Before Dr. Paul Hart even began his medical education at Memorial, he knew he wanted to volunteer as a physician.
“My wife reminded me that when we were dating and before medical school, I told her that I wanted to volunteer in Africa. Volunteering for me helps to answer the question: ‘Why am I here on Earth?’”
And he followed through. Dr. Hart has offered his services in many countries over the last 20 years, but his most recent international experience left the biggest impression.
Twice now, for a month at a time, he’s volunteered at the Moria Refugee Camp on the Island of Lesbos in Greece.
It has been called the world’s worst refugee camp and Oxfam has condemned the European Union over the ‘inhumane’ conditions.
Hardest but most rewarding experience
“Before I travelled to Greece for the first time, I thought that it would be similar to practising in another similar poor area, but never imagined the hell that the patients had come from and the new hell that they were now experiencing,” he said. “This type of medicine is the most difficult that I had practised in 45 years as a family doctor, but also the most rewarding.”
More than 13,000 refugees from Afghanistan, Iraq, Somalia, Yemen and other countries continue to flood into the refugee camp — a site designed to hold 3,500. Moria has acted as a way station for asylum seekers throughout the European migrant crisis.
1/ Refugee camp realities
2/ A young patient
3/ Doctor-patient discussion
4/ Littlest patients
5/ Healing bonds
Dr. Hart says some refugees purchase life jackets which, unbeknownst to the purchaser, are stuffed with cardboard, and pay smugglers to take them across the water from nearby Turkey to Lesbos. Many drown by falling out of the rafts, the useless life jackets strapped to their bodies.
The people who survive the journey are assigned to tents that have no hot water or electricity. Some sleep on the pavement. They line up in open sided cages for food – often fighting for food that is sometimes inedible.
At night, the water is turned off. Things can get violent, says Dr. Hart.
“Women at night will not go to the bathroom because it is not safe. We have stabbings and beatings on a too regular basis,” he said. “Countries who are sworn enemies and are separated by hundreds of miles on land, are two to three tents apart in the camp.”
Prevalence of post-traumatic stress disorder
Dr. Hart says he finds it difficult to name just one story from his experience on Lesbos as the hardest.
“A five year old Afghan child who did not want to go to sleep because of her bad dreams. God knows what she saw. A 50-year-old mother who was made to watch the Taliban torture her son. A middle aged man who was totally incontinent of urine due to torture, and the list goes on and on.”
Patients also have multiple physical problems: diabetes, hypertension, cancer and arthritis are prevalent, along with a multitude of infections including tuberculosis. Dr. Hart says it’s also the worst occurrence of post-traumatic stress disorder (PTSD) he’s seen in his more than four decades of medical practice.
“I cannot imagine that there was one patient that was not suffering from PTSD,” he said. “We did not ask what they had experienced prior to their departure from their home country. Sometimes they told us but we knew that it was always on their minds.”
Many challenges to treatment
Often, patients wait more than four hours to be seen. More people are turned away than are treated, as there are only about eight physicians available.
Using a translator was also challenging, says Dr. Hart, as translators often just give a summary, and there were some cultural differences to get used to. He says that he had to be careful to not form a conclusion based on an observation.
“In Ethiopia, I noticed many men walking with another man, with one having their arm around the other. I said to my translator that there seemed to be a high incidence of homosexuality. He laughed and said to look at the school children who did the same thing. In Ethiopia and other societies the same way of being with a friend persisted throughout life.”
Another difficulty for the medical teams is that it takes about a month to get laboratory tests back, so they must use their clinical judgment and examination skills above all else. He credits his education at Memorial with providing him with those lifelong skills.
Dr. Hart has volunteered in Ethiopia, Brazil, Peru, Cambodia, Ukraine, Moldova, Belarus, Mongolia, Zambia, Ghana and various states in the U.S. He also established two free medical clinics for the uninsured in his home state of Massachusetts, both of which are still running.
Originally from Toronto, Ont., he graduated in 1973 from the very first class at the Faculty of Medicine. He still keeps in touch with some Newfoundland friends. In fact, his first daughter was born here and is very proud to call herself a Newfoundlander.
Dr. Hart speaks very fondly of his education at Memorial.
“We were 16 in the first class, had the best teachers and were able to participate to a degree that I have not seen since. I do not know how often I have talked about the amazing four years I had at Memorial.”