Blinded by cash: The financial crisis of refugee health care

“I only have 10 percent of my eyesight remaining, but that’s not the problem. I am looking for mercy.”

My eyes drifted back and forth between Abu-Adnan’s face squinting into the distance, and the shuffling prayer beads swaddled in his right hand. I fizzled with frustration as my cochlea’s raced to transcribe his traumatic story into an appropriate emotional response.

This 65-year-old Syrian refugee from the Golan Heights pleaded me for a solution. As a rising second-year medical student lacking any significant medical skills, I felt helpless. All I would be able to do is take vitals and act like I can detect murmurs with my fancy stethoscope. Interesting how my burning desire to unveil the health care barriers of Syrian refugees left me myopic to the barriers that would exist between us. I found myself fumbling to summon the rustic Arabian condolence phrases my parents taught me before I immigrated to the United States in 2006. We conversed on two wooden stools in the back of a small medical office in the Fatih district of Istanbul, a suburb heavily populated with Syrian refugees.

Abu-Adnan was diagnosed with bilateral cataracts four years prior, but his condition began deteriorating two months ago.

“I can only see your silhouette. I don’t really know who I’m talking to.”

This was the third Syrian clinic he had visited that day, each one directing him to the next. The previous clinic requested $2,000 to conduct the necessary surgery. With his family of four “living” off a daily income of 20 Turkish lira ($7), surgery was not an option. The previous clinic directed him to our clinic not knowing that we did not have an ophthalmologist or the necessary equipment to examine him.

For Abu-Adnan, refugee health care has become a business. Still awaiting the liberation of his war-torn motherland, Abu-Adnan now aches to “see” refugee health care — the most vital element of their survival — emancipated from financial interests. He claims many of the Syrian clinics are not operated by physicians or medical personnel since the war has left many Syrian physicians unable to get their transcripts and medical degrees verified by their educational institutions.

Thus, many Syrian physicians in Turkey are either working in unaccredited clinics or resort to alternative business ventures such as opening clothing boutiques or restaurants. For an outsider, Abu-Adnan’s struggle may seem like a quick financial fix, but that is not the case. His mental exhaustion equals, if not surpasses, his physical pain. Establishing psychological support is paramount for the recovery process of Syrian refugees, yet mental health never seems to be on the priority list of clinics when dealing with refugee cases. This is due to a lack of experienced personal confounding the ingrained cultural stigma towards mental health — a phenomenon also manifested in Western medical culture.

Despite a physical blindness, Abu-Adnan carries a visionary solution to the refugee crisis in Turkey: “Scientists, physicians, and the humanitarian leaders of Syria need to build a hospital in Turkey that provides free health care for Syrians yet charges normal fees for Turkish patients. This way, the hospital can earn profit and maintain itself as a business, all while serving refugees in need, mercifully.”

I was deeply inspired by Abu-Adnan’s ability to empathize with the needs of other refugees. He reminded me that through struggle arises innovation. However, innovative ventures such as refugee health clinics must be handled by individuals who are prepared and willing to overcome the innate “survival of the fittest” mentality, even in the face of bountiful financial temptations. I left Abu-Adnan reminded of my duty to always work beyond self-interest and be grateful for everything good and bad in life because every living moment is a lesson and opportunity to grow. Despite making it through today, the future of Abu-Adnan, his family, and millions of Syrian refugees remains blurry.

Eyad Gharaibeh is a medical student. 

Image credit: Chat des Balkans / Shutterstock.com

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