Helping the Middle Eastʹs war-wounded

The hospital for all wars

In a Jordanian clinic, doctors have been treating patients from across the Middle East for more than a decade. It's a place that has seen the suffering caused by five wars. Philipp Breu paid the hospital a visit

The skin on her hands and face has the texture of wax that has melted and hardened again. The pores and hair are no longer visible and between the uneven wrinkles that make the 11-year-old look like an old woman, her skin is as smooth as plastic.

On 28 December 2008, life changed forever for Redha and her family. On that day, father Hasan, his four children and his wife were at home in the Yemeni capital, Sanaa, when gun battles broke out on the streets of their neighbourhood.

A bullet hit the apartment's gas tank, full to the brim for the cold winter months, a huge explosion set the entire flat alight, not to mention the skin of Redha and her siblings. Redha's two younger brothers and her mother were largely unscathed; she and her older brother were the worst affected.

"It was just burnt skin"

Today, father Hasan sits with his 11-year-old daughter Redha and his 12-year-old son Wessam next to the playground of the Al-Mowasah hospital in the Jordanian capital, Amman. That they are able to sit here in safety today is largely thanks to the organisation Medecins sans Frontieres, which has been running the clinic for 11 years now.

The premier clinic for reconstructive plastic surgery in the Middle East began as a project by Iraqi doctors who came across the border following the outbreak of the Iraq war, bringing their skills and some of their patients with them. "Things got up and running properly when, from 2007 onwards, the uprising of Islamist groups in Iraq reached its climax, and then several years later in countries like Libya, Syria and Yemen, when the revolutions became civil wars," explains Maria al-Fadel, media spokesperson for the hospital. Today, almost 40 per cent of hospital patients come from Iraq, closely followed by patients from Syria and Yemen.

11-year-old Redha and 12-year-old Wessam together with their father Hasan outside Al-Mowasah Hospital in Amman (photo: Philipp Breu)
Both children have already been operated on 18 times: 11-year-old Redha and 12-year-old Wessam together with their father Hasan in front of the Mowasah Hospital in Amman, Jordan

All patients, including Hasan and his children, have to go through a selection process in their home nations, thereafter Medecins sans Frontieres arranges the necessary visas in co-operation with the Jordanian Health Ministry. Most patients stay in the hospital for an average of four to six months. Since the burned bodies and the broken bones that have grown back together wrongly because of poor treatment or amputated limbs usually require therapy lasting several years, most return here for follow-up treatment – on average three times. Everything – travel costs, treatment, medication and clinic staff – is financed exclusively by donations.

"Both my children have each undergone 18 operations so far. This is the second time we've come here, and we are very happy that we can live in safety here. And of course, that the doctors have made a normal life possible for us again," says the 41-year-old father. "After the explosion in our home, some of our own neighbours no longer wanted to shake our hands. They all thought we had an infectious disease, but it was just burnt skin."

A rest from the apocalypse

Dr. Mukhallid is one of the doctors working at the Al-Mowasah clinic. One of his patients on this Sunday morning is 14-year-old Bassam from Yemen, who has also suffered burns to his arms in an explosion. After the operation, which lasted almost two hours, the 42-year-old Iraqi sits in an adjacent room for a few minutes before the next procedure. He conducts up to five such operations each day.

"Most of my patients who need plastic surgery, require between 10 and 15 operations. Because the skin contracts after it burns, many have limited mobility. We're trying to restore that for them," he says.

For example, in concrete terms, facial burns often mean that those affected can no longer close their eyes or mouth. "Bassam, on whom I've just operated, was no longer able to stretch his hands and arms properly, because the skin was too tight. So we cut it open and transplant donor skin, usually from the thighs," he continues.

Like many of his colleagues, Dr. Mukhallid previously worked in other clinics specialising in plastic reconstructive surgery – among them hospitals in Diyala, Sulaimaniyah and Baghdad – before coming to Jordan in 2013. "I like working here because the hospital pays me for my work. It's more rewarding for me if I don't have to take any money from my patients, which is the case in Iraq. For me, it's a personal matter, because here I'm paid by the hospital, and it doesn't cost my patients anything," says Dr. Mukhallid.

Equal treatment for all

The stories of the patients in attendance at the Al-Mowasah hospital are as individual as their injuries: Mohammad from Baghdad has been here for three months – this is his third visit. In 2006, unknown attackers fired on his family's home in Baghdad, killing his father and two of his uncles. He suffered serious injuries to his stomach and left leg.

Mohammed sustained serious injuries to his leg when unknown assailants attacked the family home in Baghdad in 2006 (photo: Philipp Breu)
"I’d prefer to stay here": Mohammed suffered serious injuries to his stomach and left leg when unknown assailants attacked the family home in Baghdad in 2006

The multiple leg fracture was so complex that comprehensive physiotherapy became necessary; this is how he came to be in Amman. "I'd prefer to stay here. We're still living in the same house, the bullet holes are still visible and we were even threatened again in 2016. I couldn't finish school because of the incident, I've got no money, no work and no prospects when I return home. God only knows what will happen," says Mohammad.

One of the therapists at the hospital is Zaid, a young Jordanian from Madaba. Zaid is committed to his international patients and the credo of his employer: "I treat everyone in the same way here, regardless of religion or nationality. I'm very close to many of my patients, I spend more time with them than at home with my own family," says Zaid.

On this particular Sunday, he's working with Hamid, a 65-year-old retired member of the army from Taiz in Yemen. Hamid has been in Jordan since late July – one of his sons was allowed to accompany him because he is wheelchair-bound. With the start of the civil war in 2015 and the Saudi Arabian intervention, he was injured in an explosion in his home city and had to undergo six operations in Yemen alone.

Faith in the doctors

He's been walking around the clinic on crutches, gradually putting more and more weight on his leg, which has multiple fractures, until he is able at some point to walk unaided again. "I have great faith in the doctors and myself, one must always remain optimistic. But I really miss my family. I'm already looking forward to seeing them again and being able to help with the reconstruction effort. I'd most like to be able to bring water and electricity back to our town," says Hamid.

As detailed as the patients' medical files may be, there is some information that will never be found there. For example, the doctors and nurses never enquire about the political conditions in which the violence was perpetrated against the victims.

For Medecins sans Frontieres, it is irrelevant who fired the bullets or dropped the bombs. The organisation's spokesperson Maria al-Fadel explains: "Of course this means we can't rule out the possibility that we're treating war criminals, but that's not important here, because we're committed to safeguarding the welfare of everyone and that means there's no place for political and religious labels. We just want to help."

Philipp Breu

© 2019

Translated from the German by Nina Coon

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