Preventing a Lost Generation

By Su Fang-pei (蘇芳霈)
Translated by Wu Hsiao-ting (吳曉婷)

Preventing a Lost Generation

By Su Fang-pei (蘇芳霈)
Translated by Wu Hsiao-ting (吳曉婷)

A group of Syrian doctors has been working with Tzu Chi Jordan to tend to the health of their fellow Syrians, especially that of the younger generation.

Near the end of 2014, the United Nations High Commissioner for Refugees (UNHCR) stopped helping refugee camp residents in Jordan with their surgical needs. As a result, many refugees turned to Tzu Chi for assistance. In 2015, a group of Syrian physicians was invited by Tzu Chi to attend a meeting in Akilah Hospital in Amman, the capital of Jordan.

During the meeting, Dr. Abdul Hakim Khader, a Syrian otolaryngologist, looked with mistrust at Chen Chiou Hwa, the head of Tzu Chi Jordan. The physician had come to the meeting at Chen's invitation, but he couldn't believe that a charity organization based as far away as Taiwan was interested in reaching out to his fellow Syrians. His experience escaping from Syria to Jordan more than a year before only added to his wariness: even though he had managed to find a job at a hospital in Jordan, he was cheated out of a month's pay. Given such experiences, working in a country not his own and having to fend for his family, it is understandable that he was guarded and vigilant.

Chen shared with the doctors at the meeting how he had been carrying out charitable and humanitarian aid in Jordan on behalf of the Tzu Chi Foundation for many years. He had witnessed the plight of Syrian refugees in the country, some of whom were plagued by both poverty and illness. He invited the physicians in attendance to work with Tzu Chi Jordan to help their fellow compatriots.

Though they still harbored some suspicion, the goodwill and kindness demonstrated by Chen touched the Syrian doctors. Still a bit skeptical, Dr. Ahmad Majid, a cardiac surgeon in attendance at the meeting, started taking part in free medical clinics organized by Tzu Chi. He also joined Tzu Chi volunteers in their monthly visits to Tzu Xin House, a shelter for refugee mothers and children. Once he got to know Chen and observe him, he found himself completely won over. To help Tzu Chi help his countrymen, he even negotiated with Al Bayader Hospital, which was working with Tzu Chi to provide treatment to Syrian refugees, to get preferential prices for the foundation.

Syrian refugees in Jordan need to pay for their doctor visits and have no choice but to pay whatever fees a hospital or clinic charges. One time, a Syrian refugee required a stent in his heart to deal with a heart problem, so Tzu Chi sought out Dr. Majid to perform the procedure. After the surgery, Dr. Majid told Chen that instead of a stent implantation, he had found that a balloon angioplasty procedure would work just as well for the patient, so that's what he had done for him. A stent would have cost 2,500 Jordanian dinar (US$3,525), but the balloon angioplasty procedure ran only 400 Jordanian dinar (US$565). Chen was very surprised when he heard what Dr. Majid had done. Originally from Taiwan, Chen had lived in Jordan for more than 40 years. In that time he had met many doctors, and he knew how some of them wouldn't miss a single chance to make money. "I was impressed and deeply touched by Dr. Majid's compassion," said Chen.

In his capacity as a physician, Majid does what he can to save money for his fellow Syrians. When they go to him for treatment, he charges them less to reduce their financial burdens. He charges less from Tzu Chi, too, so the foundation can help more people.

Tzu Chi Jordan has paid for the medical treatment for refugees from all sorts of backgrounds and circumstances. They included those who had sought help at a Tzu Chi free clinic and were found to be requiring further medical care, and ranged from children suffering from hernias to older people needing dentures. In the early days, Tzu Chi would refer its medical cases to the hospitals in partnership with the foundation. But in recent years, it has shifted to entrusting patients to Syrian doctors working on a long-term basis with the foundation. When a patient needs surgery, the Syrian doctor Tzu Chi has turned to rents an operating room from the hospital he works at to operate on the patient. Tzu Chi then pays the doctor for his service. This helps ensure that these Syrian physicians have better incomes.

Tzu Chi Jordan now has a strong team of Syrian doctors working with them, their specialties covering a wide spectrum of medical fields. Dr. Khader, who had doubts about Chen seven years ago, is now a regular at Tzu Chi free clinics and distributions. He has been moved by how Tzu Chi volunteers give with sincerity, integrity, faith, and honesty. He knows that no matter how hard they work, it is impossible for them to reach every Syrian refugee, but the aid Tzu Chi has provided to his fellow compatriots—whether it be via subsidizing educational fees, distributing daily necessities, or conducting free clinics—has changed the future of many families. "What Syrian children in Jordan need help with the most is education, food, and medical care," said Dr. Khader. "We must work to prevent a lost generation for Syria."

Saving My Left Forearm
In November 2021, Tzu Chi Jordan held a routine free clinic in the village of Huweyja, Mafraq. During the event, Dr. Hamzawi, an orthopedist and volunteer physician for UNHCR, examined Yousef Samara, a Syrian teenager. The muscles in Yousef's left forearm were seriously atrophied. He couldn't even move his fingers.

Yousef was from the Zaatari refugee camp. He had suffered a fall in 2020, fracturing the ulna bone in his left forearm. Medical resources at the camp were inadequate, suitable only for treating minor ailments, such as a cold. Yousef needed much more extensive medical treatment, for which he needed to leave the camp. To do so, he had to line up to get a spot in the daily quota of 500 people. It wasn't until January 2021 that Yousef was able to leave the camp for an X-ray, which showed that he would need surgery to fix his bone fracture.

Residents at the camp couldn't work, relying instead on food stamps distributed by UNHCR—at a value of 20 dinar (US$28) per person per month—to get by. Though worried for her son, Yousef's mother was helpless. How could they afford the surgery?

By the time Dr. Hamzawi met him at the Tzu Chi free clinic, more than a year had passed since Yousef's injury. He had by that time almost completely lost the ability to move his left forearm and hand. When the doctor discovered how stiff and atrophied his forearm and hand were, he asked Dr. Feras Ibrahim, a pediatric orthopedist, to check on him. Ibrahim ascertained that Yousef's left ulna had suffered a break near his wrist, and determined that a bone transplant operation was in order.

Tzu Chi helped Yousef pay for the required medical treatment. Dr. Ibrahim performed the surgery for him. The physician took a small segment of bone from Yousef's pelvis, some tendon from his calf, and a small patch of skin from his abdomen to fix the injury. The doctor hoped to help the youngster regain at least 70 percent of the function of his forearm, wrist, and hand. The surgery took six hours to complete. Yousef was discharged from the hospital in March 2022. He returned from Amman to his refugee camp with bountiful blessings from Tzu Chi volunteers.

Two weeks after the operation, Yousef went back to the hospital in Amman for a follow-up checkup. Dr. Ibrahim removed the cast from Yousef's arm and took another X-ray. He was very pleased to see that the bone was healing well. Youself exclaimed in disbelief, "I can move my fingers now!"

Dr. Ibrahim couldn't be happier. He said to Yousef, "You're recovering far better than expected. Your arm and hand might regain 90 percent of their function." The doctor put Yousef's arm back in a cast and, like a loving father, demonstrated to him how to do rehabilitation exercises to help his arm, wrist, and hand get back in shape. He asked Yousef's mother to bring him back a month later for another checkup.

"I've disliked going to school for two years now," said Yousef, "because my classmates would laugh at me for my arm. I always kept it hidden in my clothes. Now I no longer have to hide it. Thank you, Tzu Chi!"

Yousef will always remember that the freedom that comes from being able to freely use his left hand again is a result of Dr. Ibrahim and Tzu Chi. He will forever be grateful for their dedication and compassionate work.

I Want to Grow Tall
Tzu Chi Jordan logs thousands of instances of medical aid every year, helping people receive medical examinations, obtain medications, or undergo surgery. The Tzu Chi branch provides as much aid as they can using local medical resources, but occasionally seeks assistance from outside of Jordan to help patients continue their treatment.

Lujin Omar Shhadeh is a girl who escaped from Syria to Jordan with her siblings and her mother, Manar Mariri. They moved in with relatives in Jordan. By the age of six, she was only a hundred centimeters (3'3") tall, much shorter than other children her age. To determine the reason why, her mother took her to the hospital for an examination. Lujin was diagnosed with a growth hormone deficiency.

Manar was deeply worried following the diagnosis. The hormone injections used to treat a condition like her daughter's were costly—so costly she couldn't possibly afford them. Adding insult to injury, her husband had died that year in Syria. She was grief-stricken, having lost her loved one, but couldn't return to Syria. Nor could she return to her home country, Kuwait. She was trapped in Jordan.

Though Lujin was already six, her epiphyseal plates, also known as the growth plates (zones of cartilage in children at each end of their long bones), were about the same as a two-year-old's. She was severely lacking in growth hormone. It was essential to take advantage of the time window when she was still growing to have her condition treated.

"A dentist told me that a ‘Mr. Chen' from Taiwan wanted to learn more about Lujin's condition," Manar recalled. "Later, he came to visit us. After looking at the doctor's report, he decided to help us."

The man Manar was referring to was Chen Chiou Hwa. He visited Lujin for the first time in 2017, after she had been referred to Tzu Chi for help. It so happened that in December of the same year, a Tzu Chi team from Taiwan arrived in Jordan to offer free medical clinics. Wang Zhi-min (王智民), a pharmacist from Tainan, southern Taiwan, and a member of the Tzu Chi International Medical Association (TIMA), was on that team. He first helped Tzu Chi Jordan purchase locally some hormone injections for Lujin. After returning to Taiwan, he found a supplier that sold the same medicine for a lower price, and began buying it in Taiwan out-of-pocket for Lujin.

Chen Chiou Hwa took advantage of the trips he made to Taiwan to bring the injections Wang had purchased back to Jordan. Because the medicine needed to be stored in a freezer, he could only bring back a year's worth of injections with each trip. After Chen had done that for three years, the Jordan TIMA chapter found a supplier in Türkiye that sold the injections for the same price as in Taiwan. As a result, the chapter began buying the medicine to be administered to Lujin in Türkiye.

At the suggestion of Tzu Chi volunteers, Lujin had started learning Taekwondo to help boost her muscle growth. Her height began increasing quickly until 2022, when her growth spurt began slowing. Her doctor adjusted her medicine accordingly, and she's now grown to 143 centimeters (4'7") tall.

When Lujin drew pictures at home in the past, she always made the legs of the children she drew very long. When her mother asked her why, she answered, "Because I want to grow tall." Tzu Chi has been helping to make her dream come true. May the girl grow as tall as she wishes and have long legs like the figures in her drawings.

A Boy With Crohn's Disease
It was in 2019 when the team of Syrian doctors helping Tzu Chi provide medical treatment to their fellow Syrians learned about teenager Osama Sofrajy's condition.

"Someone told me about the kid's illness," Dr. Abdul Hakim Khader recalled, "and asked us to save him." The physician said he had felt deeply for the impoverished boy when he learned about his story from a nurse.

Osama was born in Homs, western Syria. He was diagnosed at five with Crohn's disease, an autoimmune bowel disorder characterized by persistent inflammation of the lining or wall of the gastrointestinal tract. If the inflammation is left unchecked, ulcers can form anywhere within a patient's digestive tract, including the mouth and anus. Sometimes such ulcers may extend through the intestinal wall, resulting in a fistula—an abnormal connection between different body parts.

The eruption of the Syrian civil war interrupted Osama's treatment. In 2013, the boy fled with his family to Jordan. Despite being in a foreign land, Osama's father sought medical attention everywhere for his son. Osama's aunt and a kind pharmacist also helped to find medical resources for the boy. Osama was able to receive treatment, though intermittent, with the help of some NGOs, but he didn't get better, and in the end was dependent on steroids provided by a charity-run clinic to get by.

Dr. Mohanad Salahi, a member of the team of Syrian doctors, referred Osama to Tzu Chi for help. Afterwards, volunteer Lai Hua-xiu (賴花秀) visited the boy at Al Bayader Hospital. She found him emaciated and too weak to walk. Though he was already 14, he weighed a mere 17 kilograms (37 pounds). A fistula had developed in his bottom due to Crohn's disease. When a doctor lightly pressed his bottom, dark green feces seeped out. The boy cried out in pain.

Chen Chiou Hwa was at an airport in Thailand waiting for a connecting flight to Taiwan when he received a video taken by Lai at the hospital. He saw how sick Osama looked, and how his mother covered her face with her hands in sadness. Osama's father, facing the camera, talked about the hardships they had endured over the years seeking medical help for his son. After seeing it all, Chen asked Dr. Salahi to quickly arrange for surgery for the boy. "Please do everything possible to save his life," he said.

The surgery took place at Al Bayader Hospital. A doctor removed the affected part of Osama's intestine and performed a colostomy to help him defecate. Antibiotics were injected to prevent infection. Tzu Chi paid the cost in full.

But Crohn's disease wasn't the boy's only problem. Long-term steroid use had led to osteoporosis, badly affecting his teeth. Tzu Chi asked a dentist to fix the boy's teeth to help him chew normally. The foundation also continued to help with his other medical needs. For example, as part of his treatment regimen, Osama required immunoglobulin injections. Chen once again enlisted the help of pharmacist Wang Zhi-min, who responded by generously underwriting the cost of more than ten injections.

Osama is now much healthier. He can run around and play soccer with his friends. He is unable to attend school due to his health, but Tzu Chi has hired a tutor for him. His smile has become very bright.

"He's very strong now," said Dr. Salahi. "I feel an urge to cry whenever I see him. Thank you." The physician's eyes were moist as he talked about the boy whose life had been saved thanks to the efforts of many people.