What can a dermatologist do in a Syrian refugee camp?

About the authors
Grace Bandow, MD, is a dermatologist at Medical Associates of Rhode Island in Bristol.
Samer Jaber, MD, is a Clinical Assistant Professor of Dermatology at the Icahn School of Medicine at Mt. Sinai in New York City.

Courtesy of Samer Jaber

What can a dermatologist do in a Syrian refugee camp? We heard this question several times as we prepared for our medical mission to Jordan. After all, our patients had fled for their lives, leaving behind their homes, their jobs, their sons. They needed food, clean water, and obstetric care, not treatment for their acne.

We are two busy dermatologists; we watched the Syrian crisis unfold from our televisions and smart phones. When we received an email request from Humam Akbik, a Syrian-American doctor leading medical missions through Salaam Cultural Museum, we felt compelled to answer.  He was asking for help, of any kind.  We wanted a fresh perspective; we signed up.

We knew that refugee camps produce the kind of close, dirty quarters that allow minor diseases to flourish. We anticipated scabies, lice, and other infections associated with crowded living.  We prepared for a parasitic infection called leishmaniasis, which causes skin lesions. We brought medicine for bacterial skin infections like impetigo. So it never occurred to us to prioritize Vaseline petroleum jelly as an item of high importance when we packed our supplies for the Syrian refugee camps.  After all, it was heavy stuff, and the airlines were counting pounds.  Syringes and gauze were lighter and more packable.

It never occurred to us to prioritize Vaseline petroleum jelly.

Then we met a man in Deir Alla.  He stood in line quietly, waiting with dozens of others at dusk, in the sand outside, for an opportunity to talk to the American doctors.  When he got his turn, he offered us the bottom of his feet and showed us their deep, painful cracks.  His feet had literally been worn out from traveling hundreds of miles on hot sandy soil in rubber sandals.  He told us that if he could fix his feet, he thought maybe he could find a job to support his children. He had been a civil engineer in Syria. Now, he is confined to a tent. Waiting. He asked us for Vaseline.


Courtesy of Samer Jaber

In Amman, we met a 12-year-old girl with a universally fatal blistering skin disease. She was malnourished because her mouth was full of blisters, making it impossible for her to chew solid food. Her wounds were infected and her bath was available only once a month with a hose and cup.

She sat silently in front of us, wrapped from her neck to her toes in soiled gauze dressings, tears slowly dripping down one side of her pale face as her mother told us their story. In Syria her daughter had good care and a daily regimen that allowed her to function. When they arrived in Jordan, all the hospitals rejected her. Her husband is missing. Five of her brothers are dead. With her four children, she left to save their lives. She needed something as simple as a tub and salt to make a proper bath for her daughter.  She needed basic supplies like gauze to wrap her chronic wounds. She needed Vaseline to put under the gauze.

We met a man with dry broad scars across his arms. He explained that after moving to the refugee camp, his tent caught on fire. His arms were burned when he tried, unsuccessfully, to pull his two year old son from the flames. We listened in horror as he explained why he left his country, to live on a dirt floor, in a tent that burned and took his child. He smiled as he spoke, showing us his skin over and over, showing us that it was dry and that the dry parts itched. We nodded and listened and agreed, realizing, he too, needed something as simple as Vaseline.

These stories continued for hours every day. Days blended together and quickly became a week. Hundreds of patients lined up to show us their skin, but really to tell us their stories.

As doctors, we’re trained to quickly identify and respond to problems, both acute and chronic. We are trained to make use of available resources and to improvise when they are scarce.  Leaving our own thriving practices to work in crowded, dusty refugee camps in another part of the world, we were reminded that sometimes simple measures, like compassion and listening are what is most vital to a human being; and that sometimes basic, inexpensive remedies, like Vaseline, good enough.

Since returning, their stories continue to haunt our daily lives. We can see their faces and we can hear their voices, always repeating the same simple request. “Please, we want to go back to our homes; we want our children to go to school; we want you to share our story.”

On our trip, we were able to treat a few specific problems in several hundred people. What a daunting task in the face of 9 million refugees, with 9 million stories.

All photos courtesy of Samer Jaber.

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