“I promised to save his son”: An MSF surgeon returns to Syria

16 June 2018

Doctor Akin Chan is a surgeon from Hong Kong, currently on assignment with Médecins Sans Frontières / Doctors Without Borders (MSF) in Tal Abyad, northern Syria. Eighteen years ago he travelled through a then peaceful Syria as a medical student. Today he writes about his emotional return to the country he fell in love with – including his fight to save the lives of two young boys.

Stepping back into Syrian once again, after 18 years, I had mixed feelings.

I was still a freshman in medical school back in the year 2000. I worked different summer jobs for two months after the semester ended. During the day, I was a courier and a delivery/warehouse assistant. At night, I was a tutor to students who were about to sit their secondary school leaving exams.

I used the hard-earned money to buy a budget air ticket. Days after I finished my two jobs, feeling daring, I started my backpacker journey.

I wandered to Syria through Turkey, then to Israel, Jordan and finally, Egypt.

A young Syrian girl stands on a ruined street. Photo: Eddy Van Wessel/MSF

A young Syrian girl stands on a ruined street. Photo: Eddy Van Wessel/MSF

There was peace in Syria; the war has not destroyed their peace back then. Everyone gave you a smile when you walked by on the street. Some even came to shake hands with you. Families who were having picnics in the park invited me to join them as I passed by.

Syria, therefore, became one of my favourite countries. 

“My once favourite country”

Syria has been torn apart by war for the past seven years. 

The scenes reported in the news are unbearable to see. So, when I was offered an assignment at an MSF project in northeast Syria, I said “yes” in no time.

I really wanted to provide a meaningful contribution to my once-favourite country. 

Some people accidentally stepped on landmines. Some triggered explosive devices when they opened the fridge... In short, everyday actions that people do can claim lives in Raqqa!"

Embarking on my journey from Hong Kong, it took me several days to get into northeast Syria due to the challenges of crossing borders between some neighbouring countries.

I had many questions:

Will the time I spent there before mean anything? How will Syria look after 18 years?

In the following two months, I got the answers.

A tense arrival in Tal Abyad

I worked for MSF in a town named Tal Abyad, in northeastern Syria, on the border with Turkey.

However, just before I arrived, conflict had broken out nearby.

Shooting could still be heard very frequently, especially in the border areas.

The atmosphere was tense.

Life in the ruins of Raqqa

Apart from receiving patients from Tal Abyad, the main workload of our hospital came from the city of Raqqa, which was almost two hours’ drive from us.

Raqqa was controlled by the Islamic State (IS) group from early 2014 until it was taken back by Syrian democratic forces and the US-led coalition in October 2017.

The ruins of Raqqa in northern Syria. Photo: Eddy Van Wessel/MSF

The ruins of Raqqa in northern Syria. Photo: Eddy Van Wessel/MSF

Afterwards, those people who had fled Raqqa during the battles began to return home. However, the ruins of Raqqa have been left with plenty of landmines and many different types of unexploded devices.

So, as civilians returned to Raqqa from where they had been displaced, we began seeing a lot of blast injuries.

Some people accidentally stepped on landmines. Some triggered explosive devices when they opened the fridge. Some detonated a bomb hidden beneath the carpet when they cleaned the house. Some simply opened a candy jar that exploded in their hands.

He told me that his boys were playing in the street and had picked up a toy. Then the toy exploded."

In short, everyday actions that people do can claim lives in Raqqa!

Civilians can only choose between being displaced or living on tenterhooks at home. 

The toy

One night, two young patients from Raqqa were admitted to the hospital with blast injuries.

One of them was a 10-year-old boy. He was severely injured.

His pupils were dilated, meaning that he had a high possibility of a brain haemorrhage. His upper body had suffered from extensive subcutaneous emphysema – a sign that his organs containing air, most likely his lungs, had ruptured, trapping air under the skin.

After a period of resuscitation, with such serious brain and lung injuries, he was confirmed dead.

Children recovering on a ward in Tal Abyad hospital. Photo: Eddy Van Wessel/MSF

Children recovering on a ward in Tal Abyad hospital. Photo: Eddy Van Wessel/MSF

The other patient, an 8-year-old boy, appeared to have injuries that were less serious. He kept on crying, suggesting that his vital signs were more stable.

After a preliminary assessment, I asked the boy’s father, who was also crying, what had happened to his child.

Then I suddenly realised… he was the father of both patients. They were brothers.

The most important thing to do at this moment was to ensure the safety of his younger son. I didn’t have time to tell him that his elder son had just passed away.

He told me that his boys were playing in the street and had picked up a toy.

Then the toy exploded.

The thought went through my head: I will and I must save his younger son’s life."

Immediately, I examined his younger son more thoroughly.

His face was covered in ash and slightly burnt. He did not appear to have serious wounds, but his abdomen was swollen and painful, showing symptoms that his organs were injured and inflamed.

An ultrasound examination showed that there was fluid in his abdominal cavity and that he may have had internal bleeding.

We arranged an emergency operation for him.

Breaking the news. Making a promise.

After explaining the needs and risks of the operation to the father, gaining his consent, the most difficult moment finally came. I had to announce the hardest news.

I wept while telling him that his elder son had died.

He wailed, holding the body of his child. Crying while kissing. My heart sank while witnessing the situation.

When he finally became calm, I couldn’t help but guarantee him that he wouldn’t lose two sons in a night.

The thought went through my head: I will and I must save his younger son’s life.

I am not God. I’m not able to make the dead come back to life. I don’t even have the power to cure every patient. I knew that I might not be able to fulfil my promise. But in that moment, I felt it, from the bottom of my heart.

His tears of sadness suddenly turned into tears of relief. I hoped that my little effort could help soothe the pain of losing his elder son."

I was not sure whether I made the promise to encourage or comfort the father or to push myself to go to great lengths. It’s not something I would usually do, but they were probably just words any person would say in that moment.

He grabbed my hands, thanking me until we got into the operating theatre. 

Saving the younger son

The surgery on the boy’s abdomen started.

I discovered his small intestine had a perforation, but, luckily, his other organs were intact. I repaired the damaged part of his small intestine and cleared the fluid that had accumulated in his abdomen.

Lastly, I stitched up the incision. Having finished the surgery safely, I immediately ran to tell the father everything had gone smoothly.

The father, who had been crying and murmuring his prayers, knew that I hadn’t disappointed him the moment he saw me coming out of the operating theatre with a smile.

I told him that, from a surgical perspective, there was no reason that he should not go home with his younger son, hand in hand.

His tears of sadness suddenly turned into tears of relief. I hoped that my little effort could help soothe the pain of losing his elder son. 

After several days of treatment, the boy recovered gradually. The father also put on his smiles, gradually, as he walked around with his little boy from here to there.

And then they were discharged from the hospital, leaving hand in hand.

I had fulfilled my promise.

 

 

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