A Cross Necklace

Being a Christian refugee in this part of the world is a dangerous affair.

Unlike in America, where counting oneself a Christian is increasingly perceived as a designation that affords privilege, sometimes to an unfair degree (I have my doubts on that one), there is no question that the opposite is true in much of the Middle East.

It is easy to see that militant Islamists are actively focused on the eradication of Christianity in at least “Muslim” lands, if not the whole world. This is true to some degree in the refugee camps as well.

Even still, many of the refugees we worked with this week are either committed Christians, or are actively exploring the faith.

The stories of how these people came to their decisions for Christianity vary widely, but most are eye-opening. Few in the Middle East can come to Christ as easily and risk-free as nearly every American can if they wish. Apostasy from Islam is often regarded as an offense punishable by death.

One man I saw this week was openly wearing a prominent silver and gold cross around his neck. I didn’t notice it at first, but as I was listening to his heart with my stethoscope the bright golden object swinging in front of me was suddenly hard to miss.

crossRealizing I wasn’t in America, where crosses are so ubiquitous they’ve become a little trite to me, I exclaimed, “You’re wearing a cross!”

“Yes,” he nodded.

I pondered the implications of wearing that specific symbol in the Islamic world. A cross is better described as cross-hairs for a man like him. Yet he wore the symbol proudly, unapologetically. Should our roles be reversed, would I have the same courage?

“You are a Christian then.” I said, continuing in my new role of Dr. Redundant.

“Yes.” He nodded again, smiling.

Through my translator, I learned that a few months ago in Iran he was awoken in the night by the figure of a man calling him to follow Christ. He said he was convinced that the man speaking to him was Jesus, the Son of God. He knew almost nothing of the Christian faith, as he was raised a Muslim.

Still, upon waking the next day, my patient committed himself for following Christ. He felt he had to do this. It was an inner compulsion; he had been called to a new faith, a new life, no matter the cost to him.

But it was indeed a ‘costly’ decision. Read anything about the Islamic regime of Iran (I recommend the the wonderful autobiography Persepolis as a cursory intro if interested), and you will know that the government of Iran is itself a religious organization. Along with typical functions of any secular government, like providing running water, working roads, electricity and health care (which in many instances, the Iranian government does quite well), it also enforces a highly conservative interpretation of Shia Islam.

How do they enforce such a thing, you ask? How do you get a nation of 77.5 million people to follow extremely strict religious rules? How can you enforce an entire nation to put every woman in robes and headcoverings, to allow no music, no dancing and to enforce frequent observance of Islamic practices like 5x daily prayer?

With “religious police” of course!

As a kid from the suburbs of America, following a Christian faith I was always free to reject, it took some reading and imagination for me to even comprehend such a notion.

It was only in 1979 that the Iranian Revolution took place. Prior to that, Iran probably looked much more like America than it does today. But in ’78-’79, things changed dramatically, as that was the year of the Iranian Revolution. It was then that the Pahlavi dynasty, led by Mohammed Reza Shah Pahlavi was overthrown by the Islamic Republic.

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Supporters of the Revolution. Didn’t Turn Out Like Many Expected.

The Republic was initially a political movement, comprised of a collection of leftist thinkers, activist students and numerous Islamic movements. It was led by a powerful Islamic leader named Ruhollah Khomeini, a scholar, author, politician and political revolutionary.

After the Shah was forced from power, to the surprise of nobody, Khomeini was designated as the Supreme Leader of Iran. However, TO the surprise of many, Khomeini was given final authority on both political and religious matters.

The irony of this transformation is hard to miss. Criticism of the Shah centered around how difficult it was for the commoner to be heard. The Shah’s rulership was a dynastic monarchy, with power passing from father to child generation after generation. This meant that nobody could rise from, say, a community organizer and member of a minority comprising 13% of a nation’s population, like Barack Obama, to the highest position of power in the land (Huzzah! Huzzah! Democracy!).

Yet the solution to this problem that emerged in Iran was the Islamic Republic, which consolidated both political and religious power in one man. The power of the rulers of Iran was, effectively, broadened as a result of the revolution. The “little people” never got their say. And, I suspect, many of those who supported the Revolution experienced colossal disappointment. Power just went from one ruling class to another. To this day, a Khomeini rules Iran.

Some version of the above rushed through my mind as I stared at the cross hanging from my patient’s neck. An Iranian, 4 months in Greece, wearing a bright silver and gold cross. Wow.

As it turns out, the father of this man was a member of this religious police force. This patient had chosen to convert from Islam to Christianity as the son of a man who is tasked with enforcing and promulgating Islam in the country. More irony.

Imagine the shame on their family for such an act! Aside from endangering himself, my patient was possibly even endangering his own father (and mother).

Many immigrants come to Europe because they think it is rich, with jobs and money flowing like wine at a wedding party. Increasingly, they are finding that Europe is no utopia. Millions are unemployed. Millions are poor. Upward mobility is rare.

But one reality of Europe is that it does remain a place where you can follow a religion in nearly any any way you choose, to include no religion at all. Say what you will about the EU, but it remains a place of tremendous religious freedom, rivaled perhaps by only the U.S.

So it is understandable that this man left Iran. But it is still amazing that he was willing to do it. He left with nothing. No family, no friends. He slunk away in the night, alone. As the son of an important man, his life had no doubt been comfortable and safe. He upended all of that.

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Pireaus Port. Lucky you if you have a tent.

My patient arrived at the Pireaus Port of Athens after crossing the Agean Sea from Turkey. He arrived nearly destitute, having given most of his money to a trafficker to get him to Greece. I think he slept on the concrete sidewalk the first night.

The next morning, he says he prayed that the God of his new faith would spare him, and shortly thereafter was approached by members of a Christian church in Athens who offered him a bottle of water. It was through this church that I met him.

ellenikoGreek authorities soon placed this man in the Elliniko refugee camp, where he made no secret of his faith, sharing it with any around him who would listen. Not long after his arrival, a riot broke out in the camp with Muslims targeting Christians.

The violence carried on for quite some time, as Greek police made no move to stop it, one even pointing out that if some of the refugees died, “there will be fewer of them for us to deal with.” My patient was beaten severely in the melee.

It is inhumane, of course, for anyone to think as these police did. But their attitude is understandable nonetheless. Would you wade into the middle of that mess?

Somewhere in this story, my patient picked up his cross. I don’t know if it was in Iran or somewhere in Athens. But he wears it daily. It is not merely jewelry to him, given at some Christmas party. It wasn’t bought from one of the ubiquitous Christian Book Stores in America, with every possible permutation of “cross trinkets” available for sale. It was bought for a price; worn for a higher one.

This isn’t necessarily a Christian story, although as a Christian I find it inspiring. But from this anyone can recognize the deep human desire to worship in freedom. This man’s life story is a reminder that people are willing to die for the right to think and act honestly in relation to their understanding of the divine.

The cross symbolizes the reality of this man’s beliefs, even if that symbol marks him for suffering or even death. Would that all Christendom be so committed. Would that all who cherish freedom be so as well.

Headed Back to Athens

 

The Acropolis in Athens, Greece.
Athens, looking pretty. A rarity, IMHO.

For the second time in less than a year, I’m on my way back to Athens. This will be a short trip with virtually no team. My colleague organizing things in Athens has stated that she “feels sorry” for me, as the number of people signed up for the clinic appears to be quite large.

From what I can tell, the situation in Greece has only gotten worse since I was last there. Many borders and routes into Europe have closed, and migrants are being turned away at far greater numbers than they were last year. But by “turned away,” I’m not describing from Greece itself. Nope. Thousands continue to arrive on the shores of Greece every day. I’m talking about further into Europe. So, the migrant population continues to swell in Greece, especially Athens. Although authorities have begun shipping back some migrants (numbering in the hundreds) in the past few days, this is a small small number.

I say I’m bringing ‘no team’ this time, but in reality this isn’t accurate. Aside from what sounds like a great number of willing helpers in Athens, I also will bring my 14 and 16 year old daughters with me this time. I don’t know what sort of role they will be able to play in the work we do this time. It could be simply watching the children of the patients while they’re waiting the doc.

migrantsHopefully, they can learn a bit about medical care in a refugee and/or underserved situation. As their lives are largely consumed with cheerleading, skinny jeans, teen-lit, French horn, Cello, soccer and boyfriends (ex…EX boyfriends), this might be quite an eye-opening experience for them. I hope so.

My biggest concern is that we will successfully collect accurate data on the patients we see. Last time we did a fair job, under the circumstances, but in my spare time I’m STILL working through the XL spreadsheet and trying to come up with data summaries that will be of some use to the wider medical world.

This time, I hope to have time to ask better questions, and to formalize how we input the data. It is well known among those who do medical research that 80% of the study is done before the study begins. Developing a means to collect data, to college USEFUL data, and to do it in a way that is searchable and accessible at a later date is difficult. It is especially difficult when at that later date, you are dealing with hundreds, maybe thousands of data points.

I’ve had enough training in this element of the medical world to feel a gnawing sense of anxiety as I approach the issue. My medical school heavily emphasizes epidemiology and biostatistics, and I was part-way through an Master’s in Public Health degree until I ran out of money. So I have a sense for how easy it is to do this stuff badly. But I wish I had a collaborator or better skills to know I could do it well.

Still, I’ve had some help from a colleague at work who maintains a quizzical affection for XL (I can’t judge, I was once in a steady relationship with Photoshop), and he has helped me clean up our data from October. And I have a much better sense for what I need to do this time around.

14_athens_imgIt should be mentioned that most relief agencies don’t actually do any of this, even the good agencies who actually help people (lots of them are there for the photo-op and little else, it seems). I received some generous help from a professor at the London School for Hygiene and Tropical Medicine prior to my last trip, and he noted only a small number of agencies who provide care AND do good, statistical research on the populations they serve.

So, it makes sense that I’m somewhat on my own here. It’s not easy to focus on research and practical care at the same time, as one is more empathy-driven, the other much more analytical and “cold.”

Example: if someone comes in coughing up blood, you can either turn and enter “hemoptysis” into your spreadsheet (and then get the heck out of there because…ew), or you can throw on some gloves, hopefully a mask, get them on a bed and start working them up for any of the many many possible reasons for that symptom (most of those reasons being prit-TEE bad).

So, we will see how this goes. We leave tomorrow (Sunday) afternoon.

 

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.

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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)

Athens, October 2015

Athens has long been a crossroads for refugees trying to make their way from the Middle East into Europe. So when I traveled there with my church pastor, David, this past February to explore the possibility of starting up a medical clinic, we had no idea what kind of summer was approaching.

At the time, it was clear that activity in Syria/Iraq (ISIS territory spans both) was worsening, so we predicted an influx of migrants seeking refugee status in the EU. We knew the numbers this summer would jump. But we didn’t predict anything to the level of what we’re seeing today.

Be advised that anything you read below this blog is from the days when my blog was largely a chronicle of my time in family medicine residency in Olympia, WA. Some of the posts are fun, some whimsical, some serious, some maybe a little helpful.

After residency I moved to Germany and live here still. I’m a practicing family medicine doctor and have long planned on working in international and relief settings. This is the primary reason for moving away from friends and family, and my decision has positioned me well to help with the current crises in Europe.

Can I, and this little clinic we’re building, do much to address these massive problems? Hardly. I understand that. But if lots of people do lots of little things, it can equal one big thing over time. So I’m starting with this little thing.

As such, from this blog forward, I’ll mostly be talking about the work we’re doing in Athens and the topics that relate to that work. Namely, cross-cultural medicine and global public health. If you care about these things, you may enjoy following along as I navigate through this project.

The media element of this project is just getting started, and it’s been awhile since I flexed my creaky “blingers” (that’d be blog-fingers). So bear with me.

However, already I’ve been met with scenarios for our clinic that I hope to present to you, SW101 nation, for input and ideas. This isn’t an easy challenge, with lots of questions that have no easy answers. So approaching this as a community is, I think, a much better way forward than going it totally alone.

So, if you’re willing to jump in with me, thank you, and welcome!