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Hospice doctor treats Syrian refugees abroad

A Syrian native, Tarek Zetoune has traveled to several countries to help refugees get the health care they need.

Tarek Zetoune, MD, has witnessed firsthand the horrors of families being injured and displaced in war-embattled Syria. The current conflict has forced more than 5.6 million people to flee the country since 2011, including nearly 45,000 individuals near the Jordanian border just a few weeks ago.

He hasn't been to his native country in 10 years, before the war began in 2011. But while volunteering for medical missions in Lebanon and Greece with the Syrian American Medical Society (SAMS), Dr. Zetoune has provided pediatric care to Syrian refugees and tried to deliver them hope.

One family in Greece, he recalled, invited him into their tent for tea.

"The father told me how he lost his home, how one of his kids still had a bullet in his arm and how they saw people dying in front of them. It's not fair for a child to witness cruelty like this," said Dr. Zetoune, a hospice physician at Hospice Care Network. "But it's encouraging to see the resilience in their smiles and laughter."

After tea, Dr. Zetoune stood to exit the tent. The father shook his hand and told him that doctors were Syrian refugees' voice to the world and that "soft voices reach warm hearts."

"He asked me to tell their stories," Dr. Zetoune said. "I felt a lot of weight on my shoulder. Every time I have a chance, I tell his story."

Providing pediatric and hospice care

Dr. Zetoune was born in Syria but left when he was 18. He traveled to Egypt to finish medical school and later moved to the US to complete a pediatric residency at Flushing Hospital Medical Center, which included rotations at Cohen Children's Medical Center.

There, the desire to work in palliative and end-of-life care began to burn.

"During my residency, and especially working with pediatric ICU doctors at Cohen Children's Medical Center, I came to realize the importance of palliative and end of life care," he said. "Death in a child is an interruption of life. It is never, and should never be considered a normal progression of life. It carries physical, psychosocial, existential suffering to a child, family and the care givers.

"While we do all what we can to save a life, science is still limited; a cure from a disease might not always be achieved."

Dr. Zetoune joined Northwell's Hospice Care Network in July 2016, bringing a unique and comprehensive approach. He often says "When cure is not an option you need a team who is can navigate this difficult road with the family, more work needs to be done."

To ease patient and family suffering, he forms a deep understanding of each patient and works to fulfill their needs.

"End of life care, represented in hospice, humanize our health care system," said Dr. Zetoune, who received the 2018 Northwell Health Physician of the Year President's Award. "Patients and families in suffering need a tremendous amount of support. We started to see more doctors who have a better understanding of the value of hospice. An appropriately early hospice referral means more time for patient, the family and the hospice team to work on the psychological, social and physical aspect of loss.

"Another thing I would like to see is residents participating in hospice, especially pediatric residents. Unfortunately, at one point, they might have to deal with the loss of a child."

Working with the Syrian American Medical Society

Dr. Zetoune jumped at the opportunity to join SAMS. Established 20 years ago, SAMS is a group of doctors in a wide range of disciplines that provides medical relief around the world. In 2017, SAMS provided more than 3.5 million medical services.

"When the conflict [in Syria] started, we wanted to offer medical experience to those in need. We have focused our work on the refugees," said Dr. Zetoune, current president of the organization's Tri-State chapter. "The war took peoples' homes and lives. We didn't want their illness to add on their suffering."

Initially, SAMS worked with trauma patients but have since transitioned to offering primary care services. They have traveled and assisted refugees in Lebanon, Greece, Turkey and Bangladesh. The group does surgical missions in Jordan. And they also answered the call to serve in the US after Hurricane Harvey pummeled Houston last year.

SAMS took a team of three doctors - three nurses and pharmacist - to Houston, where it utilized a mobile clinic and pharmacy to offer medical care. In one week, they treated several hundred individuals by traveling to two or three communities each day.

"People would come in and have their blood sugar or blood pressure checked," Dr. Zetoune said. "Some were having respiratory problems that they didn't understand.

"We wanted to give back to our communities in need here in the US. SAMS is an American NGO we have an obligation toward people in need to medical help."

For his effort in Houston, SAMS issued Dr. Zetoune its 2017 Humanitarian Award.

The perfect balance

Dr. Zetoune said volunteering with SAMS helps balance his medical expertise by providing pediatric and primary care on missions and hospice care at home. He finds each equally rewarding.

"On both sides, I'm dealing with patients who have lost a life - either represented by a loss of their home and country or a loss of their health," he said. "We can help in both.

"These experiences have opened my eyes and help me appreciate what we have here in the US. We live our life thinking we are in control of our surrounding. But when you see how others losses through a disease or a war, you realize how little control we have. In a way, my patient's saved me as I was trying to save them."

"When the conflict [in Syria] started, we wanted to offer medical experience to those in need. We have focused our work on the refugees. The war took peoples’ homes and lives. We didn’t want their illness to add on their suffering."
— Tarek Zetoune, MD
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