mother suffered severe post-partum depression after the birth of younger brother Mohammed. His mother killed his younger brother by cutting his head off, also when young Vincent was only 3. His mother has been mentally disturbed ever since, and Vincent has distanced himself from her.

As a result of all this turmoil, Vincent was raised by his grandmother, with whom he is now closest. In 1995, when he was 7 years old, the family returned to Syria while trying to escape the growing hardships resulting from the American orchestrated attack, followed by the no fly zones and embargo of Iraq.

Upon returning to Syria, the entire family was immediately arrested, and Vincent became a 7 year old prisoner. “For me, prison was like a school,” he says. They had fellow prisoners who served as teachers. After 3 months, the family was released, albeit with multiple restrictions: No passports, no educational opportunities, social distancing from friends and acquaintances who would risk persecution for any association with his family., No ability to rent a flat, etc. But over time, the restrictions eased somewhat after the second American invasion of Iraq in 2003. Vincent was able to finish high school and enter University at Latakia in 2009. “Those were the best 3 years of my life,” he laments nostalgically.

Then the Arab Spring happened in 2011. Initial circumstances seemed optimistic and encouraging, especially after apparent progress in Tunisia and Egypt. But then, the Assad regime put down an iron fist. Many of Vincent’s friends and neighbors and their entire families were slaughtered without any cause. Fellow students and friends were gunned down in the streets by snipers. Vincent continued in school for another year, but then conditions became too oppressive, so he had to leave university and flee for his life, having finished only 3 of his 4 years. He almost earned a degree in English literature, which is why he can now serve as one of our translators.

He went back to his hometown to his family and to hideout from security forces, who wanted him to serve in the Syrian Army. He hid out within the confines of his home in his small village for 3 years afraid to show his face outside: No job, no life no income no friends, etc.

Then family members with money offered him the financial means to take the chance to escape all this madness: to Turkey. And so he set off.

To get to Turkey, he had to cross Syrian territory that was occupied by Da’ish (ISIS). Unfortunately, he was captured, tortured and imprisoned for 2 months. Some of the torture he experienced included 10 days of sleep deprivation, being hung by his wrists suspended in the air for hours on end, being bludgeoned, being threatened with knives, gasoline and fire, electric shocks, etc. He was asked to recite verses from the Koran, and fortunately, he was able to do so, sufficiently. This probably saved his life, as he saw friends and comrades who had their necks slashed to death because they could not.

ISIS moved on to other torture victims and released him. Pressing onward to the Turkish border, he had to traverse mine fields, ISIS night patrols with mounted machine guns chasing them in the night and killing those behind him.

He made it across the border into Turkey, paying smugglers over a thousand dollars to bring him overland to Istanbul, then onward to Izmir. He paid other smugglers a thousand dollars more to take a harrowing rubber dinghy overfilled with refugees across the straits to the Greek Island of Chios. There he registered with the Greek government, received a 6 month visa and made it by ferry to Athens and the Greek mainland. After 13 days touring Athens, he took a train to Thessaloniki, then a bus, which dropped him off at Eko gas station, where he joined his “homies” (friends) in a tent. This is where he is now stranded. So with not much else to do, he is helping us take care of other Syrians who are sick.

Vincent has now given up any illusions about reaching Germany. His current hope is that he can somehow integrate himself here in Greece. Given what I now know, I see that it is better to have a warped sense of humor, than no sense of humor at all . . .

Screenshot 2016-04-11 at 9.29.57 PMNow I understand what you tried to say to me
how you suffered for your sanity
how you tried to set them free.
They would not listen
they did not know how
perhaps they’ll listen now.*

*From “Starry Starry Night”, Singer-Songwriter Don Mclean’s balad about Vincent Van Gogh, 1972

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.



Trying to Create Order out of Confusion and Chaos

April 1, 2016 Idomeni Greece By Dr. Bill Dienst

DSCN2007A week later, several changes are apparent here on the Greek-Macedonian border. The refugee population at Idomeni is starting to be reduced, slightly. Last Saturday, we witnessed a convoy of 4 buses full of refugees heading South on the Highway with police escorts. As far as we can tell, it appears that the population, once estimated as high as 20 thousand, is diminishing by several hundred each day. We are hearing that these are refugees willing to leave voluntarily: i.e. those who have had enough. These people are heading to reception or relocation centers which are being set up by the Greek military on the Greek mainland. There, they will have better living conditions and three square meals a day in exchange for finally sacrificing their ability to roam freely, as well as their hope for a better future in Northern Europe.

Still, many thousands remain who, so far, will not leave voluntarily: Those who have invested all their physical and financial resources to get this far and still have fading hopes for pressing on to Germany. Tensions are mounting. This past Sunday, the refugees who remain were joined by Italian and Spanish activists who flew in for the weekend to show their solidarity. They all assembled Sunday morning on the railroad tracks in the center of the refugee camp, about a hundred meters from the border. There, they were met by hundreds of Greek riot police, and a face-to-face standoff ensued.

Salaam Cultural Museum was trying to enter Idomeni camp with our mobile health van. We were blocked by the Greek Police while getting off the highway. We had to double back and take a 40 km detour through back roads and beautiful countrysides of foothills and vineyards to get to the camp. As we approached the camp, I jumped out with some others at the railway station and walked up the tracks through areas B and A toward Area C where our van was negotiating traffic to get into position at our usual spot.

DSCN1930We crossed the tracks in the middle of the confrontation: tense but not yet violent. A large crowd of refugees and their Italian and Spanish allies stood face to face with a line of police in full riot gear and shields. Slogans were being shouted. Our Norwegian partners, Medics Bergen were on standby with their trauma packs in hand. We pressed on 300 meters beyond and met up with our mobile health van in our usual spot in Area C across the road from the cluster of tents, which have become known as “Little Kurdistan”. There are also districts of Idomeni populated by Arabic speaking Syrians, Iraqis and Yazidis . . . also Pakistanis who speak Urdu and Pashtu, and others. Sometimes there are tensions between these different ethnic groups.

As we arrived, there did not seem to be much happening in terms of primary care at our usual spot. Many people were heading in the opposite direction toward the tracks and the border with all their belongings and with hopes they might finally get across. I started pulling our trauma first aid packs from the van and handing them out to our volunteers, with the intention of sending them back toward the tracks. But wait a minute . . . here is a Syrian family wanting some primary care. So we decided to see them before heading to the tracks. But before we had finished, several others arrived, and not too long after that, a long line had assembled and we were back in business. Hours later, we saw the Greek riot police walking out peacefully. Conflict had somehow been avoided, but I am not certain about the details, as I was caught up examining a lot of people with coughs, sore throats and other maladies by then.

So that was Sunday. On Monday, I inherited the role of being medical director of a freestanding medical clinic which was constructed out of plywood and tarp by Medecins Sans Frontieres. MSF decided to consolidate their operations in Idomeni. So they handed over operations for the clinic at EKO gas station to us. We moved in Monday, outfitted the clinic that morning, and started seeing patients at 2 pm. We have now offered 13 hours of continuous patient service per day for the past 2 days. Now it is Thursday . . .

DSCN1958 (1)Salaam Cultural Museum and Off Track Health had previously been present during the past few weeks running mobile health clinics at EKO gas station. Previously, EKO was the last bus stop where passengers coming from Athens were let off. Refugees getting off the bus there then had the option of taking a taxi, or walking 20 km up the highway to the border at Idomeni, or pitching a tent. And so may tents sprung up there, including many large ones sponsored by UNHCR. And so, a community of perhaps 1,200 refugees has sprung up: a ready made small town of refugees for this small town doctor now medical director of this small town clinic with a very small medical staff that changes every week.

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 in Lesbos and Idomeni, Greece.

Women & Children

#BabyBox Update

Originally posted on April 13, 2016

We have been receiving so many items for the baby box project, it has been amazing! We still need more of certain items to round out the boxes, so please, keep them coming!

You can see our wish list on Amazon here: https://amzn.com/w/20GJ6K2ZCHG9N

And you can donate to the project here: http://www.crowdrise.com/new-baby-welcome-kits-for-refugees-in-jordan/

The donations are going towards the Bed Boxes from The Baby Box Company and also to purchase anything we are short of for the boxes themselves. We are planning to have them completed by the end of May for the container going in June.

Thank you to everyone who has sent items or donated for the project!


Women & Children

Mother & Baby Housing Project

Originally posted on April 5, 2016

Rita has just returned from visiting the border of Greece and Macedonia where she was able to see first hand the situation of the refugees. As a result of her visit, SCM will be redirecting some of our efforts from coordinating medical missions to providing temporary housing for pregnant women and their new babies.

One thing many people find incredible about the refugee experience is how many women are making the journey while very pregnant. We have heard stories of the women arriving on Lesbos either about to give birth or they do give birth almost on arrival. Women walking for miles and miles while 8.5 months along. Women at the border camp giving birth in a small tent then having to wash the baby over a puddle outside with bottled (not warm!) water. So many women have risked EVERYTHING to find safety for themselves and their families and are giving birth in deplorable conditions.

To help alleviate this crisis, SCM has worked with local officials to find several condo units that we can rent for a nominal cost to house the women and their immediate family while they give birth and then give them some recuperation time before they have to leave. They will be visited by doctors and nurses on a regular basis.

Currently the rate we have been given is 300 Euro per month for each unit, and we may have access to 12 in total. We will also provide the funds for electricity and any medications the mothers will need. If you can help us provide a safe and clean place for women to give birth, please donate to our Greece Fund by clicking here or go to our Donation page and click the link there for our Greece Fund.

More information will be coming as we make progress on this program, with photos and stories about the women who have been moved into the housing. Check back for updates!


Balancing our Souls, Somewhere between our Hearts and our Brains

Originally posted April 4, 2016

EKO Gas Station Refugee Camp, Highway 75 near Polykastro, Greece
By Dr. Bill Dienst

“If you are in your twenties and you aren’t a bit of a revolutionary, you have no heart; but if you are in your 50’s and do not have some conservative tendencies, you have no brain.”
(paraphrasing Winston Churchill)

Our makeshift town of refugee tents cluttered around the EKO gas station is on the highway, two kilometers South of the exit to Polykastro, Greece. It has mostly Syrian refugees who speak Arabic and Kurdish. The current estimated population here is about 2200 people. Last Monday, our coalition of small NGO’s inherited a small plywood building, which serves as a primary care clinic from Medecins Sans Frontieres. MSF wanted to consolidate their operations among the much larger refugee populations in Idomeni, which are located 20 km to the North, immediately adjacent to the Macedonian border. People have been stranded there for over a month, trying to take the Balkan route to Northern Europe.

Our refugees at EKO are stranded too. For this small town family/ER doctor and my committed colleagues of doctors, Family Nurse Practitioners, Nurses, Emergency Medical Technicians and other humanitarians, it has been an intense labor of love this past week getting this clinic stocked with medications, bandages, tools and other supplies. We even bought a refrigerator so we could handle perishables, including vaccinations, which we hope may be coming to us through MSF in the near future. Immediately we began staffing the clinic 13 hours per day with 3 shifts of intake people, doctors, nurses and translators. Things were going well, and every day, the chaos was slowly and surely becoming more manageable.

Previously, we were providing primary health care out of the back end of mobile health vans. But in these settings, it was impossible to do much about chronic conditions like hypertension, diabetes, epilepsy and the like. Now for the first time, we were beginning to make progress in managing these chronic conditions. We were also beginning to make inroads and relationships with Greek doctors at the Polykastro Health Center, so we can line up lab, X-ray and dental services. The Greek doctors and us all realize that we must all be allies in health care. They need us to take the pressure of them with the overwhelming medical needs that this refugee crisis has created. And we need them to help us with ER, lab, X ray and dental services that we are yet unable to provide. We had accomplished a lot in just one short week. Then on Friday and Saturday, the bottom dropped out.

It all started when Greek government official showed up Friday morning asking for credentials for our doctors and nurses; this is problematic, since our medical staff is comprised of volunteer health professionals from all over Europe, North America, and Asia. Many of our health staff arrive, work intensely for 1 or 2 weeks and then return to jobs in their host countries.

But we will do our best to comply with these new onerous requirements. We sent a team Friday night an hour South to the city of Thessaloniki to meet with government officials. When our team returned, we thought we had a workable plan to assemble credentials within the following few days to keep our clinic operational. Mairi, our Scottish logistics coordinator worked feverishly through the night putting dossiers together for each of our providers, even those scheduled to leave in just a few days.

Then on Saturday morning, 3 more government officials arrived, demanding our paperwork immediately. They seemed irritated and left. Then they returned an hour later with police. Under duress, we were forced to shut our clinic down in the middle of a very busy Saturday. The refugees protested by blocking the highway with their tents; passenger vehicles were allowed to pass, but all commercial trucking was blocked. The situation became more volatile and more police reinforcements arrived.

This was a heart wrenching experience for both our Syrian patients and us providers. We have quickly grown quite close each other in our makeshift small town. We are starting to know the peoples’ names, and their families; and they are starting to know us.

What each of us thinks should be done about this mess varies depending on who we are, how old we are and how long we are volunteering with refugee health care. I feel that I must pace myself and pick my battles; only the ones I think I have a chance of winning. At age 57, I can no longer be Don Quixote chasing windmills, I simply don’t have the stamina. As medical coordinator, I am trying my best to work smarter, so that someday soon we all will not have to work so hard struggling with the latest crisis of the hour. But that does not mean I don’t care. It is all a matter of tactics.

There are some who think this is all a deliberate attempt by the Greek government to make life in these makeshift camp so miserable, that more refugees will go willingly to the relocation centers based on the military bases, where they will have better conditions and more consistent health care from Greek military doctors and the German Red Cross. Honestly, I feel ambivalent about this whole process. If refugees are all going to be forced into these relocation centers sooner or later, isn’t it better that it happens sooner? There are no easy answers.

But now I sometimes feel that I am at loggerheads with one young EMT with a revolutionary bent who I fear might have intent toward confronting the Greek authorities. We have to keep talking him down. He is in his 20’s, emotionally shattered, and hasn’t had a day off in weeks; he won’t take a day off and he really should. He is showing telltale signs of burning out. I know them well, for I have been there many times in my career myself. It is not whether or not you will burn out doing this kind of humanitarian work: you will. It is whether or not you will recover from your burnout and remain compassionate. His heart tells him that he must act.

I am trying to use my brain while acknowledging to the younger ones in our medical corp to that I too have a heart even if my distancing from every crisis of the hour doesn’t seem so to them; I do still care. I will never resort to pure pragmatic realpolitik and opportunism, like all the bastards and scoundrels that have created this horrific modern day catastrophe in the Middle East: Bush, Netanyahu, Assad, the Saudi regime and many others, including those who have profited from endless wars. For every outrageous actions, there are equally outrageous reactions: so now we have ISIS, among others.

When will it stop? I don’t know. All I can do is to try and help the vulnerable and the meek. I must ask myself, “How can I help?” Easy question, the answers are not always so easy. The corollary to this is: “If you are going to be a rescuer, don’t become a casualty, neither physically or emotionally.” It was bound to happen and one day it did. With all the hundreds of sick people coughing in our faces every day, I and others have picked up the nasty upper respiratory illness going around, compounded by all the dust and smoke in our working environment.

We must work with the Greek authorities and jump through whatever hoops that they ask of us, as best we can. After all, we are in their country and we will never win by provoking them. The predicament that they are in deserves sympathy too.

Our best response is to develop alliances with all the parties. The director of the Polykastro Health Center, Dr. Georgios Perperidis is also a dentist. A very important man to know. He also knows all they local officials in the Greek Ministry of Health and says he will advocate with them on our behalf. On Sunday, we all meet with Dr. Jolene, the medical coordinator with MSF and work out an elaborate plan to keep the Eko Clinic going under an alliance of small NGO’s.

We show up Monday morning to finalize the deal only to discover that 2 of the critical NGOs refuse to collaborate with each other, based on bad blood between them in the past. A lot is lost in translation. Dr. Perperidis explains in Greek that all the problems with the Greek Government officials have been resolved adequately. But now it is still a no-go due to what seem to me are petty differences between rival NGO’s. Who are we working for again? The REFUGEES!!! MSF now needs to take the clinic back for the next week or so, even though they don’t want to. Our clinic needs to be disassembled due to competing assets and competing interests. We have wasted a lot of effort trying to build this dream. We can no longer blame it on the Greeks. We seem to be our own worst enemy.

Are you feeling exhausted, humiliated, and sick; a little burned out perhaps? YOU BET I AM!!!

OK, step back, slow down. Take care of yourself. It’s not just a destination, it is an adventure. Go back to running mobile clinics now and see where all this goes.

Women & Children

Baby Box Project Update

Originally posted on March 28, 2016

Today we received the first half of the New Baby Welcome Kit boxes! Our goal is to get 200 total, and we received 100 boxes to get started on. We have partnered with The Baby Box Company that provides the Bed Box, and they have been really great to work with.

You can donate to our CrowdRise campaign here http://www.crowdrise.com/new-baby-welcome-kits-for-refugees-in-jordan


The boxes arrived flat, which will make them easier to get to Jordan. But I had to put one together to show everyone what you are helping us to accomplish.


The boxes provide a safe and secure place for the baby to sleep, and will be stocked with clothes, a blanket, mitts and socks, diapers, and more, for the baby and new mom to help them through the first year.


Thank you!