Varun Bisessar

Michael Grove

ENGL21003

10/12/2018

A Doctor Whose Humanitarian Advocacy in Syria Has Redefined His Career

Doctor Zaher Sahloul is a critical care specialist at Christ Advocate Medical Center in Chicago, associate clinical professor at the University of Chicago in Illinois, and senior advisor and past president of the Syrian American Medical Society (SAMS). The SAMS has brought awareness to the effect of the Syrian crisis on medical facilities and patient rights. Sahloul has participated in extensive research to determine the diseases in Syria that are most prominent and require immediate attention. Sahloul’s work in Syria has decorated him with the Chicagoan of the year award in 2016 and the Dr. Robert Kirschner Award for Global Activism in 2017. Sahloul has become a leading figure in advocating for medical relief for Syrians and Syrian refugees.

Sahloul was born in Algeria shortly after the end of the Algerian Revolution. He was born an only child to Syrian parents. Sahloul’s parents at the time were both elementary school teachers in Algeria teaching Arabic. The Algerian revolution granted Algeria independence from imperial France, therefore a reconstructed educational system was due. Teachers like Sahloul’s parents hoped to reintroduce the language to students. Shortly after Sahloul’s birth his parents decided to move the family back to their home country. Sahloul grew up and attended secondary school in Syria. Upon completion of secondary school, Sahloul went on to attend one of the most reputable universities in all of the Middle East. In 1988, Sahloul graduated from Damascus University Medical School at the top of his class.¹ Shortly after Sahloul immigrated to the United States and completed a residency in the early 2000s at the University of Illinois in Chicago.

Sahloul remained in Chicago and began his professional practice at Advocate Christ Medical Center. He emerged as a critical care physician dedicated to pulmonology. For roughly 10 years, Sahloul continued his career as a pulmonologist. In 2011, Sahloul’s career shifted because of the beginning of Civil War in Syria. Public dissatisfaction in Syria had already escalated, however in 201l headlines about protestors being murdered and imprisoned spread. Intensified public dissatisfaction with the Assad reign lead to the development of the Islamic state (ISIS) and other power-hungry regimes. Fighting between Assad’s army, ISIS, and other regimes has completely destroyed the educational and medical facilities of Syria.

SAMS originally evolved as a an educational and services society for Americans of Syrian descent in 1998. To best combat the atrocities in Syria, the society began humanitarian missions in 2011. Sahloul witnessed as the nation that had gifted him an education and career fell apart. He affiliated himself with SAMS to best advocate for patient’s rights in his home country. It was not until Sahloul’s first field visit to Syria that he comprehended the severity of the Civil War. During an interview with Danny Postel of the Center for Middle East Studies at the University of Denver, Sahloul said, “They pulled patients and physicians out of the intensive care sections and murdered them…doctors [had] to build underground hospitals.”² He alludes that treating innocents from the war-torn locations resulted in death or torture of nurses and physicians. Directly increasing the number of medical professionals leaving Syria in search of refuge, which left thousands of people without medical support.

After becoming the president of SAMS, Sahloul’s overall goal was to organize and complete extensive research to effectively determine how to combat the atrocities against patients and medical professionals in Syria. In order to combat the atrocities, the two elements of research to be completed was first establish the geographical locations of prevalent diseases and second find institutions that were being targeted. Sahloul joined research teams to produce publications of major trends in communicable diseases in Syria before and after the civil war. Throughout Sahloul’s publication “Communicable disease surveillance and control in the context of conflict and mass displacement in Syria”, data was collected using geographical coverage and outbreak thresholds. The data revealed, “Upward trends in reports of severe acute respiratory illness and acute bloody diarrhea are noted towards the end of 2015.”³ Being that Sahloul’s primary goal was to establish the most prevalent diseases, such publications reveal important rises in case numbers. The underlying data revealed the disease classes which further categorized to tuberculosis, measles, and polio that need to be prioritized. Sahloul conclusions reveals the regions covered by governmental control showed the highest trends in outbreaks because most or all physicians from those regions have been executed or exiled.

After creating a model to establish the prevalent diseases Sahloul began to formulate plans to move the SAMS to the governmental controlled areas. Sahloul combined narratives and statistics from surveyors and medical professionals in these governmental controlled areas in his publication “Determining the scope of attacks on health in four governorates of Syria in 2016: Results of a field surveillance program.” “Hospitals were significantly more likely to be attacked more than once compared to clinics and other types of healthcare facilities.”⁴ The second goal of Sahloul’s was to find institutions that were being targeted, as expected hospitals were the most targeted because they house the most patients. Being that attackers used aerial bombs, they know the most damage can be inflicted on a hospital compared to a clinic. Aleppo housed the most hospitals which made it a prime target for attackers, Aleppo was now first on the list for the SAMS. Not only were civilians suffering of tuberculosis, measles, and polio, they were being hit by sniper fire and having limbs blown off.

Directing a humanitarian mission in a government secluded neighborhood is an act of war, if killed you are labeled a casualty of war and if captured a prisoner of war. Hannah Barg of The Muslim American Leadership Alliance (MALA) asked, “How would you describe a normal day during a humanitarian mission?” Sahloul responded, “I remember when we went in– “the road to hell,” they called it–the driver of the van told us, say your final prayer, because you might not make it. And I did.”¹ Sahloul describes that participating in a humanitarian mission involves a great deal of uncertainty. Once a hospital was attacked, surviving physicians would use abandoned buildings, usually with basements to organize a medical facility. Makeshift medical facilities are all that is left in Aleppo and secrecy is the only thing keeping Sahloul and his team safe. In order to educate and work alongside the medical professionals no one can let their fear get the best of them, Sahloul gets into the facility works alongside his peers for two weeks and then returns to the states.

The traumatic experience for the SAMS on their missions in Aleppo convinced Sahloul’s team to publish “Slow Death”, arguably his most influential publication, his career shift became evident. “Slow Death” was published on March 1^st, 2015 by Sahloul and the SAMS with the purpose of documenting life and death in Syria and the international response. When Postel asked “Did speaking at the UN Arria-Formula convey the sense of urgency you felt?”, Sahloul conveyed “The United Nations Security Council have failed the Syrian people.” At the Arria-Formula he emphasized that “for every 8,570 patients in Syria affected there is only one doctor.”² The sense of urgency he hoped to convey was not properly acknowledged. “Standardized care and quality assurance and accreditation are major issues that need to be addressed.”⁵ In the regions like Aleppo the ration was 8,570 patients per doctor, however in other regions of Syria the patient to doctor ration near 50,000/1. Sahloul expresses many of these patients never had a chance, a story he called the “Slow Death”.

In “Slow Death” Sahloul condemned the Security Council for allegedly tampering with statistics to make the numbers the SAMS released about prevalence of diseases convoluted. From such statistic variations between the Security Council and SAMS, Sahloul feared that misconceptions about the SAMS may have spread. Postel debunked such misconceptions during the interview, “the fact that your coalitions are doing actual on ground work.”² Activities that not many are brave enough to commit to. Likewise, Sahloul could have avoided Aleppo altogether and go to another location, however him and his supporting cast with uncertainty travelled “the road of hell” not knowing if they would leave. Sahloul also revealed to Barg, “there was a strong stench of death–of decomposing bodies of civilians…no one dared to come and pull them away and bury them.”¹ To provide insight to the severity of the Civil War Sahloul describes the on-ground work in Aleppo as an eye opener for the SAMS, every man was for himself, cars with families were bombed and no one could help or else they would be killed, the bodies are never disposed of, civilians wake up to the stench every day and children grow up with images replaying in their mind.

After thirty plus humanitarian missions to Syria, Sahloul has resigned as president of the SAMS and accepted the senior advisement position. He has reserved himself to Chicago because of the growth of the SAMS, providing to this day millions of patients with the operations they need. Before resigning as president Sahloul was captivated by the capabilities of Tele-Intensive Care Units (Tele-ICU) Being involved in critical care for much of his life, incorporating Tele-ICU was a notable advancement for SAMS. The SAMS now has full on ground support in Syria and in the United States to communicate if a specific makeshift medical facility is overwhelmed with critically injured patients.

Alongside colleagues Dr. John Kahler and Dr. Samer Attar, Sahloul may have documented their last visit to Aleppo earlier in 2016 to the last secret make shift hospital (M10). M10 is now destroyed. Foreign aid has not made its way into Aleppo since July of 2017, Sahloul and his team have to wait as the only road in is compromised. The three doctors were presented the honor of “Chicagoan of the Year” by the city of Chicago for their bravery and efforts. Although the accolades humble Sahloul, it breaks his heart that he can no longer organize a mission to Aleppo. On April 27^th, 2017 Sahloul received the Kirschner Award for Global Activism, the award held great significance to Sahloul as Dr. Robert H. Kirschner, M.D. represented much of the values that Sahloul developed. Both activists assisted foreign countries during Civil War, Kirschner was also a Chicago native and an inspiration for Chicago based activists such as Sahloul.

In the future, Sahloul would love to one day walk the streets of Aleppo and sit in his favorite restaurants to enjoy the cuisine that has disappeared. The Civil War in Syria is far from over and has been a very emotional experience for Sahloul. Upon accepting the “Chicagoan of the Year” he said, “He has been to Aleppo before the crisis, it was truly a wonderful city.” Now that M10 has been destroyed, optimism is scarce. The final questions of Barg’s interview with Sahloul was “If Sahloul could ever envision Syria in the way he left it 30 years ago?” He responded, “It looks like it’s going to be a long way from now.”¹

 

 

 

References

1. Muslim American Leadership Alliance. Zaher Sahloul: A Syrian American Doctor’s Journey. MALA National. https://www.malanational.org/zaher-sahloul-syrian-american-doctors-journey. Published 2017. Accessed October 5, 2018.
2. Center for Middle East Studies. Dr. Zaher Sahloul-Syria’s Medical and Humanitarian Nightmare. University of Denver. https://www.du.edu/korbel/middleeast/dialogues/index. Html. Published 2016. Accessed October 5, 2018.
3. Zaher Sahloul, et al. Communicable disease surveillance and control in the context of conflict and mass displacement in Syria. International journal of infectious diseases. 2015; 47:15-22. doi: 10.1016/j.ijid.2016.05.011
4. Zaher Sahloul, et al. Determining the scope of attacks on health in four governorates of Syria in 2016: Results of a field surveillance program. PLOS Medicine. 2015; 15(4):10-20. doi: 10.371/journal.pmed.1002559
5. Zaher Sahloul, et al. Health care in Syria before and during the crisis. Avicenna Journal of Medicine. 2012; 2(3):51. http://www.avicennajmed.com. Accessed October 5, 2018.