Report on field visit to Turkey, Jordan and Aleppo Jan 28-Feb 7
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Zaher Sahloul
Feb 9, 2015, 10:34:24 AM2/9/15
to SAMS Advocacy, chap...@sams-usa.net
Dear SAMS leaders
Full report is attached with pictures.
Followed is my report on my field visit to our Turkey office, Aleppo projects, Jordan office, Alzaatari polyclinic and Igatha Union of Relief and Development Associations (URDA) conference on Syrian refugees in Lebanon held in Istanbul.
• This is my last field office as a president of SAMS. In the past 3.5 years I had 17 visits to Turkey, 6 visits to Jordan, 4 visits to Lebanon, 5 visits to Aleppo, 3 to Idlib and 3 to Latakia. In the beginning of our medical relief work, the visits were frequent to establish the operations and set up the programs. It is important for future president of the foundation (and all foundation board members) to visit the field periodically (but not as often). Emails, reports and Skype meetings do not replace physical visit and face to face meetings and inspections.
Turkey office:
• Met with the attendants of our training course and had open session with them. The course has become a signature project for SAMS and we have to build on its success by extending its period and scope. The training course was started by Dr. Jaber Molla Hasan. So far we had 14 training courses.
• This time we had joint participation of SAMS local surgeons (from inside Syria), LEAP group (Plastic surgery group) and MSF surgeon in Alamal Hospital in Reyhanly , Turkey for the first time. It was successful mission to the credit of Dr. Tarakji.
• We have total of 27 staff members in Turkey office (including our representatives inside Syria). They oversee all of our cross border relief to Northern Syria (Aleppo, Idlib, Latakia, Hama, Homs). They are considered part of our programs as they are responsible for logistics, implementations, documentation, reporting, financial reporting, information and data collection, advocacy, grants writing, grants reporting, quality improvement, administrative functions and many other tasks.
• This year (2015) they will be responsible for total programs worth of 13 million dollars to 45 medical centers (trauma hospitals, Primary Care centers, mobile clinics, field hospitals, nursing schools) in Northern Syria.
• Total patients served last year (2014) was 510,000 patients. Registered officially in Turkey
• Our staff are talented and motivated. The operations have improved tremendously since last visit.
• Had incidental lunch with Ambassador Ford and one of his associates. He works with Middle East Institute. He is in field visit to start a new political initiative. He said that Washington has given up on the Coalition. He is not much optimistic about the prospect of breakthrough or Demistura plan.
• Met with the new Minister of Health, Dr Wajeeh, who used to work with SAMS. He would like NGOs to help in several projects especially training and licensing of doctors in training who had their training interrupted due to the crisis. He has good ideas but I am not sure how strong or effective this ministry will be. People are skeptical about the prospects of success.
Aleppo:
• My 5th visit to Aleppo. Last was on April 2014
• Visited few projects and sites with Dr Kewara. Spent three days. It was fruitful visit.
• The road is open from Bab Alslama to Aleppo city via Castello road but exposed in certain areas to ground shelling (and of course to barrel Bombs and missiles). The weather was great (cloudy with fog).
• Maree hospital: between Border and Aleppo city to the east, excellent location, symbolic site, has the only functioning CT in all Aleppo area, multiple OR, ICU, patients rooms, industrial Oxygen concentrates, blood bank, underground, busy primary care, excellent physical therapy program, good Obe-Gyn, motivated and talented staff, close to frontline with ISIS, well protected, primary care clinics are offsite from trauma hospital. We should support and expand. Great place for evacuation. Closer to Turkish border and could serve in the future as training hospital. Rumors has it that ISIS is leaving the neighboring area (Northeastern rural Aleppo), which is great.
• Kfar Hamra hospital for evacuation: Joint SAMS-SEMA project funded by Kuwaiti Rahma Relief. 5 minutes west of Hreitan. North suburb of Aleppo. Close to the west frontline. Underground of apartment building.
• Aleppo general conditions: Better signs of life this time compared to my last visit on May 2014. Estimated population 400,000 compared to 100,000 last time. People are returning because it is expensive to live in camps or Turkey!. Also barrel bombing is less (5-8 daily compared to 20-40 last year). It looks that siege has failed and rebels are retaking some of regime positions in northeaster areas around Aleppo but still a threat. Regime advances to reach Nubul and Zahraa ( two Shia villages ) was halted for now ( Operation the Savior Al-Mahdi!). No electricity, ravaged infrastructure, whole neighborhoods empty ( Masaken Hanano), some markets are lively as usual, old city is frontline and empty of civilians, still war zone but surviving. Street vendors, gasoline and diesel vendors are common. Food is great! Areas of sniper activity are still common. No major change in fact line between eastern and western Aleppo. Some movement from western Aleppo to
eastern Aleppo because it is cheaper!. Demistura plan " Aleppo Freeze" is dead or arrival and has no support at all by civic society leaders ( his nickname is ديمفضوحة). Signs of potential war between FSA and Al-Nusra. Some are calling Al-Nusra ( Daesh 2). ISIS is completely discredited but the perception that their areas are more vibrant economically, with no large population movement and more secured and stable in spite of the coalition bombing campaign!
• Last year only 5 SAMS members visited Aleppo including Dr Termanini (GI), Azrak (Optholm), Hakmi (ER) and Alattar (Ortho) and myself. These visits are important to show support to local physicians and encourage them to stay.
• M-10: rebuilt in record time and fully operational at same site, 4 meters underground, well protected with two floors above to reduce the impact of barrel Bombs ( typical barrel Bomb levels two floors!), 2 OR, large ER, waiting area, 3 beds ICU with Telemedicine, 6 beds patients rooms, Nice lab ( they need few machines ), functional C-arm ( survived three bombing) but need new digital C-Arm, doctors quarter, kitchen and cafeteria, clean, warm running water, good generators, blood products available, Oxygen generators, talented and motivated staff ( survived 3 direct bombing and 15 close-by bombings). New primary care clinics and Obe-Gyn under construction. The only medical center in eastern Aleppo, vital for the whole neighborhood. We should support fully and expand services.
• Witnessed major surgery on a young boy who was brought after Barrel Bomb that destroyed his home and killed his family, only survival. 7 members surgical team operated on him for 3 hours. Admitted to ICU intubated. ICU connected to our Intensivist Dr Moughrabieh via satellite internet. Dr Moughrabieh was giving instructions on care ( I overruled his orders ;)). I-Stat was used for ABG and electrolytes. Credit goes to Dr Moughrabieh, Dr Sankari and Dr Jaber. Amazing care within the circumstances.
• SAMS nursing school: met with administration, saw two classes for females and males. In the basement of school, near M-2, qualified teachers (used to run the nursing school at Aleppo university), fully equipped with Manikins, projectors etc. Needs new desks for students. Neighborhood is alive. The location was bombed with barrel bomb next day but no injuries or major destruction.
Jordan
• Our oldest and best office and model operation. It covers cross border relief to southern Syria and refugee services in Jordan (Alzaatari clinic, psychosocial proggra, wounded program)
• Established April 2012. In 2015 we expect to spend 7 million dollars to covers 43 medical centers in southern Syria (Daraa, Qunaytera, Ghouta) and our refugee programs in Jordan. Registered officially in Jordan. Total number of patients benifited was 609,000 in 2014.
.
• Excellent management due to the effort of its director Dr. Naser Hamoud and his talented staff and Dr.Ghanem's leadership and his committee. Our consultants and partners were impressed by its reporting and processes.
• Met with our staff in Jordan office. Amazing, enthusiastic and talented group, diverse with 7 Jordanians/Palestinians out of 22, 7 women, one Christian, listened to excellent comprehensive report with PowerPoint by staff leader. Impressive data analysis by Dr. Kherallah, all board members should visit the office and listen to the presentation, excellent overview on cross border, HR policies by talented and experienced Jordanian director), programs and finance. Clear hierarchy.
• Met with IRC and presented award to their director. They offered more help in capacity building and training. They are the main sponsors of cross borders (with MDM).
• Met with IMC leaders and presbyter an award. They offered unlimited support in whatever we want. They asked to have better communication and not to be shy from asking.
• Met with UNFPA (UN Population Fund) which funds reproductive health and family planning. Very cooperative and their director is Moroccan who was impressed by our track record with other UN agencies. They are ready to support our psychosocial program in Jordan (related to Reproductive Health and Domestic Violence). They approved our proposal to provide RH to southern Syria.
• Met with our US Embassy 5 staffers. Ambassador Wells was out of town. They are impressed by SAMS. They were happy to hear that we got registration. We discussed licensing Syrian doctors in Jordan (they asked for specific plan so we need to follow up), travel of our staff and funding of local projects.
• Visited Alzaatari clinic, met with its staff, witnessed the daily work. It is one of our best programs. They see 500 patients every day. Skilled and inspiring group of physicians and nurses (mostly from Daraa). Multiple specialties. Last year they served 122,000 patients or half of all patients seen in the camp by 9 medical centers. They are better than Saudi, Qatari, UAE and Moroccan funded centers. They deserve our support.
• Met with Alzaatari camp president and thanked him on behalf of SAMS. I asked him to facilitate the incoming medical mission led by Dr Isrib.
• Talked to two staffers of the psychosocial team. The new psychosocial program under new management will be launched later this month.
Conference of Union of Relief and Development Associations (URDA) on Syrian Refugees in Lebanon:
• Held in Istanbul, third conference organized by Igatha (our partner organization in Lebanon), most speakers have some religious affiliation, large conference, well organized, substance was medium, effective media, mostly PR, raising funds from Gulf states and IHH. Good networking. Impressive and multifaceted work in Lebanon.
• Qatar Charity and IHH are major funders. We don't have relationship with them.
• Oxfam and IRC were present and had presentation. Lebanese are very smart in marketing.
• Minimal and disappointing presence of Syrian organizations (no Syrian speakers in three days of conference).
There are several policy and advocacy recommendations based on the visit. I encourage all of our leaders to visit our offices in Turkey and Jordan, meet with our talented staff and participate in medical missions to Jordan, Lebanon and Alamal hospital in Reyhanli.
Thank you
Dr M. Zaher Sahloul
PresidentSyrian American Medical Societywww.sams-usa.net
Full report is attached with pictures.
Followed is my report on my field visit to our Turkey office, Aleppo projects, Jordan office, Alzaatari polyclinic and Igatha Union of Relief and Development Associations (URDA) conference on Syrian refugees in Lebanon held in Istanbul.
• This is my last field office as a president of SAMS. In the past 3.5 years I had 17 visits to Turkey, 6 visits to Jordan, 4 visits to Lebanon, 5 visits to Aleppo, 3 to Idlib and 3 to Latakia. In the beginning of our medical relief work, the visits were frequent to establish the operations and set up the programs. It is important for future president of the foundation (and all foundation board members) to visit the field periodically (but not as often). Emails, reports and Skype meetings do not replace physical visit and face to face meetings and inspections.
Turkey office:
• Met with the attendants of our training course and had open session with them. The course has become a signature project for SAMS and we have to build on its success by extending its period and scope. The training course was started by Dr. Jaber Molla Hasan. So far we had 14 training courses.
• This time we had joint participation of SAMS local surgeons (from inside Syria), LEAP group (Plastic surgery group) and MSF surgeon in Alamal Hospital in Reyhanly , Turkey for the first time. It was successful mission to the credit of Dr. Tarakji.
• We have total of 27 staff members in Turkey office (including our representatives inside Syria). They oversee all of our cross border relief to Northern Syria (Aleppo, Idlib, Latakia, Hama, Homs). They are considered part of our programs as they are responsible for logistics, implementations, documentation, reporting, financial reporting, information and data collection, advocacy, grants writing, grants reporting, quality improvement, administrative functions and many other tasks.
• This year (2015) they will be responsible for total programs worth of 13 million dollars to 45 medical centers (trauma hospitals, Primary Care centers, mobile clinics, field hospitals, nursing schools) in Northern Syria.
• Total patients served last year (2014) was 510,000 patients. Registered officially in Turkey
• Our staff are talented and motivated. The operations have improved tremendously since last visit.
• Had incidental lunch with Ambassador Ford and one of his associates. He works with Middle East Institute. He is in field visit to start a new political initiative. He said that Washington has given up on the Coalition. He is not much optimistic about the prospect of breakthrough or Demistura plan.
• Met with the new Minister of Health, Dr Wajeeh, who used to work with SAMS. He would like NGOs to help in several projects especially training and licensing of doctors in training who had their training interrupted due to the crisis. He has good ideas but I am not sure how strong or effective this ministry will be. People are skeptical about the prospects of success.
Aleppo:
• My 5th visit to Aleppo. Last was on April 2014
• Visited few projects and sites with Dr Kewara. Spent three days. It was fruitful visit.
• The road is open from Bab Alslama to Aleppo city via Castello road but exposed in certain areas to ground shelling (and of course to barrel Bombs and missiles). The weather was great (cloudy with fog).
• Maree hospital: between Border and Aleppo city to the east, excellent location, symbolic site, has the only functioning CT in all Aleppo area, multiple OR, ICU, patients rooms, industrial Oxygen concentrates, blood bank, underground, busy primary care, excellent physical therapy program, good Obe-Gyn, motivated and talented staff, close to frontline with ISIS, well protected, primary care clinics are offsite from trauma hospital. We should support and expand. Great place for evacuation. Closer to Turkish border and could serve in the future as training hospital. Rumors has it that ISIS is leaving the neighboring area (Northeastern rural Aleppo), which is great.
• Kfar Hamra hospital for evacuation: Joint SAMS-SEMA project funded by Kuwaiti Rahma Relief. 5 minutes west of Hreitan. North suburb of Aleppo. Close to the west frontline. Underground of apartment building.
• Aleppo general conditions: Better signs of life this time compared to my last visit on May 2014. Estimated population 400,000 compared to 100,000 last time. People are returning because it is expensive to live in camps or Turkey!. Also barrel bombing is less (5-8 daily compared to 20-40 last year). It looks that siege has failed and rebels are retaking some of regime positions in northeaster areas around Aleppo but still a threat. Regime advances to reach Nubul and Zahraa ( two Shia villages ) was halted for now ( Operation the Savior Al-Mahdi!). No electricity, ravaged infrastructure, whole neighborhoods empty ( Masaken Hanano), some markets are lively as usual, old city is frontline and empty of civilians, still war zone but surviving. Street vendors, gasoline and diesel vendors are common. Food is great! Areas of sniper activity are still common. No major change in fact line between eastern and western Aleppo. Some movement from western Aleppo to
eastern Aleppo because it is cheaper!. Demistura plan " Aleppo Freeze" is dead or arrival and has no support at all by civic society leaders ( his nickname is ديمفضوحة). Signs of potential war between FSA and Al-Nusra. Some are calling Al-Nusra ( Daesh 2). ISIS is completely discredited but the perception that their areas are more vibrant economically, with no large population movement and more secured and stable in spite of the coalition bombing campaign!
• Last year only 5 SAMS members visited Aleppo including Dr Termanini (GI), Azrak (Optholm), Hakmi (ER) and Alattar (Ortho) and myself. These visits are important to show support to local physicians and encourage them to stay.
• M-10: rebuilt in record time and fully operational at same site, 4 meters underground, well protected with two floors above to reduce the impact of barrel Bombs ( typical barrel Bomb levels two floors!), 2 OR, large ER, waiting area, 3 beds ICU with Telemedicine, 6 beds patients rooms, Nice lab ( they need few machines ), functional C-arm ( survived three bombing) but need new digital C-Arm, doctors quarter, kitchen and cafeteria, clean, warm running water, good generators, blood products available, Oxygen generators, talented and motivated staff ( survived 3 direct bombing and 15 close-by bombings). New primary care clinics and Obe-Gyn under construction. The only medical center in eastern Aleppo, vital for the whole neighborhood. We should support fully and expand services.
• Witnessed major surgery on a young boy who was brought after Barrel Bomb that destroyed his home and killed his family, only survival. 7 members surgical team operated on him for 3 hours. Admitted to ICU intubated. ICU connected to our Intensivist Dr Moughrabieh via satellite internet. Dr Moughrabieh was giving instructions on care ( I overruled his orders ;)). I-Stat was used for ABG and electrolytes. Credit goes to Dr Moughrabieh, Dr Sankari and Dr Jaber. Amazing care within the circumstances.
• SAMS nursing school: met with administration, saw two classes for females and males. In the basement of school, near M-2, qualified teachers (used to run the nursing school at Aleppo university), fully equipped with Manikins, projectors etc. Needs new desks for students. Neighborhood is alive. The location was bombed with barrel bomb next day but no injuries or major destruction.
Jordan
• Our oldest and best office and model operation. It covers cross border relief to southern Syria and refugee services in Jordan (Alzaatari clinic, psychosocial proggra, wounded program)
• Established April 2012. In 2015 we expect to spend 7 million dollars to covers 43 medical centers in southern Syria (Daraa, Qunaytera, Ghouta) and our refugee programs in Jordan. Registered officially in Jordan. Total number of patients benifited was 609,000 in 2014.
.
• Excellent management due to the effort of its director Dr. Naser Hamoud and his talented staff and Dr.Ghanem's leadership and his committee. Our consultants and partners were impressed by its reporting and processes.
• Met with our staff in Jordan office. Amazing, enthusiastic and talented group, diverse with 7 Jordanians/Palestinians out of 22, 7 women, one Christian, listened to excellent comprehensive report with PowerPoint by staff leader. Impressive data analysis by Dr. Kherallah, all board members should visit the office and listen to the presentation, excellent overview on cross border, HR policies by talented and experienced Jordanian director), programs and finance. Clear hierarchy.
• Met with IRC and presented award to their director. They offered more help in capacity building and training. They are the main sponsors of cross borders (with MDM).
• Met with IMC leaders and presbyter an award. They offered unlimited support in whatever we want. They asked to have better communication and not to be shy from asking.
• Met with UNFPA (UN Population Fund) which funds reproductive health and family planning. Very cooperative and their director is Moroccan who was impressed by our track record with other UN agencies. They are ready to support our psychosocial program in Jordan (related to Reproductive Health and Domestic Violence). They approved our proposal to provide RH to southern Syria.
• Met with our US Embassy 5 staffers. Ambassador Wells was out of town. They are impressed by SAMS. They were happy to hear that we got registration. We discussed licensing Syrian doctors in Jordan (they asked for specific plan so we need to follow up), travel of our staff and funding of local projects.
• Visited Alzaatari clinic, met with its staff, witnessed the daily work. It is one of our best programs. They see 500 patients every day. Skilled and inspiring group of physicians and nurses (mostly from Daraa). Multiple specialties. Last year they served 122,000 patients or half of all patients seen in the camp by 9 medical centers. They are better than Saudi, Qatari, UAE and Moroccan funded centers. They deserve our support.
• Met with Alzaatari camp president and thanked him on behalf of SAMS. I asked him to facilitate the incoming medical mission led by Dr Isrib.
• Talked to two staffers of the psychosocial team. The new psychosocial program under new management will be launched later this month.
Conference of Union of Relief and Development Associations (URDA) on Syrian Refugees in Lebanon:
• Held in Istanbul, third conference organized by Igatha (our partner organization in Lebanon), most speakers have some religious affiliation, large conference, well organized, substance was medium, effective media, mostly PR, raising funds from Gulf states and IHH. Good networking. Impressive and multifaceted work in Lebanon.
• Qatar Charity and IHH are major funders. We don't have relationship with them.
• Oxfam and IRC were present and had presentation. Lebanese are very smart in marketing.
• Minimal and disappointing presence of Syrian organizations (no Syrian speakers in three days of conference).
There are several policy and advocacy recommendations based on the visit. I encourage all of our leaders to visit our offices in Turkey and Jordan, meet with our talented staff and participate in medical missions to Jordan, Lebanon and Alamal hospital in Reyhanli.
Thank you
Dr M. Zaher Sahloul
PresidentSyrian American Medical Societywww.sams-usa.net
abdul zanabli
Feb 11, 2015, 12:15:33 AM2/11/15
to Zaher Sahloul, SAMS Advocacy, chap...@sams-usa.net, foundat...@sams-use.net
Thank you Dr. Zaher for such a comprehensive assessment, I hope this won't be your last visit to SAMS fields offices as one of SAMS leaders. Presidency a limited time position (with few exceptions:) ). Leadership is a lifelong commitment, SAMS have and will continue to embrace your leadership, vision and expertise.
The western civilizations have been successful in creating a system were leaders transition from one role to another, the contribution continues as new leaders evolve. Your presence is essential to coach, support, and advise the new presidents and board as we move into the nomination and election process.
Your hard work and commitment is setting the bar high for all of us, Thank you for doing so, it motivates every SAMS member to do their best.
Abdulrahman Zanabli, MD
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