Thursday, September 13, 2012

Mass General Physician Reports from Benghazi, Libya

Thomas F. Burke, MD, is chief of the Division of Global Health and Human Rights in the Department of Emergency Medicine at Massachusetts General Hospital. He was in Benghazi, Libya, working to improve health care training and infrastructure when the tragic attacks on the U.S. Embassy occurred. He shares his perspective below.

September 12, 2012 4:29 p.m. EDT

Perspective from Benghazi

Thomas F. Burke MD

Today is a tragic day for Americans and Libyans alike. All over the world our hearts ache for the loss of our U.S. ambassador, Christopher Stevens, and those who died at his side last evening. Our courageous Ambassador held a unique passion and hope for all of Libya but especially Benghazi. Our ambassador was beloved by the people of Benghazi.

This is my second trip to Benghazi; the first one was in late May. My close colleague and friend, Dr. Stephen Bohan and I have been working with the leaders of the Benghazi Medical Center (BMC). BMC director general and hematologist, Dr. Fathi al Jehani, and chief medical officer and obstetrician /gynecologist (and human rights leader), Dr. Laila Bugaighis, are hoping that the Massachusetts General Hospital (MGH) can assist them with two critical areas of need; training in leadership and management skills, and establishment of the country’s first modern emergency department and pre-hospital care system. I can tell you first hand, the people of Benghazi are absolutely lovely - kind, generous and curious. However, they are just barely emerging from 42 years of brutal rule.

BMC is an extraordinarily impressive structure, built some 30 years ago with the intention of becoming a world-class 1,000-bed medical center. In keeping with
Moammar Gadhafi’s policy of controlling Eastern Libya by severely restricting resources, BMC was only able to first open in 2009. BMC was never to have an ER but instead was to focus its expertise and efforts on becoming the referral center for the eastern half of the country. All this changed in February of 2011. On February 15, peaceful demonstrations on the steps of the Benghazi courthouse marked the beginning of the revolution. Violence erupted on the 16th and Dr. Jehani immediately ordered his staff to open an ER. Within 20 minutes an ER was born. In the days that followed, the BMC staff worked tirelessly, responding to a mounting human slaughter. On the 20th, Mehdi Ziu, a Libyan petroleum engineer, drove his car filled with explosives into the fortress walls of Gadhafi’s forces, giving his own life to tip the struggle in favor of the people; and thus end Gadhafi’s brutal rule over Benghazi.

Just a few minutes ago I sat with Dr. Naseralla Elsaadi, a gentle and endlessly patient 42-year old surgeon. Tears quietly ran down his cheeks. Ambassador Stevens was supposed to have been sitting with us. Naseralla is chief of the patchwork ER and has been up all night caring for the sick and injured and has 25 patients to still round on. He said, "It is fine to write about me and use my name because I am from the most powerful tribe in Eastern Libya. They will protect me." He handed me four pages stapled together, the first being the medical note on the attempt to save the ambassador’s life, and the latter three sheets, copies of the ambassador’s flat line heart rhythm. I put my hand on Naseralla’s shoulder and he reached up, taking my hand in his.

"This is terrible not just for the Americans and Libyans but for all humanity. My wife and children just called me crying. Everyone in the hospital and everyone in Benghazi are angry with those people (the radical extremists) and we weep. Islam is peaceful. It is our duty to care for our guests." He looked down and his shoulders dropped with obvious despair. "We work so hard for peace."

I asked him to not give up. I told him that most Americans don’t know the true story of the Libyan people, but that he can count on Americans not giving up. While still holding my hand I locked onto his eyes, "If we work together on a unified commitment to peace, and together build bridges, a brighter future will emerge."

Eight weeks ago the world bore witness to the first democratic elections in Libya’s history. Although Libya’s new Prime Minister will be named today, the moment in history is overshadowed by the loss of Ambassador Stevens and those who died at his side. 

There remains much to be done in this remarkably complex region of the world; however, the Libyan people are free for the first time in many decades. The nation, although fragile, does have great potential. We must not give up our collective commitment to securing a safe, free, and peaceful Libya. The world will be a better place for us all.

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