It was a warm Thursday morning as I stuffily sat in the taxi next to my friend waiting for the last resident doctor to climb in. I remember being particularly hungry that morning. I had skipped breakfast and was looking forward to lunch already. The passenger, luckily, did not take long to arrive, and we all set off on what would become a life changing experience for me: Sabra and Shatila. Before describing my experience to you, allow me to say one thing: empathy, I think, must be practiced to be understood. It cannot simply be fathomed. You can imagine poverty, extract it from novels you read or from your mind’s ability to picture penury. You cannot however, understand the full toll of social deprivation without seeing and experiencing it firsthand.
Walking in the patient’s shoes
The Sabra and Shatila entrance was riddled with muddied water sockets, but that was mostly it. I remember walking into the TAHADI Centre located precisely at the entrance of the Sabra and Shatila camp and thinking: ”Oh well, this isn’t too bad. It smells nice in here, and the rooms are cool and clean.” I then quietly sat in the student’s chair, next to my resident, awaiting our first patient. My first patient was a little boy who came in with tattered shoes. His tired young mother followed silently. The little boy had been having fever for a week. Science tells us that a common cause of fever is infection. True to science, the child did have an infection, his ear was inflamed and painful. In the clinic in Beirut, this patient’s management would have been considered simple: an otitis-give antibiotic. I did not however expect the mother to fall into near tears at the mention of her purchasing a 3-dollar antibiotic. Her tired eyes wrinkled into a question mark and then further into an exclamation mark. I did not at that moment understand why she was so concerned.
Our next patient was a 30-year-old lady who came in for an Intra Uterine Device change. I remember the resident asking her:” So how many children do you have?” Mentally, I jotted one or maybe none. The lady answered: “Six”. Again, I was taken aback by my assumptions and made a mental not to presume that what applied to me ought to apply to others. Sooner than I could say stop assuming, my friend Paul knocked our door. I recognized him from his voice:
“Sarah, it’s already 10:30”. 10:30 was the time we planned to go to the home visit. I scurried towards the door and left the room with Paul after informing the resident. Outside the TAHADI clinic, we met the social worker who was also our guide. I was literally dragging myself out of the clinic. I thought to myself: “Fine this should take 30 minutes and then we can all go to the taxi where I can sleep.’
I didn’t sleep that night.
Many lessons learned
The Sabra and Shatila neighborhood was a misery to the eyes and a pain to the soul. The streets were piled with garbage. At one point there was a garbage mountain. Chickens were feeding off that garbage as a barefoot boy was running next to the mountain racing the sun. At the same time, an old lady pilfered her way through the trash scrummaging for anything to sell. The air smelled of sewage, and the muddied puddles I had seen at the door suddenly multiplied.
Children walked by in packs, some of them had apparently not showered for days. Loud men sold goods, their voices mingling with the tunes of Um-Kel-Thoum, a cultural landmark I recognized instantly. It was then when it hit me. These people are us. They speak our same language, listen to our same music, eat our same food, share our same history, tell their children the same stories-but they happen to be here. We are in safe and clean homes. When I leave the camp, I would have access to clean water, a clean bed, and clean food that my mom meticulously prepared. The people in the camp did not have the privilege of cleanliness-not because they did not want it, but only because it was out of their reach.
We walked and walked as I coughed the life out of my lungs from all the various smells. The social worker then led us to the home of a very interesting family. The family consisted of 4 people-actually 5. Allow me to explain. The family literally consisted of 2 parents and two children. Their newborn had however passed away a month ago even after extensive cardiac surgeries. The dead newborn haunted their little room and I watched the mother sink into sighs of grief between her sentences. The father was unemployed- again. I will not ever forget how his face relaxed into a smile when the social worker suggested that one day perhaps they would all go back home and their country would rise from the rubble again.
I realized: they were in the rubble in every sense of the word.
I cannot begin to describe the things I felt that day or the times I tossed and turned in my clean crisp bed that night. I thought of how medicine was not simply a guideline to follow, but also a privilege sometimes. I thought of how I could help turn that privilege into a right. Many organizations around the world try to help the displaced and the disadvantaged, but many still live at the brink of life. Many people who aspire and hope find themselves scrummaging through garbage, mourning a dead child, or displaced and dreaming of a day when they return home. Before shutting my eyes at around dawn, I thought of the children in the refugee camp, deprived of water, racing the sun: barefoot. I thought to myself: the sun rises on us all, but why can’t it rise on us all equally? I do not have an answer to the questions that haunt me still, to why the world is infiltrated with so much injustice and agony. I do know one thing however: we owe the world a sense of social responsibility. Our empathy is a duty we must serve to others. It is simply not acceptable to feel privileged and just stop there.