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My Journey to Kilis

Published by Abdullah Firoze

Smashwords Edition

Copyright 2013 Abdullah Firoze

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Smashwords Edition, License Notes

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person please purchase an additional copy for each recipient. If you're reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

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Table of Contents

### Preface

### Day #1

Doha International Airport, Qatar

Istanbul Atatürk Airport, Turkey

On Air: Istanbul to Gaziantep Now Playing

Hunting for Kilis

Kilis Turns Killer

In Steps "Eaup"

All That in 24 Hours?

### Day #2

Wait—I am Supposed to Enter Syria?

Killing Time Slowly

### Day #3

More Tea? Yes Please.

Plan C: Visiting a Polyclinic for Syrians

Lunch

After a Hard Day's Work

Medicine

The Pediatrician

Tea

### Day #4

Indian in Kilis = Rare

Murder in Aleppo

### Day #5

If Only I Spoke Arabic

A Walk Through History

Turkish Food in Turkey—Finally

Hepatitis A, Innocence and Chocolate Ice Cream

### Day #6

The Only Tourist in Kilis

Sheep's Milk

### Day #7

Medicine: A Universal Language

Blood Pressure of 200/110 & Fasting Blood Sugar of 367?

Kilis Museum

Night Clinic

### Day #8

Investigative Journalism: Life in Syria

My Social Circle

3 Nights in Istanbul

### Day #9

Family

Today's Gossip: Ahmed Rafe Killed in Syria

Playing Doctor

### Day #10

Ahmed's Story

In Times of Darkness—Hope is Our Greatest Strength

Mental Illnesses—MSF

### Day #11

The Polyclinic: What is the Mission?

### Day #12

How the Clinic Runs: A Step-by-Step Guide

Lunch at Bubblie's

### Day #13

Getting the Full Experience—Gastroenteritis

### Day #14

A Web of Random Thoughts

### Day #15

Another Mother's Tears

Preparing for Tomorrow's Goodbyes

### Day #16

Last Clinic in Kilis

I Hate Goodbyes

### Day #17

Off to Istanbul

Gaziantep Airport

Istanbul—Hunting for My Hotel

From Belly Dancers to Drinks—Invitations

### Day #18

Exhausted—All in One Day

### Day #19

Basilica Cistern and Sultan Ahmet (Blue) Mosque

The Panorama View of Galata Tower

### Day #20

1453: Conquest of Constantinople

### Day #21

Reflections of a Traveler: My Last Blog Post

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Preface

One million. That is the number of Syrian refugees that are "either registered as refugees or being assisted as such" according to a press release by the United Nations Refugee Agency (UNHCR) on March 6th, 2013. Thus, deciding to work with Syrian refugees was an easy decision for me. During the summer of 2012 as the Syrian crisis continued to escalate, I decided that I wanted to find a way to work with Syrian refugees. I had been involved in various charity projects raising funds or awareness before, but this time I wanted to be directly and actively involved. I wanted to be present on the ground.

I immediately set to work by communicating with the various NGOs in Qatar to see who would be willing to let me, a medical student with limited knowledge of Arabic, join them on their mission. I learnt about the Syrian refugee camp in Kilis, Turkey, which is about eight kilometers from the Turkish-Syrian border. Turkey I thought would be the best place to gain experience and possibly the safest. One of the NGOs finally agreed to the possibility of me joining their mission work in Kilis.

What was I going to do once I got to Kilis? I had no idea. I told the NGO that I was willing to do anything that was needed. Maybe provide administrative assistance to mobile clinics? Provide aid? Teach? Check blood pressures? Whatever they wanted me to do I was willing to do for the sake of helping these refugees and gain this experience.

As months passed by my plan to visit Kilis and my perseverance were both put to the test. At times I was confident I was going to Turkey, while at others everything seemed to be falling apart. When a Turkish village was caught in cross border fire I was asked by the NGO's team in Kilis to cancel my plans. Still, I was persistent and told them to give the situation a week or so to see if things would escalate on the border or not.

Finally, on October 28th 2012 I found myself at the Doha International Airport headed for Kilis. I think that is when I was sure that I was going to work with Syrian refugees. At the airport I decided that I wanted to be able to share my experience with others or at least express myself in writing. I decided to start blogging on WordPress and this was my first time creating a blog post. I was pleasantly surprised when I found out that my blog was well received by my friends.

My journey, or rather adventure, was a success as far as I am concerned. I learnt more not only about the Syrian crisis and medicine but also about myself. Most importantly, I think I was able to establish a direct connection with the victims without a media outlet, book or movie. It was personal and inspirational.

Wanting to continue to share my experience with others I decided to convert my blog into an actual book. While doing this meant making many changes I tried to stay true to the original writing, its content and emotions.

I hope you enjoy it and share it with others.

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Day #1

**Doha International Airport, Qatar**

October 28, 2012

12:45 A.M.

It is almost 1:00 A.M. in the morning and I am sitting at the airport lounge waiting to board my plane to Istanbul. The airport is bustling with people, full of life, heedless of the time outside. I on the other hand am dead tired—want to sleep or maybe even eat something light while watching a TV show.

I am excited about going on this service trip because it is something I have wanted to do for a few years now. Finally, I am on my way to do it! If I said I wasn't nervous, I would be lying. In fact, I was so focused on making this trip work; I kind of left all the "freaking out part" for my last weekend in Doha. Right now I am just praying that I reach my final destination of Kilis, Turkey safely and meet the NGO team there. I will be flying to Istanbul, then taking a domestic flight to Gaziantep and from there a bus to the city of Kilis. Safe to say, I will probably not be reaching my new home until late in the evening.

What do I know about Kilis? Well, not much as the web was not very helpful. I only know that this city is located very close to the Syrian border and houses the Syrian refugee camp that I will be volunteering at. Let's hope not being able to speak Arabic or Turkish won't be that much of a problem. [I said hope.]

Well, first thing first, I hope I don't have a problem getting my visa on arrival in Istanbul otherwise this will probably be the shortest blog ever! (I am new to this whole blogging concept.) I can hear them on the PA system asking all Istanbul bound passengers to proceed to the gate. It is time for me (and my flight of ideas) to embark on a new adventure. One that Insha'Allah, God willing, I am sure will be a great experience for me on both a personal and professional level.

Off to Turkey for three weeks! (I am still not sure whether I am more of excited or apprehensive about what I shall meet there.)

**Istanbul Atat** **ü** **rk Airport, Turkey**

October 28, 2012

9:10 A.M.

Alhamdulillah (Thank God), I made it pass immigration and got my visa on arrival. I was nervous about having problems getting a visa on arrival since the Ministry's website was somewhat unclear about the process. The wait took a while as I was sent to the end of the airport to a special cue for passport holders of "All African countries, India, Pakistan, Bangladesh and Malta." Still, the immigration process was relatively quick with no questions asked. The immigration officer first redirected me to another counter to pay for my visa. I did so and then returned back to the same immigration officer. Upon showing him my receipt of payment, he stamped my passport. That simple.

Now that I am in the country... (PA—Just great, all flights are delayed secondary to traffic congestion on the runway and the weather.) Anyways, I am not that nervous anymore but rather really excited. Although, I wouldn't mind a comfortable bed right now.

This domestic terminal is not like the international one. It is small with not much to do. Oh well, I have got many hours to kill since my flight is scheduled for 1:10 P.M. and it is only around nine (though actual time of departure may be much later given the delay).

Still, the time shall pass and this shall definitely be an adventure I will always remember! After searching for long, I finally found a good Wi-Fi spot as the free public Wi-Fi connection is very weak. I am sitting now at the corner of a café here, just browsing on my iPad through my mail, facebook, chat and YouTube.

**On Air: Istanbul to Gaziantep Now Playing**

October 28, 2012

2:45 P.M.

As soon as you get off the runway and look down at Istanbul—the view is simply breathtaking. All I see from above are buildings that to me all look the same as if they were part of a large red and white tapestry. Between them you can spot the slender but high rising majestic minarets of mosques.

The view of Turkey's natural landscape is even more breathtaking. The entire view out of my window on this flight to Gaziantep is just—wow— for the lack of better words. You really have to see it yourself to understand. The pockets of water neatly hidden away between the treacherous and rocky hills implore you to explore. (Suddenly, I am reminded of my geography class in middle school when I had to learn all those sophisticated terms to describe landscape. Once you enter medical school, you tend to forget everything else.)

Now, I cannot wait to get to Kilis. I hope it is going to be a rural region because that is what I want to see. It's actually really exciting not knowing what to expect when I finally get there because apart from the name Kilis I don't really know more about it. Oh, one thing I do know is that they are supposed to be home to some of the best and most authentic baklavas (Ottoman pastries).

**Hunting for Kilis**

October 28, 2012

4:50 P.M.

We landed in Gaziantep, I stepped off the plane and the airport was right there. I just walked about twelve meters to the airport like I had just parked my private vehicle in a parking lot. (This "international" airport is really small but convenient.)

Outside the airport I saw many people getting on to a big bus. Assuming this was the bus headed for the city's main bus station, I got on too. Once the bus was full we left the airport. I sat quietly on the bus as people started getting off one place at a time inside the city. I was confused as I did not know which stop was mine and if we would even be going to the main bus station. Also, being the only English speaker did not help. When I realized we had been through half the city and signs for Kilis were pointing in the opposite direction, I decided it was time to inquire. As the bus came to a halt once again to drop another passenger, I got off to speak to the driver who was removing a passenger's luggage. He eventually understood I was asking about "Kilis" and told me through hand signs and Turkish (which of course I did not understand) to stay on the bus. So, I just got back on the bus with no idea where I was headed.

Long story short, at another stop where most people were getting off I asked the driver again, thankfully, because he told me to get off and take a bus from across the street. I got off with my small trolley suitcase and crossed the street over to what turned out to be the main Gaziantep Bus Station, interestingly located on the outskirts of the city. Roaming and inquiring at many booths for different bus companies I eventually managed to get help from a police officer. He directed me to exit the station from the large glass doors at the back. (Just so we are clear, no one could understand my English but only the word "Kilis" and hand directions were my only means of communication.) Out the back doors I found many buses but eventually found a small mini bus or van headed for Kilis, or at least that is what I think he said. I tried to clarify and confirm this but his reassurances were not very comforting to me as I had no idea what he was saying in Turkish. It is scary not being sure where you are headed—especially in a foreign country.

As I type now on my iPad, I am still on the mini bus headed for Kilis with about ten other people. I cannot thank God enough for just making everything work because apparently there aren't night buses to Kilis (Though it is only five it's getting dark here.) And I am feeling nervous again. I guess Mustafa and Reem, my college friends, were right—I really do need Lithium. (That was a joke.)

I should end with saying that Gaziantep and its surrounding area are really beautiful; rural with small cars and small streets full of families out and about socializing. I see many elderly couples sitting together in small public parks that are dispersed throughout the city.

~~~~

It is 5:30 P.M. and it has been forty minutes since we left the bus station and we still have not reached Kilis. I have no idea even how far it is or how long it takes to get there. (Clearly, there isn't much that I do know.)

Oh well, like I always say, "Insha'Allah Khair" (God willing all will be well).

~~~~

Yay! After driving on a small dark road through the middle of what seemed like nowhere, I can finally see lights up ahead. I hope this is a good sign.

Yup, Kilis is finally here! (Confirmed by a board sign.)

**Kilis Turns Killer**

October 28, 2012

7:10 P.M.

And so my bipolar story continues as I find myself sitting sipping some hot Turkish coffee and wondering what on Earth I am doing here. So what happened? Let me tell you.

Yay, we are in Kilis. So I guess it is time to call "my contact" from the NGO in Kilis. Wait what? His phone is SWITCHED OFF! Again and again I call and I am taken to his voicemail. Well, he did know I was coming today, at least I hope so. And I had been in touch with him via email and phone. I also text messaged him before leaving Doha and when I was in Istanbul.

So what now, as I am being driven through Kilis with no idea where to stop? (How history loves to repeat itself.) I make contact with the NGO's office in Qatar after a few failed attempts. I am then put in touch with another person in Doha who knows this place well.

Meanwhile, I can clearly see that I am going out of the bustling city of Kilis. I am someone who likes to consider all possible options and interestingly one of the options that I entertain is sleeping on the streets. My eyes start darting around the city as I consider the possibility of spending one night in some hidden corner, possibly between the buildings. After all, it is just one night I'll have to survive. Okay, that has got to be the last option so I try making contact with the girl next to me on the mini bus—No English!

Thankfully, the girl behind her can speak a bit. I tell her I am looking for a hotel. (I have decided now that the best thing to do is to head towards a hotel so at least I have a roof over my head.) She tells me it is back in the city while the bus driver thinks I am crazy for waiting this long to point out I need a hotel. (At least that is what I think he thinks based on his body language since no one speaks English.) In the next minute or so we stop at a university and the girl tells me to get off. She asks me to walk to the gate about twenty-five meters down the road and talk to the security guard. (I think she was thinking I could stay at the men's dormitory for the night as a student.)

I get off the small bus, no clue what the driver is saying, and walk over to the gate she pointed out. Meanwhile, she disappears through another gate to go to her dormitory. Behind the gate I see what looks like a huge university. Anyways, again thankfully one of the four guards present can speak somewhat English. He informs me, while explaining to the others what I am saying, that I need to take the bus in the opposite direction towards the city. He inquires more about where I am from and curious as to why on Earth I would come to Kilis. He then tells me I should wait, as there will be a bus in the next five minutes or so heading back to the main city. (Again I could not be hundred percent sure as to what the guard was sayi9ng to me as at times it was like a guessing game.)

So I cross over to the opposite side of the road and stand. Seconds later the guard is screaming something at me. I have no idea what he is saying so I cross the road back to the university side assuming I must have misunderstood him. The guards are now laughing, clearly they find my situation hilarious, but can you blame them? The English speaking guard then takes me back across the street and about five minutes later he stops a small bus for me. He tells the driver to take me to a "Metro hotel" or so I think.

On the bus I call the NGO contact in Qatar again and tell him that I am going to find a hotel while he continues to try to get in touch with the team here in Kilis. A young male school student on the bus, probably in his mid-teens, is sitting next to me and in broken English says "Hello" and explains that the driver will take me to a hotel. Others on the bus simply find me amusing. Anyways the student soon gets off smiling and waves goodbye. Now, I am alone on the bus with the driver and thankfully one couple. (It's comforting knowing someone else is on the bus as I go through these small dark alleys in a completely foreign land.) The bus driver then drops me at the "Mer-Tur Hotel." About ten minutes later I am informed from Qatar that the guest house that I will be living in is only about twenty meters away from the hotel. I am to wait while the team in Kilis returns from Syria, which is why their cell phones have been switched off.

So, I wait now at a café or restaurant next to the Mer-Tur Hotel. I don't mind spending the night at the hotel if I have to as it is only nineteen Turkish Liras (about eleven dollars) per night—very cheap.

In Steps "Eaup"

October 28, 2012

7:40 P.M.

In steps "Eaup" and my Greek tragedy turns into a comedy—sounds corny I know but I am tired.

At this hotel's café that I am sitting at, a waiter named Eaup has been amazing to me from the start. He got me my first Turkish coffee here in Turkey. When I told him it was really good, he replied "God bless you." In Turkish that apparently translates to "apharos" or something that sounds like it. I inquired about internet service and he told me that there is a weak Wi-Fi connection if I sit upstairs. He also gave me the password to it. So with my backpack, trolley bag and iPad I headed upstairs.

Later he came up to ask me if I wanted tea and I replied, "No thank you." Five minutes later he came up with a cup of hot tea.

Based on his gestures it seemed like he was saying the tea is on him. It is nice to have made my first friend here in Turkey. He doesn't speak much English but communication is beyond words.

Since I haven't had much to eat today I also went down and he helped me pick out my dinner. (There is no proper food available at the moment since it is late.)

~~~~

Eaup just came up to me again to take my dinner plate and ask if I wanted baklava because I told him I've heard Kilis is famous for it. Anyways, people like him make things seem so much better and seriously brighten up your mood.

As I type this now, I still wait (it is 8:30 P.M.) to see whether I will be spending my first night at the hotel or at the guest house where I'm supposed to be staying.

[Outside the café I can hear people going around honking their cars behind what appears to be a newlywed couple's car. Apart from that and the occasional police patrol cars, all is quiet and dark on the streets of Kilis.]

All That in 24 Hours?

October 28, 2012

9:50 P.M.

Once it was nine, I was too tired to continue waiting and decided to check in to the Mer-Tur Hotel. Clearly the price of nineteen Turkish Liras (about eleven dollars) was too good to be true as the receptionist had meant ninety Turkish Liras. Still, not so expensive and apparently this is the only hotel in the city. My room is big, comfortable and cozy—nothing more I could ask for right now.

Oh well, Alhamdulillah (Thank God) all is well and hopefully tomorrow will be a new day and I will finally get in touch with the team. Now I go to bed listening to the live music from upstairs that is very loud but not really annoying. I think it's a wedding party.

As I write my last blog post for the day (October 28th), I realize all the things that have happened today within just twenty-four hours. At least I am not on the streets but in a nice comfortable hotel bed. Haven't been robbed or mugged either.

Good night world!

****

Day #2

**Wait—I am Supposed to Enter Syria?**

October 29, 2012

11:30 A.M.

I wake up in the morning and it is almost eight. I know I should get up and get breakfast but I am just too tired. I decide to continue sleeping and not worry instead.

Around nine I get a phone call from the reception downstairs. It is a woman speaking in Arabic telling me she is here to take me to the office. I assume she must be from the NGO I am supposed to work with. I quickly take a shower, throw on some clothes and head downstairs using the small elevator.

She is a pleasant young tall woman, probably my age, wearing a headscarf. We communicate in a mixture of Arabic, Turkish and English. I follow her as she takes me outside the hotel and into a cab. I have absolutely no idea where we are headed, but for once that is okay. She seems shy and doesn't talk much or maybe it is too much of an effort trying to communicate with me since her English is very limited as is my Arabic. She tells me she is Syrian and after numerous hand gestures and guessing I come to understand that she is doing her Masters here. It is her second and last year now and her Masters is in Turkish literature. She later explains that she does understand somewhat I say in English but has difficulty answering and communicating back in English.

We drive for about ten to fifteen minutes until we stop at a large villa in a residential area of the city. I get out of the car with my backpack and wait for her to pay the driver. We then walk across a wide pavement through the front lawn. She takes me into the villa where I can see some offices to the right, a kitchen in front of me and more offices to the left. There is a staircase also that leads somewhere upstairs. We take a left and enter into a large hall about the size of an average dining and living room combined. There are three small rooms I can see being used as offices lined up across the length of the hall.

I meet two gentlemen who are really pleasant to speak with and excited to see me. They apologize about what happened yesterday explaining that they were in Syria, which is why I could not reach them on their cell phones. They are clearly surprised to see me as they tell me they were actually expecting an old man. One of them even jokes about how we should play soccer tomorrow. (Just so you know, I am a small built, average height—okay maybe shorter than average—guy who looks younger than his age of twenty-three.)

One of them takes me into his office, at the left most corner of the hall, which he shares with another man. There we sit and I start discussing the purpose of my mission and what my objectives are. He asks me what I am interested in and I explain how I believe education is an essential tool and would love to focus on that in the refugee camp. Furthermore, I would love to volunteer at mobile clinics at the camp doing anything I can from assisting physicians to checking blood pressures. We discuss it further but the conversation doesn't seem to be heading in the right direction. For example, at one point he mentions how it would be hard to work in a school since they are being targeted by the forces. At another, he tells me how he could leave me in a certain town for a couple of days to work on any project of my choosing. Now, I am worried because clearly we are talking about two different things. As we get deeper into conversation, I realize he actually thinks I am here to join them on their missions into Syria! I mean I came to volunteer at the Syrian refugee camp in Kilis and not to enter Syria. My parents would probably collapse at the very thought.

Summarizing the long conversation into a short paragraph, I eventually tell him that I was under the impression that I would be visiting the refugee camp here (as per our correspondence via email). There clearly has been a misunderstanding. I don't have the courage to tell him that I am not so sure I would be okay with traveling in and out of Syria. So I decide to just wait and see where the conversation heads. He asks me about my passport to make sure my visa is a multiple exit-reentry type so that I can freely move across the Turkish-Syrian border. Well, I am almost certain my visa is a standard single entry tourist visa but nevertheless I tell him I will go home and double check. For him and the local team travel is not a problem as thankfully Turkey allows Syrian passport holders to move freely across the border. If my visa turns out to be a single entry he advises me to contact the Indian embassy and see how I could get that changed to a multiple exit-reentry visa. I agree smiling but deep inside I am confused.

On the other hand, he agrees to see if I can visit the refugee camp in Turkey while I communicate with my embassy. However, he warns me that accessing the refugee camp is very hard as Turkish authorities are very strict about it. Even he himself has never visited the camp.

As our conversation ends, he becomes my "mentor" on this mission. And my mentor leaves me feeling really nervous and overwhelmed to say the least.

**Killing Time Slowly**

October 29, 2012

5:20 P.M.

At one in the afternoon I was taken by the NGO's driver to my hotel room. I quickly packed my trolley bag, checked out of Mer-Tur Hotel and moved into the guest house. This is where I am supposed to be living for the coming weeks with the two gentlemen I met earlier in the day as my roommates. The guest house is located right behind my hotel—literally a few minutes walk and about a couple of alleys behind. I was actually expecting a small house without any beds, possibly a stove and a small bathroom. Instead there are beds that have been made with large closets, two big bathrooms, a large kitchen fully equipped along with three decently sized bedrooms and a carpeted living room. I am given my own room where there are two beds but at the moment it is all mine with my own closet. Did I mention we have Wi-Fi in the house?

Anyways, I spend all afternoon indoors locked up with not much to do. I am supposed to contact the Indian Embassy and somehow get my single entry visa converted into a multiple one. I doubt that is even possible and frankly I am not sure I want it to happen. As much as I would love to enter Syria and directly help the people, this is not the right time. Yes, it might sound cowardly and petty but this is my last year at medical school and I cannot afford any delays getting back to Qatar. With regards to safety and security—let's just not even go there.

The other two men from my team, my new roommates, joined me in the evening and we ate this Syrian dish with sheep meat topped with thick whitish curry. It was—okay. I am not a big fan of sheep meat. [I was later told by a Syrian friend that it is called Shakriyeh—lamb made in yogurt.]

Now, I am just sitting in my room on my bed doing nothing but YouTubing a bit and somewhat working on my ABS tutorial proposal. For my ABS (Advanced Biomedical Sciences) graduation requirement, I am planning on doing a literature review. I have yet to come up with a topic for it but I am sure it will have something to do with refugees.

Things don't seem to be working out at the moment...

~~~~

My new roommates are just too nice; one of them made me tea and since I was praying he just placed the cup next to my bed. But what am I doing right now and what will I be doing in the next twenty days—that is the million dollar question!

****

Day #3

**More Tea? Yes Please.**

October 30, 2012

9:50 A.M.

It is the start of a new day and I am back at the office after having breakfast with my roommates at the guest house. For breakfast we had Arabic bread with omelet and bowls of za'atar (thyme), olive oil and freshly diced tomatoes with black tea. I am back to my little work station at the office, a small desk with a comfortable chair, on my iPad finishing up my ABS tutorial proposal. I am thinking about making my tutorial a literature review that has something to do with children in refugee camps. (Oh, someone just got me another small cup of hot tea; definitely need it to keep myself warm especially after that cold killer shower in the morning.)

Let me just tell you briefly about my two new roommates who work from Kilis for the NGO I am volunteering with and are fairly fluent in English. One of them, let's name him Bilal, is a short medium built middle aged appearing general surgeon who is my mentor for this mission. The other, Mohammad, is taller, clean-shaven and a bit more on the heavier side. I am still not sure what Mohammad's position is but I get the feeling he is taking care of all the administrative work of providing medical relief to victims in Syria. They are both really jolly people who love to joke and laugh all the time.

They are still waiting for me to hear back from the Indian Embassy to see if my single entry visa can be converted into a multiple entry one. (I doubt that will be possible right now given that I already am in the country and will be leaving after about three weeks.)

So if that doesn't work what will I do then for the next twenty days—let's see. For now I keep drinking one cup of tea after another.

Plan C: Visiting a Polyclinic for Syrians

October 30, 2012

11:00 A.M.

I called up the Indian Embassy in Ankara as well as researched online to see how, if possible, I could get my single entry visa changed into a multiple exit-reentry. It seems like I have got to get a residence permit here for which I must fill out a form, have a bank statement (from a bank here or money converter showing conversion of a certain amount of money) plus a visit to the ministry. The procedure is tedious, long and too much of a hassle. Not to mention, I am not comfortable exiting and re-entering across the border.

So my "mentor," Bilal, and I head to another office at the other end of the villa. We talk to the local representative of the Turkish NGO with whom we are sharing the office space. He tells us that unfortunately they don't have any community oriented or medical projects right now. They are focusing more on supplying medications, which I've seen numerous large boxes of at the entrance to the villa. Also, the refugee camp and all the clinics are controlled and run by the Turkish government with limited access to others. Before we leave, I notice something interesting—a model flotilla. I cannot believe that I am in the office of the organization that led the Gaza Flotilla in 2010.

So we move on to what my mentor calls "Plan C." We speak to a doctor in his office here who is not affiliated with any NGO but runs a free polyclinic for Syrians in Kilis. I am to join him and his brother-in-law in the evening and they will take me to the polyclinic. From what I understand, the polyclinic has four departments: internal medicine, pediatrics, dentistry and obstetrics & gynecology. They also have their own pharmacy that dispenses medications free of charge. There are two shifts of three hours each serving about three hundred patients every day.

Though we all understand this will be a big challenge (especially given that my Arabic is so limited), it should be an interesting experience. I am to go find my own niche and see what I can do and am willing to do. Let's see how it all goes—kind of nervous and also excited. My only regret is not being able to speak Arabic fluently.

(And hey, there is always plan F, cut my trip short and leave, but that will be the last resort and only if Plans C through E all fail.)

Lunch

October 30, 2012

1:10 P.M.

It is time for lunch and all the people at the villa gather in the kitchen as the cook serves us. The others (mostly Turkish) around the table are all interested in hearing more about who I am. So I tell them where I came from and why I am here using a bit of both English and Arabic.

**After a Hard Day's Work**

October 30, 2012

3:40 P.M.

Back to the house after a "hard day's" work at the office at my workstation, which really entailed a mix of working on my research proposal, lots of blogging and some YouTubing.

My mentor, Bilal, and I discussed university life and my future plans as he told me more about himself. Oh and he also told me that apparently "MADO" is a big franchise here in Turkey, especially known for ice cream. MADO is the café I spent my first night sipping coffee and tea.

~~~~

Bilal and Mohammad are going to continue working on trying to get me to visit the refugee camp. My mentor told me that the polyclinic director, whom I met with in the morning, is also going to try to help me. Hopefully, they say, I will be able to visit it in the upcoming few days.

My Current Plan:  
1) Go pray Maghrib (evening prayers) at the local mosque that is a few minutes walk away.

2) Then relax at MADO, the café, with Turkish coffee and baklava until five.

3) At five the doctor we spoke with earlier today at the office will be coming to pick me up and take me to the polyclinic.

Medicine

October 30, 2012

8:10 P.M.

Today, I felt something. Something that I haven't felt in a long time. Something that I have desperately wanted to feel again—renewed passion for medicine. Why this sudden love? Well, I must start from the beginning.

It is around five in the evening and I am waiting by the side of the street in front of café MADO and Mer-Tur Hotel. The street is only a few minutes walk from my house. I am to be picked up by this doctor who shares an office with us and runs a polyclinic here in Kilis. About ten past five I see him walking towards me. He takes me to a small car, a red Kia Rio, parked across from where I am standing. I squeeze into the front seat with him while there are at least five people in the back. About fifteen minutes later, after going through small narrow streets between houses and old mosques, I arrive at the polyclinic.

It is a large plot, maybe a quarter of a soccer field, with a single building standing in the middle. There is a huge portable "kitchen" on wheels parked inside the field. I am told that it provides free meals three times a day to Syrians. There are also public bathrooms and some benches with shades under which some families sit. The director points to some containers of constructional material on the site and tells me that they are working on building more here, including a playground for children.

We enter the building and there is a large room serving as the reception and waiting area. It is full of Syrians waiting. I am given a short tour and quickly become impressed. There are four clinics here: internal medicine, pediatrics, dentistry and obstetrics & gynecology. There is a pharmacy, much larger than I expected, stocked with medications in a room about five by four meters. I am told that all these medications are generous donations mainly from Turkish organizations and pharmacies. The pharmacy then has to go through all of them to sort them out. This can often be challenging because most drug names are usually written only in Turkish. Furthermore, medications can sometimes be expired and these need to be separated and thrown away. Still, all these medications are for free. The entire clinic is free of charge for Syrians.

The facility is impressive given they started only two months ago and moved onto this site only a month ago—I find it hard to believe! Currently there is no lab, no X-ray machine or anything else sophisticated. As the pediatrician later explains to me, "We just listen to the family, see what we can see and based on that give medications." They hope to get more supplies through donations. The obstetrics & gynecology clinic has an ultrasound machine which the obstetrician brought with her from her old clinic before leaving Syria. Sadly, only half the probe works and thus the machine gives only half of an image. The internist has an EKG (electrocardiogram) machine and that is it. The dentist is lucky; he is equipped with a proper chair with all the tools you can imagine (and the smell). I am told it is made in Japan and was donated by some international humanitarian organization.

I am just left overwhelmed and impressed at with how little how much they have made possible. I am inspired. Definitely the best part of my visit so far has been this place.

The Pediatrician

October 30, 2012

9:40 P.M.

At the polyclinic, I end up sitting with the pediatrician and am told to move around freely. She is young, possibly in her early thirties and short with hair that fall right below her shoulders. We are in a small room that is equipped with a table, a bed for the patient, three chairs and a three-seater couch at the back of the room.

Her tools: a stethoscope, a large torch (to look down the mouth), tongue depressors, an ophthalmoscope (to look in the eyes), an otoscope (to look in the ears) and her physical exam skills.

The pediatrician, her nurse—actually now head nurse as he just got promoted yesterday—and I converse. Though they have difficulty communicating with me in English, somehow we manage. I quickly come to realize how universal the language of medicine is as we discuss the cases that come through the door. At times we use different names but we understand each other well.

Most of our kids seem to have an upper respiratory tract infection and she usually just has them sit outside and get 0.9% normal saline nebulizer. One has Candida (a type of fungus) in the mouth and another I suspect has cerebral palsy given his physical posture and limited communication skills. The pediatrician tells me that they are very busy and have very limited resources. (Imagine no labs, no X-rays and no ultrasounds—the very basics of medicine.) Thus, as the pediatrician put it, they must rely on the history provided by the family, their own physical exam and finally on prayers.

Later, we get a patient with abdominal pain who has blood work done from a local Turkish hospital. We interpret the labs—high direct and total bilirubin with high transaminases (liver enzymes) —and examine him. She feels his abdomen and tells me to feel it as she cannot express her finding in English. However, once I examine the patient I suddenly understand—hepatomegaly (a fancy medical term for a large liver). I use simple words and we discuss that the liver is about 3 centimeters enlarged.

What next? We do not have an ultrasound machine and the child is in severe pain. Turkish hospitals usually charge and these families cannot afford it. As if the father understands our dilemma he pulls out a report. Thankfully, the child has already had an ultrasound done somewhere.

Yet, our joy is short-lived as the report turns out to be in Turkish; who speaks Turkish—we are all Syrians and one Indian here? We take the report over to the internist who is working in his clinic outside our room. His clinic really is just a table with chairs in the open hall. After taking time he says he believes the report states that the child has a big gallstone in the common bile duct of the gallbladder. Now what? Next step would normally be surgery but we don't have the tools. Funnily, we find out from the father that the patient has to return to the hospital for follow-up care and we wonder why the family even brought him here. Maybe they wanted a second opinion from someone they would trust like a fellow Syrian doctor?

My pediatrician jokes saying Syrians like to see multiple doctors so they can pick and choose whom they like the best. She also says people are coming all the way from Syria here because there are no more doctors left there, except for "Dr. Bashar." At this point she starts laughing and continues to laugh slightly hysterically for a while at it, but behind the joke and laughter I cannot help but notice the pain there is.

Another patient is brought in by the mother to our clinic. He is a two year old boy with an almost nonexistent penis and undescended testicles. We both palpate his abdomen to try to locate the testicles but cannot. The mother then informs us that his brother has a similar problem. There isn't much we can do at this clinic. So we just take the family's contact information and tell them once we have an ultrasound machine we will contact them. We can do no more for this patient and move our attention to the next. We see patient after patient from around 5:00 P.M. till 7:40 P.M. when we finally close the clinic.

I am left even more overwhelmed than before after having seen infants and children being brought in by their mothers, fathers, siblings, grandparents, etc., hoping we can work miracles for them. Even though clinic was only three hours, those three hours were stressful and emotionally burdensome. I am left thanking God for being so lucky to have never had problems accessing medical care. What hurts even more is the thought that this inadequate facility is still much better than the type of medical access many get in the world today.

Tea

October 30, 2012

10:45 P.M.

And I thought the ritual of tea five times a day at my grandmother's place in India was too much, every second I am handed a cup of tea to drink. Today alone I think I drank at least six cups, three of which were within three hours.

My cause of death will probably be tea intoxication.

But all the people here at the clinic are amazing and very friendly. I feel like I am amongst friends because of this camaraderie.

****

Day #4

Indian in Kilis = Rare

October 31, 2012

1:30 P.M.

Not that exciting of a morning today. I went to the office and stayed there until about 10:30 A.M., at which point the pharmacist from the polyclinic came to pick me up. At the polyclinic I decided to spend the morning in the pediatric clinic again.

There was a different pediatrician for the morning today. He was only able to finish two years of his residency at a hospital in Aleppo when the war broke out and he was forced to stop.

He is really nice but we don't have the same rapport I had with yesterday's pediatrician. I felt more like I was doing the Medicine, Patients and Society (MPS) course—which primarily involves observing physicians working—all over again in my first year of medical school. I just sat, watched him work and occasionally chatted.

I saw a case of cutaneous leishmania in a poor six year old girl. The head nurse got us the medication box and we read the instructions together in English, which I was able to assist in doing. We had to give her about three milliliters at the base of the lesion and check back in a couple of days. The poor girl of about five was crying and fighting as her mother held her arms, the nurse injected at three four sites around the lesion and her sister, of maybe ten, tried comforting her.

We also had a case of scabies and hepatitis today.

There was an adorable little kid of four or five walking around the clinic; probably one of the employee's. My doctor called him and told him in Arabic that "this is [pointing at me] Dr. Abdullah. He is from India and probably the first Indian you've met."

I cannot believe how exotic being an Indian here in Kilis is. Whenever someone hears India, the next question is always, "What are you doing here?" It's interesting how I am the first Indian many people at the clinic have come in contact with. Hopefully, I will be leaving them with a good impression about Indians.

~~~~

Done with clinic at one, now I am just waiting to be taken back home. After this, I think I am going to explore the city now that I know where my house is located on Google Maps—God bless them.

~~~~

And another person just came over to speak with me after overhearing that I am from India. These people are all so kind-hearted and friendly. It is truly a tragedy what is happening in their country.

Murder in Aleppo

October 31, 2012

5:30 P.M.

It is around two in the afternoon as I am waiting outside the crowded pharmacy for the pharmacist to finish his work so he can take me back home. One of the young people who work here—more of help around in whatever way they can—comes up to me. I have never spoken to him before but I saw him yesterday as well as today walking around guiding patients. I tell him my name is Abdullah and he tells me his name, let us call him Khalid. He can barely speak a few words of English but we still manage to communicate through a mixture of English, Arabic and hand gestures.

I ask a couple of questions and through some effort find out he is fifteen years old. He was in grade nine but left Aleppo about three months ago. He cannot attend school here in Kilis since everything is taught in Turkish. He then points to a man, we shall call him Ibrahim, and I realize that he came up to me because there is something he wants to tell me about Ibrahim. Now you should know that Ibrahim is probably in his thirties and works here as well. As a matter of fact, I just saw him in the morning and he greeted me as always with a huge smile. He is a really jolly man full of life.

Anyways, Khalid goes on to tell me that Ibrahim has just heard that his uncle was "shaheed" or killed in Aleppo today. I look at Ibrahim and I too notice that there seems to be pain in his face and people around him are crying. Three women walk away from the pharmacy in tears saying something that I do not understand. The atmosphere has suddenly changed, when not five or ten minutes ago I was talking to people about where I come from and we were all laughing.

Ibrahim walks over to me and I can see his eyes are wet with tears but he refuses to let them fall. I give him my condolences explaining that Khalid told me what happened. I also say a prayer for his uncle and pray that God accepts him into paradise. He goes on to tell me that they live about ten kilometers out of Aleppo but because of the war they left for Kilis about three months ago. He has some family members who went to Aleppo to join the Free Syrian Army. His uncle, it is unclear whether he is part of the Free Syrian Army or not, apparently has had his house "fired at" four times in the past but always survived. He turns to the side and at one point starts rubbing his eyes, but still he does not let any tears fall. He is strong and I am left wondering if this is the first death in the family? Or perhaps these casualties have become just a matter of time and a question of when.

Then, someone comes and starts speaking to Ibrahim telling him something funny; clearly he is oblivious to the events that just took place. Ibrahim speaks back to him in a normal calm tone and even manages a laugh at the end. Then, Ibrahim goes back into the pharmacy to help and once more Khalid comes back to speak with me.

This fifteen year old boy tells me that he has two brothers and they are both in the Free Syrian Army. I do not understand whether he means they are still alive or not—I hope they are. Regardless, it is not something I can simply ask him to clarify. I just let him continue speaking. He then shows me a video in which a soldier, supposedly one of President Assad's, has a chainsaw held between his hands with which he is threatening two men. These two men, I do not know if they are Free Syrian Army members or civilians (and it does not matter because they are humans), cannot move and are helpless. Their hands are tied behind their backs and their backs placed against a wall. The soldier in the video, without warning, then takes the chainsaw and beheads one of them in what seems to be a slow and gruesome manner. Blood can be seen splashing everywhere onto the second captive that is sitting next to him and clearly in a state of fear and shock. The decapitation takes a while and Khalid does not even blink once. He does not even express any emotions. He continues to watch on with me calmly. Once the video is over, Khalid asks me if I want to see it again. Without any hesitation I reply, "NO."

Now, obviously I am disturbed by this video. What I cannot help but find even more disturbing is how comfortable such a video is for this fifteen year old boy to watch. A boy who has barely lived his years and instead should be in school pondering over his future and not working at this clinic and living this life. Khalid then shows me another video in which he points to a man, standing at the front of a moving tank. He proudly states that he is his brother.

The third video shows what appears to be a man being buried alive. He is placed vertically in the ground and only his head can be seen jutting out of the sand. Soldiers start covering his head with sand as he continues to scream again and again, "La Ilaha Illa'Allah" (There is no God but Allah), declaring his faith. His voice can be heard no more once it is drowned out by the sand that covers his head.

A fourth video seems to just show a group of soldiers shooting, what appears to be aimlessly, as it is not clear what they are shooting at. Of course as AlJazeera would say, "We cannot independently verify these images and videos."

Thankfully the video session stops as Khalid is called into the pharmacy to help with something. When he comes back we talk some more. Eager to change the conversation from gruesome videos to something else, I ask him what he wants to be when he grows up. He answers a "worker" but I think what he means is a businessman.

I know this is just one story of probably thousands, but it is not the same when you are told in person by the people it affects versus hearing about it on the news. I can see for myself how this conflict is affecting its victims not just physically but also emotionally and psychologically. It certainly puts life more into perspective and makes you thankful for the life that you are so lucky to live and so easily take for granted.

Alhamdulillah (Thank God).

****

Day #5

If Only I Spoke Arabic

November 1, 2012

10:50 A.M.

It is almost a quarter to eleven in the morning and I have been waiting by the Mer-Tur Hotel since ten like I was asked. The pharmacist is supposed to pick me up from here on his way to the polyclinic. The director of the polyclinic, who also works at our office, told me beforehand that the pharmacist is often late. Hmm...let's see what happens as I continue to wait. I have just messaged my roommate, Mohammad, at the office to see what is happening.

Thankfully, I got a key to the guest house today so I can come and go as I please. This also means I can now go exploring the city on my own.

~~~~

As I wait by the mosque near my house, I am approached by a random man. He appears well-dressed and groomed and looks younger than me—ouch I am getting old. He asks me in Arabic whether I'm Syrian or Turkish. My answer to his question, "Indian," probably confuses him even more. He walks away puzzled.

~~~~

Fifteen minutes later I see the director of the polyclinic himself walking towards me. He apologizes to me saying that this time he actually forgot to tell the pharmacist to pick me up. I too apologize for all the inconvenience I am causing them. I cannot help but often feel guilty and like an unnecessary burden.

He then introduces me to one of his acquaintances, a middle aged man with a big black beard. He is pleasant to speak with though the director has to translate for us. We pick up snacks and I am told to eat more again and again. They are freshly baked cheese rolls amongst other things.

We get into a pickup and now we are a total of five. I am told we are heading for a "hospitalization" unit. Apparently this place treats all who have been discharged from the hospital and need follow-up care. I am told wound care for example is provided here. It is open to all free of charge—Syrians and non-Syrians alike. [Note: The polyclinic is only open to Syrians.] The director struggles explaining further about the facility. It seems it is run by a group of Syrians—was not able to elicit more details (sounds like a medical student presenting a patient's history).

~~~~

The facility or hospitalization unit serves all patients with "orthopedic needs" and I am introduced to the orthopedic surgeon as "Dr. Abdullah from India." [This has become my official title for all introductions to anyone: "This is Dr. Abdullah from India." I have explained to them multiple times that I am not even a doctor yet.] There are two floors in this small building with about ten beds on each filled with patients. These beds are actually proper hospital beds. I am informed that some patients are war victims while others are not. We head for the large office on the second floor where we sit sipping hot tea. Over the next hour more and more Syrian doctors are pouring in apparently for some meeting here. When everyone has arrived, about fifteen men packed in one room, the meeting begins and lasts for about an hour or more. Unfortunately, I cannot understand most of their conversations, but it seems to be an important meeting. Most of the doctors it seems are part of some Syrian medical organization and they discuss the situation and medical needs of the Syrian people. If only I could understand Arabic well I could tell you more.

[Mer-Tur Hotel is visible in the background as the large blue building in the center as I wait for the pharmacist to arrive.]

A Walk Through History

November 1, 2012

2:15 P.M.

Today I decide to take the chance to explore the city in the few hours I have before evening clinic begins at five. I quickly fall in love with the city—it is bustling with life and yet peaceful. Every turn you take boasts of the rich history of the province of Kilis. In the short distance I cover, the few mosques that I visit are all at least a few centuries old. Their architecture is a thing of great magnificence and one has to see it for him or herself to understand.

I keep walking down the main road because I do not have time to get lost. I always make sure that whichever direction I go that I always come back to the main road along which the Mer-Tur Hotel is located. The alleys are all confusing and tortuous with numerous mosques just small distances apart. Interspersed are many small bazaars where people can be seen busy shopping. I also find a Hamam or a traditional Turkish bath. I am just about to enter when a woman pops out of the doorway. I decide not to enter worried it might be for women. [When I came home later that night, I Googled the word that was written on the entrance, "Kadinlara." It turned out to mean women in Turkish!]

The city is a place one would love to get lost in because of its rich history and the marvelous and intricate Ottoman architecture it houses.

Turkish Food in Turkey—Finally

November 1, 2012

4:40 P.M.

For the first time since I have been here, I got to have Turkish food instead of Syrian. Today, I actually felt like I was living in Turkey.

After walking around and sightseeing I got myself a shawarma (chicken wrapped in pita bread)—wasn't really that good; must find another place. I topped it off with Turkish coffee and Baklava, an Ottoman pastry which Kilis is apparently famous for.

Hepatitis A, Innocence and Chocolate Ice Cream

November 1, 2012

9:50 P.M.

At night clinic I join the same pediatrician from two nights ago. (It turns out her family is from Homs but she moved to Aleppo after her marriage.) Today, we see about seven to eight cases of Hepatitis A or at least what we suspect clinically since we have no lab tests we can run. Thus, we cannot confirm our diagnosis. Regardless, all these children come with a similar presentation of severe abdominal pain and jaundice (yellowing of the skin and eyes). It is hard to see them in such pain while knowing a simple vaccine could have prevented this. Alas, there is not much we can do but give medications for the pain and wait for the body to fight off the disease. Still, the parents are sincerely thankful for whatever help the pediatrician provides. I guess from their point of view they see the supportive management of their children with the painkillers as the cure itself.

I inquire about vaccinations and the pediatrician tells me they are hoping to get them soon. At the moment, however, children can get vaccinated at Turkish medical facilities.

At the end of the day I am told that they had about three hundred patients today between the three hours in the morning and the three in the night. They just started a new system from yesterday where they have to fill out a form so things are more organized instead of the small slips of paper they used to use. Personal details about the patient are written at the reception; then the patient must bring this sheet to the doctor who writes the diagnosis and the medications at the bottom. The form is then handed over to the pharmacy where the patients get their free medications. Later, someone transfers the information from the form to a laptop for possible statistical analysis in the future.

~~~~

I cannot help but wonder when I see these children, what did they do to deserve this? They are innocent victims of war, their only crime—the time of their birth. I see them screaming, laughing and running around full of joy and innocence. I think it is these children that give their parents the will power to push forward and hope for a better tomorrow.

~~~~

At around 8:30 P.M. when I am dropped back home, I decide to try MADO's chocolate ice cream. I found out earlier from my mentor and Wikipedia that they are known for their ice cream—it's good!

****

Day #6

**The Only Tourist in Kilis**

November 2, 2012

6:00 P.M.

Today I woke up around noon and then went down to the nearby mosque to attend Friday prayers in congregation. After that I decided to explore the city further since I had no plans for the day as the clinic remains closed on Fridays. Thanks to Hamza, a college friend, who earlier pointed out to me that my phone has a built in GPS that can work without an internet connection; I was able to have so much fun. I marked my house on Google Maps and decided to walk around in any direction exploring—no more sticking to the main road!

It was a beautiful day today—warm and sunny. I instantly fell in love with the city's rich history; at almost a block's distance in every direction you can find an ancient mosque. Each mosque has a board sign put up by the local government of Kilis Province explaining the history behind it. Other landmarks I saw included hamams, graveyards, fountains and random arched passageways. All of these are at least a few centuries old according to the signs. It is amazing how rich the history of this city is.

Finally, I had strayed far enough and it was time to turn on the GPS and start walking back in the direction of my house by the main road. On the way I stopped to have a doner/shawarma—this was the real deal. It was fresh, spicy and delicious (and only for 0.75 TL or 0.42 USD). A random man came and sat opposite to me on my table to eat. With his sandwich he ordered, like so many others sitting there, a small bottle of what looked like milk. Even though all he had said to me was salaam (peace) when he sat on the table, once his drink came he poured himself a glass and me as well. He told me to drink it and I did. It was actually laban (buttermilk)—interesting combination.

The worst part about being in this beautiful city is how hard it is to take pictures. I am the only tourist and the only non-Turkish non-Syrian person here so I can't just start snapping shots with my phone. People will look at me like I am some kind of idiot or retard. I know I would. So I try to be as discrete as possible when taking pictures—pretending to type while snapping shots. Or sometimes just walking around hitting capture as I go by.

[This is the mosque which I attend Friday prayers at and is located directly opposite to the Mer-Tur Hotel. To the right is the inside of a traditional Turkish Hamam that dates back to 1562.]

**Sheep's Milk**

November 2, 2012

8:10 P.M.

So I was right, the two members of the team that I've joined had gone to Syria yesterday which is why they did not come back home until today. I kind of wish I could have gone with them but that is obviously not practical.

Anyways, after Maghrib (evening prayers) I went out again to the grocery store to buy some "junk food" so I could give the house my touch. I also had a local burger meal at a restaurant nearby. Initially they had no idea what I was saying so the Turkish owner thought I was probably Syrian and so he called someone else. When the Syrians came they realized I am not even Syrian, but I managed to communicate in my broken Arabic. After eating my burger I went to the counter to pay. The cashier was a young Syrian woman, probably my age, who spoke to me in Arabic. Since I know Arabic numbers I was able to understand how much I had to pay. The funny thing is that when I was struggling to communicate with her in Arabic, she asked me, "Do you instead speak Fus-ha [classical] Arabic?" I could not help but laugh as I explained to her that I am actually Indian and so the problem is not with her Syrian accent but my Arabic.

Back to my roommates, they brought back pomegranates, apples and fresh yogurt from Syria. One of them made me eat the fresh yogurt and I was right it was from sheep milk; I didn't enjoy it.

****

Day #7

Medicine: A Universal Language

November 3, 2012

2:10 P.M.

I wake up and get ready to head for morning clinic at ten. Today I have decided that I am finally going to sit at the internist's clinic instead of the pediatrician's, which is what I did the last three times. Same routine—red car comes by Mer-Tur Hotel to pick me up, I squeeze in the back and off we all go to the clinic. I greet the people working at the clinic like I always do and am ready to get started. I notice there is a man in a white coat sitting at the internist's table and I figure he must be the internist. After thinking it over for a minute, I approach him. I introduce myself to him and he is more than happy to let me sit with him.

He is from Aleppo and really interested in my story. We exchange stories and laugh about a great deal of things. This man is really charming and high spirited. He takes me to the obstetrics & gynecology room to meet his wife. [His wife apparently is the one who brought with her from Syria an ultrasound machine that only has half the probe working and thus producing half an image. As you can imagine, for an obstetrician an ultrasonogram is probably one of the most valuable tools.] His wife is really sweet too and we talk in mixed English and Arabic. I've gotten really used to speaking like this and enjoy it; it's like a game at times trying to figure out what the other person is saying.

I really enjoy the internist's company and we discuss each case as it comes. Together we read the medications the patients bring with them, most of which I know and some that are foreign names (Turkish or Syrian). Nevertheless, he somehow through playing Pictionary and charades manages to relay to me which class the drugs belong to and I understand. I also manage to pick up a lot of new Arabic words for symptoms like headaches, chills, nausea and vomiting. It continues to amaze me how we are able to communicate so well through the language of "medicine." Medicine truly is a universal language and I have finally come to understand that.

As sad as it is, the clinic's capacity is limited. In other words, the clinic runs like this: patient comes in -> quick chief complaint or reason for visit-> medication(s) prescribed -> patient sent home. There is no room for any "investigations" or diagnostic steps to be taken. Diagnoses are made based solely on what the doctor can see and hear. We get many patients complaining of generalized body ache, cough and chills—probably influenza—but we cannot do a PCR (Polymerase Chain Reaction) to confirm it. Furthermore, the management of diseases depends on the medications available in the pharmacy. For example, the only option today for an antiemetic (anti-nausea) is an intramuscular injection of Zofran (ondansetron) since no oral antiemetic is available. Also, today the pharmacy is out of paracetamol (acetaminophen), which means everybody gets a nonsteroidal anti-inflammatory drug (like ibuprofen) instead. Who has ever even heard of a pharmacy without paracetamol? Unfortunately, one of our patients has asthma. So he ends up getting nothing since NSAIDs like ibuprofen are generally contraindicated. What can anyone do but make the most out of available resources.

At times I feel my internist spends more time talking to me than he should, which means the patients have to wait for him to finish with me so they can speak to him. Also at times he spends a good amount of time asking patients about their background. But the patients usually don't seem to mind this and I think that this small talk actually helps build their relationship. Their jokes and laughter lighten the gloomy mood that Bashar Al-Assad has created for so many Syrians.

[The shelves in the pharmacy are stocked with various medications.]

Blood Pressure of 200/110 & Fasting Blood Sugar of 367?

November 3, 2012

4:20 P.M.

We, my internist and I, see many patients in the three hours that the morning clinic runs from ten to one in the afternoon. A recurrent theme I notice is children and teenagers with what appears to be cutaneous leishmania. My doctor informs me that there is an increased incidence in Aleppo of leishmania. I also see a patient with a sore on her lips and the first thing I can think of is leishmania (given the number of cases I've seen so far in the clinic). The doctor says no this is not leishmania but—he cannot remember the name in English. He says its name in Arabic and I don't understand. So he turns to ask the doctor sitting next to him. [Note: There were two internists today though both sitting on the same table next to each other seeing patients individually.] I think to myself what could this be and I notice the blisters and I exclaim "herpes." He replies excitedly, "Yes—Biz-zabt," which is his favorite phrase meaning "exactly" (Biz-zabt). It is a phrase even I start using by the end of the day. So I ask him, "Shouldn't we prescribe acyclovir (an antiviral medication) for this?" He replies, "No not for this [good review for me] but for"—he does not remember the name in Arabic. He points to my chest and starts sliding his hand across my back and bringing it to the front of my chest. Suddenly I realize: a dermatome -> herpes zoster (shingles). "Biz-zabt" with lots of laughter and a friendly slap on my hand. Again, it is simply amazing how we are communicating.

One of our middle-aged patients comes in complaining of headaches and generalized body pain. She appears to be slightly obese. She has hypertension and so I check her blood pressure. I am shocked to find it to be significantly elevated to 200/110. My internist checks it to confirm and gets a similar reading. Wow, she is in hypertensive crisis (simply meaning her upper blood pressure is over 180). Any minute she could go into renal failure or develop internal bleeding or go into heart failure. She needs to be admitted! Instead, we prescribe her Losartan, a type of antihypertensive medication, and tell her that she must come in everyday to follow up on her blood pressure. The internist then turns towards me and we discuss how we would ideally admit her to the hospital if we were in a proper setting. Well like we do for most of our patients, we leave it to God to look after this poor woman. Sadly, there is nothing more we can do at the moment. I am still left in shock but clearly for my internist this is a common occurrence.

On a brighter note, when the patient finds out that I am from India she tells us that there were three Indian students living in her village. Apparently, one of them got married to a Syrian girl. My doctor asks her do you have a daughter for him, pointing to me, and she begins to laugh and replies, "But that Indian was tall and big." We all enjoy a great laugh at this. I am left amazed at how much these people have been through yet they can still laugh. It is hard to imagine at times that these are the very same people who are being slaughtered like animals because they want to be free.

As if a woman with such high blood pressure is not enough to amaze me, we meet another patient around her late fifties. Now this patient has type II diabetes but she has not taken her medications for ten days. We ask her if she is fasting so we can obtain a fasting blood sugar level. [We have a few blood glucose meters in the clinic.] She replies with a yes, but feels it necessary to explain that she did have a glass of water about an hour ago. We go ahead and check her blood sugar and I am just left shocked at the reading the machine gives— **367 mg/dL**. Yes, let me say that again, her blood sugar is **three hundred and sixty seven. [To put that into perspective,** a fasting blood sugar of 126 or above is used for diagnosing diabetes.] My doctor starts laughing and joking with her telling her, "You are going to die." Now that sounds like an insensitive joke but the patient does not seem to mind it at all and instead joins in the laughter. We prescribe her metformin, pioglitazone and Diamicron (different classes of antidiabetic medications) telling her to come back daily to check her sugar at the polyclinic.

I ask my internist how they know what medication doses to give these patients and he tells me that they don't. They simply keep them on the same doses they were previously on. For example, for a patient with hyperlipidemia they cannot check the lipid levels to determine whether they need to change the medication dosages.

This same diabetic patient is apparently from the village of Mangh (or maybe Mannagh—not sure) and she shares her story. She tells us how there is nobody left in her village since jets have been continuously bombing it. She also mentions how the troops even shot a cat that was just crossing the street. The atmosphere in the clinic is one that is predominantly full of joy and hope but then there are always transient gloomy shifts as patients recall stories from Syria.

I really enjoyed morning clinic with this doctor today and am looking forward to working with him tomorrow because he makes medicine fun. He actually makes me want to go back home and review my medical knowledge.

**Kilis Museum**

November 3, 2012

4:50 P.M.

After clinic today, I decided to go back out into the city to just walk around and have lunch. I ended up in pretty much the same place I went yesterday even though I took different alleys this time. Eventually, I ended up stumbling upon the Kilis Museum. It is a small yet neat two-story mansion that once was home to Neşet Efendi of Kilis. Today, it houses selected artifacts from the Kilis Province from numerous recent excavations.

Later I got myself another doner kebab (chicken in pita bread) with laban (buttermilk)—Kilis style.

Night Clinic

November 3, 2012

10:45 P.M.

I was really exhausted by night clinic today because I've been having problems sleeping at night. I wake up so many times in the night with ear pain because of my pillow, which is as hard as a rock to the point that I feel it crushing my ear.

Anyways, the best news tonight was finding out that we have gotten a new ultrasound machine! It was a donation from some organization. Now I know I haven't even been at this clinic for a week; yet I cannot help but feel some sort of belonging and attachment. When I saw the ultrasound machine I was ecstatic; finally no more using the old ultrasound machine that only has half a working probe. The director of the clinic, who happens to be a radiologist, tried out the machine. Well, first everyone was struggling to figure out where the ON switch was located—ahem, I found it. Then the director started blaming the "factory" for putting it at such an odd place. At this we—my internist, the head nurse, obstetrician's assistant, internist's assistant and I—all shared a good laugh. Then, we nominated the head nurse to be our "patient" and tried the machine on him. It allowed perfect visualization of his kidneys. There are even options for cardiology, obstetrics, abdomen, etc. Although the cursor ball is hard to maneuver and can get jammed, it is a huge upgrade from the last one.

Tonight the internist's clinic was being run by two doctors of whom one is actually a pediatrician and the other an ophthalmologist. They are both new to the clinic. We also got a new machine for the ophthalmologist, a slit lamp, which hopefully means that an ophthalmology clinic will be opening up next.

Tonight I got asked the question I dread being asked the most, "How much do you pay for your university?" The head nurse was asking my pediatrician so she turned to me and said, "He would like to know how much you pay per year." Great. Now what, a direct question with no way out. At least during school days I could just say I don't know my dad takes care of these things, but not today. So I told them the annual fees after deducting $10,000 from it—split second decision—nevertheless a lie. Still they were shocked and the head nurse told me in Egypt at the best medical school you would only pay about $10,000 per year. Then, the pediatrician said, "Oh you must be an only child" to which I replied, "No we are four." More shock. Anyways, then the nurse started laughing and telling me about his father who owns a small olives [and something else] farm and [with great emphasis and laughter] a "pick-up." Thankfully, a new patient came in and the conversation was closed—hopefully forever.

~~~~

I cannot believe it has only been a week in Turkey and a few days at the clinic. Yet, somehow I feel like I belong here. I have made so many new friends at the polyclinic and met some amazing people. I am just glad to be here and experience all this for myself.

****

Day #8

Investigative Journalism: Life in Syria

November 4, 2012

4:20 P.M.

One of the things that I am personally interested in is hearing the stories that these people have to share from Syria. I don't want to hear it through AlJazeera but directly from them. However, this has actually proven quite difficult. For some reason and I am not sure if this has to do with language barrier or people simply not wanting to talk about it, it has been nearly impossible. I have tried inquiring whenever possible but the most I usually get is a quick two liner about how bad the government is.

Today during morning clinic, while standing outside with my internist, I asked him about where he is from. He told me he is from a village near the city of Aleppo.

[Note: A quick search of Halab on Wikipedia made a lot of things make sense. It is apparently another term for Aleppo (in Turkish it is Halep). Now, Aleppo is not only the name of a city like I thought—explaining why all the doctors seemed to be from Aleppo—but also the name of the province or governorate. Most of the Syrian cars here are licensed from Halab and so far I've only seen one car that was from Idlib instead. (That car belonged to a Syrian organization that seems to be providing most of the financial backing to this polyclinic.)]

Back to my internist, he told me that he used to have some farms in Syria of pomegranates and olives, but now that is all gone. He moved to Kilis about three months ago with his wife and five kids. The main reason? Well, he explains to me while pointing at a house about twenty meters away, a bomb fell near his house from a jet. Now it was twenty meters away but the blast was powerful enough to knock out all the windows in his house facing that direction. So, he decided it was time for him and his family to leave Syria for Kilis. That is how he and his wife ended up at this polyclinic. More than that, all I could get him to comment on was that the government of Syria is horrible and the people are "not even at ground level but under."

~~~~

Later during the night clinic I converse with the internist's wife (the obstetrician) and ask her pretty much the same questions. She tells me the same story. She adds that her children are not going to school here because they cannot speak Turkish and as of yet there is no school here for Syrians. There is one in Gaziantep but that city is about two hours away. I cannot imagine the stress these parents must be going through—God knows how long this war will last and when they will go back to school. There is nothing but stress after stress for these people with regards to every aspect of their life.

I ask her and her assistant about life in Syria because all that I know is through AlJazeera. The obstetrician tells me that AlJazeera shows videos and images that capture just a small proportion of the grave reality. Things are much worse on ground than they appear on the screen. Her assistant then goes on to add how the government's jets are bombing all over the Aleppo governorate without regard for anything: homes, schools, clinics and now even university buildings are targeted. To this the doctor adds "and mosques" which are supposed to be holy sanctuaries. Given that everyone in Kilis I have met has the same story of leaving Aleppo three months ago, I can only conclude that during this time the situation must have deteriorated significantly.

In the end, they invite me to Aleppo once Assad is gone and I tell them how I have heard Aleppo is full of ancient history. I pray one day that can I see Aleppo, or what Assad and his air force leave behind of Aleppo, for myself with my own eyes.

My Social Circle

November 4, 2012

7:00 P.M.

I am in night clinic right now as I type up this blog post on my phone. At the moment I am frankly doing nothing apart from walking around. The internist at this shift is a new person and he does not seem that approachable. His wife is an ophthalmologist and the eye clinic has finally opened today. I miss my internist; he is simply amazing. My pediatrician is busy seeing patient after patient but now these cases have gotten boring as I do not often understand the history with which they present. Also her clinic is busy right now so there is no time for me to ask questions. She does tell me at one point though as we see another patient, possibly with Hepatitis A, that her people believe that there is a connection between Hepatitis A and fear. She explains further that they feel that when bombs fall from the sky and children get afraid that they somehow contract Hepatitis A. Lack of public awareness clearly seems to be a problem and at the same time it is understandable.

Morning clinic is definitely much more fun with my internist. Apart from discussing the diagnoses or the medications, we also end up socializing quite a bit when we are free. My "social circle" comprises mainly of my internist, his wife (the obstetrician), his assistant, his wife's assistant (Bubblie) and I. So who is Bubblie? Well, Bubblie is the obstetrician's assistant and probably just a few years older than me. She just finished studying sociology in Syria. The reason why I feel Bubblie is such a fitting nickname is because it describes her personality. She is always continuously "bubbling" with laughter and joy. She keeps on teasing me and joking about how she wants to marry me and go to Doha. I have told her I don't care because I am going to be dropping her out of the plane into Baghdad as we fly over Iraq to Doha. Our entire group participates in these conversations and we have a great time and enjoy laughing. Earlier today she was making fun of me and imitating me at how I was looking at this "blue-eyed girl" at the clinic. In reality, I wasn't even staring at her; I was just looking at her and the others in the room as they were conversing. But that won't stop her from making fun of me. Her English is severely limited but we all manage just fine at times using our doctors to try and help translate. [ _A recurrent theme I have_ _picked up seems to be the use of humor as a defense and/or coping mechanism.]_

[Bubblie calls me into the obstetrician's office as they are done with their last patient.] Finally, night clinic gets fun. We (our group minus the internist) talk about a lot of things. They are pretty impressed at how much Arabic I understand and frankly so am I. At times it's fun as we try to explain words to each other—kind of like playing Taboo or Pictionary. They are curious to know more about India and I tell them about the major religions in India with a rough estimate of their percentages. They want to know how my family got there and I briefly talk about Muslim conquests of India.

The night ends well though I still hope that before I leave Kilis I will at least once be able to visit the refugee camp. I have actually been already told by Médecins Sans Frontières (MSF)—got to meet them at the clinic one day which was thrilling—that the refugee camp here is one of the best they have seen and so does not reflect the average. It was exciting to converse with the two MSF nurses, a man from Greece and a woman from Italy. They seem to be trying to find a way for MSF to support the clinic.

~~~~

Family Connection:

Turns out that the internist's assistant is the sister of the new ophthalmologist. She takes me to meet her sister who like everyone else in this clinic is really pleasant to speak with.

Also, Bubblie (the obstetrician's assistant) happens to be the younger sister of the so called "khala" who makes breakfast and fixes up our house every morning. Bubblie asks me how I liked the kibbeh (minced meat croquette) from the other day. I lie and say they were amazing though I didn't really enjoy them because I'm not a big meat fan.

~~~~

My two roommates have been gone since yesterday afternoon till now, which means they are still in Syria. I wish that I was able to join them.

3 Nights in Istanbul

November 4, 2012

11:15 P.M.

Oh, last night I called the Turkish Airlines call center. I had my ticket from Gaziantep to Istanbul changed from November fifteenth to thirteenth as per my mentor's advice. This means now I will be able to spend three nights instead of one in Istanbul.

****

Day #9

Family

November 5, 2012

9:45 A.M.

It is amazing how I have only known these people for about a week. Yet, somehow I feel like they are part of my extended family. This morning the "khala" (middle-aged), who turned out to be Bubblie's sister, was asking me what I wanted for lunch and if rice would be okay. I assured her I didn't mind rice or anything for that matter to which she responded, "I am your mother too. Whatever you want you tell me." These people are just amazing!

Breakfast done and time to head out to clinic now.

Today's Gossip: Ahmed Rafe Killed in Syria

November 5, 2012

1:00 P.M.

I am with my internist again for today's morning clinic and we get started. A patient presents his paper, which he gets at the reception with his personal information written on and which the doctor must write the diagnosis and prescriptions on. My internist takes the paper and is about to start when the other internist (sitting next to him sharing the same table) starts telling him—all excited—the latest story from Syria. The two get into a very excited and intense conversation for maybe two minutes or so. The patient, waiting for my internist, suddenly loses his temper and starts speaking in a loud voice. I can understand that he is talking about how it is not right for the doctors to be chatting amongst themselves while there are patients waiting. The internists and the patient get into a heated argument that lasts for a few minutes. Even the other waiting families side with the doctors (no surprise there) saying that he should be more patient. Soon, the issue is put to rest.

This is exactly what I have been thinking about for the last few days, doctors talking to each other (and me) while seeing patients. Often while talking to one patient they are interrupted by someone else and have a quick conversation on the side. In my opinion there is no right or wrong way as the setting should be kept in mind. There are two sides to the story:

**Patients** : They have come a long way and waited in the reception just to meet the doctor and get his expert opinion and medications. When they are with the doctor they expect him to listen to them attentively and provide answers to all their questions. There should be no interruptions. And this is what I have been taught in medical school.

**Doctors** : They are working at a low wage in a clinic that provides free medical care and medications to its patients. Given the situation, they cannot simply just sit like machines and see patient after patient for three continuous hours without having a laugh or small conversation here and there. Perhaps, these small side conversations are what provide them motivation and the strength to continue.

Whatever the truth may be, I do not think it is fair to completely blame either side. The situation and setting must be kept in mind. In an ideal situation, the doctor would be a perfect human. The doctor would be able to sit with the patient alone (without other patients waiting behind) and discuss his or her situation. There would be no side conversations and no interruptions; for example by patients who need to come back from the pharmacy to get their medications checked by the doctors.

In an ideal world, there would be no Bashar Al-Assad.

~~~~

Anyways, later on in the day as I hear this story of a so called "Ahmed Rafe" being repeated again and again, I ask my internist to please explain. Through guessing and figuring out words, I understand what all the commotion has been about. Ahmed Rafe, a Syrian actor, was a "spy" for Assad I am told. Some rebels finally found him, kidnapped him and just recently killed him.

[When I get back home I Google the name and I find a couple of news articles on him and his death.]

~~~~

Rest of the morning goes by and today I do all the blood pressure readings for my internist. We only do them for patients _known_ to have hypertension, which is really most of them. I was really happy when I finally found one patient who did not have a blood pressure reading of 180 - 200 (like the last few days) but instead of 140/80. [Mine was 120/70—perfect!]

~~~~

Oh and we just got about six medium-sized boxes full of medications this morning. They seem to be from the city of Gaziantep though I heard someone else saying they might be from Istanbul. I wasn't able to figure out their origin but hey at least we've got more medications. Once the boxes are placed in the pharmacy I snoop around and check out the open boxes. Three of them are filled with antifungal cream, another two full of bottles of 1g Ceftriaxone (an antibiotic) and another one full of 1g Cefazolin (another antibiotic). I have no idea what we will do with the approximately two hundred newly received antifungal cream tubes. Unfortunately, we cannot pick and choose the medications the clinic needs.

~~~~

I have also been invited for lunch at Bubblie's, the obstetrician's assistant's, place tomorrow. She actually told me to come over to her family's house for lunch today, but I said maybe another day. She was insistent and so I decided I will go tomorrow. I will probably also end up going to the internist's house soon because he has invited me over a few times as well.

[This table serves as the internists' clinic.]

Playing Doctor

November 5, 2012

5:00 P.M.

[First a side story: As most of you probably know, medical students love playing the role of a "doctor." For example, when we are working at the hospital in our scrubs then have to go to a place to get lunch (and are not able to change out of our scrubs), we don't mind the attention we get. We know people are looking at us thinking, "He or she is a doctor!" But the moment something goes wrong we want to disappear—hide under the table or run for the exit. Suddenly, we don't want to be doctors anymore because we are expected to provide answers and solutions. As medical students, we are not always ready for this].

Back to the present: Morning clinic has just finished and I've said goodbye to my internist and his wife as they head home from the polyclinic. The pharmacist, who takes me back home, has to leave with his car to attend to some errand. He asks me to wait for him outside the polyclinic. So, I wait with three other people who help run the clinic for him to return with his car. They too will be going back home in the pharmacist's car with me. In the meantime, a young woman comes with her son—maybe two or three years of age—complaining that her son's ear is swollen and she needs to see a doctor. The people with me explain to her that all the doctors are gone. She insists on having something done now as she is worried the swelling is increasing. They tell her to just wait until the pharmacist comes back. Meanwhile, I watch from a short distance away.

Once the pharmacist returns to the polyclinic, after maybe ten or fifteen minutes, I go towards the car. One of the clinic employees, who too will be going home with us in the car, brings the child and the mother to the pharmacist. The pharmacist looks at the ear and there is a quick discussion in Arabic about what to do with the three or four other employees. There are no doctors at the moment and the pharmacy door is locked. Meanwhile, I am just standing with the group listening and trying to decipher what I can. The pharmacist then says something to the group about me having a look and giving my opinion. Someone playfully answers something that I do not understand.

Regardless, the pharmacist turns to me, "Doktoor (thick Arabic accent) what do you think?" Just great! I am expected to think and think smart and fast. My face and body language depict a confident me as I bend my knees to take a closer look at the child. However, my mind is totally blanked out and I am just confused and taken by surprise. I ask a quick general question, "How long?" and am told it just started this morning. The poor boy's entire left ear lobe as well as behind the ear involving part of his head is the definition of inflammation: swelling, warmth, erythema (redness) and pain. I ask if something possibly bit him and one of them answers, "Possibly but the mother's not sure." All this happens in under a minute as I am only expected to give a medical opinion without doing a full history or a proper physical exam. I turn to the pharmacist. I had heard him talk about steroids to the others before he asked for my opinion. I tell him, "It does not look like there is any blood collection but seems to all be significant edema (swelling). I think corticosteroids would help decrease the swelling." He agrees and says he thinks the same.

Phew, I survive. Oh wait, there is a follow-up question, "How much dexamethasone should we give?" In my head: "YOU HAVE SERIOUSLY GOT TO BE KIDDING ME! HOW ON EARTH WOULD I KNOW? YOU'RE THE PHARMACIST. I'M JUST A POOR MEDICAL STUDENT." Of course my lips say something totally different as I confess: "I honestly do not know." He goes on saying, "Usually we give half the dose but for this case do you think we should give full or half?" [As if I even know what a normal dose is to determine what is half or full.] I explain, "Honestly I do not know anything about dosages apart from that corticosteroids would help him with this severe edema." Finally, he turns to the mother and writes for her on a small slip of paper "corticosteroids." He asks her to go to another pharmacy and if need be come back to the clinic at night. I just pull out my Dettol hand sanitizer in the mean time to clean my hands—there was something sticky on the child's ear—standing confidently.

In contrast to the writing, the actual scenario probably took just a few minutes; it was all just so fast. Well, in a few months I will be a licensed doctor so I guess I better start getting used to such questions and start having proper answers.

****

Day #10

Ahmed's Story

November 6, 2012

5:30 P.M.

Ahmed, one of the employees at the polyclinic, walks up to me and starts sharing a bit about himself with me. This is his story:

_I am a thirty year old Syrian man who came to Kilis about three months ago. I grew up in a village near the city of Aleppo. After completing high school, I decided to go to university to study literature. During my first two years I learnt Turkish and after that English literature. Unfortunately, in the Syrian education system English is not really focused on. In university we did not learn any grammar or vocabulary per se, but we used to only read "literary works." I graduated from university three years ago following which I had to go to mandatory military service. For two years I worked for the "counter-terrorism unit." Thank God I only worked in the office doing some computer work and never hurt anyone. Then, during the last year I did nothing as I had no job and the conflict began and intensified in Syria._

I come from a village very close to the city of Aleppo and it has been under constant heavy bombardment from jets in the sky. That is why I decided to leave for Kilis three months ago. If only I knew I would be coming to Turkey some day, I would have practiced my Turkish. Now, it has been almost five years since I spoke Turkish and so I don't remember anything. Also, for the last three years I have not spoken English and so my English has become really bad, which is why I have a hard time communicating with you.

[We discuss the latest news from Aleppo.] Assad's forces have increased their bombardment over Aleppo. Yesterday, I was talking to my friend from my village and in the background I could hear the noise of bombs exploding. I also have a sister living there with her husband, who did not want to come to Turkey, and I have not seen her for months now. My uncle has been locked up in one of Assad's prisons for the last four months. Two of my family members [not sure his cousins or whom exactly he meant] have been killed by Assad's forces.

Assad's time is now numbered. He is one man for whom this country is being destroyed. I have heard that the Free Syrian Army has surrounded the police and intelligence institutions in the city of Aleppo and Insha'Allah (God willing) they will take control of them in the upcoming few days.

_Once the conflict is over, I hope to go abroad to maybe the US or UK for a year to practice my English. I am confident that after a year I will become much more fluent and will then be able to return to Syria as an English teacher. Syria is my home and there is no country like Syria. It is a beautiful place full of history and I hope you will one day come to my house to visit._

[Of course some things may not be accurate as it was difficult to communicate efficiently and get the full details.]

In Times of Darkness—Hope is Our Greatest Strength

November 6, 2012

7:50 P.M.

In clinic, today was the first time while sitting with my internist that I did somewhat of a quick physical exam on a patient. Shocking right? Unlike the pediatricians who usually have cases of children with upper respiratory infections and end up looking down throats and listening to the lungs, on the internal medicine side we usually just give out medications.

However, today we had a patient who had a myocardial infarction (heart attack) in the past and came complaining of shortness of breath while just walking about ten meters. Instinctively, we were worried about congestive heart failure. For the first time, I actually used a stethoscope not for measuring blood pressure but actually doing a quick chest and cardiovascular examination for internal medicine. (Oh, and the patient had no lower extremity pitting edema). Thankfully, his exam was normal but my internist advised him to still get an X-ray done at another clinic.

[I am told that the incidence of patients with type II diabetes and hypertension is very high in the region lying between Kilis and north of the city of Aleppo. Most of our patients have both.] Another patient this morning, probably in her mid-forties, came to get medications for her hypertension and diabetes. She was joking and laughing with the internist. However, a few minutes later while talking she mentioned her children and started tearing up. She told us how one of her sons was killed while the other is still fighting in Aleppo. Later, while the doctor was interrupted by someone else, this patient through simple Arabic words and sign language told me how difficult it is for her to sleep at night without her children. She also told me that she usually cries herself to sleep.

Moments like this one does not know what to do and as I listened I honestly wished there was something I could do to bring back her children. But, I am helpless and there is nothing I can do. I just tried to comfort her as much as possible and reassured her that Insha'Allah (God willing) her children would go to Jannatul-Firdaus (Paradise). What more can one do but listen and pray? Watching her tears flowing down her cheeks was hard. No mother deserves this.

You know when on the news you hear about thousands dying and being displaced, it is completely different. Numbers are meaningless and we have become desensitized to them. But when you hear just one story from the victims themselves first hand and try to see what they see through their tearful eyes, the effect it has on you is powerful. Even more powerful than those thousand stories you heard on the news.

This trip, these people and their stories, have been having a great impact on me. I just—I don't even know what words to use to describe what I feel; seeing these people going through so much in life and yet having the power to smile and laugh is just—again I am left speechless.

**[It is strange how everyone around me is happy and acting "normal." But every now and then when their guard falls I see the pain they have been hiding.]**

~~~~

One of the men who volunteer at the clinic, same person who was offering me lunch yesterday, was walking by me providing support to an old man. When he saw me he got really happy and pointed at the old man telling me that he is his father. I was sitting on the side rest of a chair and sprung up to greet his father. His father asked me whether I was Turkish or Syrian. The son replied saying, "This doctor is from India." His father was joyful to hear that I was from India and went on to say how we are all brothers.

This man who was so happy to introduce his father to me is someone I only met yesterday—that too for maybe a few minutes. The camaraderie here is just amazing. It brings hope to us all in the dark times that we live in. I feel like I am a part of this community now.

Mental Illnesses—MSF

November 6, 2012

10:20 P.M.

One of the representatives from Médecins Sans Frontières (Doctors Without Borders) came back today. It was the young nurse from Italy who had visited before. At the clinic there was talk of hopefully getting a psychiatrist on board and providing mental support. This will be quite beneficial as many of our patients come in complaining of palpitations and are on anti-anxiety medications. Also, there are many children brought in by their parents because of bed-wetting. Interestingly, the obstetrician told us that she has actually seen cases of grown women with recent onset of bed-wetting.

Whatever the case, the polyclinic would benefit greatly from having a professional psychiatrist given that metal illnesses in many of our patients are expected given the current situation.

****

Day #11

The Polyclinic: What is the Mission?

November 7, 2012

6:10 P.M.

A few days ago we had a patient, slightly obese, complaining of bilateral knee pain (we see a lot of such cases here). I started thinking—hmm...she might have osteoarthritis. So with some difficulty I managed to get my internist to understand that I wanted to ask her if the pain got better or worse as the day progressed. She told me that the pain tends to worsen with activity. After that, my internist just touched her knee to palpate very quickly and then prescribed her indomethacin (a painkiller like ibuprofen).

This patient left and the next came, but I was left wondering, "Shouldn't we have done more?" Maybe we should have taken a more detailed history? Maybe done a thorough physical exam? Any crepitus? Any swelling? Morning stiffness? So many questions we could have, perhaps should have, asked.

I spent quite a bit of time thinking thoroughly and deeply about this and the many similar cases we had. I was then left wondering, "What is the mission of this polyclinic?" Are we simply just giving out medications? Is it really not that much about the diagnosis and more to do with symptomatic relief?

The way I came to answering all these questions was by asking another, "Would these additional steps in history and physical exam change our management?" For example, for the obese patient mentioned earlier with bilateral knee pain, would differentiating osteoarthritis from say rheumatoid arthritis make much of a difference? Furthermore, do we even have access to X-ray machines to look at the knees or to labs to look at ESR and other things? The answer, sadly, is "No." Regardless of what this patient would be diagnosed with in a tertiary care hospital she would be started on pain management. So prescribing an NSAID (nonsteroidal anti-inflammatory drug)—pain killers like ibuprofen—is a perfectly rational decision.

The objective of this facility, or at least the way I have come to see it, is to provide short-term symptomatic management to patients (mainly through medications). Given the situation they are in and the limited resources they have, is this really a bad idea? I like to think not. True, a health institution should not only work to achieve therapeutic goals but prevention is equally important (if not more when you consider the burdens placed on finances and resources). Then again, this is not any ordinary health institution. This is a polyclinic that is providing free healthcare and free medications to all those displaced Syrians here in Kilis. (According to one patient, the hospital in Kilis charges a fee of seventy Turkish Liras—about forty dollars—for just a single visit.) Sure they would love to give hepatitis A vaccines to children instead of symptomatic relief medications for acute hepatitis, but they do not have the resources at present to do so.

Regardless, in the short time I have spent at this clinic, I have seen growth at an impressive rate. New forms for doctors to write diagnoses and prescriptions for each patient have just been incorporated. A polyclinic that only had four clinics—internal medicine, pediatrics, dentistry and obstetrics & gynecology—now also has an evening ophthalmology clinic. There are now new ultrasound and slit lamp machines. There are plans to possibly open a psychiatry clinic. All this over a period of about two and a half months.

With time this institution continues to rapidly evolve as its resources and finances continue to increase. Yet, it is still a long way from addressing more than just therapeutic needs of patients. Then again, is that so bad when its mission is to provide short-term management to medical problems?

_I like to think not._

[This is basically where patients that need to be uncovered more than what would be considered "decent" are examined or where treatments like injections are given.]

****

Day #12

How the Clinic Runs: A Step-by-Step Guide

November 8, 2012

9:40 A.M.

A brief ten steps guide or rather overview of how the clinic runs:

Step 1: Patient comes to the waiting area where there is a reception desk.

Step 2: At the reception desk a form is filled up by the receptionist including details like name, age, gender and town from which the patient hails. The receptionist writes similar details in a large notebook as well for his or her own records.

Step 3: Patient keeps the form with him or herself and waits in the waiting area for about thirty to forty minutes.

Step 4: Patient is sent from waiting area to the respective clinic, where they stand waiting some more for the few patients before them to finish. The doctor's assistant often takes the task of getting more patients as well as taking blood pressure readings (only for hypertensive patients) and fasting blood sugar readings (only for diabetic patients).

Step 5: Doctor takes the patient's form and quickly interviews the patient. One form per patient is the rule.

Step 6: Doctor writes the diagnosis and any pertinent past medical history (hypertension or diabetes usually). Then, the prescription is written at the bottom of the form.

Step 7: Doctor's assistant asks the patient to go to the pharmacy and get the medications. Then to come back to show them to the doctor.

Step 8: At the pharmacy there are about three to four employees that take the form from the patient and keep it with them. Medications are then given based on availability, so substitutions may often be made. (Many times drugs like diclofenac, a painkiller, which are usually easily given orally are given as intramuscular injections because of availability.)

Step 9: Patient returns to the doctor with the medications and the doctor may suggest some changes in the amount of times a medication should be taken based on what the patient got from the pharmacy. Sometimes patients may be asked to return in a few days to see if the medications have arrived at the pharmacy. Especially at the internist's clinic, patients with poorly controlled blood pressure and/or blood glucose may be asked to come daily for follow-up readings.

Step 10: Patient leaves with the medication(s). One of the employees puts in the demographic information and diagnosis that was written on the form onto a Microsoft Excel spreadsheet.

[This sign is placed in the waiting area and on the main door. It informs patients that the clinic is open in the morning from 10 – 1 and in the evening from 5 – 8.]

Lunch at Bubblie's

November 8, 2012

9:50 P.M.

Yesterday I was supposed to go to Bubblie's house because in the morning Bubblie's sister, who comes every morning to cook for us, invited me. Unfortunately the sudden change in weather got me sick and I was not feeling well or able to sleep at night. Thus, I did not go to the clinic or lunch and there was no way for me to inform them.

This morning when Bubblie's sister came to our house, she knocked on my room's door and came in as I was still in bed. She asked me why I didn't come yesterday and that Bubblie told her that I didn't even come to the clinic. I told her that I was sick, so she went to the kitchen and got me a cup of tea in a tray in bed! She told me I had to come today for lunch and I promised her I would. Before leaving for clinic I wanted to get some baklava (Ottoman pastry) for them as to not go empty handed, but unfortunately I didn't get the time to do so.

In clinic today, towards the end I was having fun again in the obstetrician's office. It was my internist, his wife (the obstetrician), Bubblie (the obstetrician's assistant) and me. One of the employees walked in and so did the ophthalmologist. My internist started again telling them about the conversations we've had and the "problem" there is now between Bubblie and me. The problem being that I have agreed to take Bubblie with me on the plane but I will throw her overboard in Baghdad. There was then lots of name calling as I called her a "feel" (Arabic for elephant). She started screaming playfully, "Who would marry such a small skinny yellow-skinned an—an ant!" We kept making fun of each other arguing back and forth as everyone enjoyed the theatre (as did we). Again, lots of laughter. The ophthalmologist concluded that she should change her shift to the morning because we clearly have a lot of fun.

In the end, I left with Bubblie to go to her house by walking. We got there after twenty or so minutes of walking downhill through some small alleys while chatting. Her house was a small two story building with a small room downstairs for sitting. I sat in the room and greeted her family. It felt just like home. I was introduced to Bubblie's three sisters who I think are probably in their thirties to forties. I also met her sister-in-law and her children. I instantly fell in love with this adorable little three month old boy who fell asleep in my lap as I was rocking him. We all laughed a lot and amazingly managed to understand each other. It was like playing a guessing game again and they were pretty impressed with my Arabic. We spoke about everything from myself to about them. The eldest sister had just come from Syria for a visit with her daughter. She has ten children with the boys all fighting in the war. She talked about how scary it is living under the bombs and how her twenty-four year old son lost his hand because of a bomb blast.

I was fed biscuits with coke followed by coffee. After an hour of what was one of my best times here in Kilis, we went to Bubblie's fifth sister's house for lunch. I had lots of food: chicken with white rice, chicken with spinach, meat with vegetables, red pepper and fresh laban (buttermilk). I also met Bubblie's brother-in-law who too was pleasant to speak with. As per Arab hospitality, I was encouraged to eat more and more till I could eat no more.

As we were wrapping up lunch a Turkish man that the family knew came and it was funny watching him communicating with everyone because his Arabic was even worse than mine. Anyways, I had a great time and was really happy to meet her family. I felt like they were practically part of my family or rather I was part of theirs. God bless them! They've told me that I must come one more time before I leave for Istanbul. I will try my best to do so.

****

Day #13

Getting the Full Experience—Gastroenteritis

November 9, 2012

6:40 P.M.

Today, since it is Friday, there was no clinic. I finally got off my bed, after another night of horrible sleep, and got ready to attend Friday prayers at the mosque near our house. [Oh the mosque is beautiful from inside and the only one I have seen so far that isn't a few centuries old.] Hopefully, one day I will be able to take pictures of the interior.

Anyways, I brought an entire pharmacy with me on this trip but was smart enough to forget Imodium (loperamide—an anti-diarrheal). Now, I've got a bad case of gastroenteritis, probably food poisoning from that chicken shish taouk sandwich I had last night.

Just spent the day going out and bought some sweaters. Not more to report and now it is time for the patient to get back to his movie.

****

Day #14

A Web of Random Thoughts

November 10, 2012

11:00 P.M.

First, a health report: I woke in the middle of the night (as usual) except this time I had severe abdominal cramps. This gastroenteritis is getting really annoying. Anyways, in the morning when I saw Bubblie's sister making kibbeh (meat croquettes) in our house for us, I asked her if she could please make me some plain white rice. Currently I am trying to be on a strict white rice diet with laban (buttermilk). I have been feeling a bit nauseous too lately. I bought Imodium (an anti-diarrheal) and Panadol from the nearby pharmacy—can't believe I brought different types of antibiotics but forgot to get the basics. Hopefully things will improve very soon before I head off to Istanbul, Insha'Allah (God willing).

Istanbul: My current plan is to leave from home on Tuesday (November thirteenth) early morning for the Kilis bus station, where I will have to take a bus to the Gaziantep city bus station. The journey will probably take about one and a half to two hours. Then, from Gaziantep city bus station I will take a bus to Gaziantep Airport. My flight is around three in the afternoon and should take about an hour to reach Istanbul. I will be staying in the old city area (near the Blue Mosque and Hagia Sophia) for three nights and then fly out on the fourth night for Qatar. I think it is about time I start planning my sightseeing agenda for Istanbul.

Polyclinic: No new interesting cases to report. Sadly, we seem to be running out of the strips that you use for measuring blood sugar levels. (We have a lot of diabetics and hypertensive patients.) Of the six different small containers of strips we have, only one of them is compatible with the blood sugar reading device (a glucometer). It would be nice if there was a single standard strip that worked with any glucometer, but of course that would mean less money generated for companies.

Today, we had a patient who had a stroke about nine months ago and recovered fully (at least to my understanding). She came in with her husband and daughter complaining of new onset of left-sided facial and arm weakness. There was nothing more we could do except keep her on her medications and recommend her to see a doctor here in Kilis at the hospital. According to her previous MRI report from February 2012, it seems the physicians in Syria were considering "small vessel ischemia and demyelination." I wonder if she has multiple sclerosis? I certainly hope not and she denied ever experiencing any symptoms of ophthalmoplegia (paralysis of eye muscles) in the past.

I cannot believe my journey here is almost over. I won't deny it that I am looking forward to heading back to Doha but I have certainly learnt a lot in my short stay here. I will miss more than anything the people at the clinic. In some odd way, in just two weeks these people have become like my extended family. I know I have said this many times before and will continue to do so. I will definitely miss them and miss the "pleasant" shock waves I would send when I would say that I am from India. I will also miss being called "doktoor" (doctor in a thick Arabic accent) even though I am not one. (This morning while waiting to be picked up for the clinic, I heard someone from a moving car wave and say, "Hello Doktoor Abdullah." It was the polyclinic director.) The hospitality and humility that these people have shown is something I hope I can take back with me.

Weather: Suddenly, the weather took a turn for the worse today. Since I have been here, the weather in the morning has been pretty sunny—plus or minus a chilly breeze. At times I have even felt hot while walking down the street in just a thin full sleeves shirt. Today, however, all that changed. For the most part, it has been rainy and cold with the sun hidden behind the clouds. I was freezing in clinic today because I dressed the way I have been dressing every day, a light full sleeves shirt with a jacket on top. I have no idea how I will survive my first winter in New York in January where it's going to be subzero. [I am glad to report that I did survive New York's winter and the wrath of its "polar winds."]

****

Day #15

Another Mother's Tears

November 11, 2012

3:45 P.M.

I am back at the Mado Café, next to the Mer-Tur Hotel. This is where I spent my first night in Kilis blogging while trying to make sense of everything that had happened. It was not long ago that I sat here with my first Turkish coffee (and chocolate spoon), though it feels like it was months ago.

~~~~

It was just another ordinary day at the polyclinic today as I sat with my internist and patients continued to come one after the other. One of our patients today was a woman in her forties who took a seat on the patient's chair next to mine. She was here for a prescription refill for her medications—the boxes of which lay out on the table. My internist started talking to her and I could understand enough to know that he was asking about where in Aleppo Province she was from. Soon, she appeared to be getting distressed and started talking about her family. All I understood was that there was a possible death of a two month old child, two school kids sleeping, bombs falling from the sky and a child's arm being injured. She was clearly trying to be strong and not tear up. My internist then turned to me and told me that a two month old child's mother was killed by a bomb. Before he could say more, we were interrupted by someone and my internist got up to leave (possibly to the pharmacy).

All I knew about this patient for sure at that moment was that someone she loved died leaving behind a two month old child and some speculation about other possible casualties. Meanwhile, she could not control her tears any longer and her eyes had welled up. She kept wiping her eyes with her fingers. At times she would put her head to rest on her arms that were lying flat on the table. I so badly wanted to comfort her, to tell her that I was sorry, to hug her and to tell her that it was all going to be okay. But I couldn't. I just sat on my chair next to her, uncomfortably watching her from the corner of my eye while waiting for the internist to return. About four to five minutes had passed but the doctor did not return and she continued to sob on and off. I was uncomfortable. I finally managed to muster the strength to speak to her through my limited Arabic.

I started off with telling her, "Insha'Allah khair" (God willing all will be well). She turned to me, already knowing that I did not speak much Arabic, and explained in simple words how the mother of a two month old child was killed. She also went on to talk about two other children of sixteen or seventeen in ninth grade I believe. I could not understand whether she was telling me that they died in school or in their sleep. She also told me how a bomb fell from a jet flying above her house. I felt so helpless because I could not even completely understand her story, but I continued nodding my head because I could understand her emotions. At that moment, I just needed to be a good listener and let her speak.

Even though there was a great language barrier, I have come to see more clearly how emotions can be perceived and felt without really fully understanding their context. When she would look into my eyes while speaking to me, I maintained eye contact staring into hers. As weird as it sounds, I felt I could see the pain she was in just through them. They made me feel uncomfortable and on edge. I was afraid they would stir emotions in me that I did not want to surface. Whenever she would look away, I would take the opportunity to stop looking into her eyes.

I know these eyes are no different from the eyes of mothers from Afghanistan, Iraq, Bahrain, Egypt, Libya, Tunisia and all other mothers—but then I have never really stared into their eyes the way I did into this mother's. Again, what more could I say other than Insha'Allah (God willing) they would all enter Jannatul-Firdaus (Paradise). There is nothing more that anyone can do for those that have passed but put our faith in God and pray for them.

When my internist returned and the patient left, he told me that a bomb fell on her house in Aleppo. It killed the mother of a two month old child (possibly patient's sister-in-law) as well as the patient's twin sons who I believe were sleeping at the time. It also, and I could not understand clearly from my internist, resulted in a child's arm being injured at the shoulder (not dislocated—frankly I am not sure).

I wish I could speak Arabic so I could understand better their stories without having much lost to translation. Maybe I could even have opened a small "psychology clinic" or something of that nature while I was here to allow people to just express themselves, vent out and be heard. After all, isn't that what most people want—to be heard, to share their pain, to know there are others that understand how they feel?

Moments like these it is hard to not feel helpless as the only comfort you can provide them is through words. I pray that God answers every mother's prayer out there.

~~~~

As you can see I struggle greatly in translating the emotions I feel into written words. That is because I could write a hundred or more pages describing the feeling, but one would not truly understand or grasp it until their own eyes witnessed it and their own heart felt it.

Preparing for Tomorrow's Goodbyes

November 11, 2012

10:30 P.M.

Tomorrow is going to be my last day at the polyclinic. Even though I am looking forward to heading back to Doha, I kind of wish I could spend some more time here. I am all set for morning clinic with two kilos of sweets (baklava and something else I do not know) for the team. I will really miss the experience I had and the new friends I made over such a short time. I am so glad that I got to know almost everyone at the clinic, of course some more so than others.

Bubblie asked me to come over yesterday and today again, but I promised her I would come over tomorrow. So after morning clinic tomorrow, I will head back with her once again to her amazing family. Planning on buying something nice from this store nearby for Bubblie's adorable three month old nephew—probably baby shoes because I love them. Also planning on buying lots of candy for the pediatrics clinic because pediatricians are always supposed to have candy! Will also try hard to find some souvenir for myself, though it's close to impossible as this isn't much of a tourist destination.

I pray one day I will be able to meet these amazing people in the future—in their own country.

****

Day #16

Last Clinic in Kilis

November 12, 2012

9:50 A.M.

Off to clinic with my bag of sweets—kind of nervous.

I Hate Goodbyes

November 12, 2012

7:40 P.M.

Today was my last day at the polyclinic, a place where I have gotten to make many new friends.

Morning was again patients, jokes and lots of laughter. I had taken baklava and other sweets for the clinic today. Rumor going around was that they were to celebrate my engagement to Bubblie (joke of course). In the end, I went around the clinic taking pictures and saying bye to people. I went back one last time to the obstetrician's clinic where my new extended family all gathered together—my internist, the obstetrician, my internist's assistant, Bubblie and me. We all joked and laughed together. As usual Bubblie and I were making fun of each other. I had a bottle of hand sanitizer in my pocket and another at home so I thought I'd just leave this one at the clinic. I gave it to the obstetrician and she told me she would keep it to remember me. Her and her husband (my internist) wished me all the success and asked me to send their salaams (greetings) to my parents.

It was somewhat of an uncomfortable moment as no one wanted to stop laughing and get to the goodbyes part. Finally, I started by telling them what an incredible time I had here and how happy I was meeting all of them. I went on to talk about how we became a family here. The internist's assistant—with wet eyes—just grabbed her white "tasbih" (an Islamic rosary) from her bag and handed it to me saying it was so that I could always remember her. More laughter followed with promises of hopefully visiting them all in their homes in Syria some day. The obstetrician and her husband left the clinic as I set off with Bubblie to her family's house like I promised.

At Bubblie's house I stayed for a short while and met her sister (who comes to my house every morning to cook). Then we set out to her other sister's house where I had lunch last time as well. There it took me a while to understand that what was cooking on the stove was eggplant but I finally understood after some discussion. We had lunch—even though I am not a big meat fan the meat fatayer (pies) were delicious! Of course this was followed by tea, fruits and then coffee. Bubblie's brother-in-law and I spoke about politics for a while when we were alone. When Bubblie and her sister joined us again we spoke about India and I answered the questions they had like how many Muslims are there? Where in India do I come from? I will really miss trying to explain things in Arabic. I had a great time talking with all of them until it was time to go back to Bubblie's house even though her sister and her niece did not want me to leave. I said my goodbyes to them and told Bubblie's sister the truth—that she is an amazing cook.

Back at Bubblie's house, when I entered and sat I was attacked by a group of kids (six) who all wanted to play with me. We played some silly hands game that I taught them. I told them all to have a good look at me because I was the first Indian they had ever seen. Of course I was force fed more food even though I was already full and had just eaten.

Finally, it was almost five in the evening and it was time to say goodbyes to them also and head out with Bubblie. They wanted me to stay longer but I told them that I could not because I had some errands to run. Bubblie and I left the house together with her heading for night clinic while I would go back home. We walked side by side to the main road where we would have to part. As we walked, at moments there would be an awkward silence. The truth is that we had become really good friends and neither wanted to talk about how I was leaving. We made small talk and laughed about silly things. I don't even remember what we spoke about.

When we reached the main road after ten or so minutes, the time came to part ways. It felt really uncomfortable as I told her goodbye and thanked her for everything. I told her she had a great personality and a kind heart (not really sure how much of that I was able to relay to her). She did not say a single word but just started crying quietly. She did not have to say anything and neither did I have to say anymore. I continued walking down the main road as she stood crying waiting to cross to the other side. I glanced back a few times and saw her still standing for a good three or more minutes. With a heavy heart I went home not able to do anymore.

After coming back home I soon went outside again to buy some things for tomorrow. I bought a small elephant for Bubblie (because the nickname I gave her was elephant in the clinic), candy for Bubblie's many nieces and nephews as well as candy for the pediatric clinic (this is a must). I was hoping to buy the little three month old shoes but all those stores had already closed. I will give all the things to Bubblie's sister who will be coming tomorrow morning to fix breakfast at our house as usual.

I pray for the best for all of these wonderful people that I have met (doctors, patients, nurses—all) and the Syrian people. It is time now for this chapter of my life to finish and another to begin. I must get ready to head out to Istanbul tomorrow, though to be honest right now I would prefer to just be back home in Doha (or better yet in Jeddah with my family). I cannot imagine how hard it will be to say goodbye at the end of this year to people I have known in my medical school for six years now.

Okay, I do not know what I am saying anymore—too many emotions—it is time to sleep it all off.

****

Day #17

Off to Istanbul

November 13, 2012

9:40 A.M.

Sad to leave Kilis yet excited about Istanbul!

Gaziantep Airport

November 13, 2012

3:10 P.M.

I am now sitting at Gaziantep Airport waiting to board the plane. The scheduled departure time is about forty-five minutes from now.

I woke up this morning in the guest house, had breakfast and did the last bits of packing that were left. I gave Bubblie's sister the goodies and the elephant for Bubblie as well as said my goodbyes to her and her niece who was also present. Then around 10:30 A.M. Bilal, my mentor/teammate/roommate, came back from the office to drop me off to the main Kilis bus station (about five or so minutes drive away). Since their car had an accident recently the driver actually took me in an ambulance—cool huh?

At the bus station I got off the ambulance—must have been a sight for others to see—and thanked my mentor. He replied, "I know you had a lot to deal with on your own but I knew you could do so. That is why I let you handle it to help you grow." I must say he is right, the experience did change me. I walked into the station and got on a van that left about fifteen minutes later for the city of Gaziantep. [Oh looks like people are boarding now. In short, got to go board the plane now.]

[On the plane now en route to Istanbul].

Back to my story, I rode the bus along with maybe about eight or so more people to Gaziantep. On the highway near Gaziantep, I thought I saw a board sign that read "Havaaliani" (which means airport—not sure if I spelled that correctly). Regardless, not much I could do even if it was the airport and I was now going in the opposite direction. It is not like I could ask to be dropped off on a highway and just follow the board signs to the airport. Anyways, in Gaziantep city we dropped off a few people one by one while I was trying to figure out whether this bus would actually go to the main bus station in Gaziantep or not. I ended up getting off at the last stop in the middle of the city surrounded by other minibuses and vans—not the main bus station. I inquired and with the help of a nice Turkish man who helped inquire on my behalf, I found out that none of these buses were going to be going to the airport.

Oh well, there was a taxi stand right next to this bus stop. So I got into a taxi and told the driver, "I want to go to the airport, havaalani or mataar" in three different languages just to make sure he understood. We went through the lively and bustling city of Antep (as I have come to know that is how the people refer to it) back to the highway that was headed for Kilis. We arrived at the airport about thirty minutes later and I paid him fifty Turkish Liras (about twenty dollars). Thank god I listened to my roommates and left for the airport at 10:30 A.M. instead of eight or nine like I was planning. My flight was not till 3:45 P.M. and I was at the airport by 12:30 P.M.

I will be arriving in Istanbul shortly where I have to take the metro to the old Sultanahmet area (near the Blue Mosque and Hagia Sophia) where my hotel is located. First thing I will do when I get there is take a hot shower and then just go walking around exploring and grab dinner.

Oh and having watched recap episodes of LOST (because they were for free on iTunes) is making me slightly nervous as I fly on this plane.

Istanbul—Hunting for My Hotel

November 13, 2012

7:30 P.M.

It took me about an hour or two to get to Sultanahmet District from the domestic terminal in Istanbul. I took the tram and enjoyed the ride through the ancient city. The streets were full of life with numerous busy stores neatly placed between historical monuments.

When I got off the tram at Sultanahmet, I was greeted by a breathtaking view—the Sultan Ahmet Mosque (Blue Mosque) lit like a star against the night sky. I pulled my small trolley suitcase as I tried to take it all in. I walked towards the Blue Mosque while trying to use my phone to locate the hotel. I guess I must have looked slightly confused as a middle-aged Turkish man stopped to greet me. He asked me where I was from and if I needed help. I showed him the address of my hotel and he told me to walk through the Sultan Ahmet Plaza, past the mosque and take a right at the end. Once, however, I did get to the end of the plaza and take a right I was lost again. I felt like I was in a labyrinth of some kind with small streets that all looked the same going in all directions. After walking around up and down the sloped alleys for about twenty minutes someone was finally able to correctly help me get to my hotel.

Just checked in to my hotel room and now I am going to take a quick shower before heading out.

From Belly Dancers to Drinks—Invitations

November 13, 2012

11:20 P.M.

After taking a quick shower I marked my hotel on my phone's map and headed out to explore the Sultanahmet District. It took me about five to ten minutes to get back to the Blue Mosque. I strolled around the Sultan Ahmet Plaza (previously the Roman Hippodrome) and took pictures. I spotted the Hagia Sophia across from the Blue Mosque to the left. The architecture is just simply stunning. My only regret is not having a professional camera so I could at least try to do some justice to these places. I spent a couple of hours walking around the Hippodrome (now Sultan Ahmet Plaza). There is just so much history that after barely seeing even a portion of the city I felt very overwhelmed. Everywhere your eyes gaze you can see beautiful ancient slender minarets peeking out—each one with its own history. For someone like me who loves mosques and their architecture, this place is like a little heaven. The streets were full of people from all around the world; I heard so many different languages. Definitely a change from Kilis where it is only Turkish or Arabic. There are so many shops all around open till late.

_Oh and now the interesting people I met tonight..._

I was simply walking in the park located opposite to the Turkish hamam, between the Blue Mosque and Hagia Sophia, taking pictures when someone approached me. He was a well-dressed gentleman who looked like a businessman. He asked if I knew whether the Blue Mosque would be open or not at this time? I replied, "I don't know" with an equally puzzling expression. He figured I must be a tourist as well. He started chatting and telling me how he was from Cyprus on a business trip and his name was Ismail. He worked in the carpet industry. He asked me where I was from and what I was doing here. I told him I was here for a holiday of three days. He said same with him though he has been here before. He went on to tell me that he just got back from the Hagia Sophia as it was closing and found it beautiful. He then inquired whether I came alone to Istanbul and I told him yes. He asked me what my plans for the night were and I told him nothing specific but I was going to walk around Sultanahmet. He told me he was invited for a Turkish night which he planned to attend because it was for free and there would be belly dancers present. He asked me to come with him stressing there would be belly dancers. I told him I'd prefer to explore Sultanahmet further and sleep early. So, we said our goodbyes and parted our ways.

_[About fifteen minutes pass and I am standing in front of the Hagia Sophia taking pictures of it when another man comes up to me—he definitely looks Arab.]_

He approaches me and asks if I have a lighter and I tell him no. Then he starts talking about himself and how he is from Saudi Arabia. He asks if I am here for business or tourism, I tell him for tourism for a few days. He asks if I am alone and I reply yes. He tells me he came from Riyadh to meet up with a friend who is from Kurdistan. At this point I also tell him that I grew up in Saudi Arabia. He is actually working in Doha and then asks what I do. I told him I am finishing up medical school in Doha. He is shocked and asks my age telling me I look too young for medical school. Also, he tells me he thought I was Arab. Again, same question—I got any plans for the night? He invites me to join him and his friends for drinks and then asks, "Do you drink?" I reply, "No," to which he instinctively and defensively replies that many Saudis go abroad and drink. He then asks which hotel I am staying at (I lie) and he tells me which he is staying at. Again, I tell him no I am not interested and will just walk around. We say our goodbyes and he leaves.

I don't know what it is—maybe I look sad alone like I need some company? I don't know, both times I was just minding my own business trying to take pictures.

Oh and this cold air has given me a severe headache.

****

Day #18

Exhausted—All in One Day

November 14, 2012

11:50 P.M.

I woke up and headed upstairs for breakfast around 7:30 A.M. but was informed that it does not start till 8:10 A.M. So I came back to my room, took a shower and got dressed. At breakfast I was asked by the waiter if I was Malaysian. This helped explain why a shopkeeper was screaming "Malaysia Malaysia" as I was walking by—many shopkeepers in Sultanahmet can verbally harass you and get annoying. After breakfast, which wasn't really good and I didn't have much, I began my adventure at around nine.

1. Hippodrome: During the days of the Byzantine Empire it served as an arena for chariot racing. Today, it is just a courtyard with four monuments right in front of the Sultan Ahmet Mosque.

2. Hagia Sophia: Spent a couple of hours in there without even realizing. It is simply beautiful and the architecture is stunning to say the least.

3. Topkapi Palace: This took a long time to see as it was over a large area with many chambers to see inside. The most exciting part for me was seeing objects on display that belonged to Islam's last Prophet and his companions.

4. Istanbul Archeology Museum: It was located next to the Topkapi Palace and was enormous with history from around the fourth century BC to present. I was just so exhausted at this point that I started walking fast with quick glances eventually—it was just never ending at some point.

By the time I got out of the museum it was around 3:30 P.M. I was hungry and exhausted of walking on foot for so long. So I decided to get a chocolate bun from a street vendor and headed back to the hotel with my dead phone (which meant no more pictures). I relaxed at home for about an hour while my phone charged and then left. I was planning on traveling to the Asian side of Istanbul but that didn't end up happening as the tram I took decided not to go to the final destination which would have been on the Asian side. (Istanbul is three parts separated by water with my part—clearly being the ancient Constantinople—connected to the other European part which is then connected to the Asian side by the Bosphorus Bridge.)

I met another random person along the waterside, of course while I was taking pictures, who approached me and started conversing about Istanbul. He offered me a cigarette and I told him I do not smoke. He then went on to talk about how he was here alone for a few days. He asked if I minded him talking to me and I lied, "No." I was falling behind schedule. Nevertheless, he was useful enough to let me know that I could take a ship for just six Turkish Liras (about three and a half dollars) to go to the Asian side directly. I will probably do that tomorrow. Anyways, our conversation which lasted for a good twenty minutes was followed by a lot more of walking around the ancient city of Istanbul.

5. Grand Bazaar: Got lost in this huge bazaar.

6. Nuruosmaniye Mosque.

7. Yeni Cami (New Mosque): Heard the most beautiful Athan, call to prayer, ever.

8. Süleymaniye Mosque.

9. Şehzade Mosque.

10. Valens Aqueduct: A two storey structure of arches from the Roman times for directing water to the city.

11. Fatih Mosque

I saw a lot of other huge mosques—don't know their names (and not necessarily in the order mentioned above). Haven't entered Sultan Ahmet yet (the famous Blue Mosque) as I am leaving that for the end. Although, it would be sad if I end up missing it. I am planning on attending Friday prayers there. Clearly I covered a lot of ground on foot today and it is pretty impressive for just one day in Istanbul. I also spent time walking down the street of Fatih Mosque as it was full of shops and people.

I love this city because it is so rich in history. You can enjoy walking around and won't mind getting lost because there are just so many tourist spots everywhere. Only issue at the moment is the weather as there is always a really cold strong wind blowing. It has been freezing my face and hands as well as giving me severe pulsating headaches.

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Day #19

Basilica Cistern and Sultan Ahmet (Blue) Mosque

November 15, 2012

12:30 P.M.

Just checked in to my other hotel—the one I had initially booked when I was planning on staying in Istanbul for one night only. This hotel is on the main street facing Sultanahmet metro station; so the location is amazing. I am looking forward to breakfast tomorrow on the terrace because the view of the Blue Mosque is supposed to be spectacular.

Today I started the day a bit behind schedule leaving my hotel at 9:20 A.M. in the morning. I went first to the Basilica Cistern—wow that place was stunning. Definitely one of my favorite sites in Istanbul. It is an underground chamber full of columns and water with large scary looking fish. You have to walk on the wooden planks to get around. The aura it creates is definitely one that is archaic. One thing is for sure, I would not want to be left alone here. It is a bit spooky and dates back to the sixth century when it served as a water reservoir.

After that I toured the Blue or Sultan Ahmet Mosque. The interior is beautiful to say the least with a lot of fine interior work. Now, after seeing so many mosques I can see the resemblance to the old Ottoman portion of the Prophet's Mosque in Madinah.

It is now time to head out to where the ferries are located so I can go over to the Asian side and take a quick look around. I think I've nailed most of the major tourist attractions already.

The Panorama View of Galata Tower

November 15, 2012

11:50 P.M.

I was hungry so first I had lunch. I was looking for the perfect place when I found an alley where I saw Turkish men and women in suits having lunch. I sat at an empty table in one of the small busy restaurants in the alley. They had many newspaper clippings on the table bragging about how good their meatballs were. I ordered chicken shish taouk and meatballs. Now, I am not really a big fan of meat but their meatballs were amazing—loved them! The chicken shish taouk—not so much—had better in Kilis.

After lunch I took the ferry or water public transport (for three Turkish Liras only or one and a half dollars) to the Asian side. The ride was amazing and the view of course beautiful. On the Asian side I walked aimlessly—hoping to find a metro to explore further. I walked around what looked like a Presidential Palace; it was enormous as well as heavily guarded. It was nice walking around the university area and I saw a lot of students rushing to classes. Eventually I ended up making my way back to the ferry place via another route as there wasn't much to see on the Asian side. I got onto the ferry and headed back for the European side with my hotel on it.

From there I took the tram to the other European side to visit the Galata Tower. [Note: Istanbul is split into three parts by water with two considered part of Europe and one part of Asia.] Now, the Galata Tower took some hard work walking uphill to get to but it was definitely worth it. This ancient tower with a long history of being used as a place to watch for fires all the way to being used for prisoners had a breathtaking three hundred and sixty degrees view of Istanbul. The gallery or terrace or roof—whatever you want to call it—was less than a meter wide and encircled the entire tower. From here I could see all the major historic monuments from the Hagia Sophia to the Süleymaniye Mosque. My only regret is not having a professional camera. Not to mention that I was there for almost an hour and watched the sun set but by this time my phone had died—because I was smart enough to leave my GPS on for a long time. Also, at Maghrib (evening prayer) it was magical to hear the Athan (call to prayer) coming from every direction around me.

After that I pretty much explored the city mainly by foot, but unlike yesterday I did use the bus, tram and metro more. I am simply in love with the city—one of the best cities I have ever visited. Actually, I think this is my favorite city I have visited so far. There is everything here! I cannot believe that tomorrow I will be Doha-bound with still so much more to. I wish I also had the time to actually visit Troy and other historic cities near Istanbul.

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Day #20

1453: Conquest of Constantinople

November 16, 2012

11:20 P.M.

Right now I am aboard Turkish Airlines headed back for Doha. I cannot believe it has only been three weeks in Turkey. It feels more like I have been out of Doha for months.

Going back in time—I woke up in the morning earlier today and had breakfast on the terrace. It was a great feeling sitting on the terrace with the sun shining on me while I ate watching the Blue Mosque not far away. After breakfast I decided to go to the Panorama 1453 Museum. 1453—this date has now been inscribed in my head after hearing it so many times. It corresponds to the year that Constantinople fell into the hands of the Ottomans under Sultan Mehmet (Mehmed II). To get to the museum I took a tram from the station facing my hotel. It took me about twenty minutes to get there. When I arrived I was greeted by a mesmerizing sight as the museum was located behind the very walls of the Byzantine Empire. These walls of Constantinople once stood impenetrable to any attack until 1453 when they were breached by the Ottomans. Today these walls lie in ruins reminiscent of the numerous wars they have survived.

I entered the museum where this time I decided to take the audio guide, which was a great decision as it made the whole experience more enjoyable and understandable. The museum—well maybe you will understand how I felt once I describe it. You head down two floors and enter a small dome. In the dome there is a huge mural spreading three hundred and sixty degrees all around you (including the ceiling). In front of it you can see replicas of weapons like cannons, swords and bows amongst others. The painting depicts the conquest of Constantinople with sound effects taking you back to 1453. With the aid of the audio guide I was able to understand the different parts of the scene on display from the janissaries to the sultan leading his troops all the way to the cannonballs in the sky. It was a spectacular sight to say the least and you just have to walk around in a circle to see the entire scene. Definitely worth going to and I spent quite some time walking around again and again admiring the view.

Then, after leaving the dome I walked by the various posters or sceneries in the museum with the audio guide explaining different parts of the Ottoman history. Clearly, I love history and Istanbul is a haven for history lovers.

After the museum, I got back on the tram for Sultanahmet District to attend Friday prayers at the Sultanahmet (Blue) Mosque. In the mosque, and I don't know if they do this every Friday, there were various reciters from around the world with beautiful voices who one after the other recited the Quran. One of them I am pretty sure was from Saudi Arabia judging by his clothing. After half an hour it was time for the Athan (call for prayer), which was followed by the sermon.

I went back to my hotel after prayer and checked out. Since I still had time to spare before my flight, I decided to leave my luggage at the bottom of the hotel and head back out again.

I decided to visit the other European side of Istanbul to have a look at the Dolmabahçe Palace. This palace served as the residence for the sultan and his family from the late 1850s and onwards. Prior to this they used to live at the Topkapi palace, which I visited on my first day in Istanbul. From first look you can notice the striking differences between the Topkapi and the Dolmabahçe Palaces. The former's architecture and interior design is a mixture of Byzantine and Ottoman craftsmanship while the latter—well the first thing I thought was Versailles Palace, France.

The Dolmabahçe Palace is enormous in size with the exterior reflecting western European culture. A fountain of geese and fish statues with water gushing out of their mouths greeted me by the entrance. In the gardens surrounding the palace was a section for birds from quails to hens and fowls all the way to peacocks to roam around freely. One of the rooster creeped me out because it was staring at me. And as I would move it would follow me; thankfully it did not peck me. I love peacocks—maybe it is the Indian side of me—because I think they are majestic creatures and it was amazing watching them walking around next to me in the gardens.

The funniest thing I saw was the scene of a peacock and about five or more cats. The cats were all so scared of the peacock, which I found surprising. [Okay, I think one of the passengers on the plane just farted. In case you forgot, I am currently aboard a plane headed for Doha.] While I was waiting in line to enter the harem, where the sultan and his family used to have their residential quarters, there was a café. At this cafe some people sitting on a table started throwing these small soft chewy cookies to the peacock (I think so they were cookies). The peacock would quickly grab them in its beak and gobble gobble it would go. The funny part was all the cats that were trying to eat them as well but couldn't. Because as soon as the cookie would touch the ground the peacock would move in fast and peck it off the ground. At one point one of the cats actually tried slapping the peacock as it stole its food. Everyone was enjoying the show while the poor cats were scared.

Inside the harem, where photography was not allowed, it was utterly magnificent. Wow, the amount of money they spent on the interior and the furnishing; the chandeliers, mirrors, the chairs all the way to the beds. The tour guide told us that much of the furniture was imported from France and one of the Sultan's grandmother was French which may be one of the possible explanations for its heavy influence. He also informed us that once the last sultan was exiled this place became the home for Atatürk, the well-known founder of modern Turkey as well as the first president of the new republic.

After the museum I wanted to visit the "Prince Islands" but couldn't as it takes about an hour and a half just to get there. So I headed back to my side of European Istanbul to the small meatballs restaurant where I had lunch yesterday. I love their meatballs so much that initially I ordered one portion—comes as 6 small pieces—after which I had to order another half portion. I wanted to then revisit the Basilica Cistern since I loved the feeling I felt when I was down there but unfortunately it was closed by the time I got there.

For some retarded reason, even though I had checked my ticket a million times over the course of the last few days, I was convinced 20:50 referred to 10:50 P.M. Since I had nothing to do I headed for the airport and thought I was leaving pretty early. Once I got to the airport I was shocked to find out that my flight was not around 11:00 P.M. but rather 9:00 P.M. Typical—got a flashback to Geneva a couple of years ago when I missed my flight because the country suddenly decided that day to run on daylight savings.

Now, on board the plane I will be getting back to my movie— _The Watch_. Actually it has been playing in the background on the airline entertainment system while I have been typing this blog post.

Exhausted.

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Day #21

Reflections of a Traveler: My Last Blog Post

November 17, 2012

10:20 P.M.

Today is Day #21 and officially the last day of my trip as I arrived back in Doha around 2:00 A.M. This will be my last blog post—possibly ever—and truth be told, I am shocked that I managed to write everyday for three weeks straight. Since it is my last post, it seems fitting to reflect on my journey.

I cannot believe three weeks ago was the first day that I landed in Turkey and somehow made my way to Kilis, where I got lost and stranded. I remember riding on a bus through the city of Kilis while carefully evaluating all my possible options. One of them I thought to myself was to find a small hidden dark corner between some buildings where I could hide. I even told myself that if I found the right spot the chances of getting mugged would be low. After all, I just had to survive one night out on the street. Thankfully, I got guided to the only hotel where I found a café with internet to type away as I sipped my first Turkish coffee.

My adventure—as I'd like to think it was—has been a powerful and enlightening one. True, I intended to volunteer at the Kilis refugee camp but due to some miscommunication and misunderstanding was not able to do so. Still, I was able to make the most of my trip by spending my time instead at a free polyclinic for Syrians. During my time there I learnt much about others and myself.

**1. Medicine:** I came to see how medicine truly is a universal language. It allowed me to communicate with my doctors and staff members at the polyclinic through limited English. The words we used may have been different but we understood each other well. It reignited my passion for medicine and reminded me sternly why I wanted it as a career. I saw how the patients viewed and respected these doctors and the prayers they would say for them. I saw the power words of comfort provided patients as did the drugs. I saw the significance and importance of viewing mental health as a legitimate and important concern for these people.

**2. Polyclinic:** I got to witness a polyclinic grow and expand over just three weeks. I saw how a clinic that started two months ago worked behind the scenes. How they sought to improve and the steps they took in that direction. The joy of seeing simple machines like an ultrasonogram being donated to the clinic allowing better care to be given. Or the joy of adding an ophthalmology clinic to the existing internal medicine, pediatrics, dentistry and obstetrics & gynecology clinics. Pharmacies donating boxes of medications, some of which were expired while most were not. Once there were six boxes of which three were only filled with antifungal creams. The clinic had to constantly improvise with what they had. I witnessed the struggles a clinic had to go through as at times most basic medications like paracetamol would not be available. Not to mention how many medications would be administered as intramuscular injections when most of the world had them available in an oral form. I came to understand that the polyclinic's mission was to provide symptomatic relief rather than diagnoses. It was indeed an eye opening and inspiring experience.

**3. The People:** The greatest moments I enjoyed were spent with the people of Syria. I instantly fell in love with them as they were very hospitable and social. The doctors and patients all shared their stories and I was able to first hand listen to what they had been going through. I promise you it is not the same as watching it on the news. I got to see how these people struggled for basic things like access to food, healthcare and education. Worst of all, I knew that these were some of the luckiest Syrians as they were able to enter Turkey legally and afford a place to live. Others not so fortunate were in refugee camps (according to MSF the one in Turkey is the best they've ever seen). Still, thousands live under the daily bombardment over the Aleppo Province. Yet, with everything happening in their lives, these people could still show up at the polyclinic laughing and joking. If I were not aware of their circumstances I would think they led "normal" lives. But behind all that laughter is the pain and suffering that somehow they are able to hide. They all dream and pray one day to return to a free Syria.

It's funny when we think about the simple things that we complain about—I know we all say it—but you've really got to see it to understand. We are so lucky to have access to some of the best educational systems while there are those who have money to send their kids to school but cannot. For example, in Kilis all schools are in Turkish which most Syrians do not speak. Lack of education with a buildup of mental stresses is a recipe for disaster. We should take the time to be thankful for that which we have—Al7amdulillah.

I will miss my time in Kilis as this experience has taught me much about life. I hope it will inspire me to be the best physician that I can—not for myself—but for people like them who need and deserve the best.

Thank you to everyone that has been reading my blog and supporting me to continue writing. When I started I actually did not expect so many people to be interested in reading my story. I hope that I have inspired others to help further propagate the Syrian cause; more than I ever could. Overall, I hope I have been able to put a more humanistic touch to the Syrian crisis.

I pray that one day I will be able to visit a free and peaceful Syria. May God bless the people of Syria and all those that are oppressed by their regimes, families or whatever institutions they may be.

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