'In His Image' provides medical care to Syrian refugees

December 15, 2013



A team of doctors with ties to St. John Health System in Tulsa, Okla., recently returned from a medical relief trip to Iraqi Kurdistan where they provided care to hundreds of Syrians who are among the millions displaced by war in their country.

Arab Spring demonstrations, many of which began peacefully in the Middle East and North Africa in late 2010 and early 2011, evolved into a brutal crackdown and complicated conflict in Syria. President Bashar al-Assad remains in power as civil war rages and it's estimated more than 100,000 Syrians have been killed. About 2.2 million Syrian refugees in the Middle East have fled their nation for neighboring countries, according to the U.S. Agency for International Development.

Syrian refugees wait for a visit with a doctor from the "In His Image" team that recently cared for those staying in the Iraqi Kurdistan town of Koya.

Settling in
From Oct. 26 to Nov. 5, doctors from Tulsa, including five medical residents in the In His Image Family Medicine Residency Program based at St. John Medical Center, flew to Erbil in Iraqi Kurdistan, then drove about an hour and a half to Koya, an Iraqi town where about 3,500 Syrian refugees have relocated over the past year. The 12-member team worked with World Compassion, another Tulsa-based international ministry, which had done previous work in Koya and had built relationships in the region, said In His Image doctors.

The team brought about 15 50-pound suitcases filled with medicines, hired translators from a nearby university and set up a temporary clinic at an Iraqi ophthalmologist's building in the town.

Dr. Mitch Duininck, program director of the In His Image Family Medicine Residency, said many of the Syrians in the town were ethnic Kurds from the middle class — professionals, students and shopkeepers. Local Iraqis and Syrian refugees helped to organize the visits with the Tulsa doctors. Duininck said doctors brought supplies to treat many of the medical conditions they saw in the Koya clinic, including respiratory infections, gastrointestinal infections and skin infections. They dispensed multivitamins for both adults and children because maintaining proper nutrition has been difficult for many of the refugees.

"We know there are a lot of musculoskeletal complaints when people are displaced from their homes," Duininck said. "Sometimes, there's trauma. Sometimes there's poor sleeping and living conditions, a lot of physical work, a lot of headaches." Doctors also saw patients previously diagnosed with heart disease, diabetes and hypertension who didn't have access to the medications they'd normally be taking. The doctors operated a small on-site lab and ran a pharmacy using their supplies.

Adaptive doctoring
Dr. Ambria Harris, a third year resident in the In His Image program, said working in Koya she had to rely more on taking a detailed medical history from patients and on physical exams, rather than imaging scans or the results of complex lab tests as those diagnostic tools were not available in the temporary clinic. However, some of the refugees brought their medical records or previous X-rays with them, she said.

Many of the Syrian women wanted to see a female physician, and many had questions about behaviors in their children, such as trouble sleeping, nightmares and bedwetting. The In His Image doctors undergo training with clinical psychologists in the U.S., who provide an overview of post-traumatic stress disorder. Harris said listening to worried patients, explaining that children may be traumatized from the war and suggesting how parents can communicate with children about what they've seen and respond to the children's anxiety and concerns can be a help.

Some of the team also spent one day caring for Iranian refugees, who had lived in Iraqi Kurdistan for several years.

While in Koya, the team accepted accommodation at a vacation resort. While not luxurious, Harris said it has a Ferris wheel, go-carts and bumper cars, and it is a vacation spot for locals.

Harris, a 29-year-old from Clarkston, Wash., has been on medical mission trips to China, Brazil, Vietnam, India and Egypt. She plans to work as a doctor in China after she completes her residency.

Mission-minded doctors
The In His Image Family Medicine Residency serves as the foundation for In His Image International, the medical missions organization, and Good Samaritan Health Services mobile medical vans in the Tulsa area. The residency program accepts 10 residents a year from the United States and foreign countries. It has 15 faculty attending physicians and about 50 partner physicians who teach residents their specialties during rotations. It is accredited by the Accreditation Council for Graduate Medical Education, like other university-based and affiliated family medicine programs. The faith-based program draws Christian physicians, many of whom complete an international health rotation, explained Blair Kesler, the In His Image International development coordinator.

"We believe when we care for people it's out of a heart of love for God," Duininck said.

In Kurdistan, in addition to delivering medical care, the doctors focused on actively listening to the refugees' stories and offering comfort. "It's encouraging them. It's consoling them. It's being present in their suffering and their pain, and listening to them," he said. Duininck, who has treated people in times of strife and natural disasters internationally, added, "People, I find, are just survivors. They're often in very desperate situations, and yet with a little bit of help and a little bit of encouragement, the strength of who they are as people is really remarkable. So when we listen to their stories, we encourage them. Often, we pray with them." Duininck said he asks patients: "Would you like us to pray with you? Would you like us to pray for you today?"


Copyright © 2013 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2013 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.