Yale medical and public health faculty support colleagues in war-torn Syria

In war-torn Syria, students at the newly launched Free Aleppo University (FAU) Medical School meet in small groups in basement classrooms. It’s too risky to gather aboveground where barrel bombs could decimate the entire class. According to Physicians for Human Rights, more than 700 health care workers have been shot or tortured to death. Targeting physicians and other health care workers by government forces is leading to a massive crisis in the crippled Syrian health system. According to Hani Mowafi, M.D., M.P.H., assistant professor of emergency medicine at Yale, it sends a message to the civilian population. “If they can do that to the most respected members of the community, what would they do to me? As a consequence, people are leaving or dying.”

The war in Syria began in March 2011, after protesters seeking political reforms demanded the resignation of President Bashar al-Assad. Since then, the fight among government forces, nationalist opposition forces, and such jihadist groups as al Qaeda and the Islamic State has killed more than 400,000 Syrians and displaced millions more.

The underground space where the students study is multipurpose—it functions as a lab, classroom, and office for the dean. But they lose electricity regularly, so they rely on generators for power. Satellite and fiber links to neighboring countries provide broadband coverage, but coverage can be spotty and won’t support the heavy bandwidth use that many internet educational resources require.

When the Council of Middle East Studies, an academic platform at Yale for discussion of issues relevant to the Middle East, called for grant ideas, Kaveh Khoshnood, M.P.H. ’89, Ph.D. ’95, associate professor of epidemiology, suggested the theme “Conflict and Health.” From there, an idea was born—to marshal the talents of Yale faculty and students to support health care in Syria.

A weekend-long workshop in May brought together leaders from the Union of Medical Care and Relief Organizations—an international network of NGOs providing health services in Syria—and the Syrian American Medical Society, with faculty from the State University of New York in Albany and Yale to develop plans for such support. They came up with ideas for FAU Medical School, which operates in the north of Syria in areas controlled by the national opposition, and in besieged areas in the south. The school has enough funding for the first year of students, and they’re fundraising for the next year. There are 140 students in the first cohort in the north and 70 in the south. Mowafi says the next class is likely to be just as big, if not bigger. While Yale faculty can’t make it any safer, they can provide resources to support the school’s mission. For example, students at Yale use downloadable materials that allow them to study independently. Getting these resources to medical students in Syria would help them learn in smaller groups and reduce the risks of gathering in large groups. Yale also uses a virtual anatomy program, which could be helpful to the students in Syria, where they don’t have refrigeration to preserve cadavers.

Then there is the issue of their textbooks. “Some of the books they’re using now are photocopies of photocopies,” said Robert Rohrbaugh, M.D. ’82, HS ’86, FW ’88, deputy chair for education and career development in the Department of Psychiatry. Yale faculty are working with Yale librarians to try to provide free access to the thousands of online materials that Yale students use regularly.

To make matters even more challenging, most Syrians received training in Arabic and are unfamiliar with the language of science when it’s presented in English. The University of Albany has devised a program that helps students reach graduate-level English proficiency, which they will deploy to train students at FAU. Beyond supporting the basic science curriculum, Yale faculty are looking into ways they can help Syrian postgraduate clinical workers, providing expertise to the boards that credential their graduates. Through these efforts, they are hoping to supply the system with credentialed doctors and nurses—to revitalize the public health safety net that so many people rely on for care.

Psychological support for the students putting their lives on the line to care for others is also part of the plan considered by Yale faculty. They want to establish a peer-to-peer program, pairing up students in Syria with medical students at Yale. “I think psychologically that could go a long way to make them not feel quite as isolated,” said Khoshnood. “It’s countering what the regime is saying, which is, ’Nobody cares and we can do what whatever we want to you.’ We’re saying, no—you have friends across the world that you can be connected with.”

The Yale team hopes to roll out these initiatives over the next year. They are working with people on the ground in Syria and remain in contact with the dean at the university. As for the incoming class of students in Syria, “they feel a sense of purpose, a sense of mission, a sense of service,” said Mowafi. “People have deep internal reserves but eventually those reserves will be depleted. We’re trying to help replenish those reserves just a little bit.”

For more information, click here to read about how former Yale affiliates are using technology to support the mental health of displaced Syrians.