Press
NPPA Magazine
The National Press Photographers Association (NPPA) gave recognition to the work that Leila and I are doing in the Lao PDR. We hope the article will motivate and inspire their readers to help the less fortunate in their communities.
Mugonero Hospital Rwanda
© 2001 Leila Srour
By Beth Pitton-August
Corporate and Foundation Relations Manager
Direct Relief International
One million people died in Rwanda's vicious 1994 civil war. Direct Relief International was very involved in supporting refugees from Rwanda in neighboring Zaire during the conflict. Having very little in the way of public services and infrastructure prior to that time, the country's health system has yet to emerge from the devastation. There are now fewer than 200 doctors in the entire country.
Two of those doctors serve at Mugonero Hospital located in the western region of Rwanda near the city of Kibuye and Lake Kivu. Approximately 175,000 people are dependent upon the hospital as their primary care and emergency care provider. It is estimated that 50% to 80% of the population of the Mugonero area was killed during the war. An influx of refugees from Congo has helped to repopulate the area. Among the Rwandans who remain or have returned no one talks about the war now. These embattled people merely struggle for survival.
Mugonero Hospital is staffed with Rwandan nationals, two doctors, one lab technician and thirty-five nurses who diagnose and treat the majority of the patients. The hospital helps support the services of several small clinics, completely destroyed during the war, that are scattered in surrounding villages. These beleaguered clinics perform important health outreach functions, providing immunizations, nutritional support including community gardens, as well as providing basic care to villagers.
Through the Loma Linda School of Public Health, Leila Srour, M.D., a Pediatrician from Santa Barbara, visited Mugonero Hospital for three weeks in March of 2001. Having received a specific request from the hospital before her departure, Dr. Srour contacted Direct Relief International to secure suture material to take along. With sutures on hand contributed by Ethicon, Inc., we were able to assist her. She said the shelves were bare when she arrived. The sutures came into use immediately. A little girl named Honorine was run over by a bus and was carried to Mugonero Hospital. She lost one leg but her life was saved with the use of the sutures.
Dr. Srour explains that bandages, medicines, instruments, and suture materials are needed by the hospital on a daily basis. The patients must usually wash and reuse bandages. The hospital also has no phone, no Fax and no e-mail. When asked what else might be helpful to assist the hospital, Dr. Srour commented that additional training for the staff would be extremely helpful. Radiology technology is available, for example, but it could not be used because there is no trained X-ray technician. There is a nursing school located in the village of Mugonero with 500 students but there are no textbooks. Dr. Srour observed that additional training is necessary not only to improve the level of care provided to the patients but also to give these dedicated medical professionals a measure of hope. They need hope in order to have the strength to help others. It is difficult to practice medicine without the proper material. Dr. Srour said it is excruciating for the staff to see, day after day, people dying from conditions they could treat but are unable for lack of appropriate supplies and medicines.
Lack of sanitation is a major public health concern affecting the majority of the people of the area. Infectious diseases such as tuberculosis, malaria, and dysentery are common. Malnutrition is widespread and the under-five mortality rate is extremely high. Though the hospital has no means of testing for HIV/AIDS currently, the virus is not thought to be prevalent yet. With the continual influx of refugees from neighboring countries and the repatriation of many Rwandans HIV/AIDS is a public health education priority.
Dr. Srour noticed during her time in Mugonero that beyond the poverty, malnutrition and disease, the problem is the way the people feel about themselves. They feel abandoned, inadequate, and discouraged. Patients don't come to them until they are half gone, they throw everything at them and they still die. People were utterly demoralized. Hospitals are supposed to be self-sufficient. Income generation from fees for services are supposed to regenerate the budget to procure the medical supplies and medicines needed for care. But this is not possible in a country that is so extremely poor. It is the infusion of donations of medical resources that helps keep the hospital operating.
Her experience in Rwanda was a turning point for Leila Srour. I had never experienced what the level of care really is for so many people. After completing her M.P.H. at Loma Linda, Dr. Srour will be attending the School of Tropical Medicine in London for three months. After that, she and her husband have plans to work with an organization called Health Frontiers training Pediatricians in Laos.
It is difficult to secure safe passage to Rwanda other than through small hand-carried packages like that carried by Leila Srour. If we are able to assure the safety of contributed goods, Direct Relief International hopes to provide further assistance to Mugonero Hospital. Meanwhile, the dedicated doctors and staff of Mugonero Hospital carry on.
Santa Barbara News Press
Where the need is so great
Pediatrician Leila Srour gives up her cherished Santa Barbara practice to help heal the children of Laos
12/2/01
By STARSHINE ROSHELL
NEWS-PRESS STAFF WRITER
The picture windows of Dr. Leila Srour's cozy Riviera home frame a spectacular view of the city she adores. Santa Barbara is where she met and married her husband. It's where she learned to scuba dive, operate a ham radio and fly a single-engine airplane. And it's where she has worked for 18 years as a pediatrician under what she considers ideal conditions -- supportive and friendly colleagues, ample time to see her patients and parents who take great interest in their children's health.
But the big framed photographs that hang inside her home tell a very different story.
They show a sleepy little girl suffering from malaria, a malnourished toddler with a swollen belly, a baby with a burned and bandaged hand, a small boy shouldering a huge bundle of firewood and a skin-and-bones hunter holding up a songbird he shot for dinner.
The stunning contrast between Dr. Srour's privileged existence and the troubling images depicted on her walls is one that has gnawed at her conscience ever since she traveled to the impoverished Southeast Asian country of Laos in 1997. The trip was intended as a photo expedition for her husband, documentary photographer Bryan Watt, but it turned out to be a life-changing experience for them both.
"We had an opportunity to meet the people and to see how they were living," she said, "how poor they are, the basic problems of lack of nutrition, lack of clean water, lack of simple hygiene and in many places complete lack of health care."
"After you've seen it and experienced that, you can't ever be the same."
Compelled to help, Dr. Srour has resigned her beloved post at Sansum-Santa Barbara Medical Foundation Clinic and is moving to Laos to accept a volunteer position training pediatricians there. She and Mr. Watt are reluctant to leave their family, friends and beloved hometown, and fully expect to fall victim to some of the country's grim diseases, but the promise of saving lives was simply irresistible to Dr. Srour, whom colleagues describe as compassionate above all else.
"When somebody comes to you and needs your help and you're able to help them, that's a blessing," said the physician, a petite woman with a warm and gentle demeanor. "The healing relationship is the most rewarding relationship that we can have in life."
And if anywhere needs healing, it's Laos, a small communist nation that borders Vietnam and Thailand. Nearly half the population is below poverty level, and malnutrition runs rampant. The hill tribes along the Mekong River live in thatched huts and work from first light till after dark just to feed their families, resting only during the hottest part of the day.
"They wake up before sunrise to get water from the stream down the hill from the village," said Mr. Watt. "Then they have to pound rice and start making breakfast," which might consist of cooked rice and an egg shared among several people. Sometimes they eat bugs for protein.
Even when they get enough to eat, they are subject to health hazards like malaria, dysentery, Dengue fever, parasites and pneumonia.
"All of these things just take the life strength out of people and make it very difficult for them to work and take care of their children," Dr. Srour said. "Children die of preventable and treatable diseases. I mean, they die of diarrhea. They get sick and there aren't resources to treat them."
The hospitals are crowded and often dilapidated facilities with no monitors or ventilators, and patients' family members must wash them and change their bedding. When a person can't pay for treatment, he or she is outright turned away.
Seeing these conditions for the first time in 1997 re-ignited an interest Dr. Srour had always had in international medicine. She returned home and set about earning a master's degree in public health. In March, she spent a month at a remote hospital in the war-torn African nation of Rwanda to make use of her new credentials.
Rather than satisfy her desire to be of service, though, that experience only magnified the disparity between her comfortable Santa Barbara life and the tremendous health problems in other parts of the world.
"I came back from Rwanda and went right back to work at my little job in Santa Barbara," she said. "But every night I just came home and cried because the contrast was just too great. Once you've tried to work in that situation and seen how frustrating it is and how great the needs are and how much we have here, your conscience doesn't let you rest."
"After a month of crying, Bryan said, "Leila, what are you going to do?" I said, Well, what can I do?"
She contacted someone at the World Health Organization in Laos, who told her about a program called Health Frontiers that operates a post-graduate program to train Lao doctors as pediatricians.
Half of Laos' 5.6 million residents are children, and there are only seven pediatricians in the entire nation, Dr. Srour said. The program's goal is to further educate doctors who have attended basic medical school in Laos, and send them out into the villages to teach families about disease prevention at an early age.
It so happened that Health Frontiers needed a volunteer teacher for next year, and Dr. Srour saw it as a chance to make a meaningful difference in the world.
"I was feeling that this would be such a marvelous opportunity for me to learn and to be able to use all the rewarding experiences I've had with my patients in such a remarkable way," she said. "I felt privileged to be able to do this."
She got the job -- there wasn't much competition, of course -- and broke the news to her colleagues at work.
"I thought that people would try to talk me out of it, but no one has," she said. "I think they want me to go. I hope it's because they think I have something to share."
That's exactly the reason. Fellow pediatrician Saida Hamdani admires and respects Dr. Srour for following her passion.
"When you start out in medical school, you have that fire where you want to make a difference in people's lives and it's still burning very strongly within her," Dr. Hamdani said. "She's going to make such a profound difference to the lives of so many children."
Nurse Debbie Olivera agrees.
"We basically all think the same thing, that she's a true pioneer," Ms. Olivera said. "We think, Who better than Dr. Srour to do this, with her kindness and her ability to communicate?"
Her ability to communicate in Lao is limited, actually. She only knows how to say "hello," "hospital" and "thank you very much," but the 16 doctors she'll be teaching are studying English in preparation for her arrival.
Beginning Jan. 1, Dr. Srour will study tropical medicine at a London school for three months and then travel some before starting in Laos in June. She and Mr. Watt will live in a modest house in the capital city, Vientiane, and he will work as her assistant, drawing up program schedules, budgets and lecture materials. They have already had shots for rabies, hepatitis, typhoid and Japanese encephalitis, but those diseases aren't their only concerns.
"In the capital city, it's an act of faith to cross the street," Dr. Srour said, only half-jokingly.
"It's hazardous. They don't really have a lot of traffic rules and (those they have) don't appear to be enforced."
The emotional risks are even more terrifying. "The diseases and medicines are different, the resources are so few, the people are so poor," she said. "It's hard to even imagine how great those challenges are going to be, having to stay there and face the challenges every day that don't have an answer."
"I wake up in the middle of the night all the time and I wonder, Am I going to do a good job? Am I going to have the energy, the fortitude? Am I going to be able to understand how to help?"
The only thing she knows for sure is that she will learn more than she teaches, and will save untold lives.
She will volunteer for a year or two, then probably look for a similar post in another part of the world and perhaps return to Santa Barbara some time in the future.
"It would be hard to leave Santa Barbara and say you were never going to come back," she said. "It's so beautiful to live here, but there's a whole world out there."
"It's nice to be able to go where the need is so great."
Laos
Official Population: 5,636,000
Size: 91,000 square miles (slightly larger than Utah)
Terrain: Mostly rugged mountains and forests
Climate: Tropical monsoon
Government: Communist state
Capital: Vientiane
Official language: Lao (some French and English spoken)
Average life expectancy: 53 years
If you want to help, donations can be sent to Health Frontiers c/o Center for International Health, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-4978. You can contact the organization at www.healthfrontiers.org or by phone at 216-368-6321.
LETTERS TO THE EDITOR
12/8/01
Dr. Srour a blessing to children in Laos
I have tears in my eyes after reading Starshine Roshell's Sunday News-Press article about pediatrician Leila Srour leaving for Laos. They were tears of gratitude that she was able to put on paper what we've known for years -- Dr. Srour is an incredible physician and person.
I first met Dr. Srour as a 12-year-old girl looking for a female physician with whom I could feel comfortable as I embarked on the new journey of adolescence.
I loved her from the start; she was always accessible to me and made me feel at complete ease. I even remember calling her a time or two with questions when I was over 20 years old and living on the East Coast. But I saw her true compassion and wisdom when my husband and I moved back into the area 2 years ago with our medically fragile child.
Our son Alec was barely a year old and had already undergone two open heart surgeries. He had spent most of his first year in a pediatric intensive-care unit and emerged with a variety of medical support: a tracheotomy, ventilator, feeding tube, pacemaker, a home nurse 16 hours a day, and 11 specialists.
Alec had to have a pediatrician who could not only keep on top of the specialists' treatments, but spot possible complications before they spun out of control.
Dr. Srour not only did this wonderfully, but she guided us through this very difficult time. As parents who are very involved in our son's care, and have experienced the anxiety and frustration of watching him in a daily life-or-death struggle, Dr. Srour served as our reality check, reminding us that Alec was improving.
While she trusted our assessments of him, she was also able to guide us to a place where we treat him like a healthy child, with a very exciting medical history. Alec is now very much a healthy 3-year-old. He recently started preschool, a testament to many answered prayers and wonderful medical care.
As we embark on this new chapter of our lives, we're sad to do so without the wonderful Dr. Leila Srour by our sides. She has become a part of our lives and we will miss her. But, we are happy for the children of Laos, for they are fortunate to have a wise, caring and loving pediatrician.
Leanna M. Watson, Solvang