To Iraq


The text came on an Ecclesiastical day – a day when I was despairing that there was nothing new under the sun. Especially nothing new in my immediate vicinity.

And then came the text: “How would you like to go to Iraq? Call me!”

It was from my husband. I called – immediately. The organization that he volunteers for was putting together a small team to go work with internally displaced people in Erbil, the capital of the Kurdistan Regional Government in Iraq. The president hoped to take a doctor, but after two doctors said yes and then had to back out for personal reasons, he decided to ask me. Timing was critical as he was purchasing the tickets that night.

I took a look at my schedule, rearranged one thing, and breathed a deep sigh. I was going to Iraq. As many who read CAB know, my heart has been across the world with refugees and displaced people from Syria and Iraq for a long time. In November, I was able to go to Turkey and since that time I’ve longed to go again. In fact, my husband and I have prayed long and sought hard to work with refugees full time, so the trip is a gift from God. To make it even better, my husband will be joining me a day later so we will be able to ask questions, find out what needs are, and do what we can during the short time we are there.

It will be a quick trip and include working at a clinic and visiting camps for internally displaced people. Last June, ISIS captured the city of Mosul – the site of the ancient city of Nineveh, best know from the Biblical story of Jonah. Chaldeans, Assyrians, Syrian Orthodox and more all lived and worshiped in this city. That changed when they were forced out of homes and communities, fleeing to nearby cities and towns. Erbil, as the largest city in the area, received many refugees. The churches in Erbil made room for thousands of displaced people, housing them wherever they could find room.

It’s a year later, but the crisis continues despite the world moving on. The figures are staggering in their magnitude. UNHCR (United Nations High Commission for Refugees) estimates over 3.5 million internally displaced people. Added to that are Syrian refugees who have made their way into Iraq. I can’t get my head around the figures. Take a look here to see more: UNHCR – Iraq

So we are going and it feels like even less than five loaves and two fishes – but then, that’s all most of us have. It’s barely a band-aid. But my friend Rachel says this, and I’ve quoted it before but it’s worth repeating:

It is small. And you are just one person. But a mustard seed is small. That’s the way of the Kingdom. May we always delight in being part of small things.” 

For those who pray, I would ask for prayers for this trip, but more so – for the internally displaced people and refugees in the area. I go for a week – they live there all the time. Also, if you would like to give to the clinic or to the camps in Erbil, click here. You can designate the funds specifically for Iraq. The trip is paid for, every bit of money goes toward the clinic and camps. Your gift is tax-deductible. 

Without a Country or a Home

The Long Return Home – Pakistan Flood 2010

History shows us that those without a country struggle with national identity, have no voice and no advocate”~ Annie Rebekah Gardner

On days when I most want to settle into my comfortable armchair of self pity with my iced cold cup of whining I am forced by outside voices into awareness of someone or something that is more important than my comfort. Into the frustration of a rainy afternoon came a “Faces of the Displaced” photo montage that shook me out of  the armchair and spilled my cup demanding my full attention. Beautifully shot, the people are so real and cry out for me to be aware of their plight. By the end of the montage there had been 39. But 39 out of how many million?

I am far too realistic to think that finding homes for millions of people is in my purview. I know better. But I have been learning about the power of the written word in raising awareness and encouraging action in the form of time, money, and prayer. The media moves on quickly but bloggers don’t have to. When the luxury of a newscamera detailing a tragedy for the international news ends, bloggers can continue to bring attention to the humanitarian need in places far away . So here are some facts:

  • UNHCR (UN High Commission for Refugees) says there are almost 10.4 million refugees living outside their home countries.
  • The number of internally displaced people worldwide reached 27.5 million in 2010, the highest number since the mid-1990s (Reuters)
  • Worldwide, Pakistan has the highest number of internally displaced persons (people forced to leave their homes because of violence, humanitarian crisis, violation of human rights) at 1.2 million
  • While international law gives certain rights to refugees who cross over borders, internally displaced people have none of those rights
  • It is estimated that 80% of refugees are women and children (Refugees International)
  • International law does not allow a refugee to be forced back to the country they have fled
  • UNHCR (UN High Commission for Refugees) says there are three long-term solutions to the refugee crisis: Return; local integration; and third country resettlement.
  • Recently Libyans have poured into both Egypt and Tunisia to escape the violence of the regime.
  • The recent crisis in Japan displaced over 300,000

These bullet pointed facts force me into action when I consider my love of ‘home’. As I daily walk home after long days at work I revel that in minutes I will walk in the door, there will be light and warmth, kitties and cookies, comfort and freedom. That’s what home can be and refugees,whether internally or externally displaced, have lost their home and their refuge from the assaults of the world. So what can one person do?

  • Welcome refugees in your community, sponsor a refugee family, volunteer at Catholic Relief Services or Church World Service
  • Look into Durable Solutions for Displaced People and see what you could do to help.
  • If you attend a church or are part of a faith community encourage the sponsoring of refugee families

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Series on Pakistan: The Benediction

Note from Author:  This is the closing post to a 5-part series on Pakistan.  If you are beginning the series feel free to link back to the first entry “Orientation”. Thank you for reading and caring!

Our time was coming to an end. We had only 32 hours left before leaving by van, back to the Sukkur airport and the journey from Karachi to New York via Abu Dhabi.   We had laughed until our stomachs ached, and cried from the depths of our souls.  We had communicated across the boundaries of place, poverty, language, and crisis and were humbled through the process. While dreading the thought of leaving, we knew it was time.  Husbands, jobs, children and life in general were waiting for us back in the United States.

The last IDP camp was just a kilometer away from the hospital compound.  The tents stretched from main road to railroad tracks, some surrounded by children, men, women and buffaloes and others empty with only the remains of a cooking fire left to show they had been occupied.  In between the tents were lean-to’s that sometimes sheltered buffaloes and other times people’s belongings – today it was our shelter!  A newly produced cow pie was evidence that the last inhabitant was not human.  I cursed my strong  sense of smell and buckled down to organize our clinic for a final time.

Quickly we saw the difference between this camp, where medical help had been offered 2 weeks earlier, and the others we had held.  It was encouraging to see less malaria, almost no scabies, wounds that were healing, and give out minimal Plumpy‘Nut.    Some of the people around us were gathering belongings, preparing to pack and go back to their villages.  The camp went smoothly and we began to pack up as the last patient was seen.

The old woman came up to us as we were putting away supplies.  Her right foot had two wounds, one deeply ulcerating, the other healing.  They were wounds that both Carol and I knew would heal quickly had she been in the west with good wound care. 

As Carol dressed the wound she exclaimed her amazement to the woman in how clean the wounds were: “You have kept them so clean!  This is a good thing!”  We marveled at her ability to accomplish this in the circumstances that were her reality.  (See ‘Wound Care for the Wounded’) No running water, no dressings, no ointments, no shoes…We both looked at each other at the same time – “No shoes, we can change that!  We can get her shoes!!”  Carol first took off her sturdy, close-toed shoes to try them.  Too big, too difficult to put on when she needed.  My not-so-sturdy close-toed shoes were next. No. Not a fit.  We remembered the soft soled, comfortable sandals in our closet back at the hospital and knew that was the answer.  I located our team leader and asked that I be taken back to the hospital “I’ll be quick, I promise! We need shoes!”  I knew the food and survey team was anxious to pack up and head out to another village.  Within 10 minutes I was back, shoes in hand.

The woman was sitting on a charpai.  She had no idea what was happening, just that we had asked her to wait.  I approached her with the shoes and her eyes welled up.  “Allah jo shukr aahey” ‘Thanks be to God’  Over and over she pointed to Heaven – thanking God, touching my head with blessing as I  put the shoes over the dressing carefully applied by Carol.

My last view was of the woman holding out her hands in thanks to God, her verbal expressions of amazement and gratefulness serving as a benediction to our time in Pakistan. The service was over, it was time to go home.

Marilyn Gardner & Carol Brown returned to the United States, arriving in JFK International Airport the evening of October 30th.  They are currently developing plans to return as soon as possible.  For more information about ongoing relief efforts and news on the flood here are a couple of organizations that they believe would funnel funds directly to flood victims with very little overhead.   All the organizations have the capability for online giving.  Here is the disclaimer: They are not relief work experts and are learning as they go and work to create awareness.

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Series on Pakistan: Wound Care for the Wounded

This is number 5 in a 5-part series on Medical Flood Relief in Pakistan. If you are just beginning to read please feel free to check out the other postings in the series beginning with “Orientation”. The authors are grateful for the interest and emails they have received.

Entry contributed by guest author Carol Brown(See Entry 3 – Triage)

  • Elderly woman
    blunt contusion of the abdomen caused by charging buffalo
  • Twelve-year-old girl
    Infected burns to the bone on three fingers of the right hand caused by electrical wire
  • Four-year-old boy
    friction burn on the posterior thigh caused by injury from wheel of a cart
  • Elderly man
    Cellulitis from infected scabies site on upper arm
    Reluctant to receive treatment from female doctor
  • Elderly, frail woman
    Deep ulcerated heel of right foot caused by  trauma during transport out of flooded area
  •  Seven-year-old boy orphaned of his mother in the flood
    Infected ulcer of left ankle

Wound care was my responsibility in our clinics since it is a routine part of my practice at home. Expensive, high-tech, scientifically-engineered agents of healing are my everyday tools in Western Massachusetts.  Silvadene, Acquacell AG, Versiva, Iodosorb, Duoderm, Kaltostat — the list goes on.   In Pakistan only a single, precious tube of Silvadene, was available to me.  Had I brought supplies, they would have been limited and insufficient for the needs and not reproduceable or sustainable by the families.   My tools here:  Boiled water, gauze pads, rolled bandages of torn sheets, gloves, antiobiotic cream, and the precious Silvadene.

The patient was perched on the wooden frame of a rope bed, with family members and curious bystanders eager to view the wound and watch the procedure, a captive audience for teaching.

“Keep the area clean.  Wash it with boiled and cooled water daily, applying this cream very sparingly over the wound.  Cover it with clean cloth.  Always wash your hands before and after you do the wound care.”   I heard myself explain the details.  My Urdu had come back quickly, and it all made sense — until I stopped to ask myself, how would they actually follow the instructions?

Living in a makeshift IDP camp, alongside their buffalos and chickens, collecting dung for fuel, with a single water pump for the camp, how were they to boil valuable water just to pour it over a wound onto the ground?   Yet they did.

On more than one occasion, I cut away the soiled homemade dressing fearful of what I may find. The wounds were invariably clean and well covered.  The families had been sacrificially caring for and protecting the wounds, salvaging cloth to protect the area.  I praised them and sensitively redressed the wounds.

Hameeda, a vibrant 12 year girl with a bashful smile,whose fingers were coated in yellow salve from the bazaar, was in visible pain. Her mother accompanied her to see Dr Wendel.   I was called over to cleanse and dress the electrical burn.  It was a painful process, and Hameeda was brave.  Dr Wendel had brought one tube of Silvadene from Amsterdam.  This was the day it would be used and given away. I was moved to see the care of the family as her father came in from the fields to see how we would be able to help and to watch the process.  Later in the week we heard from one of the team members who had returned to the village to do surveys of the ongoing needs that Hameeda was doing well.  The family was doing the treatment twice daily as instructed.

These wounds were symbolic to me of all that the people surrounding us had been through —  unspeakable losses, fearful traumatic flight from home, long journeys over rough terrain to an unknown destination.   I could not begin to fathom the full impact.  I felt like my act of pouring water on the wound with prayers in my heart for them was a gift of God to me.  They are a beautiful, resilient, appreciative, teachable and hospitable people!

Because of the interest in this series, a closing entry titled “The Benediction” will be posted on Saturday and “Holy Moments from an Unholy Disaster” will be an extra posting of general reflections before moving on to other topics on Sunday 1.9.11.  Stay tuned on to this blog  for ways to help the people of Pakistan.

Last night PBS Newshour had this special on the floods – A Validation of the ongoing need in Pakistan.

Series on Pakistan: Orientation

On October 15th I embarked on a medical flood relief journey to the country of Pakistan.  At the time I did not have a blog and was able to write only a few reflections because the work was busy, and I wanted to be fully present.  Much of what I saw, I believe needs to be shared.  Journalists and main stream news sources forgot this story long ago – it is up to those who care and have seen first hand the displacement of people and human need to communicate what they saw, felt and experienced.  Today is part one of a 5 part series that I will be doing this week.

I looked out the window of the van that had picked us up from the Sukkur airport just a half hour before.  On one side lush fields of rice, on the other barren dry land interspersed with tents set up by various relief agencies in the region.  The tents advertised their particular relief agency through signs – one reading “To the people of Pakistan from the people of the United States; USAID“, and another Swiss Red Cross.  We were frequently passed by every kind of vehicle, some motorized and others donkey or ox carts, piled high with belongings of those returning to homes and villages, dreading what they would see when they got to their destinations.

I wanted to pinch myself, hardly believing that I was back in a place that I had called home for over 22 years of my life.  It was real – I was back in Pakistan heading to Shikarpur for 2 weeks participating as a nurse in Medical Flood Relief for Internally Displaced Persons.  The floods had begun in late July and increased in intensity and devastation through out August.   I was with Carol, one of my best friends, one of the best nurses on the planet and as an added bonus -my sister-in-law.  How we had gotten to this point was a story of grace and generosity and we were ready to work and give what little we felt we had to the ongoing relief efforts of the area.

Arriving in Shikarpur at the Christian Hospital Compound, we were shown our rooms, showered, and fell into a jet lag sleep.  We were woken up in order to meet the Dutch physician we would be working alongside and were briefed on what the days may look like.  The plan seemed simple:  We would be briefed on what camp we would be going to and head out with male escorts, a Sindhi interpreter (Rosina) a Punjabi community health worker (Rohanna) two nurses (that would be us) and Dr Wendell, a delightful 36 year-old doctor who had come 2 weeks prior. Our days would be long with no breaks.  Take water, take snacks, be flexible were the rules.

Less than 12 hours later, dry statistics read prior to coming became human faces with names and needs too numerous to count. As I fumbled through dusty boxes searching for Ampiclox, Fansidar, Doxycycline and many other drugs that I was not totally familiar with I marveled at my own incompetency with the silent musing:

and I thought I was sort of smart and capable!”

The first camp broke us in kindly – Only 35 people to be followed by more at another Baluchi village close by.  Between keeping on my dupatta so I wouldn’t appear culturally inept (actually, so I wouldn’t feel naked!), swatting off flies, keeping hydrated, and deciphering dear Dr. Wendell’s handwriting I was exhausted after a half hour.  Relieved that we didn’t have watches so we wouldn’t appear to be counting the minutes before we could get back to the safety of our room,  Carol and I worked together trying to figure out some system of efficiency in order to fill medicines and keep the people flow going.  Somehow we made it through 30 cases of malaria, 15 malnourished kids, and 35 in need of general vitamins, cold medicines, and scabies lotion.  Our orientation was over – the next camp we would have to prove that we really could do this work.

It is a healthy feeling to go from a place of capability and strength to a place of incompetency and weakness.  And that is exactly where we were on Day One of this venture.

Just prior to publishing this post, the NY Times published an opinion piece called “Around the World in 12 Months”.  July features Pakistan in an article titled “God and Mud”.  Perfect reading for those of you who are interested in more information from other sources.