International work, medical or otherwise, is dangerous. Maybe only a little more dangerous than normal American life, maybe quite a lot. A long-term Christian missionary doing really, really good work was gunned down in Haiti just today.

About as remote as it gets.

I myself have done relief work in Haiti. One of the places I worked is located in the hills of a village-esque area called Noyau. This place is about as remote from civilized life as I can recall being in my life.

After an hour of 4WD driving on extremely-rough dirt switchbacks up a mountainside, we pulled on packs and hiked for another hour+ to reach the area of our clinic. If something went wrong out there, the time required to receive aid would exceed 4 hours easily. Assuming emergency crews had access to a 4WD vehicle, which is doubtful.

I recall thinking, as well over 100 Hatians stared at us zipping ourselves into our expensive tents and sleeping bags at the end of a clinic day, how honorable they were as a people. They had hiked for many hours to find our clinic, and often the only thing we had to offer them upon their arrival was a few TUMS tablets. Frequently their medical problems were either too complex for us to help with, or, more commonly, we simply didn’t have the medicine or procedural ability they needed.

But they could have robbed us. Selling our nice North Face and Sierra Designs gear would have fetched an impressive price in Port au Prince. Furthermore, they could have kidnapped us and held us for ransom. Now we’re talking real money. Until they talked to my wife, who would probably say something like, “Take ‘im. Never does the dishes anyway.”

We were totally vulnerable in that village. But the reason, I believe, nothing bad happened was simply because most Hatians are good people. Honorable people. Honorable, even, by my wealthy American standards, where respect for property and life is alive and well. They let me keep my nice tent, even though they couldn’t be sure of their next meal.

Similarly, while working in the Galatsia camp on our 3rd day in Athens, I ended up in an extremely vulnerable position. Again, we came out unscathed largely because most people are, quite simply, good.

Prior to entering the camp, I asked one of my team members with military training to effectively serve as our “security.” He took his role seriously: identifying sight-lines, exits, areas of risk, areas of relative safety. He developed rudimentary emergency plans, identified key leaders in the facility and communicated escape plans to our team.

But for some reason, when I was asked to leave our clinic to go see a patient reportedly too sick to walk to us, I didn’t think to ask our security guy to come with us. In “medical mode,” it’s difficult to think in “safety mode” too. Our task is to meet needs, not protect ourselves, and the thinking between the two is often very different.

See all the people? That lady in blue is an aide worker. Behind me was a large room, a courtyard, and a line of police. I thought we were going here.

I also believed we would be going to one of the large rooms with lots of people, located near the entrances, near the police, organizers, aides and managers.

That’s not where we went.

Led by the sick woman’s husband, we walked down corridor after corridor. Branching off from each of the primary hallways were other halls, down which I saw a half-dozen young Middle Eastern men, crouched against the wall, all looking at me. The halls were strewn with trash, cell phones hanging by cords from every available outlet. I heard yelling, some laughing, but mostly saw numerous drawn, emotionless, bored faces. There was no joy.

I went with our clinic organizer (a Persian woman who organized the whole medical clinic, speaks numerous languages, and knows what she’s doing) and, as luck would have it, the pastor of the local Calvary Chapel we’re working with who saw us wandering away and followed. So at least I wasn’t alone.

This happened in the Philippines just last month. However improbable, we could have rounded the corner and found guns and flags, not a patient.

But after the 3rd corridor, and up a large flight of stairs, then outside the building and then back into it and around a corner, I knew that if someone wanted to do us harm, they would have succeeded. We’d followed this guy like ducklings.

But he didn’t harm us. All the man wanted was to know if his wife would be OK, and if it might be possible to get her on her feet by that evening, in hiking condition. He intended to continue his journey into Europe as soon as he could.

I diagnosed viral gastroenteritis and told him she may be ready to roll by that evening, but giving it another day or two would be better. He clearly intended to leave that night, despite what I’d said.

Later, of course, we laughed about this. Our team leader, Sahar, laughed at me for being so worried.

But the truth is that there is no way to do this work without incurring some amount of risk. Usually the risk is small, thanks largely to the fact that although there is terror and violence in the world, most humans on this planet are good, fairly honest people. Most are just trying to make a better life for themselves and their children.

As are we all.


On day 3 we left our makeshift clinic in the 2nd Evangelical Church of Athens to work in one of the main refugee “camps” in town. But it isn’t a campground. It’s one of the main stadia used in the 2004 Olympics, located in the Galatsi suburb of Athens.

The story of how this stadium came to be used for refugees is emblematic of the refugee crisis in generally. The stadium has been shuttered for years, no lights, no electricity. But with thousands of people suddenly camping in parks all over Athens, the people of the city were understandably upset. Furthermore, anti-immigration groups were organizing and preparing potentially-violent opposition to the influx.

So the Minister of Immigration apparently decreed that refugees would be moved to the Olympic Stadium. Only then was the mayor of Galatsi notified of the dictate, while also being told that he was, in fact, in charge of the stadium.

Queuing up for lunch. The food I saw was a step up from David Copperfield-esque porrige, but not by much.

On balance, it’s a good plan. There is lots of room there, the people and tents are out of the parks and off the sidewalks. The Greek Army (I think) has been tasked with feeding the refugees 3x per day, an endeavor equal to any reasonably-trained Army. It also protects Greek political leaders from human rights criticisms, since the people are being cared for while not upending entire neighborhoods.

There is both massive influx and efflux of people from the stadium every day. Nobody intends to stay for long; the Greek government does not plan on operating the facility indefinitely either.

We were given an emergency medical license under which I could function as a de facto Greek doctor on days when I worked at any of the camps. We were asked, really more like begged, to work at the Galatsi camp because over 1000 people were there, with hundreds requesting a doctor.

Here are some observations from that day:

  • 5
    Lots of people, all trying to help. Not a lot of organization.

    We worked out of a small room, filled with donated medicines, even some supplies. It was better-appointed than I expected. It was cramped, sweaty and regularly filled with people for myriad reasons. A hazy notion of ‘organization’ came and went throughout the day.

  • We infuriated the Greek doctor, a pulmonologist, who is overseeing the medical room in the camp. We had been “begged” by the ministry of immigration to come work that day. She was never notified. So our presence was a surprise to her. She wasn’t, however, working. Nobody was. She showed up, yelled at us about attending a strategy meeting in a few days, hung around for a bit, then left.
  • The Greek Government is doing better with this crisis than reported. There
    Areas around Greece where people are helping with the refugee crisis either directly or by collecting donations, etc. Click this pic for an interactive map.

    were police on the campus (until later in the afternoon, when they apparently lost interest and wandered away). There were GIANT piles of clothes in the “clothes section,” and everyone had food at mealtimes. The camping areas were dry and were clean if the refugees cleaned up after themselves (some did, some didn’t). But the same Greek Government has relied heavily on individual donors, NGO’s and privately-funded clinics like ours’ to make this some sort of controlled chaos.

  • Before we started, I watched a T.V. reporter van pull up next to a nice black car, out of which stepped some guy in a suit. The camera started rolling as the guy stood next to a reporter-looking person. There was a quick interview, then some panning shots of the facility. Then the guy got back in his car and drove away. I found out later this was some politician getting time on T.V. “working” at the camp. This is happening on the local Greek news, with dignitaries, including local doctors, posing as helpers in this crisis.
  • The majority of refugees in the camps and on the streets are from Afghanistan and Iran, not Syria. In general, the Syrians have more money and are staying in rented apartments. Usually, those apartments are being sub-let (for a substantial profit) by other refugees. It’s a dog-eat-dog environment.
  • 4
    Quite a few meds. No smokable opium. No opium t all, in fact.

    I saw a patient with back pain who was smoking opium for pain control. He said he didn’t want narcotics for his pain, but also said nothing else worked for him. As our clinic absolutely has no narcotics of any kind, we offered him some non-narc alternatives. He left, unhappy, then returned later, forcing his way through the scrum outside to “complain” about our “service.” Apparently narc-addiction and the behavior it engenders knows no social or ethnic boundaries.

  • Our clinic lead, the Persian woman who organizes these clinics (a refugee herself 15 years ago), wisely did NOT allow advertising when we started our clinic day. Just by word of mouth alone, we were nearly overwhelmed with a shouting, occasionally-pushy mass of people that formed outside our “clinic” shortly after we opened for business. HUGE credit to a great team in front of me to help control and direct the traffic outside.
  • The Mayor of Galatsi, and manager of the camp, is not a happy man. The Greeks dislike him because he’s helping refugees invade their country. The refugees don’t like him because he oversees a camp perpetually under-resourced. The political class over runs him, taking their own photo-ops and garnering the credit for the work being done there. When I met him in the camp, he half-shook my hand, then tersely told me to “get to work.” Can’t blame him.

I was worried to work here for a host of reasons, but I’m glad I went. I wish we could spend more time in the camps. Getting patients to our clinic at the church was a big challenge. No problem here.

Medical Case


A 44 year old man came to our clinic today with a description of chest pain, mostly on the left side. He says it’s been ongoing for about 4 months.

He arrived in Athens about two weeks ago, with plans to head to Germany in another week. He was seen last week at a Doctors of the World clinic in town for the same problem.

He says they gave him the above EKG, told him he was having a heart attack, and sent him out the door with 10 pills of Prilosec and instructions to go to “the hospital.”

Due to money restrictions, lack of transportation, minimal confidence in, and maximal confusion from, his interaction with his Greek-speaking doctor, he did not go to the hospital. He instead came to our clinic 4 days later, worried he was dying from a heart attack.

How would you handle this?

My Take On The Politics

There certainly isn’t universal agreement on the refugee crisis. In fact to some, the term “crisis” is itself questionable. Many have described this as an outright “Muslim Invasion” of Europe.

As I attend a Calvary Chapel, where simplicity of thought reigns supreme, here is my super-simple take on the political side of this, using a bit of alphabet soup.

I recognize points in the following argument that lack nuance; I do not purport to know answers to this crisis. I can only say that the below line of thinking is viable enough to justify, to myself, the work we are doing here:

Say you come across a guy who has been walking, hiking, crawling from point A for the past year. He has lost half of his family and most of his money on the journey.

His intention is to reach point Z. But you meet him at point T. He is cold, wet, hungry, possibly sick and terrified especially of what awaits him should he return to points A-P(ish).

Given his determination to reach point Z, do you REALLY think ignoring him at point T will discourage him from reaching his goal? Furthermore, those of us comfortably sitting at point Z, do we want to receive multitudes of people who were ignored, possibly abused, at all points along the way?

Most of our larger endeavors in life are gambles. There is no way to know the outcome of our actions until we look back later and see how things turned out. We can’t know how the Western world will change as a result of these things happening today.

And so in this, one the greatest crises ever seen by the combined Western and Eastern worlds, bets need to be made.

As such I bet on love and kindness. Rarely, if ever, do these things result in loss.

FILE - In this Wednesday, Oct. 3, 2013 file photo, a Syrian man cries while holding the body of his son, killed by the Syrian Army, near Dar El Shifa hospital in Aleppo, Syria. Almost a quarter-century ago, a young American political scientist achieved global academic celebrity by proclaiming that the collapse of communism had ended the discussion on how to run societies, leaving "Western liberal democracy as the final form of human government." In Egypt and around the Middle East, after a summer of violence and upheaval, the discussion, however, is still going strong. And almost three years into the Arab Spring revolts, profound uncertainties remain. (AP Photo/Manu Brabo, File)

Lentils or Needles, Your Choice

The Church (not abandoned, as I first thought) were our clinic is located.

We saw around 15 patients on our first day. If I this was a video game (maybe all of life is?), by the end of the day my strength bars would have been around 2/5.

Today we have nearly 30 people on the schedule, plus a smattering of missionaries who seem to filter in with loooong lists of medical questions.

The missionaries are amazing. Most consider themselves to be “married” to the mission field, and are here by themselves, living on donations. And not just for a week. For years.

If you’re looking for “underserved” medical communities, no matter your own personal faith persuasion, here’s one. Most Christian missionaries donated their health and bodies to their work long ago. They see a doctor when they can (read: every 5 years on average), but it’s never a regular thing for them.

One question from a missionary yesterday, “We’re so excited. We’ve been given permission to use an old elementary school from the Greek government. People have been defecating and doing drugs in there for the past 5 years. All we have to do is clean it out, and it’s ours! Do I need Hep B vaccination? I think I had one of those shots. What about that HiB thing? Oh, and what about tetanus. Can’t remember when I last did one of those. And should I wear gloves? Maybe a face mask?”

Afghan migrants arrives on the shores of the Greek island of Lesbos after crossing the Aegean sea from Turkey on a inflatable dinghy, Thursday, Sept. 24, 2015. More than 260,000 asylum-seekers have arrived in Greece so far this year, most reaching the country's eastern islands on flimsy rafts or boats from the nearby Turkish coast.(AP Photo/Petros Giannakouris)
Afghan migrants arrives on the shores of the Greek island of Lesbos after crossing the Aegean sea from Turkey on a inflatable dinghy, Thursday, Sept. 24, 2015. More than 260,000 asylum-seekers have arrived in Greece so far this year, most reaching the country’s eastern islands on flimsy rafts or boats from the nearby Turkish coast.(AP Photo/Petros Giannakouris)

Another story: 12 year old girl with dizzyness. She left with her parents from Afghanastan over 6 months ago, running from the Taliban. The family took a number of cars overland from there to Tehran for around 20 hours. They then hiked from Tehran to somewhere in Turkey for days, eventually finding their way to a huge refugee camp there.

Then the family found a smuggler who, for most of their remaining money, agreed to put them in an inflatable raft for a trip to the island of Lesbos, which is officially “Greece,” and would allow them to begin the process of obtaining refugee status.

They were required to get from the refugee camp to the coast on their own. Upon finding the launch site a few days later, according to the mother, they found that the raft was about 8 feet long, and she counted nearly 30 people in it.

They were turned back by the Turkish coast guard 5 times before they succeeded. Each time they were turned away, they were “towed” back to the Turkish coast, which effectively half-sunk their raft because the front end kept getting pulled under the water. Although some had life vests, many did not, and nobody knew how to swim, so the affair was terrifying.

This young patient started her period 8 months ago. She has had to learn how to be hygenic in refugee camp conditions. She can’t understand why she feels so weak and tired all the time. I asked her how and what she eats.

“We got cookies on the road from Tehran to Turkey. They were good.”

“Do you eat the food in the camps.”

“Ew. It’s always bean soup, and they never cook the beans.”

I smile and look at the mother, she is looking at me, rolling her eyes. “Lentils, usually,” She says through my translator Sahar (and Superwoman). “But I can’t get her to eat anything. She’s my pickiest kid.”

Here I am, a billion miles from my homeland, from any Caucasian, from my life, and this mother is dealing with a UNIVERSAL problem of parenthood.

“I have the same problem in my house,” I say smiling. The mom laughs.

I then look at the daughter, “You are probably dizzy because you are losing lots of blood every month. It makes people feel weak, tired, cold and dizzy. The best way to take care of it is to eat. Cookies are not food.”

I look at the mom, smiling again, but shrewdly. “But I don’t know for sure if this is the problem. I need a,” (imagine the audio slowing down here for emphasis), “BLOOOOD TESST.”

The girl’s eyes widen. “Uh huh,” I confirm. “With a NEEEDLE.”

Cute, 12-year old crestfallen face. “So I’ll make you a deal,” I continue. “Lentils or needles, your choice.” Mom laughs again, getting it.

The daughter, I hope, got it too. The mother and I were able to make light of this, but it could get serious. The girl’s arms at the biceps are thinner than my wrists.

There are more stories from only this first day. To depict them is like trying to pour the entire Mediterranean Sea into a rain drop. It just can’t be done.

This world, these sorrows, these tragedies…they can only be know by walking, even for a moment, with those that are living them.