dispatches from here

The purpose of this project is to learn, raise awareness, and share knowledge. I strongly feel that information and knowledge should be free and open, and as a result all of the postings on this blog, including text and pictures, are published under the Creative Commons license. If you aren’t familiar with Creative Commons, you should definitely check it out. It’s a way to publish content and maintain certain copyright protections, but also allow others to make use of your work, even commercially. Essentially, it is the open source software model applied to other types of media.

Specifically, everything on this site is published under the Attribution Share Alike Creative Commons license, which means:

“This license lets others remix, tweak, and build upon your work even for commercial reasons, as long as they credit you and license their new creations under the identical terms. All new works based on yours will carry the same license, so any derivatives will also allow commercial use.“

For example, one of my recent blog posts was picked up by Nuri Kino’s blog and translated into Swedish, with attribution. That’s remixed, tweaked, and shared. Awesome.

Monday was my first day in Damascus, and it was also my first night in the clinic. There were many individuals involved in setting up the clinic, including the Assyrian General Conference and the doctor that runs it, Dr. Milad.

Its set up in one of the poorest districts of Damascus, Jeramaneh. That also happens to be where most of the Iraqi refugees live, and about 80% of the Assyrian refugees. Its really odd to walk down the street and hear people speaking Assyrian, walk into stores to find Assyrian shopkeepers, go to an Assyrian internet café (or café-net as they’re called here).

The clinic is a simple, austere outfit. A small waiting room with nine red plastic chairs and the secretary’s desk. The only wall decorations are a bare fluorescent bulb, a clock with a painfully loud second hand, a cross, and an antiquated fuse box. To right of the waiting room is the sole examination room.

To the left of the waiting room is a plain room with two beds, where I am staying with Dr. Milad. A simple room with no real signs of habitation, except a few pieces of clothing hanging behind the door and a cell phone charger clinging to the wall. He has graciously opened his clinic/home to me.

The clinic exam room, with the bare minimum of supplies to deal with the stream of patients.

The medicine cabinet with an assortment of donated medicine from all over the world. The supply is completely arbitrary and uncertain, and patients only get a week’s worth of meds per visit, even for chronic conditions like diabetes and hypertension. When we have to give patients medicine, I spend a bit of time digging around, trying to find the right meds, struggling to make out the names, sometimes in Arabic, German, French. The problem with trade names is that each country has their own, so I rely on the fine print that usually has the generic name, and usually in English.

The room I’m sharing with Dr. Milad. Simple. Quiet.

The secretary, who volunteers all of her evenings in the clinic, registers patients as they arrive. She also brings us tea and coffee throughout clinic, which is amazing. Dr. Milad I head to her house after clinic a few blocks away and join her family to watch a hugely popular Turkish soap opera, “As the Days Pass” which has been dubbed into Syrian Arabic. I only understand about 20% of the words, but am slowly learning.

There are daily rolling blackouts throughout Damascus lasting two hours. At the clinic, its from noon to 2 pm, which is fine because the clinic is only open from 6-8 pm. However, in addition to the standard rolling blackouts, sporadic blackouts also hit. Tuesday night, we ran clinic with flashlights and candles. A patient brought in her meds, sometimes she takes losartan, and sometimes valsartan depending on availability in the clinic. Valsartan is written in Arabic as “falsartan”, because Arabic doesn’t have a “v” sound. Makes trying to decipher medicine names extra tricky.

In the absence of any governmental support for refugees, the church becomes the only institution that provides any social services. As a result, in Amman the churches are the epicenter of the refugee crisis. The Chaldean Catholic Church has 7,000 members and one priest, Fr. Raymound Moussoulli. The population here has also been in massive flux, as the increased rate of foreign visas being issued has helped many of the members head to the West.

He describes the church mission to me in four parts: pastoral services, spiritual services, psychological services, and social services. The pastoral services include home visits and certain services. As far as spiritual services, being the only priest for a community of 7,000, Fr. Moussoulli holds services 9 times per week, once each evening and three services in different neighborhoods of Amman on Sundays. A grueling schedule shows clearly on Sunday night. The psychological services involve all sorts of family counseling, dealing with marital problems, and helping families cope with being away from their homes and often apart from each other. As far as social services go, there are a lot. The church turns into an ad-hoc school during the day with informal classes for children from families that can’t pay to go to Jordanian schools. The church also helps pay tuition for some children enrolled in schools, which can cost about 500 Jordanian Dinars (~700 USD) per year. They help families find places to live, fill out UN HCR (High Commissioner for Refugees) paperwork, find work, and get them plugged in to various NGOs (Caritas, Mercy Call).

On the day I attended services, there were snacks and sandwiches celebrating a family of five that had been accepted to Canada. Fr. Moussoulli, always happy and supportive when families found a more permanent home, noted that with the high flux of refugees, it was hard to keep the church’s services functioning.

A converted basement of an apartment building. Cozy, to say the least.

Two competing sources of salvation, as a flier from the UNHCR gets more bulletin board space than a picture of Jesus.

Entering church for morning service.

Fr. Moussoulli checks a passport and helps fill out an apartment rental application for one of his members.

Fr. Moussoulli finally has a moment to take a break, as Sundays are particularly busy with three sermons in different parts of the city and many people seeking his help.

Sunday evening mass

Weary after his ninth mass of the week.

Its pretty sad when it only takes about 3 minutes to bypass the government firewall and post (thanks to the Tor anonymous proxy). Photos as my little service taxi heads across the Syrian border. The meds aren’t with me (which made for an easy border crossing). They’re headed to Damascus thanks to the help of a priest, a doctor, and a vegetable truck driver. We’ll see if they ever arrive. More on that later.

Syrian Border Ahead

Bye Bye Jordan

Hello Syria!

made it comfortably across the border into Syria and now in Damascus indefinitely. The bag of meds, through a circuitous route, will eventually (hopefully) be brought to Damascus somewhere aboard a vegetable truck (more details after I get back). In the nterim, blog posts may slow down for a few reasons. First, the internet all across Syria is painfully slow, even at the fastest internet cafes. Uploading pictures may be hopeless. Also, I’ve been told to watch what i say/post, GPS is apparently illegal here, and a bunch of websites are blocked (facebook, youtube, etc). If yo want, my cell phone number here is 00963 (country code) + 991183774.

I’ve always wanted to shave my head, and on an impulse I popped into the local barber shop. My Arabic is quickly improving, and while I cant say I’m “intermediate” or “beginner”, functionally I’ve gone from being scared to try to speak to being able to feed myself and now to barbershop banter. Off it goes with a straight razor. The barber also wanted to do my beard to make me look like some famous Jordanian singer, so there we go.

Although the picture of me is blurry, check out the top left corner for my favorite part of the photo: the photographer, one of the barbers!

So? Whaddya think? Maybe needs a little tan though...

Lunch at Al-Bouney Saloon (that's right, Saloon)

My tentative plans for a 3 day camel trek through the desert in Wadi Rum were junked thanks to some strong winds and a mini-sandstorm. Cloudy, overcast, slightly foggy, and really sandy put visibility at less than a 100 meters, so I’ll be coming back in April for the camel trek when the weather improves. Definitely a huge bonus that my camera and lenses are is sealed against moisture/sand/dust, too bad my eyes and mouth arent.

Dust and sand on the Desert Highway

I spent two days exploring Petra, and it is definitely amazing. The key was getting up well before sunrise and hiking through the Siq all alone and being the first person to arrive at the Treasury façade to watch the sun rise onto it. I had the entire imposing monument in silence all to myself for a few hours until everyone else began to trickle in. Its an entire city carved into the red sandstone hills and you need at least a week to fully explore it (>45km of main trails to monuments). The most enduring feeling is just the sheer size of the carved facades. On the second day, I logged 19.5 km of hiking (thanks GPS!) and the shawerma at the end of the day definitely hit the spot.

I hate taking pictures of major monuments…everyone has seen them (in person or in photos) and because they are so huge, there are only so many unique ways of portraying them. Although I did take all of the basic site photos, I wont bother posting them (you’re all big enough to do a flickr search). But I will post a few photos…

For scale, thats me at the front entrance. The only way to get a solo shot is to be there at 6 am...

Hanging out at the giant amphitheater

One condition of this trip was that I promised my mom I would ride a donkey…so here’s the proof. I named my donkey Khosro (Khosro the khmara) and he helped me make it to one of the peaks overlooking Wadi Arabi. Side note: its way more difficult to ride a donkey and take pictures at the same time than I could have imagined.

Don't let his intensely fierce expression fool you, he's actually pretty nice.

Except when he tries to eat my camera.

Outpost overlooking Wadi Araba

Five or six of me to give the picture scale. Just a little twist on the standard "Look at me in front of some major monument" photo.

Entrance to the Al Rasheed Cafe

Lots of little cafés tucked in alleyways and sidestreets all over Amman. But these aren’t your standard Starbucks or even the dimly lit cushy cafes out of Arabian Nights. Up little sets of stairs you enter a harshly fluorescently lit room hazy with sheesha smoke, with dingy floors and cracked plastic chairs, where everyone sits with their own sheesha around tables playing cards and drinking tea.

A fierce game of cards in the works

Hanging out on my balcony, overlooking a corner of downtown Amman

As I start to post more photos with me in them, you’ll quickly notice my extremely limited wardrobe. The ~40 pounds of meds/supplies and ~35 pounds of photography equipment necessitated that I had to pack super light as far as everything else was concerned, so I went minimalist on the clothes. Fortunately its cheap and easy to have laundry done here.

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potentially heading to Petra tomorrow + miscellaneous adventures, so I may be out of touch for the next 5-6 days.

The church overlooking Amman

On Monday, I had the opportunity to meet some extremely dedicated individuals who through years of hard work have been able to dramatically change the lives of many Christian refugees from Iraq, both Assyrian and Armenian. I got here through the help of Nuri Kino, an Assyrian-Swedish journalist and documentary filmmaker based in Sweden. In 2007 he wrote an absolutely chilling piece about the status of Christian refugees in Jordan titled, “By God: Six Days In Amman”. And because he is a far better writer than I am, I strongly urge you to read the article. I contacted him for help with my project and he put in touch with Hanna Shamoun, one of the church elders and community leaders devoted to helping the refugees here in Amman.

(continue reading…)

The streets and alleys of downtown Amman are where all the action is, the hustle and bustle and chaos associated with a Middle Eastern city.  At night, things quiet down just a little and there is an eerie beauty to it.  The yellow sodium streetlights clash with fluorescent white escaping from people’s homes and blend with neon shop lights, all under the dim green glow emanating from every mosque’s minaret.

There are also LOTS of stairs.  Downtown Amman is built on hills that make SF look flat, and they are interconnected by long series of steep stairs.  Some stairs lead to other streets, while others just lead to people’s front doors or back yards.  Its impossible to tell which is which until you’ve already gone up/down the stairs.  Fortunately, Ammani’s are extremely nice and don’t seem to mind when someone wanders into their backyard.

the stairs home

dimly quiet

the front door to my "hotel" is in this alley.

closing up shop

Its everywhere…But Popeye’s?  Really? And of course, right across the street, a KFC to compete.  Bonus points for effort for the Arabic translation for KFC…Although it says “Chicken of Kentucky”.  Funny that they would de-emphasize the “fried” part, because I think in America we de-emphasize the “chicken” part.

No, I did not eat here (but was tempted)

Sorry Col. Sanders, I'll have a shawerma instead.

There’s a slight difference between no plans and no preparation. While I had no concrete plans for the next 10 weeks, I hope I’m at least adequately prepared. Case in point: GPS. I have yet to find a single straight street in Amman. Very few of the streets have street names, and even fewer have street signs. Maps only have the major streets, and the directions you get from people or in guidebooks are something like this: “Cross the street from Hashem’s Restaurant, enter the unmarked alley, and it will be the third unmarked door on your left, go up three flights of stairs.”

The only thing that has kept me somewhat sane is my handhelp GPS which I preloaded with maps of Jordan and Syria that were generated by users. While not completely accurate and unlabeled, I can at least track where I’ve been and make sure I can get back. Also very helpful for dropping pins at cool cafes or restaurants (such as the one I’m sitting in now, writing this blog post). I will also be geo-coding my photos and placing them on interactive maps so you can see where things come from.

As an aside, pretty cool to know that the GPS works even on the plane (and is an approved device, don’t worry!).

584 MPH at 34,000 feet? Awesome!

The illustrious Cliff Hotel…my second floor window opens directly into an alley full of shops. Right below my window is a falafalateer (is that a word?) that fills my room with a deep fried odor, and an arabic CD/Tape seller, who plays his samples LOUD until about 3 am.
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Success.  I made it through customs in Amman with all of the meds and supplies in tact! My bags didn’t even get searched.

I did have an issue with the immgrations agent though.  First of all, there were three lines: one for Jordanian citizens, one for all other nationalities, and one for “VIPs & Investors”. Seems like Jordan is doing their best too woo some FDI. All of the American citizens in front of me breezed right through with a quick stamp.  I get to the counter, show him my US passport, everythings going fine, and then he notices I was born in Iran.  At this point he began to freak out a little, asked me long list of questions and then disappeared to the back office for 10 minutes. Now I’m nervous. This is supposed to be simple!  His supervisor comes out, with his shabby uniform and beret ajar, and asks me the same questions.  Some reasonable (How long do you intend to stay, what is the purpose of your visit, and some ridiculous (What is your father’s name?). He seemed satisfied that I was safe and let me through. 

I think that says a lot about how low Iran’s standing in the world has become, when its easier for US born American citizens to get into a Middle Eastern country than Iranian born US citizens.

So all in all a good border crossing, and I was able to get my 60 pounds of medicine and supplies in.

Medication headed to a refugee clinic in Syria

Whenever we (UCSF med students) visit a clinic abroad, we try to take supplies and medicine to help out.  A few years ago helped on of my classmates with a student run organization called REMEDY. He founded the UCSF chapter of this group, which collects unused/unwanted medical supplies from hospitals in the US and helps deliver them to clinics in developing countries.  At UCSF, there are bins to collect unused medical equipment otherwise headed for the trash in the main hospital ORs and ICUs.  So I met with one of the med students currently helping with the group and collected a few bags of basic medical supplies, first aid supplies, glucometers + test strips, etc.  But I wanted to take some medicine too, because from what I’ve heard, the clinic I’d like to head to in Syria literally only has a blood pressure cuff and a stethoscope and hugely dedicated volunteer physicians.

So I called my uncle, a family practice physician in San Jose for some help.  I knew he would help a little, but he came through huge!  I showed up at his office to find bags of meds ready for me to take.  Useful meds too, in huge quantities that can probably supply this clinic for months.  I’m not sure the picture above does justice, so for all of the medical people reading along, here’s a short list:

tetacycline 250mg x 300 tabs, 500mg x 200 tabs
penicillin 250mg x 200 tabs, 500mg x 500 tabs
amoxicillin 500mg x 500 tabs
cephalexin 250mg x 200 tabs, cephalexin 500mg x 300 tabs
ciprofloxacin 500mg x 200tabs
septra ds x 300 tabs
erythromycin 250mg x 100 tabs, 500mg x 100 tabs
elanapril 5mg x 200 tabs, 10mg x 200 tabs
hydroxyzine 25mg x 100 tabs
amlodipine 5mg x 90 tabs
atenolol 25mg x 300 tabs, 50mg x 400 tabs
famotidine 50mg x 100 tabs
prednisone 10mg x 500 tabs
paroxetine 10mg x 90 tabs, 20mg x 40 tabs
fluoxetine 10mg x 400 tabs
citalopram 10mg x 500 tabs, 20mg x 300 tabs
erythromycin eye ointment x 2 tubes
triamcinolone 0.1% oint x 9 tubes
ibuprofen 400mg x 500 tabs
naproxen 220mg x 50 tabs
diphenhydramine 25mg x 50 tabs
robitussin x 11 bottles

This is seriously a huge haul…I have no idea how I’m going to get through customs in Jordan or Syria with all of this stuff. I guess this will be the first of many challenges on this trip.

meds and supplies for refugee clinics