Fieldset
Syria: “I cannot abandon my patients”

For eight years, people in Syria have lived in the shadow of war. As shelling intensifies in his home area of Idlib, one doctor shares his story of saving lives, and explains why, for him, it's personal...

Ten years ago, I had a kidney transplant. In that moment, I switched roles: I was not the doctor anymore, I became the patient.

This operation turned out to be a decisive moment in both my life and career.

There have been times when I even wanted to give up, but my patients did not give up on me

Endocrinologist by training, I had always focused mostly on the treatment of diabetes.  My transplant, as well as the war that started two years later in my country, encouraged me to change my specialty.

Today, I am one of the only doctors in northern Syria providing treatment for patients who are living with a donor kidney.

The only means of survival

Before the war broke out in Syria, the treatment for these patients was quite straightforward.

They would get taken care of in governmental hospitals or health centers. Everything was available and dialysis or medications were free of charge for kidney transplant patients.

But in 2011, everything changed.

Checkpoints started to appear everywhere on the roads and people could not go in and out of their village or town to receive their treatment as they used to. Depending on where you were from, you could get arrested or even killed. It did not matter if you were sick.

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Illustration showing a checkpoint and medication

Coming from the wrong place could complicate your movements considerably and, by extension, your medical treatment.

Everyone I knew who was living with a donor kidney resorted to buying their own medicines or asking their relatives abroad to ship them to Syria. These drugs were their only means of survival.

Too expensive to live

After a kidney transplant, to avoid the body rejecting the new kidney, patients have to take immunosuppressant medication for the rest of their lives.

If they stop the medicine, patients go into kidney failure.

If there’s kidney failure, they have to start dialysis. Dialysis is a much less convenient, much more expensive form of treatment than taking immunosuppressant.

For instance, when you total all the costs, dialysis, per patient, is up to around 500 USD per month. In comparison, immunosuppressant medication is usually less than half that: between 150 USD and 200 USD per month.

But even this is a huge amount of money for people in Syria.

200 dollars is more than an average person’s monthly salary. Most of the patients can simply not afford it.

Completely overlooked

And so, in 2014, I decided to reach out to MSF, with the help of local health authorities. I knew MSF was working with kidney-transplant patients in Homs, another governorate in Syria.

I told MSF that I knew 22 kidney-transplant patients in this situation, unable to afford their medications. MSF agreed to support these patients and to provide, free of charge, the treatment that would keep them alive.

The only thing that I am sure of is that I will not give up on my work, as long as my patients need treatment

This made me incredibly happy.

As a kidney transplant recipient myself, I wanted to support others, to be there morally, but also to help, as much as possible, practically.

Since the beginning of the war and until then, the situation of these patients had been completely overlooked by most humanitarian organizations.

Over a hundred lives saved

The group of patients I was treating grew over the next few months and years. Through word of mouth mostly, more and more kidney transplant patients started to reach out to me.

From 22 patients, I started to treat 45, then 73 and then almost a hundred!

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Illustration showing the donation of kidney medicines

In 2015, another humanitarian organization started treating kidney transplant patients in Aleppo governorate and asked me to help there too.

I started sharing my time between MSF and this second organization, overseeing the treatment of over a hundred patients in the north of Syria. Some of my patients, displaced by the conflict, come from other parts of the country too.

"I wanted to give up"

Taking care of these patients for the past five years has changed me.

When people talk about Syria, we often hear about wounds and trauma injuries. There is little to no focus on what the situation can be like for people who had regular access to life-saving treatment before the conflict, and who must now struggle to survive.

Since I started to work with MSF, everything we’ve achieved has brought me relief and satisfaction. But, if I am completely honest, I am also very tired of working and living in such a challenging situation.

There have been times when I even wanted to give up, but my patients did not give up on me. They told me that I had to continue, they didn’t have anyone else to rely on.

The future

Today, in Idlib, the context is particularly bad and the war is far from over.

We cannot know what the future holds because everything changes every day. The only thing that I am now sure of is that I will not give up on my work, as long as my patients need treatment.

I cannot abandon them and I’ll continue to do this job until I am sure they are safe.

These people don’t care about war; they just want to live a normal life. Providing this treatment is the only way to make this possible and to ensure their survival.

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