Sitting in the office of Dr. Ashraf Albustanji, MSF’s maxillofacial surgeon in Amman, Qusay asked, “Doctor, can you refer me to an ophthalmologist?” Dr. Albustanji, who had just finished reading Qusay’s medical file, was puzzled by the request. “His eyes ruptured at the time of injury,” recalled Dr. Albustanji. “So, the doctors of the American army removed them to prevent infection.”
For years, Qusay’s family had kept alive his hope that one day he would get his sight back. When Dr. Albustanji told Qusay that his blindness was irreversible, the patient was devastated. “All hope was gone,” Qusay said. “I didn’t want to be alive anymore.” He thought about taking his life that night. “I prayed that [night] a lot,” he said. “I prayed [while] crying. It helped me [stay] calm. I said, I’m in a test. This is the big, difficult moment for the test, so I want to pray, and then I wish I will pass the test.”
The next day, Dr. Albustanji was surprised to see how his young patient had accepted the news. “He was shocked [but] he accepted the reality. It’s not easy for him, but that brave man, he can accept this. This is what makes him extraordinary. He is a strong guy. Not physically, I mean emotionally, very strong,” said Dr. Albustanji.
Qusay spent three years at the MSF hospital in Amman undergoing multiple surgeries and receiving rehabilitative care. Dr. Albustanji worked with a team of orthopedic and plastic surgeons to repair the injuries left untended in Iraq. The metal plates that were fixated to the right side of Qusay’s face years earlier had become infected. Now that his bones had healed, they could be removed. This meant that Qusay no longer needed someone to help shower him and wash his hair. He underwent multiple surgeries to try and restore his ability to breathe through his nose. MSF doctors also replaced the skin on his nose. (An earlier transplant had used skin from his scalp, so every morning Qusay had to shave the thick black hair that grew where it shouldn’t.)
The surgical team also rebuilt his top lip, lifted up his eyelids, implanted prosthetic eyes, and took cartilage from his ears to reshape part of his forehead. Qusay jokes that he was particularly pleased with that surgery as it made his ears smaller. “He likes to make jokes to make people around laugh,” said Dr. Albustanji. “When you visit him in the morning after surgery, he has a sense of humor. And [people] were surprised how this young man with this misery can laugh.”
In Amman, MSF’s multidisciplinary teams work together to provide patient-centered care. “We are treating post-war injured patients, so it’s complex reconstructive surgeries in orthopedic, plastic, and maxillofacial,” said Dr. Rasheed Fakhri, MSF’s surgical coordinator who helped open the hospital in 2006 and has worked there since. “I knew him well [and] I kept in touch with him through all these years, because for me Qusay is a mentor.”
The hospital was designed to respond to the lack of specialized treatment available to civilians who were injured during the early years of the Iraq war. “Mainly they were victims of explosions, roadside bombs, and bullets,” said Dr. Fakhri. After the Arab Spring, the hospital started treating patients from other countries in the region, mostly Yemen and Syria, with complex injuries from barrel bombs and collapsing houses.
Unless people can afford to pay for expensive surgeries at private clinics in their home countries—if the necessary supplies and technology are even available—most victims in the region are left untreated with little hope for their future. “Doing surgeries for patients who didn’t have any access at that time to any facility is, in itself, comforting to the patient that the future can still be good for them,” said Dr. Fakhri.
After surgery, patients are also supported with physical therapy, health education, pain control, and mental health support. “All those people really play a major part in making the patients find their way back to their normal life,” said Dr. Fakhri. About once a month, the staff also organized group therapy activities, such as poetry nights (Qusay was a regular participant) and field trips to sites around the city.