Fleeing the mouth of a shark | Bill Dienst on the refugee crisis
Syndicated from moonmagazine.org, Jan 06, 2018

23 minute read


Bill Dienst SCM Medical MissionsBill Dienst, MD, is a rural family and emergency room physician from north central Washington who has been volunteering for humanitarian medical missions since 1982, when he was a young man in medical school. His first experience profoundly changed his life and he was “hooked,” he says, volunteering repeatedly for medical exchange programs in Veracruz, Mexico, the West Bank, and the Gaza Strip. Most recently he served as the medical coordinator for Salaam Cultural Museum (SCM), a Seattle-based nonprofit conducting humanitarian and medical relief work with refugee populations in Jordan, Lebanon and Greece.

After volunteering among Syrian refugees in Greece, Dienst and his fellow volunteers collaborated on a book about the experience. He is the co-author/co-editor of Leaving Syria (Cune Press), which is due out on May 20, 2017. Dienst previously co-edited and co-authored Freedom Sailors (Free Gaza, 2012), an account of how a small group of ordinary people conceived and successfully executed an audacious plan to break Israel’s military blockade of the Gaza Strip in 2008. Sailing in two dilapidated fishing boats, 44 “leaderless, hard-headed, non-violent peace activists” became the first to break the siege in 41 years. That voyage, of which Dienst was a part, launched the Free Gaza Movement.

Now 58 years old, Dienst has balanced his work as an ER physician at various hospitals in central and eastern Washington with periodic humanitarian trips abroad. The son of a US Air Force colonel, he grew up in various locations across the US and spent three formative years during junior high in Brussels, Belgium. He attended medical school at the University of Washington in Seattle and completed his family practice residency in Tacoma.

“Fleeing the mouth of a shark” is a reference to Warsan Shire’s poem, Home, which begins, “No one leaves home unless home is the mouth of a shark.” — Leslee Goodman

The MOON: What prompted you to travel to a refugee camp to provide medical care?

Dienst: I’ve done a lot of medical volunteer work in the Middle East over the years, and so have a lot of friends from the region. I knew there was a need to help with the rescue of refugees arriving in Lesbos, Greece, from Turkey, so when I had a period of time off last year, I used it to travel to volunteer with Salaam Cultural Museum.

The MOON: OK, I guess I’m wondering what prompted you initially to volunteer for medical relief work?

Dienst: I’ve been doing human rights work for Palestinians since the 1980s. I’ve been to Gaza or the West Bank 11 times, most recently for medical exchange work with Washington Physicians for Social Responsibility.

The MOON: Again, what motivated you to get involved, especially in such controversial and dangerous areas?

Dienst: [Laughs] In 1982 I was a medical student in my 20s, when Israel invaded Lebanon to eradicate the Palestine Liberation Organization (PLO). That invasion culminated in the massacre at Sabra and Shatila, which got my attention. For people who don’t know, in September 1982, following PLO withdrawal from the region according to the terms of a ceasefire, a militia group allied with Israel systematically killed between 2,000 and 3,000 residents of Sabra and Shatila, mostly Palestinians and Lebanese Shiites. The Israeli Defense Forces blocked the exits of the towns to prevent residents from fleeing. I became an activist at that point, although I didn’t go over there for the first time until 1985, when I stayed five months—extending a year of medical school to do it.

I returned to the Middle East in 2003, right about the time George W. Bush launched his war in Iraq, and also about the time Rachel Corrie was killed by an Israeli bulldozer in Rafah, Gaza. When you go there and see what’s going on, it’s hard to just let it go. I’ve been back 10 times since 2003.

I believe in equal rights for all people—and that includes all people in Israel and Palestine. It’s not right that the Israeli occupation and settlement policies are stealing more land from Palestinians and squeezing them into the world’s largest open-air prison, with little hope for their future. I try to do what little I can about that.

Through that work, I was led to doing relief work with Syrian, Iraqi, Afghan, and Pakistani refugees in Greece. I’ve also been in Egypt and Jordan.

The MOON: What have you seen?

Dienst: In the West Bank—which is 22% of historical Palestine—a little over half of the land has been confiscated for exclusive use by the Israelis—Jewish settlers. Palestinians who live there are stranded in enclaves surrounded by walls and Jewish-only settlements and Jewish-only highways that they can’t use. It’s very difficult for them to earn a living, or access goods and services. This is in the context of more than 20 years of so-called “peace” negotiations, during which more and more of their land is confiscated, while the Israeli settlement population mushrooms. There is very little land left for “a Palestinian state.”

In Gaza, the Palestinians are surrounded by a huge Berlin-like wall and, with very few exceptions, are not allowed to come and go. One point eight million people are crammed into an area about 25 miles long by about five miles wide, or about 125 square miles. The water supplies are marginal because all of the upstream supply is controlled by Israel. Israel also controls what goes in and what comes out of Gaza. It’s really a concentration camp, which is a term first used in South Africa. Gaza fits the definition. Most Americans don’t realize this because we’re kept in the dark out of so-called defense of Israel.

The MOON: And you were there to provide medical care?

Dienst: Actually, there are two medical schools in Gaza, so they have plenty of doctors. What they don’t have is access to post-graduate medical education. I’ve been there 11 times since 1985 under different auspices, most recently with Washington State Physicians for Social Responsibility.

As you might imagine, it’s a very arduous process to get in there. Dr. Bob Haynes, a colleague, and I have been able to provide Advanced Cardiac Life Support (ACLS) courses, with support from agencies in the West Bank. After several improvisational courses, we were finally able to deliver American Heart Association-certified courses to give doctors in Gaza the latest in ACLS. Our delegation has other specialists, too. A general surgeon teaches advanced surgical techniques at one of the medical centers. Mental health specialists, an expert in child autism, and others engage in projects to empower Gaza’s own healthcare providers, rather than going in there and doing the doctoring. For one thing, most of us speak very limited Arabic, so we’d be of little use as primary care physicians. Besides, they have their own doctors. We offer support to them.

The MOON:  Now let’s talk about what you’ve seen in Lesbos, Greece.

Dienst: Sure. And I hope you’ll have a chance to read the book, Leaving Syria, because it’s impossible for a single report to do the situation justice. It’s an ever-changing landscape. For example, in the months prior to my arrival at the end of February 2016, as many as 10,000 refugees were coming ashore on a daily basis. That peaked in October 2015.  So an infrastructure had been developed by various NGOs to mitigate disasters like mass drownings and provide support to refugees upon their arrival in Lesbos—which is an island, by the way, not a city. At the same time, there was international political pressure to try to reduce the number of people attempting the crossings.

When I arrived at the end of February 2016, the number of crossings had dropped substantially, so after a couple of weeks we moved our operations to the Greek mainland and a little farming village called Idomeni. This village is strategically located on the Greek-Macedonian border, where in the ballpark of 15,000-20,000 refugees were stranded. The Macedonian government had built something akin to an Iron Curtain to block refugees’ further travel through their country and into northern Europe—where they were principally heading to Germany and Scandinavia. By this time, Germany had already accepted close to a million refugees.

When we got to Idomeni—again, I was working with Salaam Cultural Mission—we partnered with other small NGOs to provide mobile urgent care health clinics to the refugee camps at Idomeni and a smaller camp at Eko—which was set up next to a gas station—that’s how impromptu and makeshift these camps are. We also partnered with large NGOs like Doctors Without Borders, International Rescue Committee, the UNHCR (UN High Commission on Refugees), and others—including the Greek government—to try to respond to the crisis. But our support, by its very nature, had to be improvised because the situation was constantly changing.

Of course, Greece and Turkey both had their own financial and economic crises prior to the refugees’ arrival, but these two countries have shouldered the lion’s share of the global response. Their situation is being exacerbated as northern Europe shuts its doors and is unwilling to accept additional refugees. The US government has been even stingier than Europe, allowing only about 10,000 Syrian refugees to enter the country.

The MOON: Yes, I want to ask more about that, but first can you tell us what kind of medical care people were in need of? I started reading your book and know that many people drowned, or nearly drowned, or came in soaking wet and suffering from hypothermia. Was that the primary health issue you faced?

The United States has been at war in the Middle East for 14 years. Wars have consequences. They lead to people willing to leave their homeland because they see no better option for the future.

Dienst: No. Again, most of that was over by the time I got to Lesbos. There was the famous picture of the three-year-old Syrian boy washed up dead on the beach of another island, Kos. And there were many mass casualties—drownings of dozens of people all at once. Greek lifeguard rescue boats, coast guard boats, EU coast guard boats, and so on were there to try to mitigate that, as well as healthcare providers on the beach caring for people immediately on arrival. Plus, there were people doing laundry so that refugees could have dry clothes to change into; volunteers trying to feed them; and others trying to process their paperwork so that they could move about legally. It was really an enormous undertaking by many people and organizations.

However, once the borders were blocked off to the north, people started to amass in the Port of Piraeus near Athens and at the borders in Northern Greece. So we relocated to assist in the second phase of the crisis, which involved different kinds of challenges. It was March, pouring down rain, cold, with temperatures just above freezing. People were living in inadequate tents, soaked through, shivering in the rain, building bonfires to burn whatever they could find to keep warm. Often that was plastic, producing toxic fumes. We started treating a lot of upper respiratory infections made worse by chronic smoke inhalation. Crowded conditions and many children meant that we were also treating burns and various other forms of trauma. Plus, you had all the illnesses and conditions that any community of thousands of people would experience—from childbirth to heart attacks to accidents—all aggravated by cold, crowded conditions, less than optimal sanitation, nutrition, and so on.

Then, as the temperatures warmed, we had other challenges. Insect infestations—lice, scabies—followed by sun exposure, dehydration, plus all the usual primary care issues. It was difficult to handle severe cases—strokes, heart attacks, difficult childbirths—because the nearest hospital was 25 miles away and the ambulance service in this part of Greece was overtaxed by this deluge of people. There were also language issues. Arabic was the main language, because most of the people were from Syria. But there were also people speaking Kurdish, Urdu, Dari, and Pashto, so we had to develop ways of translating these various languages to deal with all these cultural groups—from Iraq, Afghanistan, and Pakistan. We relied heavily on international humanitarian volunteers who were capable of translating into English and we often utilized refugees themselves if they could speak English, German or Spanish.

This is what happens when you have a policy of endless war. The United States has been at war in the Middle East for 14 years. Wars have consequences. They lead to people willing to leave their homeland because they see no better option for the future. All these regime changes have been disasters. We now have failed states in Iraq, Afghanistan, Libya…and our attempt at regime change in Syria is a stalemate because the regime is backed by the Russians and the Iranians.

All of these wars have ended up “lose-lose.” I mean, who’d have thought that Iraq would end up worse off than when Saddam Hussein was in power? But in many ways it is because now the country has no infrastructure, no social safety net, and no functioning government.

We need to find different ways to deal with international problems instead of defaulting to our military hammer—which of course reacts as if every problem is a nail. As a result, we’re displacing thousands, if not millions, of innocent people who are just trying to survive and create normal lives for their children.

The stories we’ve heard from these people are horrific. Many times they’ve seen their family members massacred; they’ve been tortured—both by the Assad regime and by ISIS. There’s a chapter in our book that tells the story of “Vincent,” a young man who served as one of our translators, who has been tortured by both the Assad regime and ISIS. That’s why he’s a refugee; he doesn’t want to take either side; he just wants a life.

The MOON: Since it’s a fact that we have killed, tortured, and destroyed people’s lives, is there some justification to the fear that these refugees now hate us and would want to retaliate against us if we granted them asylum?

Dienst: All actions have consequences. That’s one of the things I find so troubling about the American mentality: we think we can act with impunity. Our mainstream media do not seem very sensitive to the physical consequences of our military actions. They show us footage of the missiles being launched. They show us the “shock and awe,” but they don’t show the physical consequences on the ground; the terror we inflict on human populations.

In modern warfare, about 90% of the casualties are civilians—which is a war crime in itself. The Geneva Conventions prohibit the targeting of civilian populations. Yet we seem very indifferent to all that. But of course it creates enemies. How would we feel if our country was bombed, or a foreign power tried to institute “regime change” on us? Violence begets violence. Calling people terrorists is a very loaded term and seems to apply only to combatants who don’t use conventional weapons. But if it applies to anyone who has caused others to feel terror, it certainly applies to the United States.

Nevertheless, refugees are fleeing terrorism; they’re not terrorists. And the United States already has an extreme vetting process for screening them before admitting them to this country. It’s a process that takes years.

The MOON: What is happening with the refugees stranded in northern Greece after Macedonia closed its border?

Dienst: The Greek authorities tried to transport some of the refugees back to Athens, but people were reluctant to go because they thought it meant giving up hope of ever making it into northern Europe. What eventually transpired is that the Greek government transported refugees to military camps and housed them there. The advantage was a little more control of the environment: there was shelter; people were out of the mud and rain. That’s where most of the refugees are now; the other refugee camps have been destroyed.

I left in May 2016, so I can’t give firsthand updates, but there is a process for asylum and some people are slowly making it through that process and moving to new home countries around the world. Other refugees are being moved to apartments in Greece, which most consider a step up from life in the military camps. And others still linger in the military camps. And, unfortunately, more refugees continue to come ashore because the military pressure to prevent them is hard to sustain over time. As long as the situation in Syria and other countries is unresolved, the pressure to flee will be overwhelming.

And we’re just talking about the situation in Greece. Turkey has probably shouldered an even greater burden from refugees. Plus, there are all the refugees streaming out of northern Africa, as well. The UN has said this is the greatest refugee crisis to affect Europe since the end of World War II.

The MOON: The people fleeing northern Africa are coming from…?

Dienst: Somalia, South Sudan, Yemen, Libya—another failed state that we created. Whatever you might have thought about Qaddafi, the country had infrastructure and social services—indeed quite generous social services—that now have been destroyed.

How many refugees can Europe absorb? Germany has taken in about a million. Here in the United States, we’ve taken in only about 10,000—and we have a much larger capacity than Germany does. And a much larger responsibility for creating the situations that refugees are fleeing.

The MOON: What do you think will be necessary to get the United States to shoulder a greater share of the load?

Dienst: For every action, there’s a reaction. Certainly the election of Donald Trump was an action in the wrong direction. The good news is that it’s sparked a lot of counter-reaction and protest challenging the Constitutionality of banning people from certain countries based on religion. I do think we need to be more generous in our refugee acceptance policy—particularly by virtue of the fact that our government created a lot of the situations that refugees are fleeing. The principle of compassion symbolized by the Statue of Liberty—“Give me your tired, your poor, your huddled masses yearning to breathe free”—that’s what we say we stand for, but we’ve really turned our back on that philosophy as a policy matter. And then, of course, we have to get serious about diplomacy as a solution to international issues and disagreements, rather than using the military as our first response—because it really only makes matters worse. The fact is that many—if not most—refugees would like to return to their home countries, if there was peace and stability and a chance for a meaningful life. Trying to create that reality should be our goal.

I want to emphasize that I’m not against the military at all; but it should be used as a last resort, when all other means have failed. Instead, since the early 2000s, if not earlier, war has been our first resort, and has produced disaster after disaster, making each situation much more difficult to resolve than it would have been initially. We need to rethink that. And by the way, I’m not saying that either the Democrat or Republican parties have had the right approach. They both rely on fear rather than reason to move public opinion.

The MOON: You are a family and emergency medical practitioner in in rural America, which is generally regarded as conservative country. How have your neighbors responded to your propensity to help refugees—which many seem to fear as “terrorists”?

Dienst: Well, sure, it’d be easier for me to hang out in the university district of Seattle with people who think just like me, but that’s not really where the need is. When I was going to medical school the need was for primary care in rural areas, so that’s what I went into. It hasn’t been easy to live in the red part of a blue state, but again, I think it’s valuable to provide another perspective. I’ve been outspoken against the war in Iraq, I’ve had articles about Palestine published in conservative local newspapers, and it’s fair to say I’ve made some adversaries, which has perhaps made my life more difficult than it would have been otherwise, but…so what? My trips overseas have given me a greater context for framing the types and magnitude of adversities that human beings have to face; mine are pretty minor. And if my “propensities,” as you say, get me in too much short-term trouble, I can always go overseas again. [Laughs] This work has certainly made my life more interesting.

The MOON: What can you say to reassure people who might be more fearful about refugees? What has been an effective approach to talking with your neighbors?

Dienst: The main thing is that refugees are people just like you and me. They love their families; they want their children to have a better future; they want peace and stability. Yes, they come from a different culture. Yes, they practice a different religion—although Islam has its roots in the Old and New Testament, tracing its lineage back to Abraham, same as the Jewish and Christian faiths. All three religions worship the God of Abraham, even though they call him by different names. All three believe that this same God is the creator of the universe. Muslims also honor Jesus, believe he was a prophet, born of the Virgin Mary, and came with a message for all people. So, when you sit down and break bread with them, they are much more like you than different. We need to get past the urge of our leaders and media to stereotype and demonize these people. Be advised that when you are stereotyping and demonizing a group of people, you are setting yourself up to justify committing horrific acts against them. This is true about my work in Palestine, too.

The MOON: It’s interesting to me that we are supposedly concerned about them enough to want to “liberate” them from their evil dictators, but at the same time, don’t trust them or want to live with them. Why would we risk American lives to liberate them if we’re convinced they’re evil terrorists?

Dienst: That’s why we have to be skeptical about what we’re told by our leaders when they want us to go to war: liberating Iraq, for example. I’m not so sure we would have been interested in liberating Iraqis from Saddam Hussein if their country hadn’t been sitting on one of the biggest known oil reserves on the planet. There are horrific things going on in central Africa—the Congo, say—and we do nothing about it. I would be very skeptical about using our military “to liberate” anyone.

The Ku Klux Klan calls itself a Christian organization, but I doubt that many Christians would agree with that.

The MOON: Well, how about Syria? We’re trying to liberate Syria from the evil dictator Assad, but we don’t want to let his people into our country.

Dienst: I’ll be honest with you. I have friends—refugees, some of whom I’m in touch with on Facebook—who are happy we bombed the Syrian military base last week. And I have other Middle Eastern friends who were very much against it. So what to do is clear as mud at this point. I personally agree with Albert Einstein when he said, “Insanity is doing the same thing over and over again and expecting a different result.” We can’t bomb our way to a new democratic government—whether you support or oppose the Assad regime. We think we’re minimizing our involvement when we supply military aid to the so-called Syrian resistance; but a lot of it ends up in the hands of ISIS or Al-Qaeda, so we’re literally arming our enemies. That’s why even John Kerry has said he doesn’t see any military solution in Syria. Escalating takes us head-to-head with more powerful opponents, like the Russians. I don’t think any additional warfare will liberate the Syrian people.

The MOON: I don’t know how familiar you are with the Quran, but I’ve heard it said that it is the only Scripture to encourage “killing infidels,” all infidels. Is this true? What is your response to those who say this justifies excluding Muslim refugees from entering the country?

Dienst: I think that’s a joke. You can turn to the Bible, the Torah, or the Quran, and cite scripture to justify all kinds of barbaric things, and this has been done for centuries. The Old Testament is full of examples of God telling the Jews to kill those who worship other gods; to kill the Canaanites, the Midianites, and so on. I’ve known Jews, Muslims, and Christians on all points of the political spectrum. They can all quote scripture to justify their point of view. So to fear that all Muslims are going to behave according to the dictates of the most violent verse in their holy book is ridiculous. Most people want to live and let live. They’re not interested in putting other people to death for any reason. I know a lot of Muslims. The very word “Islam” is from “salaam,” which means peace, so a Muslim is a person who follows the teachings of peace. And that’s how I would say 90% of Muslims see themselves: as devotees of peace; not as holy jihadists.

You know, the Ku Klux Klan calls itself a Christian organization, but I doubt that many Christians would agree with that. Similarly, most Muslims don’t identify with or condone ISIS, either. But there are people in this country who want to create Islamophobia and demonize Muslims. They haven’t sat in coffee shops with them, or traveled with them, or broken bread with them, to find out that they’re simply human beings with much more in common with you than different from you.

The MOON: Have you been able to follow any of the refugees you’ve treated beyond their camp experiences?

Dienst: I’m mainly in touch with Syrian refugees who have worked as translators for us. In fact, just before we talked I was speaking on the phone with one who is still stranded in Greece. He actually supports Trump’s bombing of Syria, but he was tortured by the Assad regime, so he has his reasons. He was also tortured by ISIS.

Vincent—the pseudonym I’ve given this young man in our book—was born in Iraq, not Syria, because his father was an opponent of Assad’s father, Hafez al-Assad. When his father left home and his mother fell into a depression following the birth of his younger brother, three-year-old Vincent went to live with his grandmother. In 1995, when he was seven years old, the family returned to Syria to escape the growing hardships resulting from the bombings of Iraq, followed by the no-fly zones and the embargo. Upon returning to Syria, however, the entire family was arrested. Vincent became a seven-year-old prisoner.

After three months, the family was released, but with restrictions. Friends and acquaintances risked persecution for any association with his family. Over time, the restrictions eased somewhat, and Vincent was able to finish high school and enter the university in 2009. He calls those three years at university the best of his life.

Then came the Arab Spring in 2011. Although people were optimistic, especially after what looked like progress in Tunisia and Egypt, the Assad regime cracked down on the dissidents. Many of Vincent’s friends, neighbors, and their entire families were slaughtered. Fellow students and friends were gunned down in the streets by snipers. Vincent left school to flee for his life, having finished only three of his four years. However he’d almost earned a degree in English literature, which is why he can now work as a translator.

He went back to his hometown to hide from security forces who wanted him to serve in the Syrian Army. He stayed within the confines of his home in his small town for three years, afraid to show his face outside: no job, no life, no income, no friends. Finally his grandmother offered him the resources to try to escape all the madness, go through Turkey, and live with relatives in Germany. Vincent decided to risk it.

To get to Turkey, he had to cross Syrian territory that was occupied by ISIS. Unfortunately, he was captured, tortured, and imprisoned for two months. The torture he experienced included sleep deprivation, being suspended by his wrists for hours on end, bludgeonings, being subjected to electric shocks, and more. He was ordered to recite verses from the Quran, and fortunately, he was able to do so. This probably saved his life, as friends  who could not had their necks slashed. ISIS finally moved on to other torture victims and let him go.

Vincent and a group of other travelers moved at night towards the Turkish border. Their route took them across minefields and past ISIS night patrols with mounted machine guns. On several occasions Vincent’s group was chased and people running behind Vincent were killed.

When he at last made it across the border into Turkey, he paid smugglers over a thousand dollars to bring him overland to Istanbul and then to Izmir. He paid other smugglers an additional thousand dollars to take a rubber dinghy overfilled with refugees across the straits to the Greek island of Chios. There he registered with the Greek government, received a six-month visa, and made it by ferry to Athens and the Greek mainland. He took a train to Thessaloniki, and then a bus, which dropped him off at the refugee camp at Eko, where he joined his friends in a tent. He has since moved on from the gas station camp to a military camp, and then back to Athens. He has given up on reaching Germany and now hopes that he can make himself useful enough to be allowed to stay in Greece—or to gain asylum in Australia or New Zealand. His story is not that unusual in terms of horror.

The MOON: Please tell us about the Salaam Cultural Museum—the nonprofit you travel with.

Dienst: Salaam Cultural Museum is a nonprofit engaged in humanitarian and educational activities, with a sister organization, SCM Medical Missions, which focuses on medical relief. SCM started as a Seattle-based cultural organization focused on helping Americans get to know and understand Middle Eastern and North African peoples and culture. It was founded by a Jordanian woman, Rita Zawaideh, whom I’ve known since the 1980s, and evolved when the crisis in Syria began to unfold. Rita had lived in Syria as a teenager, and many Syrian refugees first spilled over into Jordan, so SCM provided both medical and humanitarian assistance in Jordan—and then in Lebanon, which has also been hugely impacted by the Syrian refugee crisis. Most recently they’ve added work in Greece. They’re holding a fundraiser in Seattle on May 20, 2017, which is also when Leaving Syria will be launched. They will be serving a traditional Middle Eastern dinner, and there will be a number of speakers—including myself. There will also be quite a few Syrian refugees, who live in Seattle now, available to tell their story. Anyone who lives in the Seattle area is welcome to attend.

The MOON: Despite the hostility many so-called Christians display towards the threat of a “Muslim invasion,” hasn’t it often been church groups that support many of the resettlement efforts in the U.S.?

Dienst: Yes, I think so. Mercy Corps, Church World Service, and several others are faith-based groups. It really does take a community of people to assist the transition—particularly because refugees arrive with so little. However, they often relocate among relatives, and the ones who have been here longer help the new arrivals. That process is under way now with Syrian refugees in Seattle and Spokane. It’s a very hard transition, and those who make it deserve our empathy and support.


This article is syndicated from the The Moon magazine, an online magazine of personal and universal reflections.